Subject: The Great Cholesterol Lie

Summary: Without inflammation, cholesterol would not accumulate in wall of blood vessel and cause heart disease

A Heart Surgeon Admits Huge Mistake!

By Dwight Lundell, MD

Part 1 of a 2-part article (see part 2 below)

We physicians with all our training, knowledge and authority often acquire a rather large ego that tends to make it difficult to admit we are wrong. So, here it is. I freely admit to being wrong.. As a heart surgeon with 25 years experience, having performed over 5,000 open-heart surgeries, today is my day to right the wrong with medical and scientific fact.

I trained for many years with other prominent physicians labeled “opinion makers.” Bombarded with scientific literature, continually attending education seminars, we opinion makers insisted heart disease resulted from the simple fact of elevated blood cholesterol.

The only accepted therapy was prescribing medications to lower cholesterol and a diet that severely restricted fat intake. The latter of course we insisted would lower cholesterol and heart disease. Deviations from these recommendations were considered heresy and could quite possibly result in malpractice.

It Is Not Working!

These recommendations are no longer scientifically or morally defensible. The discovery a few years ago that inflammation in the artery wall is the real cause of heart disease is slowly leading to a paradigm shift in how heart disease and other chronic ailments will be treated.

The long-established dietary recommendations have created epidemics of obesity and diabetes, the consequences of which dwarf any historical plague in terms of mortality, human suffering and dire economic consequences.

Despite the fact that 25% of the population takes expensive statins
medications and despite the fact we have reduced the fat content of our diets, more Americans will die this year of heart disease than ever before.

Statistics from the American Heart Association show that 75 million Americans currently suffer from heart disease, 20 million have diabetes and 57 million have pre-diabetes. These disorders are affecting younger and younger people in greater numbers every year.

Simply stated, without inflammation being present in the body, there is no way that cholesterol would accumulate in the wall of the blood vessel and cause heart disease and strokes. Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped.

Inflammation is not complicated -- it is quite simply your body's natural defense to a foreign invader such as a bacteria, toxin or virus. The cycle of inflammation is perfect in how it protects your body from these bacterial and viral invaders. However, if we chronically expose the body to injury by toxins or foods the human body was never designed to process, a condition occurs called chronic inflammation. Chronic inflammation is just as harmful as acute inflammation is beneficial.

What thoughtful person would willfully expose himself repeatedly to foods or other substances that are known to cause injury to the body? Well, smokers perhaps, but at least they made that choice willfully.

The rest of us have simply followed the recommended mainstream diet that is low in fat and high in polyunsaturated fats and carbohydrates, not knowing we were causing repeated injury to our blood vessels. This repeated injury creates chronic inflammation leading to heart disease, stroke, diabetes and obesity. Let me repeat that. The injury and inflammation in our blood vessels is caused by the low fat diet that has been recommended for years by mainstream medicine.

What are the biggest culprits of chronic inflammation? Quite simply, they are the overload of simple, highly processed carbohydrates (sugar, flour and all the products made from them) and the excess consumption of omega-6 vegetable oils like soybean, corn and sunflower that are found in many processed foods.

In Part 2 of this two-part article, I'll discuss which foods cause inflammation, how those foods trigger the inflammatory process, and the foods to eat that will cure inflammation.

Part 2

By Dwight Lundell MD 02/06/2009

Take a moment to visualize rubbing a stiff brush repeatedly over soft skin until it becomes quite red and nearly bleeding. Let’s say you kept this up several times a day, every day for five years. If you could tolerate this painful brushing, you would have a bleeding, swollen infected area that became worse with each repeated injury. This is a good way to visualize the inflammatory process that could be going on in your body right now.

Regardless of where the inflammatory process occurs, externally or internally, it is the same. I have peered inside thousands upon thousands of arteries. A diseased artery looks as if someone took a brush and scrubbed repeatedly against its wall. Several times a day, every day, the foods we eat create small injuries compounding into more injuries, causing
the body to respond continuously and appropriately with inflammation.

While we savor the tantalizing taste of a sweet roll, our bodies respond alarmingly as if a foreign invader arrived to declare war. Foods loaded with sugars and simple carbohydrates, or processed with omega-6 oils for long shelf life have been the mainstay of the American diet for six decades. These foods have been slowly poisoning everyone.

How does eating a simple sweet roll create a cascade of inflammation to make you sick?

Imagine spilling syrup on your keyboard and you have a visual of what occurs inside the cell. When we consume simple carbohydrates such as sugar, blood sugar rises rapidly. In response, your pancreas secretes insulin whose primary purpose is to drive sugar into each cell where it is stored for energy. If the cell is full and does not need glucose, it is rejected to avoid extra sugar gumming up the works. When your full cells reject the extra glucose, blood sugar rises producing more insulin and the glucose converts to stored fat.

