dinoiii
December 26th, 2005, 11:21 AM
The Cholesterol Controversy, Part II
Author’s Note: If you have yet to read part I of this series, it can be found at the following address:
http://www.discountanabolics.com/forum/showthread.php?t=1949
Central Cardiovascular Dogma
Of all the possible health risks, the two with which Americans are most familiar are smoking and cholesterol. The reason most of us are familiar with cholesterol, aside from its constant presence in the media, is that coronary heart disease remains the leading cause of death in the United States. Almost everyone at one point or another has learned that elevated blood levels of cholesterol may be hazardous to health. Out of a concern for controlling cholesterol levels through dietary means, whole new categories of foods have since been created, such as inassimilable artificial fats for use in mayonnaise, in ice cream, and so forth. Similarly, vegetable oils now are used in place of animal fats by major fast-food chains for frying purposes, and the list goes on.
The usual rendition of the health hazards of cholesterol runs as follows: Dietary fats, especially animal and other saturated fats, are readily absorbed by the body and/or cause the liver to produce fats known as low-density lipoproteins (LDLs), which damage the walls of the major arteries and other blood vessels. Cholesterol then collects at these damaged sites and narrows the vessels until blood cannot pass. In classic coronary artery disease, vessels that supply blood to the heart are blocked, and the heart is starved for nutrients and oxygen. Alternatively, as in the case of many strokes, cholesterol narrows the blood vessels that feed the brain. Eating a diet low in saturated fats and cholesterol is purported to lower the risk of cardiovascular and related diseases.
The problem with this picture is that it does NOT appear to be entirely true! Accepted cardiovascular dogma – the link between ‘bad’ LDL and cardiovascular disease (CVD) – is weakening. Some people with high LDL are free of CVD. Others with low LDL suffer from CVD. There has to be an explanation. There are many things that can be done to reduce the risks of heart disease and strokes, but removing fats from the diet is a fairly minor factor – IF A FACTOR AT ALL! Before delving into what can be done to lower our risks, a brief look at the present state of research on cholesterol and heart disease is in order.
“Recent” Research
In 1992 one of the most prestigious of all journals devoted to the study of heart and circulatory diseases, Circulation, published an article entitled “Health Policy on Blood Cholesterol: Time to Change Directions.” The authors of this article evaluated the best studies on lowering cholesterol through dietary and drug intervention that we have on record and came to these conclusions:
In both men and women, low blood cholesterol readings are associated with elevated mortality rates from non-cardiovascular diseases. Readings below 160 in men may actually be associated with slight INCREASES in cardiovascular disease, as are readings above 200.
In women, high blood cholesterol levels have NO association with deaths from cardiovascular disease.
In the major long-term intervention studies, whether these used dietary or drug means for lowering serum cholesterol levels, reduced mortality rates from cardiovascular causes were offset by increased mortality rates from non-cardiovascular causes in those populations not already characterized by heart disease (8).
It should be pointed out that other similar findings have received considerable airing on the research side of the medical community. For instance, at the November 14, 1991, annual meeting of the American Medical Association (AMA), Dr. Peter Wilson reported that the rates of heart attack and angina have NOT been lowered over the past decade. Death rates declined almost entirely because of improved techniques of intervention and treatment, not because of lowered incidence of attack (9). This is true despite the steady decline of saturated fats and cholesterol as components of the American diet.
Several recent books and booklets have covered in great depth the failure of the cholesterol hypothesis to account for most heart disease. The most troubling aspect of the recent turnabout toward cholesterol, leaving aside the realization that the American public has remained almost in the dark, is that none of the doubts about the cholesterol hypothesis are new.
The same report forty years ago that led the U.S. Surgeon General to require that all cigarette packages bear warnings of the health risks of smoking also indicated that fat consumption was not a health risk. The massive Hammond Report, which surveyed well over a million subjects, was presented to the AMA’s Annual Meeting on December 4, 1963. The surprise finding in the Hammond Report was that the more times per week that subjects ate fried foods – and keep in mind that in the early 1960s most frying used animal fats – the LOWER their death rates. This is virtually the same as concluding that the more saturated fats that were eaten, the longer the subjects lived. The Hammond Report was deemed authoritative when it came to health hazards of cigarette smoking, but completely ignored when it came to the issue of dietary fats. Its very strong epidemiological evidence that dietary fat consumption was NOT linked to heart disease did NOT fit the current medical model of that time.
