Express Course; Cholesterol

Translated and slightly modified by Helena Mathis from: Snabbkurs i kolesterol (blodfetter) by Andreas Eenfeldt, M.D.

The underlying reason for the low fat diet ideology is based on the theory that fat increases the cholesterol and high cholesterol generates heart disease.

But eating natural fat has never been proven to increase the risk of heart disease. In fact, many late studies, done in the 21st century, have shown that there is no health gain in lowering the intake of natural fats. On the contrary, it might even be dangerous to do so.

How dangerous is cholesterol?
Cholesterol as a key risk factor for heart disease has been heavily questioned by many, especially because cholesterol is a substance that we cannot survive without. Cholesterol is needed to protect our cells and to sustain normal hormone levels. And many of the people that suffer heart disease do not have high cholesterol levels.

A more modern view
It has been proven that the total number of the cholesterol is not a good reference to show a correlation between cholesterol and heart disease (with the exception of genetic deviation). There is a much more reliable risk analysis when looking at the different types of cholesterols.

Most of our cholesterol travels in our blood in small packages called lipoproteins with the largest being VLDL or Triglycerides > LDL > HDL; which is what most cholesterol tests will give you along with the total amount.

Triglycerides and LDL
Triglycerides and LDL is what many refers to as the bad cholesterol but there are very few that know it is crucial for keeping us alive. The only danger is if you get too much of some of them.

The fat we eat gets transported to the lever where it then gets packed into VLDL (triglycerides). These get released into the blood and bonds with cells in the body to supply energy or as cell building blocks. During this process the VLDL will shrink into a smaller size and will soon become LDL. Unless the LDL gets completely absorbed by a cell it will continue to decrease in size and can later be referred to as small-LDL. The smaller it gets the easier it will oxidize and get stuck on a damaged part in the endothelium (the blood vessel lining). And cholesterol can on this path contribute to heart diseases when added to other reactions in the body.

What is important and interesting to mention is that fat we eat is not the major reason we develop LDL cholesterol, but large amounts of fast carbohydrates like sugar and refined wheat is.

HDL
HDL is referred to as the good cholesterol and works by picking up the surplus of cholesterol in the blood and transports it back to the lever. A high level of HDL decreases statistically the risk of heart disease due to its capacity to remove small LDL that has gotten stuck in the endothelium.

The food that increases the HDL is saturated fats and fast acting carbohydrates decreases HDL.

Why have we been told a lie?
If carbohydrates gives you unhealthy types of cholesterol and fat gives you healthy cholesterol – why have we, for the past decades, been told by official authorities the complete opposite?! There are many reasons to this but the biggest basis is probably because focus was put on LDL very early as the biggest risk factor for heart disease.

They knew that saturated fat seemed to rise LDL cholesterol short term. Later there was medication in form of statins that showed to decrease both LDL cholesterol and the risk of heart disease.

All of a sudden it became very profitable to recommend people to control their cholesterol levels with statins. Pfizer’s Lipitor sold for 12.6 billion dollars in the year 2006; making it the world’s most profitable medicine. And why would they want to change this reliable cash cow?

The question is if this is not the biggest reason to why we are focusing on lowering our LDL levels as a main goal to stay away from heart disease. As new research shows, LDL comes in different sizes. The larger don’t seem to be that dangerous from what we know but are the easiest to detect because they are larger. De larger LDL particles such as VLDL increases when eating saturated fats, but the smaller more dangerous LDL particles increases when eating carbohydrates.

It is however much more profitable to sell statins to all people that have raised LDL levels than to those who just have raised small-LDL levels; as that number is probably significantly lower.

It is not only ironic but rather dangerous to accuse dietary fat to be the biggest reason for increased cholesterol levels and danger of getting heart disease. Dietary fat increases the larger LDL particles and the HDL particles – those particles that are good and necessary for us! This off course raises the total number of cholesterol showing again that the total number is far from reliable to use as a risk analysis.

