February is Heart Health Month!

If you're like millions of Americans who go in to have their cholesterol & blood lipid levels tested, and your LDL or total cholesterol is above the currently defined "normal" level, you're likely to hear something like this:

"Eat a low-fat diet, stay away from dietary cholesterol, and use the salt shaker a little less. Oh, and exercising more wouldn't hurt, either. Now here's a prescription for Lipitor (or Crestor, or fill in the blank with one of the popular statin drugs) just to be safe.

This is called the "Diet-Heart Hypothesis," and it is just that - an interesting theory. It's a theory that sometimes makes sense, and has some data showing correlation between eating cholesterol and higher rates of heart disease. But is also a theory based on messy, soft science, and lots of repetitive dogma. The scientific world is no different from the rest of the world in that matter. There are religious fundamentalists, and there are scientific fundamentalists. (My definition is one who clings to a belief with complete disregard for any idea or concept that contradicts said belief. A fundamentalist refuses to listen to or consider new facts, ideas, or concepts because they hold onto their beliefs so strongly.) The allopathic ("Western") medical profession, along with the public health industry, pharmaceutical industry, and processed food industry have repeated this pseudoscientific dogma so often, it is regarded as unquestionable truth. And as long as we cling to these ideas and call them facts, people will continue to suffer needlessly.

The Diet-Heart Hypothesis is based on data showing a correlation (not definitive causation) between certain populations of people who consume high dietary cholesterol and higher rates of cardiovascular disease (heart disease, coronary artery disease, stroke, etc). From the start, the scientists who promulgated this theory had to ignore data that contradicted their theory. (Spain, Switzerland, and France, for instance, all consume more fat and cholesterol than we do in the U.S. but all have consistently lower incidence of CVD.) There have always been cultures and countries that consume far more saturated fat and cholesterol than the U.S. that have lower rates of cardiovascular disease (CVD), but that correlative data is ignored. So is the fact that Americans have consumed LESS fat and LESS cholesterol every year for the last 40+ years, while being medicated MORE with the statin drugs every year for the last 10 years, while heart disease and CVD continues to rise each year. In fact heart disease is the number one cause of death in the U.S., and kills over 800,000 people per year (34% of all deaths). Take into account the following facts regarding statin drugs, which are the drug treatment of choice, both therapeutically and beginning to be prophylactically: (Originally compiled by Mark Hyman, M.D.):

• if you lower bad cholesterol (LDL) but have a low HDL (good cholesterol), there is no benefit to statins (i)
• If you lower bad cholesterol (LDL) but don't reduce inflammation (marked by a test called C-reactive protein), there is no benefit to statins (ii)
• If you are a healthy woman with high cholesterol, there is no proof that taking statins reduces your risk of a heart attack or death (iii)
• If you are a man or a woman over 69 years old with high cholesterol, there is no proof that taking statins reduces your risk of heart attack or death (iv)
• Aggressive cholesterol treatment with two medications (Zocor & Zetia) lowered cholesterol more than one drug alone, but led to MORE plaque buildup in arteries and no fewer heart attacks (v)
• 75% of people who have heart attacks have normal cholesterol!
• Older patients with lower cholesterol have higher risks of death than those with higher cholesterol (vi)

In short, the answer to helping people with heart disease, and with all illness, is in asking the appropriate questions scientifically. We should not be asking "How do I lower my LDL cholesterol?" (Whether through drugs or natural medications like herbs or supplements.) Instead, we should be asking "Why is my body dysfunctioning?" Unless you get to the root cause of the problem, you will inevitably end up providing temporary symptom relief while you allow the person to become sicker and more dysfunctional. (To a large degree, this is the current state of our medical system!)

So what does cause CVD, and what can you do about it? It is becoming ever more clear that chronic inflammation is much more the root cause of most types of CVD, and cellular inflammation is a common denominator in many of today's chronic diseases, including CVD, cancer, metabolic syndrome, autoimmune disease, etc. You must decrease systemic inflammation, but you also must take responsibility for your state of health. The good news is, nothing beats diet and exercise in treating cardiovascular disease. And nothing beats diet and exercise for preventing CVD in the first place!

Diet: Eating a "Mediterranean Type" diet (lots of veggies, fruits, whole grains, lean meats, nuts, fats, and seeds) has been shown to:

• Reduce recurrent CVD mortality by over 70%
• Has been shown to reduce ALL CAUSE mortality by 72% (no drug even comes close to working this effectively on any chronic illness)
• HALE study showed that beginning the Mediterranean Type Diet after age 70 resulted in a 23% reduction in all-cause mortality. This rose to 65% when combined with other lifestyle factors (exercise, no smoking, etc)

Exercise: It doesn't have to be high-impact, 3-hour long workouts. "Moderate" exercise in the scientific journals is described as 20 minutes of physical activity (walking) 3 times a week!:

• 48% of Americans are completelysedentary
• Key factor in CVD, obesity, Cancer, Osteoarthritis, osteoporosis, and dementia
• Walking 20 minutes, 3x per week reduces CVD in women by 35%, in men by 25%
• Daily activity reduces colon cancer risk by 35-40%
• 2006 data shows exercise 2x/week reduces Alzheimers diagnoses by 60%!

Get checked! Prevention is not the same as early detection of disease. Get your blood work done, regardless of whether you have overt symptoms or not. Have your doctor look at basic lipid panels, but also the inflammatory markers C-reactive protein and homocysteine, which will tell you much more about your CVD risk.

In our office, we order inexpensive blood work that reveals information on your cardiovascular, liver, kidney, insulin and glucose metabolism, thyroid, and hormone function. Combining subjective information that you provide on questionnaires with lab work gives us a clear roadmap to guide you towards growing your health. You will know you are making positive strides as you see your functional assessment improve over time, and you will be feeling the difference in your health! We also work with insurance companies and have deeply discounted cash rates through our membership in a laboratory co-op.

Call our office to get started right away! We are always here to answer any questions you have and to help you grow your health!

720-379-3519 Ananda Wellness - Nutrition Programs

In true wellness,

Dr. Jared Gruhl

References

(i) Barter P, Gotto AM, LaRosa JC, Maroni J, Szarek M, Grundy SM, Kastelein JJ, Bittner V, Fruchart JC; Treating to New Targets Investigators. HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events. N Engl J Med. 2007 Sep 27;357(13):1301-10.

(ii) Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ; JUPITER Study Group. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008 Nov 20;359(21):2195-207.

(iii) Abramson J, Wright JM. Are lipid-lowering guidelines evidence-based? Lancet. 2007 Jan 20;369(9557):168-9

(iv) IBID

(v) Brown BG, Taylor AJ Does ENHANCE Diminish Confidence in Lowering LDL or in Ezetimibe? Engl J Med 358:1504, April 3, 2008 Editorial

(vi) Schatz IJ, Masaki K, Yano K, Chen R, Rodriguez BL, Curb JD. Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study. Lancet. 2001 Aug 4;358(9279):351-5.

(vii) Hansson GK Inflammation, Atherosclerosis, and Coronary Artery Disease N Engl J Med 352:1685, April 21, 2005