It’s heart health month, the time of year when I typically get apoplectic reading all the bullshit about how important it is for us to check our cholesterol.
And with a new class of cholesterol lowering drugs about to hit the market, you can count on aggressive campaigns to get you to pay attention to your cholesterol levels, and how great these new drugs are when you combine them with a statin, which is what they did in the research. So now, you can be on two drugs to solve the terrible problem of high cholesterol (although I saw an encouraging article recently that said that the new drugs—Repatha and Praluent—aren’t selling. Such a pity.)
Two drugs that may lower cholesterol stupendously. But which do very little if anything for lowering the risk of heart disease.
That’s because—- as I said on the Dr. Oz show—trying to lower the risk of heart disease by lowering cholesterol is like trying to reduce your risk of obesity by giving up lettuce.
So let’s start with one, basic, incontrovertible, evidence-based, non-alternative fact: Cholesterol does NOT cause heart disease. Not even close. It’s actually not even a good predictor of heart disease. Fully half the people admitted to US hospitals with cardiovascular disease have perfectly normal cholesterol. Tim Russert, the beloved host of Meet The Press, dropped dead on a treadmill at the NBC studios with his cholesterol perfectly in check.
Now that we’ve got the cholesterol thing out of the way, let’s talk about what does cause heart disease, and, more importantly, what we can do about it. Which turns out to be a lot (more on that in a moment).
Heart disease doesn’t have a single cause. Many different factors can contribute to a weakened heart, just as they can to a weakened immune system. And when the heart—or more precisely, the cardiovascular system—is weakened, it doesn’t take as much to overwhelm it.
Imagine building a fence out of bamboo around a house on the coast of Florida. That fence may stand perfectly straight in good weather, but at the first sign of a hurricane, goodbye fence. (A fence made of something more substantial would be exposed to the same hurricane winds, but probably wouldn’t get knocked down.)
Your body is like that fence. When your system is weakened by a diet high in sugar and starch, by stress, by inflammation, by oxidative damage, by the absence of exercise and the presence of toxins, it’s like having a fence made of paper maché. In our book, The Great Cholesterol Myth, my co-author, cardiologist Stephen Sinatra, MD, tells the story of a banker who was felled by a heart attack after hearing a bit of minor bad news. His system was so weakened that even a minor setback was enough to bring him down.
Think about all the stories you’ve heard about couples who were married for 57 years, one dies, and the other is gone within a month. (Case in point: my grandparents.) The grieving survivor’s system is simply overwhelmed, flooded with cortisol (which depresses immunity), their will is gone, their physical resources depleted and they simply die, often triggered by an ordinarily innocuous bacteria or virus. Thinking we are speaking metaphorically, we might say of that person that he died of a broken heart—- but a broken heart might be closer to the truth than we think.
We weaken our systems every time we consume sugar, soda, donuts, French fries, or any of the other staples of our great American experiment in horrible diets. Our system is further weakened by exposure to the toxins in the air we breathe, the water we drink, the food we eat and the stress we experience. All add up to a significant increase in our susceptibility to heart disease. Cholesterol has absolutely nothing to do with it.
And one more thing—perhaps the most important. Have you ever noticed that there are no newspaper articles—let alone studies—of healthy, robust centenarians that live in isolated cabins in the wilds of Montana? That’s because there are no such people. All the places in the world where they have the highest concentration of healthy 100-year olds have one thing in common, and it’s not their diet, their exercise, their supplementation program or their genetics.
It’s the fact that they all have strong social connections.
And I’m not talking Facebook friends, I’m talking real people whose eyes you can actually look into when you talk to them. Who you talk to with actual words, not texts. The social fabric is such a strong protector of health that it may even counter the negative effects of some really bad risk factors.
There’s even a name for this phenomenon—The Roseto Effect— named after a close-knit Pennsylvania community with a heart attack mortality rate about half that of all the surrounding areas, baffling all the scientists and researchers of the day .
The people of Roseto lived a really hard-scrapple life. They worked in toxic slate quarries, inhaling horrible gases, dusts and other awful stuff. They smoked. Their diet was as bad as you can imagine. But the town was mostly composed of closely-knit Italian immigrant families who had an incredibly strong social fabric. They shopped locally, patronizing their neighbors’ businesses. They didn’t show off, or care terribly about status. They attended the same churches, went to the same schools. They didn’t seem terribly unhappy or stressed out. They ate family dinners together, and had virtually no crime in their neighborhoods. They had a sense of purpose and a sense of connection to things outside (and bigger) than themselves. And they took care of one another—though hardly a well-heeled town, they had a very low percentage of people on public assistance.
Apparently that lifestyle protected them a hell of a lot more than a statin drug.
Look, let’s face it. You can’t completely eliminate the risk of heart disease. But you can do an awful lot of things to reduce the risk of it killing you. You can eat real food—food your grandmother would have recognized as food. You can move. A lot. You can get up and walk around for a few minutes every hour or so, so you never sit for extended periods of time. You can get some sun, and take a walk in the woods. Play with a pet. Make love. Meditate. Spend a few minutes every day contemplating the things you’re grateful for. Eat an apple. Drink some tea. Dance like no one’s looking. Take fish oil, vitamin D, magnesium, and probiotics. Laugh. Make someone else feel good—every single day of your life.
These are the things that create a strong “fence” They ultimately protect you and insure that you’re as strong, healthy and fit as you can possibly be.
That’s how you protect your heart.
Lowering your cholesterol has absolutely nothing to do with it.