What does all this have to do with inflammation? Blood sugar is controlled
in a very narrow range. Extra sugar molecules attach to a variety of proteins that in turn injure the blood vessel wall. This repeated injury to the blood vessel wall sets off inflammation. When you spike your blood sugar level several times a day, every day, it is exactly like taking sandpaper to the inside of your delicate blood vessels.

While you may not be able to see it, rest assured it is there. I saw it in over 5,000 surgical patients spanning 25 years who all shared one common denominator — inflammation in their arteries.

Let’s get back to the sweet roll. That innocent looking goody not only contains sugars, it is baked in one of many omega-6 oils such as soybean. Chips and fries are soaked in soybean oil; processed foods are manufactured with omega-6 oils for longer shelf life. While omega-6’s are essential – they are part of every cell membrane controlling what
goes in and out of the cell — they must be in the correct balance with omega-3’s.

If the balance shifts by consuming excessive omega-6, the cell membrane produces chemicals called cytokines that directly cause inflammation. Today’s mainstream American diet has produced an extreme imbalance of these two fats. The ratio of imbalance ranges from 15:1 to as high as 30:1 in favor of omega-6. That’s a tremendous amount of cytokines causing inflammation. In today’s food environment, a 3:1 ratio would be optimal and healthy.

To make matters worse, the excess weight you are carrying from eating these foods creates overloaded fat cells that pour out large quantities of pro-inflammatory chemicals that add to the injury caused by having high blood sugar. The process that began with a sweet roll turns into a vicious cycle over time that creates heart disease, high blood pressure, diabetes and finally, Alzheimer’s disease, as the inflammatory process continues unabated.

There is no escaping the fact that the more we consume prepared and processed foods, the more we trip the inflammation switch little by little each day. The human body cannot process, nor was it designed to consume, foods packed with sugars and soaked in omega-6 oils.

There is but one answer to quieting inflammation, and that is returning to foods closer to their natural state. To build muscle, eat more protein. Choose carbohydrates that are very complex such as colorful fruits and vegetables. Cut down on or eliminate inflammation-causing omega-6 fats like corn and soybean oil and the processed foods that are made from them. One tablespoon of corn oil contains 7,280 mg of omega-6; soybean contains 6,940 mg. Instead, use olive oil or butter from grass-fed beef.

Animal fats contain less than 20% omega-6 and are much less likely to cause inflammation than the supposedly healthy oils labeled polyunsaturated. Forget the “science” that has been drummed into your head for decades. The science that saturated fat alone causes heart disease is non-existent. The science that saturated fat raises blood cholesterol is also very weak. Since we now know that cholesterol is not the cause of heart disease, the concern about saturated fat is even more absurd today.

The cholesterol theory led to the no-fat, low-fat recommendations that in turn created the very foods now causing an epidemic of inflammation. Mainstream medicine made a terrible mistake when it advised people to avoid saturated fat in favor of foods high in omega-6 fats. We now have an epidemic of arterial inflammation leading to heart disease and other silent killers.

What you can do is choose whole foods your grandmother served and not those your mom turned to as grocery store aisles filled with manufactured foods. By eliminating inflammatory foods and adding essential nutrients from fresh unprocessed food, you will reverse years of damage in your arteries and throughout your body from consuming the typical American diet.

[Ed. Note: Dr. Dwight Lundell is the past Chief of Staff and Chief of Surgery at Banner Heart Hospital, Mesa, AZ. His private practice, Cardiac Care Center was in Mesa, AZ. Recently Dr. Lundell left surgery to focus on the nutritional treatment of heart disease. He is the founder of Healthy Humans Foundation that promotes human health with a focus on helping large corporations promote wellness. He is the author of The Cure for Heart Disease and The Great Cholesterol Lie]

Comments by visitors to Dr Lundell’s article ‘The Great Cholesterol Lie’

1. OH no!!!!! no!! This article added on to more confusion regarding the causes of coronary heart diseases!! What about taking the so called OMEGA eggs, soft boiled or sunny side over? What about prawns and crabs?? Scallops and throw in with sotong? Is there anyone out there care enough to provide a more rational and down- to -earth and more localized explanation / suggestions / comments or argument that may be of help?

A worried Perry

Date: Fri, 26 Jun 2009 13:38:42 +0800
Subject: The Great Cholesterol Lie help

2. Hi all,

After reading this it is still better to go easy on the LARD and 'chee yau char’ when you eat Char Kueh Teow though lard is NOT process oil! Hahaha! Carry on eating Bak Kut Teh with ease of mind!

