Cholesterol: Trick or Treat?

Is this much maligned food the fount of life or the font of sickness?

These days we're led to believe that there's a pill for every ill. From a twilight birth to a narcotized death our lives are being controlled by drugs. Doctors are now ready to write prescriptions to help us sleep, mask our anxieties, kick start our sex lives and raise our mood when we're feeling depressed. An even greater contemporary corruption is that diseases are being invented, simply to give drug companies the excuse to peddle remedies for their relief. One of the most glaring examples of these malades imaginaires is 'hypercholesteremia', a make-believe sickness which was devised only when biologists developed the ability to measure the levels of cholesterol in the blood. Unlike most other maladies, this is a condition which is diagnosed in the healthy as well as the sick. It exhibits no outward signs. In fact it's merely a label which 'experts' pin on people who show what they believe to be an adverse deviation from the norm, an arbitrary level which is given to widespread variation. Thirty years ago any middle-aged man whose blood cholesterol level, at the time of measurement, was over 240 was judged to have an increased liability to heart attacks and strokes, providing he had other risk factors like smoking, obesity and a genetic predisposition. In 1984, the Cholesterol Consensus Conference moved the goal posts and decided that the term 'hypercholesteremia' should be given to anyone whose cholesterol was above 200. Eight of the nine doctors on this panel were later revealed to be making money from the Big Pharma companies selling anti-cholesterol drugs Since then the level has dropped to 180 for both men and women, whatever their life style and level of general heath. The gradual lowering of the threshold has meant a great increase in the number of 'patients' in need of regular supervision and treatment, and a vast increase in the profits made by pharmaceutical companies. In America, cholesterol lowering drugs are now the second biggest pharmaceutical earners after anti-hypertensives, generating profits of billions of dollars every year. Doctors, by their uncritical acceptance of this new disease entity, are doing the drug industry an enormous favour, but are not serving the best interests of their patients. Can it be that they've forgotten the physiology lessons they learnt at medical school, when they were taught about the vital functions performed by cholesterol, the substance which they probably knew then by its molecular formula C27H46O?.

In the words of Dr Ron Rosedale, one of America's leading gerontologists, there is no life on Earth that can live without cholesterol (which) is a vital component of every cell membrane.' It's estimated that a human adult contains roughly seventy trillion cells, about a million of which die every second. Cholesterol is needed to build the walls of this multitude of cells, to repair them when they are damaged and replace them when they die. That's why our blood streams must always carry a plentiful supply of cholesterol. One of the earliest medical discoveries was that cholesterol was needed for the production of bile, which plays a vital role in the digestive processes of most vertebrate animals. That's how the substance got its name from the two Greek words chile (bile) and stereos (solid). Cholesterol is also an essential precursor of all the body's steroid hormones, including estrogen, testosterone and cortisone, and plays a vital role in the formation of the fat soluble vitamins A, D, E and K. In addition it's the main organic molecule in the brain, constituting over half the dry weight of the cerebral cortex.

Nowadays we're led to believe that there's a marked distinction between 'good' and 'bad' cholesterol. This is based on a total misconception, for every molecule of cholesterol is 'good'. Every one has the same atomic structure and is equally capable of carrying out its life preserving functions. The confusion arises because C27H46O, being a fatty molecule, is only slightly soluble in water. This means that it has to be teamed with protein molecules before it can be carried around the body. Some of these complex lipoproteins are larger than others. Hence the talk of High Density Lipoproteins (HDLs) and Low Density Lipoproteins (LDLs) But size doesn't matter to the cells of the heart, lungs, kidney and brain. As long as they get an adequate ration of cholesterol, they don't mind whether it's brought to them by a big daddy HDL or a tiny Tim LDL.

At one time it was held to be impossible to reverse the ravages of arterial decay. Once fatty plaques had been deposited in the blood vessel walls it was believed that there was little that could be done to shift them. Now it's known that the job can be carried out by cholesterol, providing it's not carried to the damaged cells by the very tiniest LDLs, which can squeeze through the linings of the arterial walls. Here they can lodge, become oxidised by free radicals, turn rancid, and produce inflammatory by-products which cause further damage to the cells of the arterial wall. The prudent way to prevent this happening is to take steps to ensure that cholesterol is transported around the body by lipoproteins which exclude the very tiniest LDLs. This can't be done by taking statins, or any other form of anti-cholesterol medication, but can be achieved by adopting one or two sensible life style changes.