If lowering dietary fats according to many heart healthy recommendations a normal person would increase their intake in fast acting carbohydrates to feel full. This on the other hand raises the small LDL particles that are hard to detect on a regular LDL test. And the carbohydrates also lower the protecting HDL particles. In the end this will most likely result in a lower total cholesterol level but with a VLDL, LDL, small LDL, and HDL quota that increases the risk of heart disease!

To eat less fat and more carbohydrates will lead to lower HDL levels and higher small LDL levels. High levels of triglycerides may be a sign of high levels of small LDL.

Prestige and Money
Many cholesterol researchers know all this very well. This is not new controversial news to them. Yet we don’t get to hear about it, why? One reason is that this goes against the older (and current) heart healthy low fat recommendations and it is hard for authorities to admit that they have been wrong all of these years. Unfortunately the human race pays for them to keep this secret with their lives.

Another reason is that the pharmaceutical companies don’t want to give up their market share of this huge cash cow and food producers don’t want to loose money on their very profitable low fat products. The result is that these new studies become disliked and companies that make profit of the old habits will oppose to result like these. And once again we are paying for it with our lives!

What about cholesterol in food?
Many times you hear that you should avoid eating too much cholesterol for example egg. The yolk has the highest cholesterol levels we know of today and is probably because it is needed to build up all the cells in the chicken. Even though we hear about restrictions in dietary cholesterol no one has been able to prove that less cholesterol in food gives better health.

It has, however, been showed that about 80% of the cholesterol found in our body is made by our body (mostly in the lever). If we eat less cholesterol the body will make more, if we eat more cholesterol the body will make less. The dietary cholesterol has pretty much no impact of your health and there is probably safe to not care of how much of it is consumed.

How should I read my cholesterol results?
Total Cholesterol – is in the most cases a very poor measurement all by itself. Most often the recommended levels are 200 or lower. About 70% of people between 30 and 50 have higher levels than 200, and about 90-95% of people older than 50 have levels over 200. (Good for statin selling business).

Triglycerides (VLDL) – A low number is good. A high number depends mostly on high intake of carbohydrates. The recommendation is 150 or lower. Over 200 may be a sign of metabolic syndrome and is a threat to your heart health.

HDL – A high number is good, natural fats increases HDL. Low levels leads to higher risk of heart disease, dietary intake of many carbohydrates decreases HDL. Men should strive for a number over 35 and women a number over 45, the higher the better.

LDL – Most often is the recommended number for LDL between 100 and130. But this is, as we have previously discussed, a hard number to interpret. The small LDL particles are the dangerous ones but also the particles that will not show up accurate on the LDL result. If your HDL is high and your triglycerides are low than that would show that most of your LDL particles are bigger and safe and your number could safely be larger than 100-130. If your HDL is low and your triglycerides high then your LDL particles are most likely a formation of many small particles and are dangerous to you and your LDL should be lower than 100-130.

Total cholesterol / HDL – A low number is good. This is easy to measure and is more recommended to use as a risk analysis for heart disease than just the total number of cholesterol, the LDL alone, triglycerides, and LDL/HDL.

The blood test of the future
As you have probably noticed there are controversies over the way to measure cholesterol and prove relationship between that and bad health. Luckily there is a much more reliable method to measure the small dangerous LDL particles than to measure triglycerides and LDL levels: Every LDL particle have one protein composition called apolipoprotein B and HDL have one protein composition called apolipoprotein A1.

By measuring the Lp(B) we get to know the total amount of LDL particles, small LDL included! By knowing your apolipoproteins you can measure the apo-quota: Lp(B)/Lp(A). This is probably the best way of measure blood fats to use it in risk factor analysis for heart disease.

Suggested quotas for men are under 0.7; 0.7-0.9 is ok but not excellent, over 0.9 means increased risk. Recommended quotas for women are under 0.6; 0.6-0.8 is ok but not excellent, over 0.8 means increased risk.

So does increased risk in this case mean that a healthy person needs medicine like today? No, the first treatment should always be change of lifestyle. If it is not enough, after trying for 6-12 months and there are other risk factors involved, not until then should statins be considered. One good lifestyle change is to start eating LCHF.

Statins
Statins are most often used to lower blood fat levels, example of statin drugs are Simvastatin and Lipitor. Statin drugs work by slowing down the enzyme (called HMGR) that produces cholesterol in the body resulting in lower levels.

