Monday 4 October 2010

Does Cholesterol Cause Heart Attacks?



The World Heart Day on 26-9-10 saw a spate of articles and advertisements in many newspapers on the various ways to prevent heart attacks. They were unanimous in advising the public to restrict their intake of saturated fats and reduce cholesterol levels to avoid heart problems.

But available evidence indicates that cholesterol may not be the culprit after all. There seems to be no correlation between cholesterol levels in the blood and the risk of heart attacks. In one of the largest studies ever conducted on heart patients (and published in the January 2009 issue of the prestigious American Heart Journal - AHJ), 137,000 patients hospitalized for heart attacks between 2000 and 2006 were studied. The results were surprising to say the least.

Blood cholesterol is of two types, LDL and HDL. LDL cholesterol is supposed to be bad and according to the guidelines of the U.S. National Heart, Lung and Blood Institute, a level of more than 130 mg. of LDL cholesterol per deciliter of blood is considered unhealthy. But in the AHJ study, 72% of the heart attack patients had less than 130mg/dl of LDL cholesterol, a level considered safe. Only a very small fraction of these patients should have had low levels of LDL cholesterol. Instead, almost three fourths of the heart attack patients had low levels of the "bad" cholesterol and should not have had heart attacks! So reducing LDL cholesterol levels does not ensure that the risk of heart attack is reduced!

It is likely that other popular theories about heart attacks are also wrong. A distinguished heart surgeon has also recently debunked these theories which have been accepted by the vast majority of the medical fraternity. According to Dr. Dwight Lundell, a heart surgeon who has performed more than 5000 open heart surgeries in more than a quarter century of practice (and a pioneer of the beating heart bypass surgery), doctors have not paid attention to the recent discovery that inflammation in the artery wall is the real cause of heart disease and not cholesterol (click here). As a result, doctors have been prescribing diets which exclude saturated fats and reduce cholesterol, contrary to medical evidence. These diets are not only not reducing the incidence of heart attacks, but are creating an epidemic of diabetes leading to increased expenditure, suffering and deaths.

Despite the fact that 25% of the population takes expensive statin medications and despite the fact that the fat content of the average diet is lower, more Americans will die this year of heart disease than ever before.

Statistics from the American Heart Association  show that out of a total current population of 310 million, 81 million Americans suffer from heart disease, 23 million have diabetes and 63 million have pre-diabetes. These disorders are affecting younger and younger people in greater numbers every year. Dr, Lundell says that these alarming numbers are a direct consequence of the diet changes recommended by the majority of doctors.

According to Dr. Lundell, cholesterol does not accumulate in the wall of the blood vessel and cause heart disease and strokes unless there is inflammation of the walls. Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped.

Inflammation is the body's natural defense to protect it from irritants such as bacteria, toxins, viruses or even foods the human body was not designed to process (such as low fat diet and highly processed carbohydrates - sugar, maida wheat flour, etc.). Inflammation is necessary for wounds and infections to heal, but, if these irritants are allowed to repeatedly attack the body, they cause "chronic inflammation" which is harmful, causing diseases such as hay fever, arthritis, heart attacks and strokes. Chronic inflammation of the blood vessels allows cholesterol to become trapped in large quantities at these spots and block the vessels, leading to heart attacks and strokes.

Another cause of chronic inflammation of blood vessels and hence heart attacks and strokes is the production in the body of proteins known as cytokines. It has been found that too much consumption of omega-6 oils (such as groundnut oil, corn oil, sunflower seed oil) promote production of cytokines. To reduce the production of cytokines, one should increase the proportion of omega-3 oils (such as butter and ghee) in one's diet. Ideally, the ratio of omega-6 to omega-3 oils in one's diet should be 2:1 or 3:1. But most doctors discourage the use of butter and ghee and encourage the use of sunflower seed oil and corn oil. This has skewed the ratio of omega-6 to omega-3 oils in the average diet to 10:1 and in some cases 20:1. It is ironic that persons who skew their diets in favour of omega-6 oils to prevent heart attacks are just doing the opposite. They are increasing the risk of a heart attack because their bodies are now producing extra cytokines which cause chronic inflammation of the blood vessels which lead to increased heart attacks!

C.V. Nagaraj, Mysore Grahakara Parishat

UPDATE:(6-10-10) Our Press release Does Cholesterol Cause Heart Attacks? stated that butter and ghee were good sources of omega-3 fatty acids. This was based on a study published in Proc Nutr Soc. 2003 May;62(2):329-36 which found that milk from grass-fed cattle is an important source of omega 3 fatty acids. Based on this research, the Wikipedia article on omega -3 fatty acids says that a match-box size piece of cheese can provide 88% of the recommended daily intake of omega 3 fatty acids.

But Dr. M.N. Krishna Murthy, formerly of CFTRI, who is an expert in this field, says that milk available in and around Mysore is very low in omega-3 fatty acids and butter and ghee made from this milk contains less than 1% of these fatty acids.