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By Dr. Mercola

There’s serious confusion about cholesterol; whether high cholesterol levels are responsible for heart disease, and whether statins — which are cholesterol drugs — are really the appropriate solution to reduce heart disease risk.

The documentary above, Statin Nation — The Great Cholesterol Cover-Up, sheds much needed light on this topic. The film is available for free viewing for only seven days, so please share it widely as soon as possible.

As noted in the film, heart disease is the leading cause of death worldwide, the most common form of which is coronary heart disease (CHD). CHD affects the blood vessels supplying blood to your heart, causing them to narrow, thereby restricting the amount of oxygen supplied to your heart.

The conventional view is that high cholesterol is a major risk factor for this condition — even children “know” that cholesterol forms plaque and is bad for your heart.

The focus on cholesterol has created an enormous market for statins; drugs that act by blocking the enzyme in your liver that is responsible for making cholesterol.

Statins are now among the most widely prescribed drugs on the market, and are the number one profit-maker for the pharmaceutical industry, largely due to relentless and highly successful direct-to-consumer advertising campaigns.

Meanwhile, as of 2010, there were no less than 900 studies proving their adverse effects, which run the gamut from muscle problems to increased cancer risk! Besides the fact that statins are dangerous to your health, they also do not reduce your risk for heart disease, because high cholesterol does NOT increase heart disease risk...

Where Did the High Cholesterol-Heart Disease Myth Originate?

The idea that high cholesterol causes heart disease can be traced back to Rudolph Virchow (1821-1902), a German pathologist who found thickening in the arteries in people he autopsied, which he ascribed to a collection of cholesterol.

Later, Ancel Keys (1904-2004), a well-known physiologist, published his seminal paper known as the "Seven Countries Study¹," which served as the basis for nearly all of the initial scientific support for the Cholesterol Theory.

The study linked the consumption of saturated fat to coronary heart disease. However, what many don’t know is that Keys selectively analyzed information from only seven countries to prove his correlation, rather than comparing all the data available at the time -- from 22 countries.

As you might suspect, the studies he excluded were those that did not fit with his hypothesis, namely those that showed a low percentage fat in their diet and a high incidence of death from CHD as well as those with a high-fat diet and low incidence of CHD. When all 22 countries are analyzed, no correlation at all can be found.

And that is what mounting research now confirms. There really is NO correlation between high cholesterol and plaque formation that leads to heart disease.

Why Do You Need Cholesterol?

Missing from the cholesterol-CHD hypothesis is the holistic understanding of how cholesterol operates inside your body, and why arterial plaques form in the first place, which is clearly described in the film. Cholesterol is actually a critical part of your body’s foundational building materials and is absolutely essential for optimal health. It’s so important that your body produces it both in your liver and in your brain.

There’s no doubt that your body needs cholesterol. In fact, we now have evidence showing that cholesterol deficiency has a detrimental impact on virtually every aspect of your health. One of the primary reasons is because cholesterol plays a critical role within your cell membranes.

Your body is composed of trillions of cells that need to interact with each other and cholesterol is one of the molecules that allow for these interactions to take place. For example, cholesterol is the precursor to bile acids, so without sufficient amounts of cholesterol, your digestive system can be adversely affected.

Cholesterol also plays an essential role in your brain, which contains about 25 percent of the cholesterol in your body. It is critical for synapse formation, i.e. the connections between your neurons, which allow you to think, learn new things, and form memories. In fact, there's reason to believe that low-fat diets and/or cholesterol-lowering drugs may cause or contribute to Alzheimer's disease. Low cholesterol levels have also been linked to violent behavior, due to adverse changes in brain chemistry.

Furthermore, you need cholesterol to produce steroid hormones, including your sex hormones. Vitamin D is also synthesized from a close relative of cholesterol: 7-dehydrocholesterol.

To further reinforce the importance of cholesterol, I want to remind you of the work of Dr. Stephanie Seneff, who works with the Weston A. Price Foundation. One of her theories is that cholesterol combines with sulfur to form cholesterol sulfate, and that this cholesterol sulfate helps thin your blood by serving as a reservoir for the electron donations you receive when walking barefoot on the earth (also called grounding). She believes that, via this blood-thinning mechanism, cholesterol sulfate may provide natural protection against heart disease. In fact, she goes so far as to hypothesize that heart disease is likely the result of cholesterol deficiency — which of course is the complete opposite of the conventional view.

Identifying Risk Factors for Heart Disease

As mentioned in the film, if you want to understand what causes heart disease, you have to look at what causes damage to your artery walls, interferes in disease processes, and causes blood clotting. When the endothelial wall is damaged, repair mechanisms are set into motion, creating a “scab.” To prevent this scab from dislodging, the endothelial wall grows over it, causing the area to become thickened. This is what is called atherosclerosis. There’s no fat (cholesterol) “clogging the pipe” at all; rather the arterial wall is thickened as a result of your body’s natural repair process. So what causes damage to your arteries?

One of the primary culprits is sugar and fructose in particular. So eating a high sugar diet is a sure-fire way to put heart disease on your list of potential health problems. Meanwhile, total cholesterol will tell you virtually nothing about your disease risk, unless it's exceptionally elevated (above 330 or so, which would be suggestive of familial hypercholesterolemia, which, in my view, would be about the only time a cholesterol-reducing drug would be appropriate).

Two ratios that are far better indicators of heart disease risk are:

• Your HDL/total cholesterol ratio: HDL percentage is a very potent heart disease risk factor. Just divide your HDL level by your total cholesterol. This percentage should ideally be above 24 percent. Below 10 percent, it's a significant indicator of risk for heart disease
• Your triglyceride/HDL ratios: This ratio should ideally be below 2

Additional risk factors for heart disease include:

• Your fasting insulin level: Any meal or snack high in carbohydrates like fructose and refined grains generates a rapid rise in blood glucose and then insulin to compensate for the rise in blood sugar. The insulin released from eating too many carbs promotes fat and makes it more difficult for your body to shed excess weight, and excess fat, particularly around your belly, is one of the major contributors to heart disease
• Your fasting blood sugar level: Studies have shown that people with a fasting blood sugar level of 100-125 mg/dl had a nearly 300 percent increase higher risk of having coronary heart disease than people with a level below 79 mg/dl
• Your iron level: Iron can be a very potent oxidative stress, so if you have excess iron levels you can damage your blood vessels and increase your risk of heart disease. Ideally, you should monitor your ferritin levels and make sure they are not much above 80 ng/ml. The simplest way to lower them if they are elevated is to donate your blood. If that is not possible you can have a therapeutic phlebotomy and that will effectively eliminate the excess iron from your body

Statin Drugs Place Millions of Americans at Risk of Serious Health Problems

It’s important to note that statins are classified as a "pregnancy Category X medication" meaning, it causes serious birth defects, and should NEVER be used by a woman who is pregnant or planning a pregnancy. If it is prescribed it is simply gross negligence and malpractice as many doctors are ignorant of this important piece of information as it is relatively recently identified.

Statins have also been shown to increase your risk of diabetes, via a number of different mechanisms. The most important one is that they increase insulin resistance, which can be extremely harmful to your health. Increased insulin resistance contributes to chronic inflammation in your body, and inflammation is the hallmark of most diseases. In fact, increased insulin resistance can lead to heart disease, which, ironically, is the primary reason for taking a cholesterol-reducing drug in the first place. It can also promote belly fat, high blood pressure, heart attacks, chronic fatigue, thyroid disruption, and diseases like Parkinson's, Alzheimer's, and cancer.

Secondly, statins increase your diabetes risk by actually raising your blood sugar. When you eat a meal that contains starches and sugar, some of the excess sugar goes to your liver, which then stores it away as cholesterol and triglycerides. Statins work by preventing your liver from making cholesterol. As a result, your liver returns the sugar to your bloodstream, which raises your blood sugar levels.

Drug-induced diabetes and genuine type 2 diabetes are not necessarily identical. If you're on a statin drug and find that your blood glucose is elevated, it's possible that what you have is just hyperglycemia — a side effect, and the result of your medication. Unfortunately, many doctors will at that point mistakenly diagnose you with "type 2 diabetes," and possibly prescribe another drug, when all you may need to do is simply discontinue the statin in order for your blood glucose levels to revert back to normal.

