“Cholesterol is a relatively minor player in heart disease and a poor predictor of heart attacks.”
– Dr. Jonny Bowden, PhD and Dr. Stephen Sinatra, MD

In 1956, Dr. Ancel Keys, an American physiologist, launched a 20-year multinational study to examine the relationship between lifestyle, diet, coronary heart disease (CHD), and stroke. Dubbed the Seven Countries Study, it tied CHD to elevated levels of serum cholesterol. It also demonized saturated fats while praising unsaturated fats. These findings have influenced the medical profession and public perception ever since.

In their 2012 book The Great Cholesterol Myth, Dr. Jonny Bowden, PhD and Dr. Stephen Sinatra, MD take conventional wisdom to task. They remind us that “cholesterol is an essential molecule without which there would be no life.” It is an integral part of our cell membranes. It is used to make Vitamin D, our sex hormones, and the bile acids required for digestion. It helps neutralize toxins. In fact, low serum cholesterol levels could be detrimental to our physical and emotional health.

So what about Dr. Keys’ research?

It turns out that Dr. Keys cherry-picked data from the 7 countries for which the association between CHD and serum cholesterol matched his preconceived notions. When a British doctor named John Yudkin studied the raw data from the 22 countries originally covered by Keys’ study, SUGAR was the dietary factor most closely associated with CHD.

So what causes coronary heart disease?

Bowden and Sinatra tell us that CHD begins with oxidation. For example, when a piece of metal or a freshly cut apple gets exposes to air, it oxidizes. It loses electrons, which our eyes observe as “rust.” This same thing can happen to Low-Density Lipoprotein (LDL) cholesterol molecules inside the body. When oxidized, these molecules degrade and stick to our arteries, causing inflammation. Our immune system responds by sending its “heavy artillery” to contain the damage. As these little “fighters” cast off their waste products, the lining of the arterial wall gets more inflamed, and the cycle continues. Pretty soon, you’ve got a build-up of plaque that constricts blood flow.

So what causes LDLs to become oxidized?

LDL molecules are not one-size-fits-all. Subtype A molecules are “big and fluffy” like cotton balls and behave rather nicely in the body. Subtype B molecules are small and hard like BB pellets and are highly susceptible to oxidation. (Note: There are also “good” and “bad” types of High-Density Lipoproteins which many of us have been led to believe are all “good.”) The right kinds of fat raise the kindly LDL Type A molecules and lower the nasty LDL Type B ones. Sugar has just the opposite effect – more Type B, less Type A.

Sugar’s villainy goes a step beyond the production of the wrong type of LDLs. When we chronically subject our bodies to excess sugar, we lose our ability to process sugar and store it as energy reserves. Unprocessed sugars stick to proteins in our bloodstream (e.g., LDLs) and damage them, thereby setting the stage for arterial inflammation. While all of this action is happening in the bloodstream, our fat cells “lock their doors,” making it hard to draw down their reserves and lose weight. Sugar also raises triglycerides, which is an independent risk factor for CHD.

So, are all fats OK?

No! Bowden and Sinatra think saturated fats (as found in butter, cheese, meat), monounsaturated fats (as found in extra virgin olive oil, macadamia nuts, avocados), and Omega 3 polyunsaturated fats (as found in walnuts, flaxseed, fish) are OK in moderation. After all, fat still packs a caloric punch! Omega 6 polyunsaturated fats (as found in vegetable oils) should be avoided. They’re prone to damage when heated/reheated for frying, leading to the production of noxious chemicals. By contrast, saturated fats are relatively stable, cause HDL to go up more than LDL, and favor production of the “big and fluffy” molecules. As for trans fats – avoid them like the plague!

What are their recommendations for a healthy lifestyle?

1. Eliminate sugar, soda, processed meats, processed carbs, trans fats, and vegetable oils from your diet.
2. Eat more wild salmon, berries/cherries, grass-fed meat, vegetables, nuts, beans, dark chocolate, garlic, turmeric, pomegranate, green tea, red wine, and extra virgin olive oil.
3. Meditate or practice deep breathing daily.
4. Express your emotions.
5. Cultivate intimacy and pleasure.
6. Enjoy life!