Why do we care about cholesterol? Because cholesterol is linked to heart disease which is the leading cause of death in the U.S.
Nearly 2,200 Americans die of heart disease every day with an average of one death occurring every 40 seconds. And this isn’t just among men-it’s the leading cause of death in women over age 65.
The truth is, we can’t live without cholesterol. It’s in every cell in our bodies and is necessary for cell growth and repair. It helps us digest food and is a precursor to vitamin D, estrogen, testosterone, cortisone, and other vital hormones. Yet we often talk about cholesterol like it’s a disease that should be prevented or treated.
It’s estimated that only 5 percent of the population has a genetic tendency toward heart disease. Therefore, the leading cause of death in our country is largely preventable through lifestyle choices like a healthy diet, exercise and avoiding smoking. However, we’ve created a culture that has led us to rely heavily on drugs (primarily statins) to reduce cholesterol.
Roughly 32 million Americans take a statin or cholesterol-lowering drug. Statins work by blocking a liver enzyme responsible for producing cholesterol.
While statins are among the most prescribed medications in the world, they also present complications:
1. Heart disease risk-assessments that doctors use to decide if statins should be prescribed are often funded by pharmaceutical companies.
2. Statins can have side effects that include muscle pain, memory loss, confusion, fatigue, and intestinal and liver problems. Their use has been linked to Type 2 diabetes.
A study led by researcher Giovanni Corona at the University of Florence in Italy, found that men on statins were twice as likely to have low testosterone. Ironically, maintaining healthy levels of testosterone is necessary for healthy heart function. The researchers emphasized they found a link, not a cause and effect, between statins and lower testosterone.
3. Statins don’t treat the cause of heart disease; at best, they suppress the symptoms.
4. The efficacy of statins is uncertain. They are often prescribed as preventive medicine for people who have never had a stroke or heart attack. Critics argue that out of every 100 people taking statins for five years, only one or two people will avoid a heart attack, and none will live longer.
5. We’re relying on outdated risk factor measurements for heart disease. Functional medicine clinician Chris Kresser often talks about the inefficacy of typical tests that measure total cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL), saying they aren’t strongly associated with heart disease.
He argues that the ratio of HDL to non-HDL cholesterol is a better predictor than tests for total cholesterol or LDL, but still nowhere near as predictive as some of the newer markers like LDL particle numbers. Even more predictive is Lipoprotein(a), or Lp(a) levels, which is not typically lowered by statins. He also suggests more broad tests that look at fasting insulin, inflammatory markers and dysbiosis (the balance of bacteria in the gut).
What preventive measures are you currently taking to maintain a healthy heart?
This is part two of a three part series on cholesterol. Part one can be found in the May, 2018 blog post. The July blog post will focus on dietary fats and cholesterol.