Does high cholesterol cause heart disease?

Does high cholesterol cause heart disease? No.

But if you think it does, you’re not alone. The Centers for Disease Control. The American Heart Association. The Mayo Clinic. Go to any of their websites, and you’ll find information telling you that high cholesterol causes heart disease.

Cholesterol isn’t the problem

Their articles explain how high serum cholesterol levels cause fatty deposits to build up in blood vessels. This blocks proper blood flow, resulting in a heart attack. In other words, the article is about cholesterol and heart disease, not that it is caused by it.

Cholesterol and the risk of heart disease technicality

That is technically correct. Cholesterol is a waxy substance in the bloodstream that does build up in vessels and blocks blood flow to the heart. But, as cardiologist Dr. Stephen Sinatra states on his website, cholesterol is only a bit player in the process.

The real culprit in heart pathology is inflammation. Cholesterol has been demonized for far too long. It’s time to give it some angel wings.

Is cholesterol really so bad?

High cholesterol has been so vilified that many people think cholesterol is bad. Period. Although it does play a role in the risk of heart disease, in specific cases, nothing could be further from the truth. Cholesterol is a waxy substance called a sterol. Your arteries actually really enjoy HDL Cholesterol – the good kind.

A sterol is a type of fat found in animal and plant tissues. Your body needs cholesterol. In fact, it’s so important to your survival that the liver makes all of it that you need.

Cholesterol plays several essential functions in your body.

• The body needs cholesterol to make vitamin D, a necessary nutrient. (The sunlight converts cholesterol on exposed skin into vitamin D3. Vitamin D3 is carried to the liver and then the kidneys to be transformed into active vitamin D.)
• The liver uses cholesterol to make bile, a fluid necessary for digesting fats.
• Nerve cells need cholesterol for insulation to ensure more efficient conduction of nerve impulses.
• Cholesterol helps create and maintain cell membranes.
• Cholesterol is needed to make steroid hormones, which are critically important to life and physical development. Steroid hormones include the sex hormones estrogen, progesterone, and testosterone. They also include the stress hormone cortisol, which helps regulate blood sugar levels.
• HDL cholesterol is the good kind of cholesterol involved with heart attack risk, blood pressure, and optimal levels of blood cholesterol.

So, you see, (HDL) cholesterol isn’t so bad, after all.

When and why did elevated cholesterol become so bad?

Increased levels of cholesterol have been the “villain” in heart disease for so long that almost nobody alive today remembers when it was just…well…cholesterol. But there was a time when it turned bad. To be more specific, there was a time somebody made everybody think it was bad. After all, something had to take the blame for heart pathology.

The Seven Countries Study

In the ‘50s and ‘60s, the increasing rates of heart problems in America alarmed the public and experts. Ancel Keys, a physiologist in Minnesota, was one of them. He was interested in why heart attacks killed so many American businessmen. This was at the end of World War II, and these men were prosperous and well-fed. The Europeans, on the other hand, were barely surviving on food rations. Yet, those countries had low rates of heart issues.

Keys theorized the heart pathology rate was so high in the U.S. because Americans enjoyed rich diets filled with saturated fats. Keys believed consuming these fats raised serum cholesterol levels, ultimately causing heart disease. He didn’t consider blood pressure, coronary artery disease, or even type 2 diabetes.

Keys’ study and dietary habits

To test his theory, Keys analyzed the dietary habits of 22 countries and then chose 7 countries for his study. He compared the dietary habits of the residents with the rates of disease in each of those countries. The results were amazing. He indeed found a clear link between saturated fat consumption and heart disease.

The Seven Countries Study was the first significant study to examine nutrition, lifestyle, and cardiovascular disease risk variables across different countries and cultures throughout time, and it received much fanfare. Keys became so famous that he was featured on the cover of Time Magazine. (How many physiologists–from Minnesota or anywhere–can say that?)