Statin drugs also interfere with other biological functions. Of utmost importance, statins deplete your body of CoQ10, which accounts for many of its devastating results. Therefore, if you take a statin, you MUST take supplemental CoQ10, or better, the reduced form called ubiquinol.  A recent study in the European Journal of Pharmacology²showed that ubiquinol effectively rescued cells from the damage caused by the statin drug simvastatin, thereby protecting muscle cells from myopathies. Another study³ evaluated the benefits of CoQ10 and selenium supplementation for patients with statin-associated myopathy. Compared to those given a placebo, the treatment group experienced significantly less pain, decreased muscle weakness and cramps, and less fatigue.

Statins also interfere with the mevalonate pathway, which is the central pathway for the steroid management in your body.

How to Optimize Your Cholesterol Levels Naturally

The most effective way to optimize your cholesterol profile and prevent heart disease is via diet and exercise. Remember that 75 percent of your cholesterol is produced by your liver, which is influenced by your insulin levels. Therefore, if you optimize your insulin level, you will automatically optimize your cholesterol and reduce your risk of both diabetes and heart disease.

There is NO drug to cure heart disease, as the underlying cause is insulin resistance and arterial wall damage — both of which are caused by eating too many sugars, grains, and especially fructose. So, my primary recommendations for safely regulating your cholesterol and reducing your risk of heart disease include:

• Reduce, with the plan of eliminating grains and fructose from your diet. This is one of the best ways to optimize your insulin levels, which will have a positive effect on not just your cholesterol, but also reduces your risk of diabetes and heart disease, and most other chronic diseases. Use my Nutrition Plan to help you determine the ideal diet for you, and consume a good portion of your food raw.
• Get plenty of high-quality, animal-based omega 3 fats, such as krill oil, and reduce your consumption of damaged omega-6 fats (trans fats, vegetable oils) to balance out your omega-3 to omega-6 ratio.
• Include heart-healthy foods in your diet, such as olive oil, coconut and coconut oil, organic raw dairy products and eggs, avocados, raw nuts and seeds, and organic grass-fed meats.
• Optimize your vitamin D levels by getting proper sun exposure or using a safe tanning bed.
• Optimize your gut flora, as recent research suggests the bacterial balance in your intestines may play a role in your susceptibility to heart disease as well
• Exercise daily. Make sure you incorporate Peak Fitness exercises, which also optimizes your human growth hormone (HGH) production.
• Walk barefoot to ground yourself to the earth. Lack of grounding has a lot to do with the rise of modern diseases as it affects inflammatory processes in your body. Grounding thins your blood, making it less viscous. Virtually every aspect of cardiovascular disease has been correlated with elevated blood viscosity. When you ground to the earth, your zeta potential quickly rises, which means your red blood cells have more charge on their surface, which forces them apart from each other. This action causes your blood to thin and flow easier. By repelling each other, your red blood cells are also less inclined to stick together and form a clot.
• Avoid smoking or drinking alcohol excessively.
• Be sure to get plenty of good, restorative sleep.

Ninety-Nine Out of 100 People Do Not Need Statin Drugs

The odds are very high — greater than 100 to 1 — that if you're taking a statin, you don't really need it. From my review, the ONLY subgroup that might benefit are those born with a genetic defect called familial hypercholesterolemia, as this makes them resistant to traditional measures of normalizing cholesterol.

Remember, your body NEEDS cholesterol for the production of cell membranes, hormones, vitamin D and bile acids that help you to digest fat. Cholesterol also helps your brain form memories and is vital to your neurological function. There is also strong evidence that having too little cholesterol INCREASES your risk for cancer, memory loss, Parkinson's disease, hormonal imbalances, stroke, depression, suicide, and violent behavior.

Statins really have nothing to do with reducing your heart disease risk. In fact, this class of drugs can increase your heart disease risk — especially if you do not take Ubiquinol (CoQ10) along with it to mitigate the depletion of CoQ10 caused by the drug.

Knowing that high cholesterol is NOT the cause of heart disease finally frees you to take a serious look at what does cause this potentially lethal condition. And as described above, poor lifestyle choices are primarily to blame, such as too much sugar, too little exercise, lack of sun exposure and never grounding to the earth. These are all things that are within your control, and don’t cost much (if any) money to address.

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By Dr. Mercola

Nearly 41 million US adults are sleeping just six hours or less each night, putting them at risk of adverse health effects (such as heart disease and obesity) and potentially fatal drowsy driving linked to lack of sleep.¹

While stress is one of the most-often cited reasons why people can’t sleep, there’s another factor that could be keeping you up at night: your diet. Certain foods can significantly interfere with your sleep, including the five worst of the worst below.

What Are the Five Worst Foods for Sleep?

1. Alcohol

A drink or two before bed can make you drowsy, leading many to believe it’s actually beneficial for sleep. But while it may make you nod off quicker, research shows that drinking alcohol makes you more likely to wake during the night, leaving you feeling less rested in the morning.

The latest study found that alcohol increases slow-wave “deep” sleep during the first half of the night, but then increases sleep disruptions in the second half of the night.²

Since alcohol is a potent muscle relaxant, it can also increase your risk of snoring. Snorers -- and their bed partners -- often experience restless sleep leading to sleepiness and difficulty concentrating during the day.

2. Coffee

Coffee, of course, is one of the most common sources of caffeine. This stimulant has a half-life of five hours, which means 25% of it will still be in your system even 10 hours later, and 12.5% 20 hours later (see the problem?). Plus, in some people caffeine is not metabolized efficiently, leaving you feeling its effects even longer after consumption. So, an afternoon cup of coffee or tea will keep some people from falling asleep at night. Be aware that some medications contain caffeine as well (for example, diet pills).

3. Dark Chocolate

Dark chocolate, though the healthiest form of chocolate from an antioxidant perspective, can contain relatively high levels of caffeine that can keep you up at night if you’re sensitive. It also contains theobromine, a compound that has caffeine-like effects.

4. Spicy Foods

Spicy foods before bedtime can give you indigestion that makes it nearly impossible to get a good night’s sleep. But even if you can eat spicy foods without discomfort, they are still linked with more time spent awake during the night and taking longer to fall asleep.³ It’s speculated that this may be due to capsaicin, an active ingredient in chili peppers, affecting sleep via changes in body temperature.

5. Unhealthy Fatty Foods

When you don’t get enough sleep, you’re more likely to crave high-fat, high-sugar foods the next day. But eating a high-fat diet also has impacts on your sleep, including leading to more fragmented sleep. In fact, an animal study revealed that eating fatty foods may lead to disrupted sleep and excessive daytime sleepiness.⁴

The link may be due to the brain chemical hypocretin, a neurotransmitter that helps keep you awake and also plays a role in managing appetite. Keep in mind that while you should limit your intake of unhealthy fats like those from fried foods, healthy fats (including saturated fats) play an important role in your diet and shouldn’t be eliminated.

Recent Study Gives Clues on How Diet Impacts Sleep

The link between what you eat and how well you sleep, and vice versa, is only beginning to be explored, however, a recent study evaluating the diets and sleep patterns of more than 4,500 people did find distinct dietary patterns among short and long sleepers.⁵

While the study was only able to generate hypotheses about dietary nutrients that may be associated with short and long sleep durations, it did yield some interesting data.

• Very short sleepers (less than 5 hours a night): Had the least food variety, drank less water and consumed fewer total carbohydrates and lycopene (an antioxidant found in fruits and vegetables).
• Short sleepers (5-6 hours): Consumed the most calories but ate less vitamin C and selenium, and drank less water. Short sleepers tended to eat more lutein and zeaxanthin than other groups.
• Normal sleepers (7-8 hours): Had the most food variety in their diet, which is generally associated with a healthier way of eating.
• Long sleepers (9 or more hours): Consumed the least calories as well as less theobromine (found in chocolate and tea), choline and total carbs. Long sleepers tended to drink more alcohol.

As for what the data means, researchers aren’t yet sure, but it could be that eating a varied diet is one key to normal, healthful sleep. If you need some help in this area, check out my nutrition plan for a step-by-step guide to optimizing your eating habits.