The outcome of using statins is that the cells get starved with too little cholesterol and have to start using the LDL cholesterol that exists in the blood. First the body has to produce something called LDL-receptors that get attached to each cell membrane. The LDL particle will later attract to the LDL receptor and the cell will absorb the LDL particle and receive the cholesterol it needs that way.

The point with statins is to induce a deficiency of cholesterol in the cells of the body so that they will use the LDL cholesterol from the blood, and the number of LDL cholesterol in the blood will decrease.

The most interesting thing is that the body can do this transformation by itself, without the help of statin drugs! The HMGR enzyme production is related to blood insulin levels and insulin levels are directly triggered by eating fast acting carbohydrates… Let’s take it the other way…

When eating carbohydrates your insulin levels will go up fast in order to try to take care of all the sugar. Parts of the carbohydrates will be absorbed by the body and used as energy and the carbohydrates that the body can’t use right away will be stored as fat. When the body gets too much carbohydrates then what it can absorb the insulin level will spike. At the same time the high insulin level will call for an increase in HMGR enzyme resulting in a higher cholesterol production. Did you get that?

Eating fast acting carbohydrates > High insulin levels > Spiked HMGR enzyme > Faster cholesterol production > Cholesterol staying in the blood stream longer and can develop small LDL easier > Risk for heart disease

Solutions
So there are really two solutions on the issue with the risk of heart disease. One is simply to take statin drugs for the rest of your life and watch out for side effects. The other is to decrease your intake of sugars and other fast acting carbohydrates such as pasta, bread, soft drinks, juices, and dried fruit. This will also promote a lower risk of inflammations just as statin drugs are said to do. The back side of taking statin drugs (except for the side effects) without changing your lifestyle is off course that the body will always crave the sugars as its main source of energy, causing your blood sugar constantly go up and down, which often results in overweight.

Off course there are some people at very high risk that might not have time to waste and may have to do both for a while until the levels are manageable.

I will always vote for the natural way what way you choose it entirely up to you!

Warning: Your cardiologist may be hazardous to your health!

Copyright 2009 Track Your Plaque, LLC
http://www.trackyourplaque.com/newsletters/newsletter0709.asp

When you put your life into the hands of a stranger, you might be entrusting it to someone who has one thing in mind: How to profit from the experience. Perhaps you gain health from it, perhaps not -- that’s not the point, sadly. Understand this sad fact and modern healthcare suddenly makes sense.

Here is Laurie’s chilling story of her near-fatal brush with Dr. Aldesani.

Tuesday, August 19, 2008

At approximately 5:40 am, I was struck with chest pain. My husband, Ray, drove me to a nearby hospital where I was given oxygen and a cardiac workup.

Eventually, I met Dr. Aldesani and he told me that I had suffered a heart attack and would need to have cardiac catheterization to locate the blockage and put in a stent. When I voiced my concern about putting in an unnecessary stent, he became agitated and said if I didn’t let him put a stent in, I would just have another heart attack.

While Dr. Aldesani was gone, I asked a nurse if I could get a second opinion from another cardiologist, but he said they would have to talk to Dr. Aldesani first because they couldn’t go behind his back.

When Dr. Aldesani returned I asked him again what the risks of this procedure were and if there were other options. He became even more agitated and would only tell me that I need to have the procedure done. He said, “Now listen, I don’t want to waste your time, and you don’t want to waste my time, so what do you want to do?

It made me feel uncomfortable. I felt as if he only wanted me to speak when spoken to and that he was offended that I was question his judgment. I asked if there was another cardiologist that I could talk to. Not wanting to anger him further, I said it was nothing against him but that I never had any kind of surgery before and I would just feel better if I got a second opinion from another doctor. Dr. Aldesani acquiesced and called in Dr. Steve Cutler.

Dr. Cutler arrived and, after asking me a number of questions, said that he thought the cardiac catheterization should be done. I asked if he could do the procedure instead of Dr. Aldesani, but Dr. Cutler said he wasn’t licensed to do so. I then asked him what Dr. Aldesani’s record was with the procedure and Dr. Cutler hesitated, lowered his head and said, “I think you should ask Dr. Aldesani that.”

