BY: MICHAEL LEWIS, MD, ABFM
FACT: 71 million Americans have high cholesterol levels
FACT: The number of people needed to treat to prevent 1 heart attack using a Statin medication (Lipitor, Zocor etc) is 60.
FACT: Only 1 out of every 3 adults with high LDL cholesterol has the condition under control
FACT: High cholesterol has no symptoms so many people don’t know that their cholesterol is too high.
FACT: People with high cholesterol have about twice the risk of heart disease as people with lower levels
FACT: MORE THAN 50% of people who suffered a heart attack had normal cholesterol levels at the time of their hospitalization
FACT: Cholesterol isn’t the entire story when it comes to heart attacks…read on.
Cholesterol isn’t all bad! We need cholesterol to build cell walls, to make hormones including testosterone, to make bile acids which break down and get rid of fat and to allow proper brain function. Cholesterol is also made up ofHDL (high density lipo-proteins) which acts like PAC-MAN gobbling up the bad stuff (LDL and VLDL, low density and very low density lipoproteins respectively). Think of the bad cholesterol to be as sticky as the gum that sticks to the soles of your shoes on a hot day. Now imagine what it can do inside your blood vessels! Yikes.
No doubt, for years the American Heart Association (AHA) and the NCEP (national cholesterol education program) has been telling us that Cholesterol is bad for you and therefore you should avoid Eggs, Fatty foods and other fat-laden sources…but are they correct? Sort-of. Let’s just say they’re not entirely incorrect. Let’s look at it this way –
if cholesterol was killing us off 1-by-1, then cholesterol lowering medicine (statins) should have a more significant impact on survival from heart attacks, right?
Well, it does have an impact, however not to the extent one would think if cholesterol was the sole problem. Statistics tell us that 1 in 60 people treated with statins were prevented from having a heart attack (statistically defined as the number needed to treat, NNT). We also know that MORE THAN 50% of people who suffered a heart attack had normal cholesterol levels at the time of their hospitalization. At this point you should be saying, huh?
So, what’s the culprit then? Are we not being told everything we need to know? Is it more complicated than most patients AND doctors seem to understand? The answer is yes and yes. The culprit starts causing mayhem at the microscopic/cellular level. The lining of our blood vessels are fragile and can be injured from multiple sources including, increased blood pressure, toxic chemicals from tobacco smoke, free radicals and oxidative damage from poor diets, tobacco, UV light and normal metabolic activity in our bodies. Once this damage begins so does INFLAMMATION! – This is the culprit. Inflammation sets off a chain of events eventually leading to atherosclerosis (hardening of the arteries), which can lead to heart attacks or even peripheral vascular disease (narrowing of arteries in extremities and other places other than the heart).
So then, how do you get rid of the inflammation? There are many ways – but we will break them down into 2 major categories. Exercise and Diet.
EXERCISE. Exercise decreases your body’s blood sugar therefore lowering circulating insulin levels which are inflammatory. Further, exercise increases Nitric Oxide (NO) and relaxes the inner layer of your blood vessels making them less sensitive to damage. Nitric Oxide also may help your erections too. What do you think the little purple pill does? Therefore, what do you think exercise may do for your erections? Bingo. Schwing!
DIET. Check out the Mediterranean Diet – This ‘diet’ is mostly high in lean fish, legumes and contains much less Trans-fats which are pro-inflammatory (make inflammation) by nature. Further, decreasing your sugar intake will lower your inflammatory response because insulin secretion (which increases in response to sugar) sets off a cascade of events leading to inflammation and causes fat storage. Is there good fat? Fats which are liquid at room temperature tend to be better. Fat which contains Omega 3 fatty acids are best because they not only support lowering your cholesterol but are ANTI-INFLAMMATORY. These fats are usually found in fish including S.M.A.S.H. fish i.e. Salmon, Mackerel, Anchovies, Sardines and Herring. If possible also avoid Omega 6 and 9 fatty acids (cod liver oil and flax) as they promote inflammation. Oh yeah – lose that belly fat!
Inflammation is thought to be associated with Depression, Arthritis, Alzheimer’s disease and multiple cancers. We are learning more and more every day about cholesterol and inflammation thanks to some great research. As you can imagine, this isn’t the whole picture but it’s a start and gives us something that we can control!
If you haven’t had your cholesterol checked, see your doctor and get it checked out. See the chart to review your target levels.