Sleep Tip: Stop Eating at Least Three Hours Before You Go to Bed

It is ideal to avoid eating any food three hours before bed, as this will optimize your blood sugar, insulin and leptin levels and contribute to overall good health and restful sleep. Specifically, avoiding food for at least three hours before bed will lower your blood sugar during sleep and help minimize damage from too much sugar floating around. Additionally, it will jumpstart the glycogen depletion process so you can shift to fat-burning mode.

A recent study⁶ is a powerful confirmation of this recommendation, as it found that the mere act of altering your typical eating habits — such as getting up in the middle of the night for a snack — causes a certain protein to desynchronize your internal food clock, which can throw you off kilter and set a vicious cycle in motion. Eating too close to bedtime, or very late at night when you'd normally be sleeping, may throw off your body's internal clock and lead to weight gain.

Routinely eating at the wrong time may not only disrupt your biological clock and interfere with your sleep, but it may also devastate vital body functions and contribute to disease.

That said, while you’ve likely heard the advice that breakfast is the most important meal of the day, some experts believe that skipping breakfast and eating your main meal at night may actually be more in-tune with your innate biological clock. I've revised my own eating schedule to eliminate breakfast and restrict the time I eat to a period of about six to seven hours each day, which is typically from noon to 6 or 7 pm.

Diet Is Only One Factor in Getting a Good Night’s Sleep

There are many variables that impact how well you sleep. I suggest you read through my full set of 33 healthy sleep guidelines for all of the details, but to start, making some adjustments to your sleeping area can go a long way to ensure uninterrupted, restful sleep.

1. Cover your windows with blackout shades or drapes to ensure complete darkness. Even the tiniest bit of light in the room can disrupt your pineal gland's production of melatonin and the melatonin precursor serotonin, thereby disrupting your sleep cycle.

So close your bedroom door, get rid of night-lights, and refrain from turning on any light during the night, even when getting up to go to the bathroom. If you have to use a light, install so-called "low blue" light bulbs in your bedroom and bathroom. These emit an amber light that will not suppress melatonin production.

2. Keep the temperature in your bedroom at or below 70 degrees F (21 degrees Celsius). Many people keep their homes and particularly their upstairs bedrooms too warm. Studies show that the optimal room temperature for sleep is quite cool, between 60 to 68 degrees F (15.5 to 20 C). Keeping your room cooler or hotter can lead to restless sleep.
3. Check your bedroom for electro-magnetic fields (EMFs). These can also disrupt your pineal gland's production of melatonin and serotonin, and may have other negative effects as well. To do this, you need a gauss meter. You can find various models online, starting around $50 to $200. Some experts even recommend pulling your circuit breaker before bed to kill all power in your house.
4. Move alarm clocks and other electrical devices away from your head. If these devices must be used, keep them as far away from your bed as possible, preferably at least three feet.
5. Reduce use of light-emitting technology, such as your TV, iPad, and computer, before going to bed. These emit the type of light that will suppress melatonin production, which in turn will hamper your ability to fall asleep, as well as increase your cancer risk (melatonin helps to suppress harmful free radicals in your body and slows the production of estrogen, which can contribute to cancer). Ideally, you'll want to turn all such light-emitting gadgets off at least one hour prior to bedtime.

• Alcoholism Clinical and Experimental Research April 2013; 37(4):539-49.

• Prevent Disease April 18, 2013

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By Dr. Mercola

The incorrect idea that high cholesterol causes heart disease has led to the demonization of entire categories of extremely healthful foods (like eggs and saturated fats), and cholesterol has been falsely blamed for just about every case of heart disease in the last 20 years.

Fat and cholesterol are commonly believed to be the worst foods you can consume. Please understand that these myths are actually harming your health.

Not only is cholesterol most likely not going to destroy your health (as you have been led to believe), but it is also not the cause of heart disease.

Chris Kresser, L.Ac., an acupuncturist and a licensed integrative medicine clinician, has investigated risk factors for heart disease and promotes the use of a relatively novel way of assessing your heart disease risk based on your LDL particle number.

He’s currently writing a book about this topic for the Paleo ancestral health community. His interest grew from losing his grandfather to heart disease several years ago. His grandfather’s case was badly mismanaged, which spurred Kresser to learn more about what really causes heart disease.

A few years later, while in graduate school studying integrative medicine, he did a semester-long research project on the relationship between cholesterol and heart disease.

Since then, he’s read about 750 peer-reviewed studies, consulted with numerous experts in the field, and has challenged everything he thought he knew about the role of cholesterol in heart disease.

Over the last several years, he’s been sharing that information on his blog, in his podcast, and in educational seminars and programs.

The Problem with the Conventional Approach, in a Nutshell

For the past 50 years, you’ve been told that eating saturated fat and high-cholesterol foods will raise cholesterol serum levels. However, research published over the past 10 or 15 years suggests that neither of those statements are true.

Furthermore, the typical cholesterol tests your doctor prescribes, which are supposed to measure your risk for heart disease, don’t actually do a very good job of predicting your risk.

You can have low or normal LDL or total cholesterol and still be at high risk from heart disease. Alternatively, you can have high or normal total or LDL cholesterol yet be at low risk. Subsequently, many are not getting enough treatment, and others are getting too much.

“We’ve learned a lot about what causes heart disease over the past 10 years,” Kresser says. “But unfortunately, that knowledge hasn’t really trickled down into the mainstream yet. So, your average general care physician, primary care nurse, or even science writer that’s writing for the mainstream media is still operating on information from the old paradigm.

The other issue is that the current dietary guidelines that are offered for how to reduce your risk for heart disease are based on this information that’s still 30 to 50 years old. And they’re clearly not working. Cardiovascular disease is still the number one killer. One out of every three deaths is due to this cardiovascular disease, and it affects about 65 million people in the U.S. alone.”

The INTERHEART study, which looked at heart disease risk factors in over 50 countries around the world, found that 90 percent of heart disease cases are completely preventable by modifying diet and lifestyle factors. As Kresser points out, we clearly need a new approach that’s based on more current evidence.

“The problem, of course, that we face is that the old paradigm is so entrenched. The idea that cholesterol and saturated fat are bad for us is so deeply engrained in our society that a lot of us don’t even question that anymore.

One of the main problems there is the massive conflicts of interest in the medical profession. We have a situation where two-thirds of medical research is sponsored by pharmaceutical companies. Eight out of nine of the doctors who are on the National Cholesterol Education program that write the guidelines for cholesterol receive money from pharmaceutical companies,” he says.

Conventional Tests are Not Accurate Predictors of Heart Disease

If you’ve had your cholesterol levels checked, your doctor most likely tested your total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. But we now know those are not accurate predictors for cardiovascular disease risk. According to Kresser, a much more accurate predictor is testing your LDL particle number. He explains:

“To use an analogy: if you imagine your bloodstream’s like a river, the LDL particles are like the boats that carry the cholesterol and fats around your body. The cholesterol and fats are like cargo in the boats. Right now doctors are usually measuring the amount of cargo or cholesterol in the LDL particles. But what we should be measuring is the number of LDL particles, or the number of boats in the river, so to speak, because that’s a much more accurate risk factor for heart disease.”

As mentioned, it’s possible to have normal total or LDL cholesterol yet have a high number of LDL particles. This is completely missed using the conventional testing. On the other hand, you may end up being prescribed a statin drug to lower your cholesterol when in fact your LDL particle number is normal, placing you in the low risk category for heart disease. (As a general rule, regardless of your LDL particle number, chances are you do NOT need a statin drug to address high cholesterol. The only people who may truly benefit from a statin drug are those with the genetic defect called familial hypercholesterolemia.)

How to Test Your LDL Particle Number

Some groups, such as the National Lipid Association, are now starting to shift the focus toward LDL particle number instead of total and LDL cholesterol, but it still has not hit mainstream. Fortunately, if you know about it, you can take control of your health and either ask your doctor for this test, or order it yourself.

There are several ways to test for your LDL particle number. Kresser recommends using the NMR LipoProfile, offered by a lab called Liposcience. The test uses FDA approved technology for testing LDL particle number, and it’s the test used in most of the scientific studies on LDL particles.

“All the different lipoproteins have a unique magnetic signature, and this test uses a nuclear magnetic resonance technique to pick up on that signature. It can correctly identify the number of particles in each case,” he explains.

It’s easy to get and all major labs offer it, including LabCorp and Quest. Most insurance policies cover the test as well. Best of all, even if your doctor were to refuse to order it, you can order it yourself via third-party intermediaries like Direct Labs, or you can order the test online, and get blood drawn locally.

