Heart disease is the leading cause of death for both women and men in the United States. In 2005, 27.1% of all U.S. deaths were from heart disease, and 68.3% of those were from coronary artery disease. More people died from heart disease than from strokes, respiratory diseases, diabetes, flu, pneumonia, Alzheimer’s, kidney disease, blood poisoning, and accidental causes (including car accidents) combined. Health care services, medications, lost productivity, and other costs of heart disease are projected to equal more than $304 billion in 2009.
Clearly, heart disease is a major problem in our country (and in many countries around the world, particularly developing countries). The mainstream medical community’s approach to reducing heart disease risk depends primarily on prescribing drugs to lower blood pressure, cholesterol, and triglycerides. Your dependence on these drugs is expected to be lifelong, even though they have side effects such as fatigue, dizziness, cough, frequent urination, impotence, heart arrhythmia, and muscle pain. According to mainstream medicine, you can also reduce your risk by following a diet low in saturated fat, cholesterol, and sodium, but most people struggle to follow this diet, and even if they are successful, they don’t necessarily see reduced cholesterol, blood pressure, or triglycerides. The failure of these dietary recommendations implies that heart disease is just genetic, and that medication, despite its side effects, is the only way to “fix” the malfunctioning body and thereby reduce heart attack risk.
However, I believe that the real reason why the low–fat, low–cholesterol diet doesn’t work is that it is based on flawed reasoning and on poor analysis of dietary studies. A truly healthy and balanced diet, can, in fact, be so powerful in protecting you from heart disease that, regardless of your genetics, you probably do not need the medications at all. In what follows, I’ll explain the mechanism of heart disease such that you can clearly see why a healthy diet and lifestyle makes a difference.
II. Heart Disease Pathology
The term “heart disease” covers a wide variety of heart–related health problems, the most common of which is coronary artery disease, or CAD. I’m going to focus on CAD in this article, although other heart health issues such as heart failure, ischemic heart disease, etc., respond equally well to the same diet and lifestyle changes.
CAD is a condition in which the flow of blood to the heart muscle through the coronary arteries is blocked by plaques that have accumulated over time in the arteries. The plaque is made up of cells or cell debris, cholesterol, triglycerides (fatty acids), calcium, and connective tissue. Almost everyone has some plaque built up in their arteries, and the plaques are present not just in the coronary arteries, but also in larger arteries like the aorta and the pulmonary artery, and in arteries that bring blood to the brain (which, if blocked, lead to a stroke). Over the years, the plaques grow in size and number, until finally they are large enough to block blood flow altogether. Blood flow can also be blocked by ruptured plaques getting wedged in between other plaques. The narrow width of the coronary arteries explains why they tend to be blocked before any others. Lacking sufficient oxygen from blood, the heart muscle breaks down, and the heart stops beating unless flow is quickly restored.
Clearly, reducing CAD risk is a matter of reducing arterial plaque, which is mostly made up of cholesterol and triglycerides. Research has confirmed that a person with high levels of cholesterol and triglycerides in the blood is much more likely to develop CAD. Also important is lowering blood pressure, which, if too high, increases the likelihood that a plaque will rupture and block the artery entirely. As stated above, most people try a combination of diet and medication to address these three main “risk factors”—high triglycerides, high cholesterol, and high blood pressure—but the standard recommended diet does not make much of a difference, and the medications don’t bring about a permanent cure. We’ll look at each of these risk factors one by one, exploring their relation to CAD, and clarifying why the correct diet will eliminate the risk factor at its source.
III. High Triglycerides
A triglyceride consists of three fat molecules (aka fatty acids) joined to a glycerol molecule. Most of the fat that we eat (animal or vegetable) is in the form of triglycerides. When triglycerides enter the body, they are either metabolized for energy or for transporting fat–soluble vitamins, or they are stored as “body fat.” Believe it or not, this latter occurrence is actually quite uncommon. Because of its density and complexity, fat digests slowly, which makes it very filling. We can only eat so much of it at once, and that limits the quantity of calories from fat that we can consume. It’s very hard to eat so much fat that you would have to store some of it as body fat, or as extra triglycerides floating around in your blood. If you have high triglycerides, or are overweight, those extra triglycerides probably came from refined carbs: white flour, white rice, sugar, and high fructose corn syrup.