I now feel that I should have trusted my initial instincts, but there was no one else available to do the procedure and both doctors had me convinced that, if I didn’t have this procedure done soon, I could die. I signed a paper, consenting to the procedure and agreeing that if something went wrong, they had the right to do an emergency bypass procedure.

Later, I was lying on a flat metal surface. I was lucid and felt relatively comfortable (considering the circumstances). A small screen was to my left, and I could hear Dr. Aldesani’s voice as he pointed out a blockage in my artery. He said, “I can pull it out with a wire.” Then, his voice rose, becoming unexpectedly aggressive. He said, “So what do you think, should I take it out?” Now bellowing, “You’re so smart! What do YOU think I should do? Do you want a second opinion?!“

I felt completely vulnerable and powerless as he mocked and ridiculed me with the questions I had asked him hours earlier. His unpredictable and threatening behavior in the midst of performing my heart procedure scared me deeply. I was terrified of what he might do.

Tuesday, August 19, 2008; 7:30 pm

Dr. Aldesani told my family that “there was a complication” and we learned that a healthy artery had been dissected during the procedure. At this point, he told my family that he would like to have me taken to a facility where open heart surgery would be available should I need it.

Wednesday, August 20, 2008

At approximately 9:00 am the next morning, surgeon Dr. Hector O’Hanley told my family that the artery wasn’t healing and a lifesaving open heart surgery was needed or I would die.

Later that day, at approximately 2:30 pm, I had double bypass surgery.


Track Your Plaque, LLC; Editor's Comments:

In the midst of an emergency, or, in this case, what appears to be a pseudo-emergency, we sometimes have to submit to the judgment and abilities of the people around us. We usually trust hospitals and doctors to do what is in our best interest, particularly when we are at our most vulnerable.

If Laurie could replay this unfortunate scene again from the start, here’s some advice I’d offer:

I asked a nurse if I could get a second opinion from another cardiologist, but he said they would have to talk to Dr. Aldesani first because they couldn’t go behind his back.

There is no such rule. The patient has a right to another opinion, whether or not the primary doctor approves. The nurse would have an obligation to notify the primary doctor that a second opinion is being sought, but it is entirely within the patient’s rights to obtain another opinion.

When Dr. Aldesani returned I asked him again what the risks of this procedure were and if there were other options. He became even more agitated and would only tell me that I need to have the procedure done.

Unacceptable. Everyone deserves an explanation about the procedure they are about to undergo. If Laurie had been critically ill, delirious, or not in full possession of her faculties, then the healthcare provider must simply act in the patient’s best interests. But to deny a description of the risks of a procedure just because she “really needed to have it” (if that was true) is simply unacceptable.

At that point, Laurie could have 1) insisted, 2) demanded a second opinion, whether or not Dr. Aldesani agreed, or 3) demanded transfer to another hospital if she knew of a doctor who would accept her as a patient (which is usually not difficult).

I asked if [Dr. Cutler] could do the procedure instead of Dr. Aldesani, but Dr. Cutler said he wasn’t licensed to do so.

This was a clear set-up by Dr. Aldesani. He sent someone in who was likely to agree with him (probably for political reasons) and who (purportedly) was unable to perform the procedure in his place.

This is a difficult situation. However, possibilities for handling it better include 1) identifying a second opinion source yourself with the assistance of friends, family, and nurses (who can be an extremely useful resource); 2) if the second opinion of Dr. Aldesani were accepted, asking why he chose who he did and asking both Dr. Aldesani and Dr. Cutler what their relationship was (partners, friends, etc.).

I now feel that I should have trusted my initial instincts, but there was no one else available to do the procedure and both doctors had me convinced that, if I didn’t have this procedure done soon, I could die.

Dr. Aldesani used the tried-and-true tactic of cardiologists everywhere: Scare them to death, then “save” their lives with a procedure. Sometimes it’s true, often it’s not. While Laurie may indeed have required a procedure, it was hardly the dire situation painted by the doctors.