In Europe and other parts of the world, LDL particle number is more commonly measured using an indirect marker, apolipoprotein B (apoB). ApoB is a protein required for the formation of the LDL particle. About 90-95% of apoB particles are LDL particles, which makes apoB a fairly accurate measure of LDL particle number. If you live in a country where the NMR profile is not available, you can use the ApoB test to roughly determine your LDL particle number, and then use triglycerides, HDL, fasting blood sugar, blood pressure and waist-to-hip ratio to determine if you have insulin resistance.

The Devil is in the Details... How Medicine Got the Wrong Idea about Fats

Saturated fat has long been demonized as a heart attack waiting to happen, and many doctors still cling to this outdated view. Ironically, saturated fat is not only healthful fat, it’s one of the most important dietary factors to support health! There’s simply no way to calculate the harm inflicted by the low-fat craze. We now know that if you avoid saturated fats, you’re asking for trouble. Not only is saturated fat the optimal fuel for your brain, it also:

Provides building blocks for cell membranes, hormones, and hormone-like substances	Acts as carriers for important fat-soluble vitamins A, D, E and K	Is required for the conversion of carotene to vitamin A, and for mineral absorption
Acts as antiviral agents (caprylic acid)	Helps lower cholesterol levels (palmitic and stearic acids)	Modulates genetic regulation and helps prevent cancer (butyric acid)

 

The US Department of Agriculture's dietary guidelines¹ advises you to consume less than 10 percent of calories from saturated fats. I and other nutritional experts have warned that most people actually need upwards of 50-70 percent healthful fats, including saturated fat, in their diet for optimal health. How did medicine get this so wrong?

A combination of factors is likely to blame. There were early studies showing that saturated fat raised cholesterol levels in the blood, but they were almost always short-term studies. Since then, much larger observational studies, conducted for extended periods of time have been done, completely refuting earlier short-term results. Later studies have shown absolutely NO relationship between saturated fat intake and blood cholesterol levels.

“We’re talking about some really big, well-known studies that cover tens of thousands of people,” Kresser says. “In fact, there was research published in the American Journal of Clinical Nutrition that covered about 350,000 people in a follow-up period of five to 23 years. And there was no relationship at all between saturated fat intake and heart disease. And then a large Japanese study of about 58,000 people actually found an inverse association between saturated fat intake and strokes. So, in other words, the people who were eating the most saturated fat actually had the lowest levels of stroke.”

Another problem is that early studies did not differentiate between critically important omega-3 and less health-promoting omega-6 fats.

“There’s a study... that went back and looked at some data. Some of the early data suggested that replacing saturated fat with industrial seed oil or polyunsaturated fat would lower cholesterol and lower the risk of heart disease. But what they didn’t realize back in the ‘60s when they were doing those studies [was the difference between omega-3 and omega-6]; they thought all polyunsaturated fats were the same, so they would lump them together in the studies.

Now we understand that omega-6 has very different effects from omega-3. When you study them separately, you see that omega-6 actually doesn’t reduce the risk of heart disease and may increase the risk of heart disease when it’s studied independently of omega-3s.”

Today we have yet another complicating factor when it comes to omega-6 fats and that’s the fact that many of them now come from genetically engineered corn and soy. When you add that into the mix, the health hazards may be worse than we currently imagine.

Which Fats are Healthy?

Sources of healthful fats (and in some cases cholesterol) include:

Olives and Olive oil	Coconuts and coconut oil	Butter made from raw grass-fed organic milk
Raw nuts, such as, almonds or pecans	Organic pastured egg yolks	Avocados
Grass fed meats	Unheated organic nut oil

 

Another healthful fat you want to be mindful of is animal-based omega-3. Deficiency in this essential fat can cause or contribute to very serious health problems, both mental and physical, and may be a significant underlying factor of up to 96,000 premature deaths each year. For more information about omega-3s and the best sources of this fat, please review this previous article.

High Cholesterol is NOT the Cause of Heart Disease

There are two parts to this persistent myths relating to cholesterol and heart disease:

1. The idea that eating cholesterol and saturated fat raises cholesterol levels in your blood, and
2. That high cholesterol in your blood is what drives the risk for heart disease

Some of the healthful fat sources listed above are also sources of dietary cholesterol, such as eggs. Contrary to early studies, which suggested eating cholesterol-rich egg yolks raises your cholesterol levels, we now know that’s actually NOT true.

“'That’s been pretty thoroughly disproven in the scientific literature,' Kresser says. 'You have between 1,100 to 1,700 milligrams of cholesterol in your body at any given time. But only 25 percent of that actually comes from your diet, and 75 percent is internally produced primarily through your liver. Why would that be? Because cholesterol is so important to the proper function of your body that your body tightly regulates its production. If you don’t eat enough cholesterol, your body will make more. It needs more cholesterol, not less.

The other thing that most people don’t know is that only free or unesterified cholesterol can be absorbed from the diet through the intestines. Most foods have esterified cholesterol that can’t actually be absorbed.'

The first thing to understand is you don’t have a cholesterol level in your blood, actually. Cholesterol is fat-soluble, and blood is mostly water. For it to be transported around the blood, cholesterol needs to be carried by a protein, specifically by a lipoprotein. These lipoproteins are classified by density. So, you have very low-density lipoprotein or VLDL, low-density lipoprotein or LDL, and high-density lipoprotein or HDL, which are the main ones.

I mentioned before the analogy that our bloodstream is like a river. Remember that the lipoproteins are like boats that carry the cholesterol and fats around the body. The cholesterol and fats are like cargo in the boats.

So, here’s the really crucial point: up until about 10 or 15 years ago, we thought that it was the concentration of cholesterol in the lipoprotein (or the amount of cargo in the boat) that was driving the risk of heart disease. But recent research indicates that it’s the number of boats or the number of LDL particles that’s really the driving factor.”

So, it’s not the amount of cholesterol that is the main risk factor for heart disease, rather it’s the number of cholesterol-carrying LDL particles. Oxidized LDL can also be a greater risk factor for heart disease. When oxidative stress is high due to poor diet, insufficient exercise and sleep, and chronic stress, or when your antioxidant capacity is low (again usually because of a poor diet), then oxidative damage can occur. Oxidized LDL is more harmful than normal non-oxidized LDL because it’s smaller and denser. This allows it to penetrate the lining of your arteries, where it will stimulate plaque formation associated with heart disease.

“The more LDL particles you have, the more likely you are to have some oxidized LDL, and they can be more atherogenic. However, oxidized LDL loses their predictive value when it’s adjusted for LDL particle number. That suggests that LDL particle number may be an even more important risk factor and may need a high number of LDL particles before oxidation becomes a big problem,” Kresser explains.

What Raises Your LDL Particle Number?

If the primary cause of heart disease is not high cholesterol, then what is? Part of the reason why statins are ineffective for heart disease prevention (besides the fact that the drug causes heart disease as a side effect) is that drugs cannot address the real cause of heart disease, which is insulin and leptin resistance, which in turn increase LDL particle number via a couple of different mechanisms. While some genetic predisposition can play a role, insulin and leptin resistance is primarily caused by a combination of factors that are epidemic in our modern lifestyle:

• A diet high in processed and refined carbohydrates, sugars/fructose, refined flours, and industrial seed oils
• Insufficient everyday physical activity. Leading a sedentary lifestyle causes biochemical changes that predispose you to insulin and leptin resistance
• Chronic sleep deprivation. Studies have shown that even one night of disturbed sleep can decrease your insulin sensitivity the next day and cause cravings and overeating
• Environmental toxins. Exposure to BPA, for example, can disrupt your brain’s regulation of weight
• Poor gut health. Studies indicate that imbalances in your gut flora (the bacteria that live in our gut) can predispose you to obesity and insulin and leptin resistance. According to Kresser, gut inflammation can even affect your cholesterol more directly.

“There are some studies that show that lipopolysaccharide, which is an endotoxin that can be found in some types of bacteria in the gut… If the intestinal barrier is permeable, which shouldn’t be, of course, some of that lipopolysaccharide can get into your bloodstream. LDL particles actually have an antimicrobial effect. So, LDL particles will increase if there is some endotoxin going into the bloodstream... causing a direct increase of LDL particles.”