Continued Results
On June 15, 1993, the results of the third National Health and Nutrition Examination Study were released by the National Center for Health Statistics. These results showed that the average blood cholesterol reading for American adults has declined from 220 mg/dl in 1960-1962 to 205 mg/dl for the period of 1988-1991. Most news accounts have linked this decline in cholesterol readings to the decline in death rates from CVD over the same thirty-year period. Not mentioned in such success stories of the prior three decades of modern medical intervention techniques. Also not mentioned is the striking difference in the statistical picture between the United States and France. American males have an average cholesterol reading of 209 mg/dl, perhaps lower, and a CVD death rate of 197 per 100,000. French males have a much higher cholesterol average of 230 mg/dl, yet they also have a far lower CVD death rate of only 78 per 100,000. In addition, we should not forget that the French continue to smoke at a rate far above the current American norm (10).
It will be much easier to understand the nature of the confusion regarding cholesterol if the following points are kept in mind: First, the body itself manufactures two-thirds OR MORE of its own cholesterol, and it can do this even from a diet consisting mostly of carbohydrates (through VLDL production, a topic beyond the scope of this article set). Some quite small percentage of the populace is genetically disposed to produce far too much cholesterol, but this fraction does NOT include the vast majority of us. Second, cholesterol is the base for a great many of the body’s key hormones and it is found in all cell membranes. Third, a growing number of researchers now accept that cardiovascular disease may be a subclinical sign of problems involving INSULIN REGULATION and/or FREE RADICAL DAMAGE. Finally, in all the major population studies done on cholesterol, it was usually next to impossible to lower blood cholesterol by dietary means UNLESS the subjects also lost excess weight.
This last point, of course, is key. Obesity, especially if characterized by excess abdominal fat (which often indicates lowered thyroid – AND NOT ADRENAL – function as purported by most marketing savvy supplement companies...fictitious cortisol understandings and claims be damned) can increase the risk of heart disease by as much as 300 percent. If we factor in the problems caused by excess weight and add to this the modern American tendency to rely upon canned and frozen foods (which through processing lose almost all of their intrinsic antioxidants and many of the naturally present vitamins and minerals), then it becomes much simpler to explain why cardiovascular disease is such a problem in the United States into the 21st century.
Does this mean that diet and blood cholesterol levels do not matter? Not at all! Individuals with cholesterol levels above 200 and with bad HDL-to-LDL ratios may be faced with elevated health risks. Low-fat diets and cholesterol-lowering regimes using niacin, oat bran and the like still have their place in therapeutics.
The trick is to avoid blaming the messenger. If high serum levels of LDLs in fact represent the body’s attempt to compensate for a lack of antioxidants, then lowering cholesterol levels through heroic dietary measures and drug intervention is a false victory. If high cholesterol levels merely mark the presence of cholesterol-containing hormones associated with the body’s response to stress, then the real answer is to slow down, not to starve the body of the building blocks for hormones. Finally, if high LDL cholesterol levels, and especially high triglyceride levels, are the result of insulin resistance and a diet high in sucrose, fructose, and refined carbohydrates and low in vitamins and minerals, then the permanent solution is to stabilize blood sugar levels. Remember, high protein/high fat/low carbohydrate diets also are successful as a therapeutic realm, but as usual – NO blanket statements in therapeutics.
Nutrients Control Cholesterol & Heart Disease
Now, it should be recognized that conclusions such as those presented in the Hammond Report have not been thoroughly examined by the American medical research community. Only recently have significant new ways of approaching the issue of heart disease been widely entertained. Two of these deserve some attention here. The first is that of excessive iron in the diet, and the second and related question is that of adequacy of antioxidants in the diet. Let us begin with the role of iron in heart and other diseases.
Iron, while being important in human nutrition, is perhaps the most widely supplemented mineral in everyday foods. However, as with other minerals, the important thing is to get the right amount. Too much iron in the diets of children, men, and postmenopausal women has been linked to increases in a wide variety of diseases, and the common practice of “fortifying” American foods with iron has been harshly condemned by a number of leading medical authorities (11). Imagine how this fortification process impacts the typical diet of your average bodybuilder who consumes copious tallies of red meats and the like with significant tallies of iron already present.
