By David Blyweiss, M.D., Advanced Natural Wellness

Ask most people what the biggest threat to heart health is and 99% of them—including most doctors—will say, “high cholesterol.”

But here’s the $64,000 question… should we all be so focused on our cholesterol?

Cholesterol is one of the most misunderstood molecules on the planet. It’s been so successfully demonized that lowering it is a multibillion dollar business. In fact, Americans spend more than $20 billion a year on just the two best-selling cholesterol-lowering drugs, Zocor and Lipitor.

But let’s face it: You don’t really care what your cholesterol level is. Right? What you really care about is your risk for heart disease. And doctors will tell you they are essentially the same thing. But they’re not.

The truth is cholesterol levels are a lousy predictor of heart disease. A large percentage of people with normal cholesterol have cardiovascular disease, and half of people who have heart attacks have “normal” cholesterol. That’s 50%.

Consider the Lyon Diet Heart Study, a classic study conducted in France over a 4-year period that looked at 605 patients who had already had a heart attack and who had classic risk factors, including high cholesterol and being a smoker. About half of the participants were told to eat a diet lower in fat and cholesterol; the other half ate a Mediterranean diet high in olive oil, vegetables, fruits, nuts and fish. Neither group was given a statin drug.

The folks who ate the Mediterranean diet had a 72% decrease in coronary events and a 56% decrease in overall mortality. But here’s the best part. Their cholesterol levels hardly budged.¹

Other studies have come up with similar results.

For example, the Nurses Health Study—one of the longest-running and most respected studies on diet and health—found that 5 basic behaviors reduce the risk of heart disease by an astonishing 82%. What are the 5 behaviors?

1. Maintaining a healthy weight
2. Exercising regularly
3. Eating a diet rich in omega-3 fats, fruits and vegetables
4. Drinking alcohol only moderately
5. Not smoking.²
   

Coincidentally, all 5 of these behaviors support healthy cholesterol levels.

But they also support heart health by lowering inflammation and free radical damage that can damage the lining of your arteries.

There’s something else you need to know about cholesterol. Not all LDL cholesterol is the same. Some LDL molecules are large fluffy particles. These are fairly harmless.

There are also 3 three increasingly dense and dangerous forms known as medium, small, and very small LDL.³ A diet high in saturated fat mainly boosts the numbers of large-LDL particles, while a low-fat diet high in refined carbohydrates creates the smaller forms. And the smaller and denser your LDL, the more dangerous it is.

So it’s no longer enough to know that your “bad” cholesterol has gone up. More cutting-edge physicians are testing for the four subtypes of LDL.

And then there’s HDL—the “good” cholesterol. Even if you have very small LDL particles, having lots of HDL cholesterol in your blood helps to remove harmful bad cholesterol from where it doesn’t belong. High HDL levels reduce the risk for heart disease. But low levels increase the risk.

So how can you get more good cholesterol? Here’s a handful of ways—and none of these include taking a statin drug:

• Lose weight. For every 6 pounds you lose, your HDL can increase by 2 mg/dL.
• Get moving. You can boost your HDL by 5% after just 2 months of regular aerobic exercise. Try exercising for at least 30 minutes, 5 times a week.
• Try niacin. This B vitamin prevents HDL from being removed from the blood by the liver—and that can boost your levels by up to 35%.⁴ But if you opt for niacin, here’s what you need to know:

1) For the most benefit, take a regular niacin supplement. Non-flushing and extended release forms aren’t as effective.

2) Start by taking 100 mg at bedtime and build up gradually by adding 100 mg per week.

3) To help prevent flushing, take your niacin supplement with a dose of stinging nettles.

4) Keep your doctor in the loop. Niacin can impact your liver so it’s smart to take this supplement under a doctor’s supervision and have your liver function monitored regularly, especially if you take higher doses.

There are a lot of factors that contribute to heart disease. Cholesterol is just one of them.

Concentrating on creating a healthy lifestyle—starting with the tips I’ve just mentioned—can keep many of these factors in check.

References:

1. de Lorgeril M. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99:779-785.
2. Nurse’s Health Study. Available at www.channing.harvard.edu/nhs/
3. Toft-Petersen AP. Small dense LDL particles–a predictor of coronary artery disease evaluated by invasive and CT-based techniques: a case-control study. Lipids in Health and Disease. 2011;10:21.
4. Reiner Z. Low HDL-cholesterol–an important risk factor for cardiovascular diseases. Lijec Vjesn. 2011;133:111-116