The culmination of the synergistic effect of these factors will put pressure on your liver to increase production of lipoproteins, more specifically: low-density lipoproteins (LDL), (i.e. more “boats in the river”), which increases your heart disease risk.

Another way leptin resistance contributes to increased LDL particle number, and hence increased heart disease risk, is as follows: When a cell signals that more cholesterol is needed for the cell to perform its function, LDL receptor activity increases. The LDL receptor sits on the outside of cells, and its job is to act as a docking station for the LDL particles floating around in your blood. Once “docked” into the LDL receptor, the LDL particle can deliver the nutrients it carries into the cell.

However, if you’re leptin resistant, the LDL receptor doesn’t get the message. It’s not sensitive enough to hear the signal. And without LDL receptor activity, the LDL particles floating around are never encouraged to “dock” into the receptor, and this too directly increases LDL particle numbers.

Besides insulin and leptin resistance, another common cause of elevated LDL particle number is poor thyroid function. T3 hormone (which is the most active form of thyroid hormone) is required to activate the LDL receptor, which is what takes LDL out of the circulation. If you have poor thyroid function or low T3 levels, then your LDL receptor activity will be poor, and you’ll have a higher number of LDL particles. The good news is, if this is the cause for your elevated LDL particle number, then addressing your thyroid problem will reduce it.

How Intermittent Fasting Can Help You Address High Cholesterol

I’m particularly fond of coconut oil because I believe it’s a useful therapeutic agent to help you implement intermittent fasting, which is perhaps one of the most valuable stealth strategies to get healthy—largely because it can radically improve your insulin and leptin resistance. In that respect, intermittent fasting is also a powerful way to address cholesterol and LDL particle number. Kresser explains:

“Insulin resistance and leptin resistance are widespread problems... and that’s one of the main driving forces in elevated LDL particle number. The reason for that is that LDL particles carry not only cholesterol, but also triglycerides, fat-soluble vitamins, and antioxidants... If you have high triglycerides, which you often will when you have insulin or leptin resistance, then that means a given LDL particle can carry less cholesterol, because it’s stuffed full of triglycerides. Your liver will then have to make more LDL particles to carry that same given amount of cholesterol around the tissues and cells in your body.

...Intermittent fasting is one of many ways to improve insulin sensitivity and leptin sensitivity, because there are certain processes in the body that engage after you haven’t eaten for a period of time. They’re all evolutionary mechanisms that are designed to help us survive in periods of food scarcity. You have an upregulation in metabolism basically, and... your insulin and leptin sensitivity improves.

It’s a really good way for people to lose weight, which again will improve insulin and leptin sensitivity, because obesity is both a cause and an effect of leptin resistance. I think it’s a really great strategy for most people; I do use it in my practice a lot.

The only kind of caution might be in people who have pretty severe fatigue, or are suffering from some kind of chronic illness, and need to eat more often. But for most people, I think it’s great.”

Coconut oil is most beneficial during the transition period from burning sugar to burning fat, as it will not upset insulin and leptin resistance. It’s neutral, yet it is rapidly metabolized and provides a good source of energy. Fatigue can be a real challenge, so if you want to try intermittent fasting but worry about flagging energy levels, coconut oil can be a useful tool. You can even have some coconut oil during your fasting period as it will not interrupt the beneficial processes that are happening while you’re fasting. It’s mainly protein and carbohydrate that will interrupt those processes. So having a little coconut oil in the morning might help you make it through until you break your fast for your first meal. Kresser recommends putting it in a smoothie, or even adding it to your tea or black coffee, if the idea of eating the coconut oil by itself is too unappealing.

Tying It All Together

Remember, the most important test you can get to determine your heart disease risk is the NMR lipoprofile, which measures your LDL particle number. This test also has other markers that can help determine if you insulin resistance, making it doubly useful. If you have insulin or leptin resistance, you’ll have an increase in LDL particle number and specifically the number of small LDL particles. The NMR lipoprofile measures that too, and gives you an objective score called the lipoprotein insulin resistance score or LP–IR. If your LP–IR is above the recommended reference range, chances are that you have leptin and insulin resistance.

Insurance usually covers the test, but if you order it yourself from Direct Labs or Access Labs, it costs about $100. If your LDL particle number is high, Kresser recommends searching for the cause. Again, two of the major ones are insulin and leptin resistance, which the NMR test will alert you to. The third common cause is poor thyroid function. Chronic infections could also be a factor.

Once you’ve determined the cause, you need to address those. Remember, statin drugs CANNOT address insulin or leptin resistance, and they do NOT affect particle size or particle number. They ONLY suppress cholesterol production in your liver, which can make your situation worse. Kresser advises paying careful attention to the following seven factors when addressing insulin and leptin resistance:

1. Diet: shifting toward the nutrient-dense-food-based diet with higher fat and lower carbohydrate intake
2. Intermittent fasting may be useful
3. Make sure you’re getting enough sleep
4. Exercise regularly, and make sure to incorporate high intensity interval exercises, as they are particularly effective for improving insulin and leptin sensitivity
5. Avoid sitting too much, as that can have a direct adverse effect on insulin and leptin sensitivity
6. Minimize your exposure to environmental toxins as much as possible
7. Optimize your gut health by eating fermented foods, soluble fiber that enriches the beneficial gut flora, and avoiding food toxins and things that harm your gut flora

As you can see, the things you need to do to treat your high LDL particle number are identical to what you would do to promote optimal health in general.

“To me, that just makes sense. The things that keep us healthy in one department or one area are more likely to make us healthy in another. And this is no different from that,” Kresser says.

For more information, see Kresser’s website: ChrisKresser.com. He also has an Internet radio show called Revolution Health Radio, available on his site and on iTunes, where he discusses these topics on a regular basis. His web site also offers educational programs, including a nine-week long self-guided multimedia course called The High Cholesterol Action Plan, which goes into a whole lot more detail on the subject.

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By Dr. Mercola

Nearly 100 trillion bacteria, fungi, viruses and other microorganisms compose your body’s microflora, and it’s becoming increasingly clear that these tiny organisms play a major role in your health.

Gut microbes are particularly prominent in the news lately, and one of the most talked-about studies suggests bacteria in your gut may play a role in your risk of heart disease through a surprising mechanism: the breakdown of a widely consumed compound in protein known as L-carnitine.

As a result, the media has mounted a virtual campaign warning that red meat eaters may be at higher risk of heart disease. But does the research really back up that claim? Some nutritional experts disagree, pointing out the many weaknesses in the study, and why giving up meat to prevent heart disease may be premature, if not downright wrong.

This 6 person study may be one of the worst and most publicized since last year's media attack stating eggs were as bad for you as smoking.

Microflora Composition--A New Explanation for the Link Between Red Meat and Heart Disease?

It’s widely stated that eating red meat causes heart disease, an association that is often blamed (incorrectly) on its impact on cholesterol levels. Yet, research has repeatedly shown that the dietary cholesterol-heart disease connection is incorrect.

So while the featured study may offer intriguing clues to the importance of gut bacteria, and how gut bacteria is influenced by your diet, it’s doubtful that this latest hypothesis linking heart disease to red meat consumption via another pathway is entirely correct.

For example, a 2010 study from Harvard found no evidence that eating red meats leads to heart disease.¹

That said, the featured study published in Nature Medicine² claims to shed some light on why some people who eat red meat develop heart disease while others do not – and the reason may come down to differences in gut bacteria.

The study,³ by researchers from the Cleveland Clinic, found that human gut bacteria can metabolize L-carnitine, a substance found in red meat, energy drinks and dietary supplements, and in so doing produce a byproduct called trimethylamine-N-oxide (TMAO). TMAO is thought to encourage fatty plaque deposits to form within arteries (atherosclerosis), and therefore, the more TMAO you have in your blood the greater your risk of heart disease might be.

Interestingly, people with diets high in L-carnitine, i.e. meat eaters, had a gut microbe composition that was more prone to forming TMAO, while vegetarians and vegans did not. Even after consuming large amounts of L-carnitine in a steak or supplement, the vegetarians and vegans in the study did not produce significant amounts of TMAO.