The journal Circulation reviewed evidence showing that extremely high risk of heart attacks characteristic of men in eastern Finland reflects not just high blood cholesterol levels, but also very high levels of iron (12). The editor of the journal pointed out that he is currently examining the connection between findings of this type and the dramatic increase in heart disease observed in women following menopause. As a concurrent member of the bodybuilding community, I am embarking on exploration of a similar relationship I have witnessed in the hypercaloric diets used by bodybuilders.
The argument being put forward by medical researchers is this: Men, UNLESS they are involved in very heavy physical labor or endurance athletics, tend to readily collect iron in the body since they do NOT tend to excrete it. (As an aside, women who stop menstruating too begin to collect iron in their tissues) Excess iron is known to interfere with the heart’s muscle contractions. However, the primary danger posed by excess iron is free-radical damage. Iron acts as a catalyst to oxidative processes, and in excess promotes the oxidation of LDLs, again as we previously noted in part I, these are the bad lipids. The damaged LDLs settle into the walls of arteries and narrow them (well, its a little more complex, but I want to spare you the super-highly scientific sense this time because of the importance of implications for which we will focus here).
In careful studies, it has been learned that men who had high blood cholesterol levels also had the highest levels of iron suffered twice the heart attack rate of the normal population. Furthermore, there is some evidence that those most at risk are individuals who are genetically predisposed to store iron (13). Do you know if you are genetically predisposed to store iron? While the answer is most likely an emphatic “NO,” look back at your family tree – what has been quoted as “running in the family” may provide answers!
In addition to infectious diseases and heart disease, cancer has been linked to the excessive consumption of iron, especially by men. The likely mechanism is the same suggested for heart disease, that is, some sort of free-radical damage encouraged by excess iron in the tissues (14). Still other diseases, such as arthritis, similarly may be caused, or at least triggered, by high tissue levels of iron.
Omigod, so what do we do?
Once again, we have come to the conclusion of this part of the series. I have presented a lot for you to digest, so please read it carefully. The next two parts are MUST NOT MISS articles. Not only can you further your understanding of heart disease, still the number one leading cause of death in the United States, BUT you may just become equipped with information that will save your life!!!
A Full set of references will be listed at the conclusion of this series!
Author’s Note: If you have yet to read part I of this series, it can be found at the following address:
http://www.discountanabolics.com/forum/showthread.php?t=1949
Central Cardiovascular Dogma
Of all the possible health risks, the two with which Americans are most familiar are smoking and cholesterol. The reason most of us are familiar with cholesterol, aside from its constant presence in the media, is that coronary heart disease remains the leading cause of death in the United States. Almost everyone at one point or another has learned that elevated blood levels of cholesterol may be hazardous to health. Out of a concern for controlling cholesterol levels through dietary means, whole new categories of foods have since been created, such as inassimilable artificial fats for use in mayonnaise, in ice cream, and so forth. Similarly, vegetable oils now are used in place of animal fats by major fast-food chains for frying purposes, and the list goes on.
The usual rendition of the health hazards of cholesterol runs as follows: Dietary fats, especially animal and other saturated fats, are readily absorbed by the body and/or cause the liver to produce fats known as low-density lipoproteins (LDLs), which damage the walls of the major arteries and other blood vessels. Cholesterol then collects at these damaged sites and narrows the vessels until blood cannot pass. In classic coronary artery disease, vessels that supply blood to the heart are blocked, and the heart is starved for nutrients and oxygen. Alternatively, as in the case of many strokes, cholesterol narrows the blood vessels that feed the brain. Eating a diet low in saturated fats and cholesterol is purported to lower the risk of cardiovascular and related diseases.
The problem with this picture is that it does NOT appear to be entirely true! Accepted cardiovascular dogma – the link between ‘bad’ LDL and cardiovascular disease (CVD) – is weakening. Some people with high LDL are free of CVD. Others with low LDL suffer from CVD. There has to be an explanation. There are many things that can be done to reduce the risks of heart disease and strokes, but removing fats from the diet is a fairly minor factor – IF A FACTOR AT ALL! Before delving into what can be done to lower our risks, a brief look at the present state of research on cholesterol and heart disease is in order.