Why do they use this tactic? Many reasons: It abbreviates the conversation, since patients become eager to have the procedure. (Proceduralists hate talking to patients.) It tends to pre-empt any liability if the procedure goes sour, since it was “necessary to save her life.” Lastly, it increases procedural volume, since just about anyone is unable to endure the fear of being told they were going to die without the procedure.

I felt completely vulnerable and powerless as he mocked and ridiculed me with the questions I had asked him hours earlier. His unpredictable and threatening behavior in the midst of performing my heart procedure scared me deeply.

Too late. Laurie was trapped, a victim of the unprofessional, inexcusable behavior of Dr. Aldesani. At this point, she had no recourse - partly sedated - with catheters inserted in her body.

[Dr. Aldesani] told my family that he would like to have me taken to a facility where open heart surgery would be available should I need it.

A non-emergent procedure being performed at a facility with no surgical backup? While clinical trials have confirmed that emergency angioplasty during an ongoing myocardial infarction (heart attack) can be safely performed in such “no backup” hospitals with equivalent results to that obtained in a hospital with surgical backup, there are limited data to support non-emergent angioplasty. In fact, some data suggest that mortality is doubled: http://www.bmj.com/cgi/content/extract/321/7272/1308

The fact that no surgical backup was available and the likelihood of adverse outcomes should have been fully disclosed prior to Laurie’s catheterization. There was no way for Laurie to have known this. But, Dr. Aldesani’s intractable reluctance to discuss the procedure concealed this crucial fact.

Learn from Laurie’s unfortunate experience. Having met Laurie, I can see how this sweet, accepting woman could have been bullied into a procedure. Don’t let it happen to you.

There is a time and place for procedures. When the situation permits, it is your right to receive 1) an adequate explanation of a medical procedure, its risks, benefits, and alternatives, 2) a second opinion if you are dissatisfied with the first, and 3) humane treatment regardless of differences of opinion.

Laurie and her attorney have since filed a lawsuit against Dr. Aldesani, who continues to operate a busy practice.

DISCLAIMER

While the content and text of “Laurie’s” story are genuine (except edited for brevity) and provided by “Laurie” herself, all names and personally identifying information have been changed.

Cardiologist excited about results

By Leroy Coast

In 1994 I suffered my first heart attack. At that time, angioplasty was performed and extensive cardiac rehabilitation was done. I met a friend who introduced me to natural products, and my rehabilitation reports were looking good. I was able to keep the disease at bay by taking large amounts of natural products, but eventually pill fatigue won and I substantially reduced the amounts of products I was taking. In 2004 I had another heart attack and stints were used as the solution. I was totally disabled with arthritis and cardiovascular disease.

A friend introduced me to arginine. A few months later I had an examination by my cardiologist, and he was excited about my improvement and the fact that I was using arginine. He performed a scan on me and could not find any calcification or plaque in my heart. My stints were clear, and he indicated that I could have the knee replacement that I needed.

Are you interested in supplementing with a natural amino acid answer this blog post and I will help you out!

My King of Pop

Jackson, who fought long-running battles with prescription medication throughout his career, was taking the drugs after suffering injuries during training for his comeback, lawyer and spokesman Brian Oxman said.

Oxman told CNN that he had harboured concerns about Jackson's use of drugs, saying members of the star's entourage were "enablers'' and comparing his case to the drug overdose death of Playboy centrefold Anna-Nicole Smith.

"This is not something that has been unexpected... because of the medications which Michael was under,'' Oxman said from the hospital where Jackson's family members had gathered.

"The people who have surrounded him have been enabling him... if you think that the case of Anna-Nicole Smith was an abuse, it was nothing to what we have seen in Michael Jackson's life."
To read more click here

I hope that everyone can read through the lines here and see that the cause of his cardiac arrest was not to try to get in shape for his upcoming tour, but the cause of years of heavy medications and who knows, maybe unhealthy living. So to all of you out there. Please listen to the side effects and try to find other ways to reach good health then by taking the Rx.

As a fan of the King of Pop ~ I hope you have found peace, you will be missed, but never lost.