This, the authors believe, means that eating red meat alters your gut flora in a way that predisposes your body toward TMAO production, and subsequently, heart disease. This was confirmed by giving the omnivores a course of antibiotics, after which they did not produce TMAO. Stanley Hazen, MD, PhD, the study’s lead author, said in a statement:⁴

“The bacteria living in our digestive tracts are dictated by our long-term dietary patterns… A diet high in carnitine actually shifts our gut microbe composition to those that like carnitine, making meat eaters even more susceptible to forming TMAO and its artery-clogging effects.”

Is Red Meat Being Inaccurately Singled Out as a Heart Disease Promoter?

The latest study is not the first to link gut bacteria to heart disease. In 2011, the same researchers, Hazen and colleagues, used data from nearly 2,000 people and showed that when the bacteria in your gut break down lecithin, a type of fat found in meat, eggs, dairy and other animal foods along with baked goods and dietary supplements, and its metabolite choline, it also leads to the creation of TMAO and, subsequently, increases your risk of heart disease.⁵

In response to this and the current study, many have wondered whether red meat and other animal foods, along with supplements containing L-carnitine, lecithin or choline should be avoided. Chris Masterjohn PhD, who is currently researching fat-soluble supplements at the University of Illinois, rebutted the 2011 findings stating:⁶

“...previous studies have shown that supplements with salts of free choline do in fact generate TMAO, but uncontaminated phosphatidylcholine, the main form of choline found in food, does not. Moreover, choline-rich foods like liver and eggs did not produce more TMAO than a control breakfast, but seafood, which is generally contaminated with some trimethylamine or TMAO, did.”

Masterjohn also disagrees with the group’s latest findings, in which the researchers claim that carnitine in red meat contributes to heart disease via the same pathway, i.e. the creation of TMAO. According to Masterjohn, incomplete reporting of data in the paper combined with “wild runaway inferences” by the press has generated a grossly misleading picture of red meat’s impact on heart disease, while simultaneously ignoring the food group that actually generates the most TMAO.

He points out that red meat is only one of many foods that increases TMAO when eaten, and cites data from a 1999 study that evaluated TMAO excretion following consumption of 46 different foods, which shows that red meat generated no more TMAO than fruits and vegetables. In fact, some veggies, such as peas, cauliflower and carrots generated more TMAO than beef did! Still, none of the foods generated TMAO at levels that were statistically different from the control. (Similarly, there was no statistically significant difference between different kinds of meats, compared to the control.)

Previous Research Shows Seafood Produces More TMAO than Any Other Food, Including Beef

The 1999 study did show however, one food group that stood out as a major source of TMAO, and that was seafood. Virtually all fish and invertebrates, with few exceptions (including trout and cockles) produced statistically significant more TMAO than the “light breakfast” control alone. And, according to Masterjohn’s own statistical test, all invertebrates except clams and cockles, and all fish except tuna, trout, plaice, and roe produced significantly more TMAO than beef. He writes:

“The single 'representative female omnivore' from the [2013] Nature Medicine⁷ paper excreted similar amounts of TMAO in her urine as the six subjects from the 1999 study after consuming red meat, suggesting that, had they measured the response to seafood, the authors of the Nature Medicine paper would also have found much greater excretion of TMAO after consumption of seafood than after consumption of red meat.

The difference between seafoods and red meat in the 1999 paper is like the difference between night and day. To take the most extreme example, halibut generated over 107 times as much TMAO as red meat. It seems obvious from this study that if any foods should be singled out for the production of TMAO, it should be seafoods. Yet the Nature Medicine paper makes no mention of fish and the New York Times⁸ article only mentions fish to point out that it has less carnitine than red meat (and thus, by inference, will generate less TMAO, though that is clearly not the case, presumably because seafood tends to be contaminated with trimethylamine or TMAO itself...)

If we are to single out red meat as a source of TMAO, we should be able to identify other foods with which it should be replaced that generate less TMAO. Yet this 1999 study, which had a small sample size but tested an expansive number of foods, found that there basically are no other foods that generate meaningfully less TMAO than red meat.”

Axing Beef to Prevent Heart Disease Looks Like Another Red Herring...

Chris Kresser L.Ac has also weighed in on this issue,⁹ comparing the hypothesis that red meat causes heart disease via TMAO to the patently false notion that dietary cholesterol and saturated fat cause heart disease by raising serum cholesterol. Kresser lists three reasons for not taking the featured study at face value:

1. Inconsistent epidemiological evidence
2. “Healthy user” bias, and
3. Inconclusive and insufficient evidence on the role of TMAO in heart disease

“...even if Paleo meat eaters have higher TMAO levels than vegans and vegetarians, we still don’t have evidence proving a causal relationship between TMAO and cardiovascular disease,” he writes. “Once again, the supposed link between cholesterol and saturated fat and heart disease should serve as a reminder not to jump to hasty conclusions that unnecessarily deprive people of nutrient-dense, healthy foods. It is virtually impossible to control for all of the possible confounding factors.”

Should You Avoid L-Carnitine and Choline-Rich Foods and Supplements?

Masterjohn offers an in-depth critique of the featured study’s data in his recent Weston A. Price article,¹⁰ so for more information I recommend reading it in its entirety. For example, he points out that the study does not include any data for eating steak alone (the steak was consumed with a carnitine supplement); the data also does not indicate if TMAO differences are due to a single outlier or a fundamental gender difference, or if the antibiotic treatment is a confounding factor as none of the vegans were given antibiotics. According to Masterjohn:

“There is no data in this paper showing that TMAO increases in response to steak alone in anyone.”

At this time, more investigation is still needed to support the assumption that red meat and other animal foods, along with supplements containing L-carnitine, lecithin or choline should be avoided. What’s more, these substances occur naturally in a wide range of foods, making it nearly impossible, and likely inadvisable, to avoid them entirely.

In terms of L-carnitine, an omnivorous diet provides 20 to 200 mg/day, compared to a strict vegetarian diet, which would add about 1 mg/day.¹¹ But even non-dairy infant formulas are sometimes fortified with L-carnitine, and the substance is also found in seafood, chicken breast, avocado and cheese (although in far lower amounts than are found in red meats, especially beef). It’s also important to realize that both L-carnitine and choline are essential nutrients your body needs. Choline, for instance, is linked to beneficial epigenetic changes in fetuses that likely last into adulthood, while L-carnitine has been shown to improve insulin sensitivity in type 2 diabetes.

Masterjohn also points out that while there were significant differences in the intestinal bacterial strains between omnivores and vegans, which might account for why TMAO levels were 45 percent higher in the meat eaters, intestinal flora may not be the sole answer. He writes:

“While it is possible that intestinal flora accounts for the difference, it is disappointing that the authors did not consider other possibilities, such as differences in the activity of the enzyme that converts trimethylamine to TMAO. For example, vitamin B2 is the main cofactor for the enzyme, and vegans are three times as likely to be deficient in vitamin B2 as vegetarians and omnivores.

...While antibiotics wipe out TMAO levels in humans and mice, showing that intestinal bacteria are necessary for its formation, the authors provide no clear evidence that the specific differences in intestinal bacteria between vegetarians and vegans on the one hand and meat-eaters on the other cause the observed difference in TMAO levels. It is unclear whether the 45 percent higher TMAO levels in meat-eaters represents something that we should regard as 'unhealthy.' As I pointed out above, for all we know it could be due to riboflavin (vitamin B2) deficiency among the vegans.”

The Link Between Whole Grains and Gut Bacteria that Drive TMAO Production

Jeff Leach with the Human Food Project has also weighed in on the featured study. His article is well worth reading in its entirety as well. He expounds on many of the same issues as Masterjohn and Kresser, but also focuses much of his discussion on the role of gut bacteria in the conversion of carnitine to TMAO. He writes, in part:¹²

“If we assume for the moment that TMAO can accelerate atherosclerosis, then the observation that enriched levels of Prevotella are associated with higher levels in of TMAO become more interesting – especially as enrichment of this group of bacteria seems to occur in vegans and vegetarians as well as omnivores. So what causes enrichment of Prevotella?

In a paper published in 2010, Italian researchers found that rural African kids in Burkina Faso had super high levels of Prevotella, while a similar aged group of kids in suburban Italy had none.The striking dietary difference between the kids in Burkina Faso and the Italian kids was whole grain consumption... whole grains made up >50% of the daily calories in this [African] village... In contrast, the Italian kids got ~25% of their daily calories from highly processed bread, biscuits, pasta, and rice... All in all, a much more diverse diet, though apparently devoid of whole grains but high in processed foods. As mentioned, the Italian kids had no traceable amounts of Prevotella in their stool samples...

