Dr. Arturo M. Volpe

If you keep up with the news, you may have read or heard about the newly publicized “war on cholesterol”. It was announced that, in a shift in policy, the National Institutes of Health (NIH) is recommending that cholesterol-lowering drugs be prescribed more aggressively to individuals with a history or other risk factors for heart disease, even if they do not have particularly elevated cholesterol levels. This could potentially triple the number of adults in this country taking cholesterol-lowering drugs. But is this new policy based on science alone, or on drug companies’ skillful marketing and vast profit potential? Interestingly, this announcement did not follow any new breakthrough studies showing that cholesterol is the ultimate cause of heart disease. In an interesting op/ed article published in the May 23, 2001 edition of the Houston Chronicle and other leading newspapers, Robert Atkins, MD pointed out that the new policy fails to address serious side effects of these drugs, including potentially severe liver damage and increased risk of cancer. In addition, these prescriptions have a high financial cost to individuals and/or insurers. The NIH also disregards a mounting body of evidence indicating that, through a controlled-carbohydrate diet, exercise and dietary supplements, cholesterol and other risk factors for heart disease can be effectively corrected. Dr. Atkins is a board-certified cardiologist and the author of several books on the benefits of a low-carbohydrate diet. Numerous studies spanning a decade or more point to a complex set of causes that lead to heart disease, rather than implicating cholesterol alone. Some of these causes are strongly linked to lifestyle, diet and nutrient deficiencies. They include chronic inflammation, elevated insulin levels in the blood, pro-oxidants and so-called free radicals, as well as low testosterone in men and low estrogen in women1. Elevated blood levels of a chemical called homocysteine have also been shown conclusively to be associated with a higher risk of heart disease even in the absence of elevated cholesterol2. Homocysteine buildup in the blood is caused by a deficiency of certain B vitamins.

Tags: Cholesterol
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Diane Schwarzbein, MD is an endocrinologist and the author of an excellent book, “The Schwarzbein Principle.” In a recent interview she related the remarkable story of how she went from being a conventional physician to embracing nutritional medicine. Dr. Schwarzbein worked with a group of adult diabetics who were highly motivated to control their disease and their increased risk of heart disease through diet. Gradually, through trial and error – and very cautiously at first – she came to realize that the high-carbohydrate/low-fat diets commonly recommended today were counterproductive. Her patients were actually getting worse. Although “low-fat” may sound good (many of us are trying to lose fat, after all), carbohydrates such as pasta, breads and other starches are nothing other than sugar molecules bound together in long chains. They are broken down and converted back to their sugar building blocks through the digestive process. Sugar has a dual action in the body: it raises insulin levels in the blood and promotes inflammation, thereby aggravating two known risk factors for heart disease. In addition, the body can only store minute amounts of sugar once its immediate energy needs have been met. Excess sugars are converted in the liver to triglycerides or cholesterol, and particularly to LDL, the “bad” cholesterol. Triglycerides are the type of fat that is stored in the body and are, themselves, a risk factor for heart disease. Once Dr. Scwharzbein began to recommend a more balanced diet that restricted carbohydrates and included more fat and protein, her patients began to improve. They lost weight, their cholesterol levels normalized, their diabetes was controlled and their risk of developing heart disease was lowered. Other factors, including exercise and nutritional supplements, also proved beneficial.

1. N Engl J Med 2000;343:1139-1147, 1148-1155 and 1179-1182; Free Rad Biol Med 2000;28(12):1717-1725; Diabetes Care 1991;14:173-194.

2. A great deal of the research on homocysteine is reviewed in the book “The Homocysteine Revolution” by Kilmer McCully, M.D.. According to some experts, the recent decline in heart disease may be attributable to the increased use of multivitamin supplements that may help lower homocysteine levels by supplying adequate amounts of B vitamins

Tags: Cholesterol
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