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While not 100% on topic, after having recently suffered a (thankfully mild) heart attack, I want to pass on some of what I have learned since then. While sitting in the hospital bed, I proceeded to educate myself about the real cause of the plaques that cause our arteries to narrow as we get older. Despite what most of the medical profession tells us, the problem is NOT cholesterol as such, the cholesterol is merely a symptom of an underlying problem that the body is trying to repair, using that cholesterol. The underlying problem is inflammation in the arteries, and insulin resistance, and those related problems are caused by excessive consumption of refined carbohydrates. The cholesterol is used as a biological Band-Aid to heal the inflammation, and the result is plaque. The simple fact is that our bodies did not evolve to deal with the amount and low quality of carbohydrates that we have had in our Western diets for the last hundred years or so. Obviously, 100 years is not enough time for our bodies to adapt, if that is even possible (since arthrosclerosis almost never kills people before childbearing age). In any case, the solution is to cut way back on carbohydrates, and even when you have carbohydrates, they should be combined with either protein, fats or both. Also, the type of fat that you have is critically important - cut out all of the seed oils (corn, soy, canola, etc.), and stick with either the fat that is in the meat and fish that you eat, or use extra virgin olive oil and avocado oil. Oh, and you are way better off with either pasture-raised meat or wild caught fish, rather than grain-fed meat or farm raised fish. Ditto for eggs, the pasture-raised are better than the “cage-free,“ and those in turn are better than the cheap white eggs that most people buy, which are produced by grain-fed chickens, rather than chickens eating as they are naturally intended to out in the fields.

With regard to cholesterol, there is an immense amount of bad information out there. The first and most dangerous myth is that we consume too much cholesterol in our diet. Second, is that our cholesterol levels are too high if they are above 200. The level used to be 300 before statins were invented, and I just spoke to a good friend of mine, who is my age (63) who told me that when he was in medical school the acceptable level was 240. Most of the studies that we see regarding cholesterol are funded by the pharmaceutical companies, and there is a very clear conflict of interest. The simple fact is that we need cholesterol, and the proof of that is that our bodies produce far more than we consume, because it is necessary for life. Our brains and our nervous systems are composed primarily of cholesterol. Most of the hormones in our body are manufactured using cholesterol as a base. Finally, every cell in your body incorporates cholesterol into the cell wall to maintain its viability. If you have too little cholesterol in your body, you will end up with some very serious health problems, likely starting with Alzheimer’s or dementia. That is the reason why one of the primary side effects of long-term statin use is Alzheimer’s or dementia.

The first thing that the vast majority of doctors, including cardiologists, do when you have “excessive” cholesterol is to push statins. There are definitely certain circumstances under which statins are warranted, but not such that 50 million or more people should be taking them on a regular basis, just in the US. Dramatically reduce the inflammation, and the insulin resistance, by cutting way back on carbohydrates, and you will prevent most of the further development of plaque in your arteries. Nothing works perfectly, of course, but that is the best possible solution. Continuing to eat the diet that the food companies produce for us to maximize their own profits is a surefire recipe for heart disease. Eat natural foods as much as possible, not the ultra processed garbage that is being pushed upon the public, and has been for at least the last 30 years. We evolved to eat natural foods, not ultra processed chemical concoctions that have never existed in nature.

As an aside, as part of my research, I did find one drug that is extremely helpful in reducing systemic inflammation, and that includes inflammation in our arteries. That medication was originally developed to treat gout, but like many medicines it has uses beyond its original purpose. The medication is called colchicine, and the typical dose Is 0.6 mg per day. You need a prescription from your doctor to get it. I raised this issue with my cardiologist, when I went to see him after my heart attack, and he told me that he and the other doctors in his practice had started prescribing it for those patients who met the criteria, starting about six months ago. He looked at my charts and lab tests, and then prescribed it for me. I am pretty sure that he would not have prescribed it for me if I had not mentioned the issue, so I would urge everyone reading this to research the issue a bit and discuss it with their GP or cardiologist.

One final note: I had a stress test about 18 months ago. I was told that the test would probably last eight minutes, until the point at which I had reached the target heart rate. Well, they had to keep me on for 12 minutes, constantly increasing the incline and the speed of the treadmill. When I went back to discuss the results a couple of weeks later, I was told that I had a very good results, other than a couple of minor and inconsequential anomalies. I left that appointment with a very undeserved sense of security that I was quite healthy, especially since I had been doing a fair amount of cardio in the several months beforehand, and had been “eating right” according to the recommendations that we hear about all the time (low fat, use seed oils wherever possible because they have no cholesterol, etc.). As it turns out, stress tests have very little in the way of predictive value. Clearly, the fact that I was able to go 12 minutes on the treadmill indicated that my heart itself was healthy, but it did not give one single clue about the status of my arterial health. Frankly, if a stress test shows that your not healthy, your next stop should be the emergency room. What my cardiologist should have done, especially since I was 62 at the time and have a family history of sudden and fatal heart attacks, was to order various imaging tests, so that we could see exactly what my arteries looked like. Had I known that my arteries were more than 80% blocked at that point in time (because this doesn’t occur overnight, it takes decades to build up to that point), I would have done a lot more to improve my health in various ways, and quite possibly have avoided my heart attack.

The bottom line is that, as patients, we need to be our own advocates, and that requires that we be educated as to the facts regarding our health. There are a lot of very incorrect and destructive myths out there, many based upon what the pharmaceutical or food companies would like us to believe, because it significantly improves their bottom line. Just like government, they don’t care about you, they care about themselves. We each have to be concerned about ourselves and our loved ones, and that means spending some time and dedicating some effort to learn the actual facts about our health, and not just our cardiovascular health, but all aspects of it. Good luck and long life to all of you.