In the Burkina Faso paper, the researchers attributed the high levels of Prevotella to grain-based carbohydrates... it doesn’t appear that dietary fiber in general is driving enrichment of Prevotella... So, it appears somehow specific to the starch in grains or the dietary fiber in grains.”

The Bottom Line...

According to Masterjohn, to interpret the featured study “as an indictment of red meat makes no sense.”

“Even if physiological levels of TMAO contribute to heart disease in humans (which is a big 'if' at this point) and even if red meat were to raise TMAO substantially more than most other foods (which appears to be false), it wouldn’t in any way whatsoever follow that eating red meat causes heart disease. The biological effects of a food cannot possibly be reduced to one of the biological effects of one of the food’s components. Believing such a thing would require believing not only that the particular component has no other relevant biological effects, but that there are no relevant biological effects of any of the other tens of thousands of components of that food

...If the carnitine in red meat were promoting atherosclerosis through its conversion to TMAO, however, then red meat should be no more dangerous than potatoes and carrots and the real killer should be seafood. How likely is this to be true?”

Indeed... Countless studies have shown the health benefits associated with a seafood-rich diet, including its value for prevention of heart disease. Personally, I believe the best option is not to avoid these potentially beneficial substances in your diet but to optimize your gut bacteria so it favors health-promoting, rather than disease-causing, processes.

Testing Your Breath May Reveal Gut Bacteria Linked to Obesity

Another area where gut bacteria are making headlines is related to your weight. One study last month revealed that as much as 20 percent of the substantial weight loss achieved from gastric bypass, a popular weight loss surgery, is actually due to shifts in the balance of bacteria in your digestive tract.¹³

Separate research has also revealed that a breath test of the gases given off by your gut bacteria may help predict your likelihood of becoming obese. The study found that people with high levels of hydrogen and methane in their breath are more likely to have a higher body-mass index (BMI) and proportion of body fat.¹⁴ This, the researchers believe, may be because the related gut bacteria influence your body’s ability to extract calories from food, leading to weight gain.

Previous research has also shown that lean people tend to have higher amounts of various healthy bacteria compared to obese people. For example, one 2011 study found that daily intake of a specific form of lactic acid bacteria could help prevent obesity and reduce low-level inflammation.¹⁵ Taken together, the research adds to the growing knowledge that nurturing the growth of beneficial bacteria in your gut is likely to have significant benefits to your health and may be essential for:

• Protection against over-growth of other microorganisms that could cause disease
• Digestion of food and absorption of nutrients and certain carbohydrates
• Producing vitamins, absorbing minerals and eliminating toxins
• Preventing allergies
• Maintaining natural defenses

Numerous studies have also shown that your gut flora plays a role in:

• Mood, psychological health, and behavior
• Celiac disease
• Diabetes
• Weight gain and obesity
• Metabolic syndrome

Your Gut Flora is Constantly Under Attack

Your gut bacteria are vulnerable to your diet and lifestyle. If you eat a lot of sugar, refined grains, GMOs and processed foods, for instance, your gut bacteria are going to be compromised because processed foods in general will destroy healthy microflora and feed bad bacteria and yeast. Your gut bacteria are also very sensitive to:

• Antibiotics
• Chlorinated water
• Antibacterial soap
• Agricultural chemicals
• Pollution

Because of this, you need to avoid processed, refined foods in your diet (this is essential for heart disease prevention, too) and regularly reseed your gut with good bacteria by taking a high-quality probiotic supplement or eating non-pasteurized, traditionally fermented foods such as:

• Fermented vegetables
• Lassi (an Indian yoghurt drink, traditionally enjoyed before dinner)
• Fermented milk, such as kefir
• Natto (fermented soy)

One of the reasons why fermented foods are so beneficial is because they contain lactic acid bacteria as well as a wide variety of other beneficial bacteria. Also, if fermented with a probiotics starter culture, the amount of healthy bacteria in a serving of fermented vegetables can far exceed the amount you’ll find in commercial probiotics supplements, making it a very cost effective alternative. Ideally, you want to eat a variety of fermented foods to maximize the types of bacteria you’re consuming.

Nurturing Your Gut Flora is One of the Foundations of Optimal Health

Mounting research indicates the bacterial colonies residing in your gut may play key roles in the development of cancer, asthma, allergies, obesity, diabetes, autoimmune diseases and even brain, behavioral and emotional problems like ADHD, autism and depression. The heart disease connection is also now emerging, as discussed, although I’d hesitate to draw any conclusions from it as of yet.

Overall, I believe it would be unwise to try to eliminate foods just because they’re known to raise TMAO, as they’re all healthy and appear to include everything from meats to vegetables and seafood It’s far more likely that maintaining a healthy gut flora is paramount to prevent heart disease, and if you’re going to eliminate a food to protect your beneficial gut bacteria, it would be processed foods, not fresh whole foods of any kind.

Another confounding factor not addressed is the fact that meat from confined animal feeding operations (CAFO’s) are a source of hidden antibiotics, which wreak havoc on your gut bacteria. So that too may have played a role. This is reason alone to make sure you only buy organically raised grass-fed meats, as they’re not allowed to use antibiotics as growth promoters.

Previous research has shown that around age 60, there is a significant drop in the number of bacteria in your gut. According to Dr. Sandra McFarlane from the microbiology and gut biology group at the University of Dundee, people over 60 typically have about 1,000-fold less "friendly" bacteria in their guts compared to younger adults, and increased levels of disease-causing microbes.¹⁶ What this means is that it’s incredibly important to actively nurture your gut flora health, especially as you get older.

Eating fermented foods should be your primary strategy, but if you don't enjoy the taste of fermented foods, taking a probiotic supplement is definitely advised. However, before you give up on fermented foods, it is best to start with small amounts like half a teaspoon and use them as a condiment integrated with your food, similar to a salad dressing. If you still don't want to eat them, then it is important to note that while I do not generally advocate taking a lot of supplements, a high-quality probiotic is an exception. I recommend looking for a probiotic supplement that fulfills the following criteria, to ensure quality and efficacy:

• The bacteria strains in the product must be able to survive your stomach acid and bile, so that they reach your intestines alive in adequate numbers
• The bacteria strains must have health-promoting features
• The probiotic activity must be guaranteed throughout the entire production process, storage period and shelf life of the product

Through my years of clinical practice, I've found that no single probiotic supplement works for everyone. However, more people seem to respond favorably to Lactobacillus sporogenes than any other probiotic, so when in doubt, that's a great place to start.

• Nature Medicine April 7, 2013

• Forbes April 8, 2013

• Medical News Today March 28, 2013

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By Dr. Mercola

One in four Americans over the age of 45 now takes cholesterol-lowering drugs known as statins, typically for the primary prevention of heart attacks and strokes.

Not only is their benefit for preventing heart disease highly questionable, but these drugs come with an avalanche of potential side effects, so much so that new research showed a staggering number of patients stop taking them entirely.

Half of Those Taking Statins Quit

A recent study of more than 100,000 people who’d been prescribed statins from 2000 to 2008 found that 17 percent of patients reported side effects such as muscle pain, nausea, and liver and nervous system problems.¹

Two-thirds of those who reported side effects quit taking the drugs, and, the study found, half of those prescribed statins quit taking them at least temporarily, while 20 percent quit for more than a year.

The researchers noted that many of the side effects are “tolerable” or specific to only one statin, not the entire class, suggesting that people can remain on the drugs or switch to a different statin if problems arise. But the truth is that many statin side effects are quite serious.

Oftentimes statins do not have any immediate side effects, and they are quite effective at lowering cholesterol levels by 50 points or more (which may not actually have any impact on your heart disease risk). This makes it appear as though they're benefiting your health, and health problems that develop later on are frequently misinterpreted as new and unrelated health problems.