Keys’ study on the risk of heart disease

There were many problems with Keys’ study that nobody mentioned — or maybe even noticed — back then. The main one is that Keys chose only 7 countries for his study. These countries were ones he knew scored high on the “fatty diet” scale. He left out countries, that had low rates of disease despite the fatty diets of their citizens. France was one of those countries.

But nobody looked too closely at Keys’ study. The publicity surrounding saturated fats grew. Soon, even the government started listening.

The government issues dietary recommendations

In 1977, the United States Select Committee on Nutrition and Human Needs issued the first-ever dietary recommendations for Americans. It was titled, Dietary Goals for the United States. This document advised Americans to lower saturated fat intake and increase carbohydrate consumption.

The committee meant for Americans to add more fruits and vegetables to their diets. They did not mean for Americans to increase their intake of sugar and donuts and other bad stuff.

But that’s not what happened. Most people thought any carb was okay to eat. They thought almost all carbs were healthier than any fat. They thought it would keep them from getting heart disease and keep them from gaining weight. That turned out to be wrong.

Low fat/no fat movement makes the cholesterol problem worse

Partly spurred by the committee’s recommendations, the low-fat/no-fat movement began making waves in the mid-’70s and into the eighties. Food companies were eager to give the public what they wanted. Before long, food companies filled grocery store shelves with low-fat and fat-free items. They also tirelessly advertised these products on TV.

Cholesterol, American diet, and myths

Americans thought eating fat and, by extension, dealing with cholesterol not only caused heart disease but also caused weight gain. They thought they could eat all the fat-free and low-fat foods they wanted. After all, they didn’t contain that evil ingredient (fat) that caused so much trouble.

What they didn’t know is when food companies removed fat from their products, they replaced it with sugar to improve the taste. Often, the fat-free products had the same number of calories as the full-fat version. But it was more unhealthy and more fattening because of the sugar content.

Cutting fat didn’t help elevated cholesterol levels or heart disease rates

This was the start of the obesity epidemic. And heart disease? Well…the rates of heart disease deaths actually peaked in the mid-’60s and started decreasing. But heart disease is the leading killer of both men and women in the United States.

Still…the government and experts continued telling people that eating a low-fat diet was the best way to prevent increased cholesterol. They said this would reduce their chances of heart disease.

In 1992, the United States Department of Agriculture Introduced the Food Pyramid. They replaced it with MyPlate in 2011. However, both of them still recommended Americans reduce fat and increase carbohydrate consumption.

It should have been clear to the government and health experts a long time ago that cutting fat from the diet didn’t affect heart disease rates or prevent increased cholesterol. This is because fat does not cause these issues. Yes, having a heart attack from coronary artery disease is an established scientific fact, but cholesterol isn’t the problem, per se.

The real origin of heart disease? inflammation

The real cause of heart disease is inflammation, as many studies have shown. Inflammation itself is not a bad thing. It is an essential function of the immune system. When you cut your finger, the damaged cells release chemicals to alert the immune system of the damage.

The immune system then sends inflammatory cells that cause blood vessels to leak fluid into tissues. This causes swelling that isolates germs and other foreign substances, keeping them from having any contact with other tissues until the healing process is sufficiently underway. At that point, the immune system releases anti-inflammatory chemicals, and the inflammation recedes.

Chronic inflammation occurs when the immune system sees something as a threat that is not a threat. The body is on high alert all the time. And this is what causes heart disease. Remember, when cells are damaged or distressed, they release chemicals to alert the immune system.

The immune system then sends inflammatory cells to trap the foreign invader.

If cells inside your blood vessels are distressed, the immune system sends inflammatory cells in response. But these cells really have no enemy to fight. Regardless, it can trigger the buildup of dangerous plaque.

The immune system sees this plague as an enemy and sends more inflammatory cells, resulting in more plaque buildup. As plaque builds, the arteries can thicken, causing a heart attack. Specifically, coronary artery disease, in combination with blood pressure levels elevated, causes cardiovascular disease risk.