CHM

3. Dear Dr Lim,

Sorry have to consult your expert opinion again. Could I get a copy of your Keynote Address and your presentation on the Definition of Health you presented at the Health and Wellness Seminar of the Malaysian Senior Scientists Association.

I would also like your paper on ‘The Physiological Basis for Weight Management & Stabilization’ you also presented at the seminar. Kindly also seek your expert view on Dr Lundell’s article ‘The Great Cholesterol Lie’

Thank You & Best Regards,

CK Cheong

4. Dear Dr Lim,

We would like you to comment on the above article ‘The Great Cholesterol Lie’ by Heart Surgeon Dr. Dwight Lundell e-mailed to you earlier. We would appreciate your qualified professional opinion on this health issue as all along nutritionists and cardiologists have put the blame on cholesterol as the cause of coronary arterial disease. Your expert comment please!

Thanks.

Dr KM Tan and colleagues

Dr JB Lim replies below:

Thank you to all of you for your questions and e-mails.

It is very difficult for me to explain why eating high cholesterol foods like brain, liver, eggs, prawns DO NOT cause your blood cholesterol to be elevated permanently. The explanation is very lengthy, and requires a technical understanding of liver biochemistry, and I don’t intend to start on this. This belief that high cholesterol foods cause high blood cholesterol and heart disease was very popular in the 1940’s – 1950’s but it is now out of fashion to talk about it. Advances in nutritional science have debunked this myth.

Nevertheless very briefly, high cholesterol foods may cause a mild and temporary rise in blood cholesterol lasting for only a few hours post digestion stage. This effect will go away a few hours later, only to rise again at night.

But this nocturnal rise in blood cholesterol has nothing to do with any high cholesterol foods you have taken earlier. It is due to your own liver producing them in high amounts at night when you are asleep. In fact the liver can produce its own cholesterol to meet your body’s need 10 times better than all the cholesterol you can eat through foods during the day.

Hence it is no longer a fashion to say that eating foods high in cholesterol causes high cholesterol in the blood or heart disease. It is the type or nature of the oil you consume or use them for cooking that is far more important. By this I mean saturated oils from animal fats such as lard or tallow, or trans-fatty acids from hydrogenated margarine, or saturated oil from coconut oil that you need to avoid, but not eggs, liver etc.

Furthermore, even if you manage to eat a lot of cholesterol, say 10 eggs a day which is about 3,500 mg of cholesterol, the liver is able to throw out at least half of it everyday through the bile. The liver will compensate by balancing its body output (endogenous) of cholesterol with the amount you have taken through food (exogenous), to stabilize the level in the blood. That is why unlike blood sugars, blood cholesterol do not rise up and down sharply after a meal. The liver keeps this in check.

Yes, fish oil containing omega 3 fatty acids do lower your blood cholesterol. Eating a lot of fatty fish, especially the belly part is healthy as it is cardio-protective. Again, the chemistry why this is so, is highly technical in any attempt to explain. But you may find the explanation given in advanced textbook of nutrition, biochemistry or nutrition biochemistry. Check them out.

This is my very brief answer to your question. Full explanation involves complex and lengthy biochemistry, and it is not necessary to go into that for education purposes for the housewives and lay public

Regards

JB Lim

Thank, CK Cheong, for consulting the expert advice of Doctor and Nutritionist JB Lim. I really valued reading that controversial coronary / food articles on the net can actually lead to tremendous stress!

And thanks Dr Lim, for taking the trouble and valuable time to explain in the simplest of terms and avoiding all the medical jargons...!!

For your info, I have undergone angioplasty with a 22mm stenting done but two years later, its was completely occluded. The cardiologists advised an immediate off-pump CABG with a double artery graft taken from my wrist - 4 yrs ago)

I am under regular medication of aspirin, irbesarstan SR & atorvastatin, plus many self -administered food supplements like omega fish oil, milk thistle, vit.E and even glucosamine and a few others!

After the CABG, my nutritionist put me on a strict diet and i missed all the high cholesterol food esp. sea food and my favorite soft boiled eggs for yrs.. The unbelievable thing is I immediately gave up smoking 100% after being a heavy chained smoker for 30 yrs!! -- haha, ck, now you know why i gave up smoking!!!

If according to that article, and yr invaluable explanation, I can occasionally deserve a sumptuous meal of crabs and what not!!

So, CK, the next time I visit you in KL, lets go for sea food instead of roti canai!! Invite Dr Lim along!

*Dr. Lim, one more worried question? Do the drugs I take, esp. atorvastatin, does it cause harmful side effect like affecting libido?

** by the way, any one in my situation is sure to be gullible to all sorts of 'professional advice' from the "street doctors" esp. direct sales people on their miracle health food/products.... and i am a regular victim!!

Thanks again,

Still worried, but lesser!

Perry