Diabetes, Fatal Kidney Damage and Other Possible Statin Side Effects

With well over 30 million Americans now taking statin drugs, we're witnessing a massive ongoing 'live' experiment, and many are putting their health on the line for drugs that offer little in the way of heart protection. Just last year, the US Food and Drug Administration (FDA) announced it would be requiring additional warning labels for statin drugs. Among them are warnings that statins may increase your risk of:

• Liver damage
• Memory loss and confusion
• Type 2 diabetes
• Muscle weakness (for certain statins)

Statins have also been shown to increase your risk of diabetes via a number of different mechanisms. The most important one is that they increase insulin resistance, which can be extremely harmful to your health.

Increased insulin resistance contributes to chronic inflammation in your body, and inflammation is the hallmark of most diseases, including heart disease, which, ironically, is the primary reason for taking a cholesterol-reducing drug in the first place. It can also promote belly fat, high blood pressure, heart attacks, chronic fatigue, thyroid disruption, and diseases like Parkinson's, Alzheimer's and cancer.

Earlier this year new research also found that taking higher doses of the statins simvastatin (Zocor), atorvastatin (Lipitor) or rosuvastatin (Crestor) increases your risk of acute kidney injury by 34 percent, a condition that can be fatal.² Some experts are now urging that people on statins have an assessment of their kidney risks, similar to what used to be recommended regarding liver function.

Due to statins' potential to increase liver enzymes and cause liver damage, it used to be recommended that patients be monitored for normal liver function.

The FDA removed this long-standing warning in 2012 and ruled that patients taking statins no longer need routine monitoring of liver enzymes, but instead can have liver enzymes tested before starting the drugs, and then only as clinically needed, which seems reprehensibly irresponsible. In all, statin drugs have been directly linked to over 300 side effects,³ which include:

Cognitive loss	Neuropathy	Anemia
Acidosis	Frequent fevers	Cataracts
Sexual dysfunction	An increase in cancer risk	Pancreatic dysfunction
Immune system suppression	Muscle problems, polyneuropathy (nerve damage in the hands and feet), and rhabdomyolysis, a serious degenerative muscle tissue condition	Hepatic dysfunction. (Due to the potential increase in liver enzymes, patients must be monitored for normal liver function)

Statins Might Make Your Heart Health Worse

The biggest “sham” of all is that statin drugs, which millions are taking as a form of “preventive medicine” to protect their heart health, can have detrimental effects on your heart. Take a study in the journal Atherosclerosis,⁴ which showed that statin use is associated with a 52 percent increased prevalence and extent of calcified coronary plaque compared to non-users. Coronary artery calcification is the hallmark of potentially lethal heart disease!

One of the primary mechanisms of harm appears to be CoQ10 depletion. If you take statin drugs without supplementing with CoQ10 (or ideally, the reduced form, called ubiquinol, which is far more effective), your health is at serious risk. CoQ10 is used by every cell in your body, but especially your heart cells. Cardiac muscle cells have up to 200 times more mitochondria, and hence 200 times higher CoQ10 requirements, than skeletal muscle.

Premature aging is yet another side effect of statin drugs, and it's also a primary side effect of having too little CoQ10. Deficiency in this nutrient also accelerates DNA damage, and because CoQ10 is beneficial to heart health and muscle function this depletion leads to fatigue, muscle weakness, soreness and heart failure.

Measure Your LDL Particle Number, Not Total Cholesterol, to Gauge Heart Disease Risk

Could it be that all of this focus on lowering cholesterol levels has missed the boat entirely? Certainly, because cholesterol is NOT the cause of heart disease. Your body NEEDS cholesterol -- it is important in the production of cell membranes, hormones, vitamin D and bile acids that help you to digest fat. Cholesterol also helps your brain form memories and is vital to your neurological function.

If your physician is urging you to check your total cholesterol, know that this test will tell you virtually nothing about your risk of heart disease, unless it is 330 or higher. One of the most important tests you can get to determine your real heart disease risk is the NMR LipoProfile, which measures your LDL particle number. This test also has other markers that can help determine if you have insulin resistance, which is a primary cause of elevated LDL particle number and increased heart disease risk.

The NMR LipoProfile test easy to get and all major labs offer it, including LabCorp and Quest. Most insurance policies cover the test as well. Best of all, even if your doctor were to refuse to order it, you can order it yourself via third-party intermediaries like Direct Labs, or you can order the test online, and get blood drawn locally. Two other ratios you should pay attention to:

1. HDL/Total Cholesterol Ratio: Should ideally be above 24 percent. If below 10 percent, you have a significantly elevated risk for heart disease.
2. Triglyceride/HDL Ratio: Should be below 2.

Four Additional Risk Factors for Heart Disease

You’ll notice that none of these involve your cholesterol levels …

1. Your fasting insulin level: Any meal or snack high in carbohydrates like fructose and refined grains generates a rapid rise in blood glucose and then insulin to compensate for the rise in blood sugar. The insulin released from eating too many carbs promotes fat and makes it more difficult for your body to shed excess weight, and excess fat, particularly around your belly, this is one of the major contributors to heart disease.

Your fasting insulin level can be determined by a simple, inexpensive blood test. A normal fasting blood insulin level is below 5, but ideally you'll want it below 3. If your insulin level is higher than 3 to 5, the most effective way to optimize it is to reduce or eliminate all forms of dietary sugar, particularly fructose, from your diet.

2. Your fasting blood sugar level: Studies have shown that people with a fasting blood sugar level of 100-125 mg/dl had a nearly 300 percent higher risk of having coronary heart disease than people with a level below 79 mg/dl.
3. Your waist circumference: Visceral fat, the type of fat that collects around your internal organs, is a well-recognized risk factor for heart disease. The simplest way to evaluate your risk here is by simply measuring your waist circumference. For further instructions, please see my previous article, Your Waist Size Can Be a Powerful Predictor of Hypertension and Other Chronic Diseases.
4. Your iron level: Iron can be a very potent cause of oxidative stress, so if you have excess iron levels you can damage your blood vessels and increase your risk of heart disease. Ideally, you should monitor your ferritin levels and make sure they are not much above 80 ng/ml. The simplest way to lower them if they are elevated is to donate your blood. If that is not possible you can have a therapeutic phlebotomy and that will effectively eliminate the excess iron from your body.

Diet Can Reduce Your Risk of Heart Attacks Better Than Statins

According to Dr. Barbara Roberts, author of The Truth About Statins, studies haven’t shown that statins are beneficial for women who do not have heart disease, even if they have risk factors like obesity or family history.⁵ Yet, a recent study found heart attacks were reduced by 30 percent among people eating a Mediterranean diet!⁶

The healthy eating proved to be just as beneficial, if not more so, than statin drugs claim to be. While I don’t recommend a Mediterranean diet, per se, a healthy diet, like the one described in my nutrition plan, is the cornerstone of any heart-protection “plan.” If you want to protect your heart health, I recommend reducing, with the plan of eliminating, grains and sugars (including fructose) in your diet, replacing them with mostly whole, fresh vegetable carbs and healthy fats. Also try to consume a good portion of your food raw. Examples of healthy fats include:

Olives and olive oil	Coconut and coconut oil	Organic raw dairy products	Avocados
Raw organic nuts	Seeds	Pastured eggs (raw, or lightly cooked with yolks intact)	Organic, grass-fed meats

 

To round out your heart-disease prevention program:

• Make sure you are getting enough high-quality, animal-based omega 3 fats, such as krill oil.
• Optimize your vitamin D levels, ideally through appropriate sun exposure as this will allow your body to also create vitamin D sulfate, which may play a crucial role in preventing the formation of arterial plaque
• Exercise daily, especially with Peak Fitness exercises
• Avoid smoking or drinking alcohol excessively
• Be sure to get plenty of good, restorative sleep

Are You Taking a Statin Drug for No Reason?

That these drugs have proliferated the market the way they have is a testimony to the effectiveness of direct-to-consumer marketing, corruption and corporate greed, because the odds are very high — greater than 1000 to 1 — that if you're taking a statin, you don't really need it.

From my review, the ONLY subgroup that might benefit are those born with a genetic defect called familial hypercholesterolemia, as this makes them resistant to traditional measures of normalizing cholesterol.

If you’re currently taking a statin drug and are worried about the excessive side effects they cause, please consult with a knowledgeable health care practitioner who can help you to optimize your heart health naturally, without the use of these dangerous drugs.

• Annals of Internal Medicine April 2, 2013; 158(7):526-534

• BMJ March 19, 2013

• NPR April 3, 2013

• WBAY March 21, 2013

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