Causes of chronic inflammation

There are many causes of chronic inflammation. Here are a few of them.

Eating a poor-quality diet risk:

Processed foods. Sugars. Starchy carbs. These foods introduce chemicals into the body. The immune system sees these things as foreign invaders. Because you’re eating the same things constantly, the immune system keeps sending inflammatory cells. The inflammation never goes away and becomes chronic.

Environmental toxins influence cholesterol numbers:

Air pollution. Pesticides on produce. Growth hormones in the meats you eat. All these things provide a constant supply of foreign substances into your body that the immune system tries to destroy. All that happens, though, is chronic inflammation.

Chronic stress slams HDL:

Consider this, with high blood pressure, poor levels of HDL cholesterol, and other risk factors, you are on the chopping block for a damaged coronary artery.

Inflammation, elevated cholesterol, and heart disease

We have always been told LDL cholesterol (low-density lipoprotein) is “bad,” and HDL is “good.” Science now shows there are two types of LDL particles, only one of which is bad for your heart.

• The small, dense LDL particles (Type B) are bad for your heart.
• The large, fluffy ones (Type A) are okay.

Small, dense LDL (low-density lipoprotein) particles are harmful because they are more likely to lodge themselves into arterial walls. This triggers inflammation, causing plaque build-up that can lead to heart attack or stroke.

If inflammation wasn’t present, cholesterol would flow right through your arteries. Increased cholesterol levels don’t matter as much as the size of your LDL particles.

What makes those small LDL particles?

But do you want to know what makes those small LDL particles? No, it’s not saturated fat. It is sugar and refined carbohydrate consumption. This means sugar consumption is more of a risk factor for heart disease than saturated fat. In fact, there has never been one scientific study proving saturated fat causes increased cholesterol levels or heart disease.

The sugar industry cover-up

In the ‘50 and ‘60s, experts vigorously debated whether saturated fats or sugar caused the increasing rates of heart disease. Many studies had been done on both of them. The sugar industry became scared and took action.

The Sugar Research Foundation hired three researchers from Harvard to conduct a review of research on the subject. They were tasked with reviewing studies on the possible role fat and sugar might play in heart disease. The review, published in the New England Journal of Medicine, concluded that reducing fat consumption was the best way to reduce heart disease risk.

What nobody knew at the time was that the Sugar Foundation supplied the researchers with every study they reviewed. The Foundation also funded the study.

Many studies then and now, have shown excess sugar consumption to be a factor in heart disease.

Fat was finally found “not guilty” of causing increased cholesterol levels!

In 2015, the U.S. Dietary Guidelines Advisory Committee ruled that consuming cholesterol has no effect on serum (blood) cholesterol levels. This committee of experts meets every five years and provides the scientific basis for both medical- and government-established nutritional guidelines.

Forget increased cholesterol levels, focus on inflammation

The science behind cholesterol is clear: to reduce your heart disease risk, you should focus on reducing inflammation. Having high total cholesterol is not as important.

To reduce chronic inflammation:

• Reduce or eliminate refined sugar from your diet as much as possible.
• Reduce highly processed food consumption. Instead of buying processed foods, buy the ingredients for your meals and prepare them at home.
• Minimize exposure to toxins. You can do this by purchasing natural cleaning products. You can also use HEPA filters in your HVAC system to eliminate indoor air pollution. Purchasing organic foods whenever possible is another great way to reduce chronic inflammation.

The SANE way to reduce chronic inflammation

The SANE diet is an excellent way to reduce chronic inflammation. You will enjoy delicious, nutritious foods, and you will not be hungry.

The four main SANE food groups are non-starchy vegetables, nutrient-dense proteins, whole food fats, and low-fructose fruits. These foods fill you up fast and keep you full longer.

Next step: stabilize high cholesterol with the SANE plan