Refined carbs are not as calorie dense as fat, but they digest much more quickly. Soon after you eat a cookie, drink a soda, or work your way through a bowl of pasta, you’re hungry again. Since you can keep eating carbs without getting satisfied, you can eat many more calories from carbs than you can from fat. When the carbs are digested, they pass into the blood as blood sugar. High blood sugar levels are good when you’re about to exercise, but when you’re not, they are dangerous to the health of your body. Fortunately, your body can produce insulin to remove the excess sugar from the blood and take it to the liver, which converts it into triglycerides. These are the triglycerides that are stored as body fat and/or circulate in the bloodstream, depending on your genetics (of course, if you eat enough excess calories from carbs, you’ll have triglycerides everywhere). Refined carbs are even dangerous before they get turned into triglycerides, because high blood sugar increases blood clotting (just think of how sticky sugar syrup is).
More and more studies are pointing to a link between diabetes and heart disease, and it’s not hard to see why: constant insulin production for lowering blood sugar is what exhausts the pancreas and causes diabetes. If we were to get our energy from healthy fats and complex carbs, instead of from refined carbs, we would be unable to eat excessive amounts of calories, while at the same time staying full and satisfied from meal to meal. We’d reduce pressure on the pancreas and we’d lower triglyceride levels.
However, I do need to make a distinction between different kinds of fats when it comes to preventing CAD. It’s true that saturated fats don’t cause high triglycerides, but that doesn’t mean those fats always healthy, and there’s a reason why they were linked to heart disease in the first place. It’s just not the reason everyone thinks.
Most of the saturated fat that we eat comes from animal products: beef, pork, chicken, eggs, milk, cream, butter, etc. Until the mid–twentieth century, almost all livestock was raised on small family farms, given room to roam, and fed their natural diet of grasses, insects, seeds, etc. Then, as now, we ate saturated fat from these animals, but we didn’t have the same heart disease rates that we do today. Heart disease rates only went up after our meat and dairy industry moved from family farms to factory farms, in which animals weren’t given room to move, and cows in particular were fed corn and soybeans instead of green plants.
Corn and soybeans are to cows a lot like pure sugar is to human beings. Since their digestive systems are so lengthy and complicated (they’re made to digest grass, after all), a diet of grains, even whole grains, gives them way more calories than they could use, and not enough nutrition. This is deliberate: it’s a way to fatten cows up, in the same way that people put on weight when we eat our version of refined carbs (sugar and white flour). Cows turn these carbs into triglycerides and store them as saturated body fat. At the same time, they lack the nutrition they got from grasses, so they’re unable to synthesize another kind of fat, polyunsaturated omega-3 fatty acids. Omega-3s, although they are fatty acids, actually clear out your arteries, thinning blood clots and lowering blood pressure (they’re much better for you than aspirin, too). Prior to the establishment of factory farms, animal products were one of our main sources of the omega-3s: they actually protected us from heart disease! But after we started eating meat from carb–fed, factory farmed animals, we stopped getting those omega-3s, and the heart attack rates started rising.
IV. High Cholesterol
Cholesterol is an waxy substance (an alcohol, in fact) that is manufactured by the liver. It helps form hormones, bile, and vitamin D, and provides stiffness and stability to cells. In addition to making it ourselves, we can get it from eating animal products. Cholesterol is essential to the proper functioning of the human body, but it has a very poor reputation, due to its presence in the arterial plaques that lead to heart attack. If you have high cholesterol levels, the odds are that you have a lot of plaque built up. You probably have been told that to reduce your heart attack risk, you need to lower your cholesterol levels by eating fewer foods with cholesterol and/or by taking cholesterol lowering drugs, such as statins. Twelve million Americans take statins, and many of them experience side effects such as muscle pain, weakness, and mental fatigue. Statins lower cholesterol levels, but not permanently, so people have to keep taking them all their lives.
Why is it that a substance your own body makes can be so dangerous? Remember that, in preventing heart disease, we’re trying to help the body work the way it’s supposed to. We want to help the heart keep beating. We trust the heart to beat properly if the blood flow is not blocked. Why don’t we trust the liver to manufacture the right amount of cholesterol? Why is a statin drug necessary to “fix” our cholesterol levels? In reality, it’s not: you can achieve healthy cholesterol levels without drugs. To understand why, we need to address the root cause of high cholesterol.
An arterial plaque, which contains not only cholesterol, but also triglycerides, calcium, connective tissue, and cell debris, is essentially a scab covering an area where an artery has been damaged. The source of the damage could be a micro–organism—some form of bad bacteria—but in most cases the artery wall has probably been damaged by free radicals.
