Does Cholesterol Really Cause Heart Disease?

When I say the word "cholesterol" what do you think? Most people think in terms of heart disease. We're taught to believe that cholesterol is the cause of heart disease, and as a nation we've spent trillions of dollars on spreading the belief that cholesterol is very bad. We have The War on Terror, The War on Drugs and The War on Cholesterol, and whenever we have a war on something it normally has a lot of propaganda fueling it, with unintended (or intended) consequences.

The advent of this cultural belief system has its roots in the 1950s' diet-heart hypothesis, which basically states that saturated fat in the diet causes cholesterol in the blood, which causes heart disease. This theory also states that polyunsatured fatty acids (PUFAS) — those found in soybean, corn, canola and vegetable oils — have the opposite effect. This traditional view also says that LDL and total cholesterol increase your chance of heart attack or stroke.

This oversimplified view is completely wrong and contributes to the perpetuation of the healthcare problem we face as a society. If cholesterol causes heart disease, then it should be a risk factor in all populations, all ages and both sexes. Conversely, lowering cholesterol should also reduce heart disease. In reality, though, we see the opposite.

The rate of heart disease in 65-year-old men is 10 times higher than that of 45-year-old men. A study in the Journal of American Medical Association found that high LDL is not a risk factor in heart disease or a cause in any deaths in the elderly. Isn't it highly unlikely and illogical that the risk factor of the disease would cease to be important when most people are dying from the disease? That's like saying smoking is a risk factor for lung cancer for people in their 40s, but not when they're 80.

Nor is high cholesterol a risk factor for women. Women have 300% lower rates of heart disease despite higher cholesterol levels than men on average. Approximately 125,000 women have been researched in 11 different studies, with no relationship being found between cholesterol and heart disease.

The World Health Organization's MONICA Study looked at a wide range of populations and their cholesterol and heart disease rates in an attempt to find a directly proportional correlation. What they found was quite the opposite. Australian Aboriginals have the lowest cholesterol and the highest rate of heart disease. They have 30 times that of people in France and 15 times higher than those in the UK. Conversely, the Swiss have some of the highest cholesterol levels, and 1/3 the heart disease rate of the UK. Dr. Malcolm Kendrick, author of The Great Cholesterol Con, stated, “It is unbelievable to me that you can look at this data and sustain your belief in the cholesterol hypothesis."

If the diet-heart hypothesis were accurate, shouldn't lowering cholesterol prevent heart disease? We see the opposite in the literature. Over 40 trials on the subject showed that lowering cholesterol had the same or actually higher risk of heart attack as the control groups

You probably heard LDL called "bad cholesterol", but again, this is oversimplified and incomplete. There are actually two types of LDL: small dense LDL, and large buoyant LDL

Small dense LDL particles are like little darts that tear holes in the lining of blood vessels. On the other hand, large buoyant LDL particles are like large fluffy balls. They can't do any damage, and may actually prevent the small dense LDL from its damage.

What Are Good Predictors Of Heart Attack and Stroke?

There are bio-markers that are stronger predictors of heart attack and stroke:

  • Low HDL
  • High triglycerides
  • High levels of small dense LDL

I run a blood test on my patients called the NMR (Nuclear Magnetic Resonance) that tells me if they have more small dense LDL (potentially bad) or large buoyant LDL (good). We also need to look at inflammation, which is an underlying cause of heart disease, and chronic disease as a whole.

Two other predictors of heart attack and stroke are:

  • Homocysteine
  • C Reactive Protein

I run these two blood tests on my patients to determine the patient's level of inflammation.

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William Cole, D.C., IFMCP

Functional Medicine Practitioner
Dr. Will Cole, leading functional-medicine expert, consults people around the world via webcam at and locally in Pittsburgh. He specializes in clinically investigating underlying factors of chronic disease and customizing health programs for thyroid issues, autoimmune conditions, hormonal dysfunctions, digestive disorders, and brain problems.Dr. Cole was named one of the top 50 functional-medicine and integrative doctors in the nation and is the author of Ketotarian in which he melds the powerful benefits of the ketogenic and plant-based diets.
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William Cole, D.C., IFMCP

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