“Recent” Research
In 1992 one of the most prestigious of all journals devoted to the study of heart and circulatory diseases, Circulation, published an article entitled “Health Policy on Blood Cholesterol: Time to Change Directions.” The authors of this article evaluated the best studies on lowering cholesterol through dietary and drug intervention that we have on record and came to these conclusions:
In both men and women, low blood cholesterol readings are associated with elevated mortality rates from non-cardiovascular diseases. Readings below 160 in men may actually be associated with slight INCREASES in cardiovascular disease, as are readings above 200.
In women, high blood cholesterol levels have NO association with deaths from cardiovascular disease.
In the major long-term intervention studies, whether these used dietary or drug means for lowering serum cholesterol levels, reduced mortality rates from cardiovascular causes were offset by increased mortality rates from non-cardiovascular causes in those populations not already characterized by heart disease (8).
It should be pointed out that other similar findings have received considerable airing on the research side of the medical community. For instance, at the November 14, 1991, annual meeting of the American Medical Association (AMA), Dr. Peter Wilson reported that the rates of heart attack and angina have NOT been lowered over the past decade. Death rates declined almost entirely because of improved techniques of intervention and treatment, not because of lowered incidence of attack (9). This is true despite the steady decline of saturated fats and cholesterol as components of the American diet.
Several recent books and booklets have covered in great depth the failure of the cholesterol hypothesis to account for most heart disease. The most troubling aspect of the recent turnabout toward cholesterol, leaving aside the realization that the American public has remained almost in the dark, is that none of the doubts about the cholesterol hypothesis are new.
The same report forty years ago that led the U.S. Surgeon General to require that all cigarette packages bear warnings of the health risks of smoking also indicated that fat consumption was not a health risk. The massive Hammond Report, which surveyed well over a million subjects, was presented to the AMA’s Annual Meeting on December 4, 1963. The surprise finding in the Hammond Report was that the more times per week that subjects ate fried foods – and keep in mind that in the early 1960s most frying used animal fats – the LOWER their death rates. This is virtually the same as concluding that the more saturated fats that were eaten, the longer the subjects lived. The Hammond Report was deemed authoritative when it came to health hazards of cigarette smoking, but completely ignored when it came to the issue of dietary fats. Its very strong epidemiological evidence that dietary fat consumption was NOT linked to heart disease did NOT fit the current medical model of that time.
Continued Results
On June 15, 1993, the results of the third National Health and Nutrition Examination Study were released by the National Center for Health Statistics. These results showed that the average blood cholesterol reading for American adults has declined from 220 mg/dl in 1960-1962 to 205 mg/dl for the period of 1988-1991. Most news accounts have linked this decline in cholesterol readings to the decline in death rates from CVD over the same thirty-year period. Not mentioned in such success stories of the prior three decades of modern medical intervention techniques. Also not mentioned is the striking difference in the statistical picture between the United States and France. American males have an average cholesterol reading of 209 mg/dl, perhaps lower, and a CVD death rate of 197 per 100,000. French males have a much higher cholesterol average of 230 mg/dl, yet they also have a far lower CVD death rate of only 78 per 100,000. In addition, we should not forget that the French continue to smoke at a rate far above the current American norm (10).
It will be much easier to understand the nature of the confusion regarding cholesterol if the following points are kept in mind: First, the body itself manufactures two-thirds OR MORE of its own cholesterol, and it can do this even from a diet consisting mostly of carbohydrates (through VLDL production, a topic beyond the scope of this article set). Some quite small percentage of the populace is genetically disposed to produce far too much cholesterol, but this fraction does NOT include the vast majority of us. Second, cholesterol is the base for a great many of the body’s key hormones and it is found in all cell membranes. Third, a growing number of researchers now accept that cardiovascular disease may be a subclinical sign of problems involving INSULIN REGULATION and/or FREE RADICAL DAMAGE. Finally, in all the major population studies done on cholesterol, it was usually next to impossible to lower blood cholesterol by dietary means UNLESS the subjects also lost excess weight.
This last point, of course, is key. Obesity, especially if characterized by excess abdominal fat (which often indicates lowered thyroid – AND NOT ADRENAL – function as purported by most marketing savvy supplement companies...fictitious cortisol understandings and claims be damned) can increase the risk of heart disease by as much as 300 percent. If we factor in the problems caused by excess weight and add to this the modern American tendency to rely upon canned and frozen foods (which through processing lose almost all of their intrinsic antioxidants and many of the naturally present vitamins and minerals), then it becomes much simpler to explain why cardiovascular disease is such a problem in the United States into the 21st century.