Free radicals are molecules that have become unstable by undergoing a chemical reaction with oxygen, usually due to a heat catalyst. These “oxidized” molecules are highly reactive because they contain unpaired electrons. In the human body, free radicals will attack stable cells and “steal” an electron from molecules in them to stabilize themselves. The attacked molecule then becomes a free radical and attacks another molecule, and so on, ultimately disrupting the function of the cell. Your body sometimes makes free radicals as a defense mechanism against viruses and bad bacteria, but an excess of free radicals is dangerous to the body’s cells. Excessive free radicals come from stress, cigarette smoking, pollution, toxins in foods, and, most of all, rancid vegetable oils. To neutralize them, your body must rely on antioxidants, which are capable of safely “donating” an electron to the free radical. Antioxidants are found in many fresh fruits and vegetables and other natural plant foods. But if, like most people, you’re not eating enough of those foods, your body will have to manufacture antioxidants of its own. And the primary antioxidant that it manufactures is cholesterol.
Your body sends cholesterol to the damaged site via low–density lipoproteins (LDLs. LDL, the “bad” cholesterol, refers to cholesterol being carried on its way to the arteries). Cholesterol helps in repairing the arteries (giving stability to the cells, as stated above) and neutralizing the free radicals. Afterwards, high–density lipoproteins (HDL, the “good” cholesterol) carry cholesterol back to the liver. All of this is a natural and necessary process. But if you’re taking in too many free radicals, the damaged sites can’t fully heal, and cholesterol just accumulates, getting tangled up with triglycerides and also with calcium, a mineral whose health benefits have been overemphasized in order to benefit the milk industry. Calcium is an essential nutrient, but it can’t be properly absorbed unless you also have enough magnesium in your diet, and most people don’t. Excess calcium contributes to the cholesterol plaques, making them stiff and difficult to break down (hence the term, “hardening of the arteries.”).
High cholesterol levels are not the result of a genetic defect, nor are they traceable to a diet high in fat and cholesterol (except to the extent that fat from factory farmed animals contains many toxins). High cholesterol is your body’s attempt to deal with marauding free radicals, which come from poor diet and a stressful lifestyle. Artificially lowering cholesterol will not solve the problem, because you’re just fighting against your body’s efforts to protect you. Now it’s clear why cholesterol–lowering drugs must be taken continually: they only address the symptom, not the source of the problem. For real healing, you must cut down on the sources of free radicals in your life, and increase your levels of antioxidants. In doing so, you’ll find that your cholesterol levels are able to get down to normal all on their own.
V. High Blood Pressure
Blood pressure refers to the force of the blood against the blood vessels (veins and arteries). “High blood pressure,” also known as hypertension, refers to a condition in which the blood pressure is chronically elevated. There is a clear connection between high blood pressure and incidence of heart attack, stroke, and kidney disease, so lowering your blood pressure to normal levels is extremely important for your long–term health.
The standard medical view is that the cause of high blood pressure is unknown. However, studies have shown that stress, tobacco, alcohol, drugs, lack of exercise, and a high–sodium diet are all correlated to high blood pressure. In fact, blood pressure can have more than one cause, and it can cause more than one kind of damage in the body. In the case of heart disease, if blood pressure is chronically high, the blood vessels suffer increased wear and tear. They are more likely to need continual repair, which sets the stage for the formation of plaques. And if the plaques get large enough, high blood pressure can cause them to break off and clog the arteries.
If we don’t know the cause of high blood pressure, and just chalk it up to genetic factors, we’re more likely to rely on medications like beta–blockers and diuretics, even though they interfere with the body’s natural processes, and have side effects including mental fatigue, depression, impotence and nightmares. In my opinion, what causes high blood pressure isn’t all that hard to understand. Obviously, high blood pressure is a sign of increased physical tension. In many cases, that tension a physical response to mental stress. If we’re frequently angry, frustrated, anxious, or just “tense,” that’s going to cause a physical reaction that will increase our heart rate, tighten all our muscles, and keep our blood pressure high. However, we don’t have to be stressed out in order to have high blood pressure. We can also get it from a diet that’s too high in toxins, and not high enough in nutrients.
oxins are molecules that are either harmful to or unneeded by the body. We can get them from the food we eat, particularly processed conventional foods (organic, whole foods would have very few toxins) and also from our environment—if we’re breathing polluted air, for example. We definitely get them from alcohol, cigarettes and drugs, even from medications. These toxins are filtered from the blood by the liver and kidneys, and are eliminated as part of our waste. Or at least, they should be. That’s how it works normally. What’s crucial is that the liver and kidneys get enough nutrients to carry out their jobs, and that they’re not overloaded with more toxins than they can handle.
