Whenever celebrities die of heart-related issues—George Michael, Carrie Fisher, and Alan Thicke being recent examples—it raises our collective awareness about heart disease, the No. 1 cause of death in the United States. And while awareness is always a good thing, it's even better when accompanied by action. Unfortunately, mainstream medicine's prescription for action—lowering cholesterol—is way past its expiration date.
As I stated on the Dr. Oz show, "Trying to lower heart disease by lowering cholesterol is like trying to lower calories by taking the lettuce off your whopper." About half the people admitted to hospitals for coronary artery disease have perfectly normal cholesterol. Tim Russert, the popular moderator of Meet the Press, died of a massive heart attack on a treadmill, with his cholesterol perfectly under control. His LDL was 68 and his total cholesterol was a 105—figures that would make any conventional doctor very happy. But if I had those numbers, I'd be seriously scared.
Here's the problem with low cholesterol.
Low cholesterol is associated with a baker's dozen of bad health outcomes, including increased risk for cancer, stroke, and (counterintuitively) heart disease itself. It's even been linked to an increased risk of suicide. Many people don't realize that cholesterol is a vitally important molecule for the brain, for the immune system, and for the creation of sex hormones and vitamin D.
Our obsessive fixation on lowering it has actually caused us to lose sight of the meaningful steps we can take to lower our risk for heart disease. If you take away nothing else from this article, remember that lowering the risk of heart disease and lowering cholesterol are very far from the same thing.
This is not the place to go into the fascinating history of how we got cholesterol so wrong (while, until very recently, giving sugar—a far more dangerous substance—a free pass). There are excellent books on the subject for anyone interested in how we got here—Nina Teicholz's The Big Fat Surprise, Malcolm Kendrick's The Great Cholesterol Con, Gary Taubes' The Case Against Sugar, and the aforementioned Great Cholesterol Myth by me and cardiologist Stephen Sinatra. But for now, let's talk about what we can do.
If you want to protect your heart, this is what you should watch out for.
In our book, we identify four factors that promote heart disease: stress, sugar, inflammation, and oxidative damage—all of which (not coincidentally) promote other degenerative diseases as well. So rather than spending another minute worrying about cholesterol, I'd much rather see us focus on lowering inflammatory markers (like homocysteine, IL-6, and small-particle LDL-b), reducing triglycerides and blood pressure, reducing oxidative damage to our cells and organs, managing our stress and eating less sugar. In fact, in study after study, following five mandates has been associated with up to an 80 percent reduction in heart attacks:
- Don't smoke
- Eat a healthy diet
- Exercise about 150 minutes a week
- Maintain a healthy weight
- Drink alcohol moderately or not at all
Now that's a plan for reducing heart disease. And cholesterol has almost nothing to do with it. In addition to that excellent list of basics, here are a few more things that increase your odds of dodging the heart disease bullet.
Wild salmon and fish oil supplements contain two powerful omega-3s that have been found to lower triglycerides and blood pressure. Omega-3s are also one of the most potent anti-inflammatory molecules on the planet, and virtually everyone can benefit. Make sure to buy the best you can afford or you're wasting your money.
Four or five minutes with your eyes closed, sitting quietly or lying down, breathing deeply (five counts in, hold for five, exhale for five) will do wonders for your stress levels, blood pressure, and state of mind. Of course, if you can meditate, that's even better!
Almost no one gets enough of this important nutrient that relaxes both the mind and the arteries and helps regulate blood sugar. If you're not a huge fan of more pills, consider a drinkable form or an Epsom salt bath that will reduce stress and provides a nice dose of magnesium through the skin.
4. Citrus bergamot
This wonderful extract from the same Italian fruit used to make Earl Grey tea actually has a number of heart-healthy properties such as lowering triglycerides, blood sugar, and inflammatory LDL particles.
Not getting enough sleep—or getting poor-quality sleep—is a huge stressor to the body, raising cortisol levels and causing general metabolic dysfunction. Keep the room dark and cool and don't sleep with the TV on!
6. Sitting breaks
Recent research has shown that sitting for long periods of time causes metabolic havoc, even for people who exercise. Take a few minutes' break every hour or so, even if you just walk down the hallway and back.
One of the best predictors of a long life, according to research done on the so-called Blue Zones (areas in the world with incredibly long life expectancies) was connectedness, purpose, and relationships. And I'm talking real people and real interactions—none of the people in the Blue Zones had a Facebook account.
There are so many little things you can do to achieve good heart health.
Undoubtedly, there are more actions you could take. Get on a good supplement program that includes probiotics, vitamin D, vitamin K, resveratrol, and curcumin. Eat an anti-inflammatory diet with lots of plant foods in it (especially nuts, berries, apples, and greens), and consume only clean, grass-fed meat. Make sure to ditch processed fast foods and take a slow, relaxed 15-minute walk five times a week. Don't forget to spend some time in the sun and surrounded by greenery. Drink pomegranate juice, green tea, and lots of water. Follow the principle of HALT: Don't get too hungry, angry, lonely, or tired.
All good stuff, all in good time. Meanwhile, the steps outlined above are a terrific place to start for just about everybody. Get those down first. The rest are just bonus credit.