Listen to my latest Defiant Health podcast episode: Does wheat cause heart disease?
We are told that, in addition to obvious causes of heart disease such as cigarette smoking and diabetes, risk factors for coronary heart disease and heart attack include high total and LDL cholesterol and that you need to reduce dietary fat intake and take statin cholesterol-reducing drugs to address this source of risk. We are bombarded by this message by the American Heart Association, the American College of Cardiology, practicing cardiologists and primary care doctors, and drug advertising. These efforts at raising public awareness of this message would be terrific—if it were true.
As I have often pointed out, the original research by Drs. William Friedewald and William Frederickson at the National Institutes of Health in the 1950s and 1960s identified cholesterol in the various fractions of plasma (the clear portion of blood after red blood cells have been removed) as a way to crudely and indirectly estimate the lipoproteins (fat-carrying proteins) in the very low-density, low-density, intermediate-density, and high-density fractions layers of plasma spun down in a centrifuge, thus the terms VLDL cholesterol, LDL cholesterol, HDL cholesterol and, when all added up, total cholesterol. In other words, measuring cholesterol in these blood fractions was meant to be a means of indirectly gauging the number of lipoproteins present. It did not mean that cholesterol, a ubiquitous component of every cell in your body, was a causative factor in coronary heart disease, but that is the modern public misconception that most people hold.
Just take a single layer of lipoproteins in the centrifuged plasma: the low-density fraction, estimated by measuring the amount of cholesterol in that layer. The lipoproteins in that layer are not all the same; in fact, they vary widely in size and configuration: some are small, some are large, others are intermediate, with varying surface proteins and conformations. You can appreciate that characterizing this heterogeneous fraction of lipoproteins by simply measuring cholesterol is astoundingly overly simplistic.
But broadcasting the notion of “reducing cholesterol,” especially with the use of statin cholesterol drugs, was something healthcare practitioners and the public could embrace—even if it was wrong. I hope that you can appreciate that the real tragedy of focusing on cholesterol and statin drugs is that it took everyone’s attention off the real causes of heart disease that include provocation of small LDL particles (the actual lipoprotein particle, not LDL cholesterol), excess VLDL particles caused by consumption of grains and sugar and exaggerated by insulin resistance, and the processes of insulin resistance and inflammation. That’s why nobody around here is concerned about cholesterol, saturated fat intake, or silly statin drugs. Instead, we focus on eliminating the dietary provocateurs of small LDL particles (wheat, grains, and sugar); and reversing the causes of insulin resistance (wheat, grains, and sugars; lack of vitamin D, magnesium, omega-3 fatty acids, iodine; bacterial endotoxemia)—all accomplished without resorting to drugs to “reduce cholesterol.”