If the liver and kidneys do have a big workload, it takes longer to filter the blood, and blood flow is not as smooth and regular. If the blood flow is backed up, this increases the pressure on the blood vessels. If at the same time there’s a lack of nutrients in the diet, the liver and kidneys can’t use those nutrients to neutralize toxins, so it takes even longer to filter the blood. Retention of toxins causes more fluid retention in general, so that increases blood pressure too. Even having an imbalance of needed nutrients can be a problem, as is the case with sodium and potassium. Sodium increases blood pressure while potassium helps reduce it. We need both to have healthy blood pressure, but most people have too much sodium and not enough potassium.
There’s parallel between the two causes I’ve discussed, mental stress and toxins. In the former, we find ourselves becoming more tense and pressured (whether we like it or not) as we try to deal with life’s problems. In the latter, the stress placed on the liver and kidneys by physical toxins causes high pressure in the blood vessels. Of course, we can never completely eliminate toxins, just like we can’t eliminate the things that cause stress. But we can add into our lives things that help us deal with stress and toxins in a constructive way. Nutrient–rich foods are one example. Exercise is another—it helps with mental stress, by encouraging the production of feel–good hormones, and with toxins, by giving our body the chance to sweat them off instead of relying just on the liver and kidneys (does your sweat taste salty? There goes all that sodium!).
Heart disease, like so many of our other modern–day health concerns, is caused primarily by stress, lack of exercise, and poor diet. Genetics may determine in what way an unhealthy lifestyle affects your body, but it does not directly cause high cholesterol, high blood pressure, or high triglycerides. These are not signs of your body’s inherent defectiveness; rather, they’re the result of your body trying to heal the damage. For long–term healing, we need to change our lifestyles so that we eliminate or negate the true cause of heart disease. To reduce your risk, try the following recommendations:
Reduce stress. There are many stressful situations in life, but they’re not worth dying for. Stress raises blood pressure and inhibits your body’s ability to burn triglycerides. It increases the production of free radicals, thereby increasing cholesterol levels. Don’t just avoid stressful situations, but try to find peace in the midst of them, so that your happiness doesn’t depend on circumstances.
Exercise more. No one looks forward to exercise if they haven’t done it in a while, or if their form of exercise is stressful. Exercise can be as simple as walking. Nothing more strenuous is needed to reduce your CAD risk. Start slowly and working up to greater distances, in peaceful settings.
Eat more complex carbs. If you want to get off sugar and white flour, the way to do it is by eating more whole grains (brown rice, whole wheat, oats, barley, quinoa) and natural sweeteners (agave nectar, maple syrup, raw honey). These “complex carbs” are just as satisfying, and they’re more filling, so you can’t eat excess calories that would be stored as triglycerides.
Eat more saturated fats from grass–fed animals. Yes, I am telling you to eat butter, cream, even red meat—the kind that contains not just saturated fat but the blood–thinning omega-3 fatty acids. Coconut oil is good too. You’ll be more full and consume fewer calories in the end. More healthy saturated fats will help you avoid the rancid vegetable oils in clear containers that contain free radicals: soybean oil, canola oil, cottonseed oil, corn oil, etc. Especially avoid hydrogenated vegetable oils (aka trans fats). For a liquid vegetable oil, choose cold–pressed, unrefined olive oil from a dark bottle. Say goodbye to cholesterol plaques!
Eat more organic/locally grown fruits and vegetables. These foods contain many antioxidants, which neutralize the free radicals from stress, toxins, and rancid oil. All vegetables contain some potassium, which lowers blood pressure. Many, especially leafy greens, contain magnesium that helps you absorb excess calcium. Finally, fruits and vegetables have the nutrients that the liver and kidneys need to detoxify the body.
Notice that these recommendations focus on the positive. I haven’t stressed cutting out smoking, alcohol, or sugar (though if you do cut back on them, that’s great!) It’s easier to add good–tasting, healthy foods into your diet than it is to just abstain from processed foods, fighting your cravings with willpower. Once you have healthy foods in your diet, you’ll begin to crave them instead, such that not only is your heart attack risk greatly reduced, you’ll still be eating what you like! It may be difficult at first to make these lifestyle changes, but there is no doubt that it’s worth the effort—for better day–to–day health, for better longevity, and for greater peace of mind. You are welcome to contact me for a free consultation if you would like support with improving your heart health, or with any other health issue.