Does this mean that diet and blood cholesterol levels do not matter? Not at all! Individuals with cholesterol levels above 200 and with bad HDL-to-LDL ratios may be faced with elevated health risks. Low-fat diets and cholesterol-lowering regimes using niacin, oat bran and the like still have their place in therapeutics.
The trick is to avoid blaming the messenger. If high serum levels of LDLs in fact represent the body’s attempt to compensate for a lack of antioxidants, then lowering cholesterol levels through heroic dietary measures and drug intervention is a false victory. If high cholesterol levels merely mark the presence of cholesterol-containing hormones associated with the body’s response to stress, then the real answer is to slow down, not to starve the body of the building blocks for hormones. Finally, if high LDL cholesterol levels, and especially high triglyceride levels, are the result of insulin resistance and a diet high in sucrose, fructose, and refined carbohydrates and low in vitamins and minerals, then the permanent solution is to stabilize blood sugar levels. Remember, high protein/high fat/low carbohydrate diets also are successful as a therapeutic realm, but as usual – NO blanket statements in therapeutics.
Nutrients Control Cholesterol & Heart Disease
Now, it should be recognized that conclusions such as those presented in the Hammond Report have not been thoroughly examined by the American medical research community. Only recently have significant new ways of approaching the issue of heart disease been widely entertained. Two of these deserve some attention here. The first is that of excessive iron in the diet, and the second and related question is that of adequacy of antioxidants in the diet. Let us begin with the role of iron in heart and other diseases.
Iron, while being important in human nutrition, is perhaps the most widely supplemented mineral in everyday foods. However, as with other minerals, the important thing is to get the right amount. Too much iron in the diets of children, men, and postmenopausal women has been linked to increases in a wide variety of diseases, and the common practice of “fortifying” American foods with iron has been harshly condemned by a number of leading medical authorities (11). Imagine how this fortification process impacts the typical diet of your average bodybuilder who consumes copious tallies of red meats and the like with significant tallies of iron already present.
The journal Circulation reviewed evidence showing that extremely high risk of heart attacks characteristic of men in eastern Finland reflects not just high blood cholesterol levels, but also very high levels of iron (12). The editor of the journal pointed out that he is currently examining the connection between findings of this type and the dramatic increase in heart disease observed in women following menopause. As a concurrent member of the bodybuilding community, I am embarking on exploration of a similar relationship I have witnessed in the hypercaloric diets used by bodybuilders.
The argument being put forward by medical researchers is this: Men, UNLESS they are involved in very heavy physical labor or endurance athletics, tend to readily collect iron in the body since they do NOT tend to excrete it. (As an aside, women who stop menstruating too begin to collect iron in their tissues) Excess iron is known to interfere with the heart’s muscle contractions. However, the primary danger posed by excess iron is free-radical damage. Iron acts as a catalyst to oxidative processes, and in excess promotes the oxidation of LDLs, again as we previously noted in part I, these are the bad lipids. The damaged LDLs settle into the walls of arteries and narrow them (well, its a little more complex, but I want to spare you the super-highly scientific sense this time because of the importance of implications for which we will focus here).
In careful studies, it has been learned that men who had high blood cholesterol levels also had the highest levels of iron suffered twice the heart attack rate of the normal population. Furthermore, there is some evidence that those most at risk are individuals who are genetically predisposed to store iron (13). Do you know if you are genetically predisposed to store iron? While the answer is most likely an emphatic “NO,” look back at your family tree – what has been quoted as “running in the family” may provide answers!
In addition to infectious diseases and heart disease, cancer has been linked to the excessive consumption of iron, especially by men. The likely mechanism is the same suggested for heart disease, that is, some sort of free-radical damage encouraged by excess iron in the tissues (14). Still other diseases, such as arthritis, similarly may be caused, or at least triggered, by high tissue levels of iron.
Omigod, so what do we do?
Once again, we have come to the conclusion of this part of the series. I have presented a lot for you to digest, so please read it carefully. The next two parts are MUST NOT MISS articles. Not only can you further your understanding of heart disease, still the number one leading cause of death in the United States, BUT you may just become equipped with information that will save your life!!!
A Full set of references will be listed at the conclusion of this series!