Before these natural measures are described, it's as well to recognize that the human body has its own homeostatic mechanism which ensures that our blood streams always carry an optimum level of C27H46O.Just as there is a internal thermostat which maintains a healthy body temperature, so we have a cholesterostat, which ensures that our blood streams always carry an optimum level of cholesterol. This is a highly complex, biostatic arrangement, which was first described by two American doctors - Dr Michael S. Brown and Dr Joseph L Goldstein - who gained the Nobel Prize in Physiology in 1985 for their seminal discoveries in this field. This regulatory system is essential, partly because of our moment-to-moment need for cholesterol is constantly changing, and partly because of the wide variations in our dietary intake. Eskimos live on a diet rich in fatty meat; whereas vegetarians consume only the animal fats they get from eggs and dairy products. There is no way that we ourselves can do the necessary computations to ensure that our cells and vital body organs receive the cholesterol they need. This we must leave to our cholesterostats. Every body cell has the ability to manufacture cholesterol, a facility which is particularly marked in the adrenal glands, reproductive organs, intestine and especially the liver, which is the source of about a quarter of the body's endogenous production of cholesterol. Under normal conditions, four times as much cholesterol is synthesized in the body as is obtained in the diet. If cholesterol is lacking in the food we eat, an immediate signal goes out to step up its production within the body. At the same time the gall bladder is ordered to release some of its store of bile, and the gut to increase its re-absorption of cholesterol in the gut. If cholesterol levels show any sign of rising too high, some of the excess is stored in the gall bladder, and the remainder excreted in the stools.

This regulatory system works exceedingly well without our involvement, and it's a brave man who tampers with its operation, and a criminally irresponsible drug industry that actively promotes such suicidal intervention. According to a recent estimate, forty per cent of admissions to British geriatric wards are the result of adverse drug reactions. That figure will soar if Big Pharma has its way and encourages countless adults to take its anti-cholesterol drugs. Relatively little attention has been given to the risks arising when drug medication causes cholesterol levels to fall too low. However several quality studies have been carried out, all of which reveal that drug-induced hypocholesteremia is a serious health hazard. One research trial, published in the Lancet five years ago, showed an inverse relation between cholesterol levels and heart disease in people over the age of 65, whereby 'the lower the cholesterol the higher the risk of 'all-cause mortality.' A longer investigation was carried out as part of the Honolulu Heart Programme, a survey which spread over a period of twenty years and examined the possible health benefits of employing drugs to artificially lower cholesterol levels. The results revealed that the 'long-term persistence of low cholesterol concentration actually increases risk of death.' The earlier the patients embarked on this treatment, 'the greater the risk of death.' This danger also applies to patients with a known history of cardiovascular disease. This was shown when researchers from Hull University, England, followed one-hundred-and-forty-five heart failure patients and found that for every point of decrease in serum cholesterol there was a thirty-six per cent increase in the risk of death within three years. Several studies have also shown that low cholesterol levels are associated with symptoms of depression, most probably because cholesterol plays a key role in the production of serotonin, a naturally occurring hormone which raises our mood. Canadian researchers have found that individuals with low cholesterol have more than six times the risk of committing suicide as those with the higher levels of cholesterol.

Drugs are available to lower blood cholesterol levels, but they are totally indiscriminate. They override the body's cholesterostat, and cannot discriminate between 'good' and 'bad' lipoproteins. A far better approach is to adopt a series of life style changes, which do not interfere with the body's inherent fat regulating mechanism, favour the production of HDLs, and are accompanied by spin-off effects which are wholly beneficial. These include:-

? Take more physical exercise Workers at the University of Minnesota's Laboratory of Physiological Hygiene, encouraged a group of overweight young men to embark on a gradually increasing exercise on a treadmill. By the end of the four month conditioning programme they were walking briskly for five days a week and had lost eleven pounds and gained a sixteen per cent rise in the levels of HDLs in their blood.

? Study the art of stress management Learn to relax. Adopt an attitude of che sera, sera. Don't sweat the small stuff, and remember that it's all small stuff. Get a proper balance between work and play. Blood tests have revealed that accountants show a steady increase in their blood cholesterol levels as they approach the end of the tax year, when they're working long hours under severe pressure.

? Take steps to improve the quality of your personal relationships Marriage is good for your health, providing it's a congenial marriage. Research at University of Utah shows that marital discord causes a rise in blood pressure and increased cholesterol levels among women, but not in men. However the research on male accountants, referred to above, revealed that dysfunctional marriages, marked by anger and incessant argument, could lead to a doubling of blood cholesterol levels.

? Increase your intake of vegetables When researchers at Stanford University, California took a sample of over a hundred adults with mildly raised cholesterol levels, they found that those who stepped up their intake of fresh fruits and vegetables, enjoyed a reduction in their 'bad' cholesterol levels which was twice that of those who had followed the typical instructions to reduce their intake of fatty foods.

? Fill your day with laughter. A good belly laugh is infinitely better than a constant belly ache. When we're engaged in any light hearted mirthful activity we relax, which seems to increase our blood levels of 'good' cholesterol. This was shown when a research team at Loma Linda University, California took a small sample of patients with a high risk of developing heart disease and divided them into two groups. The first was given cholesterol lowering drugs, the second was set the therapy of spending half-an-hour a day in laughter inducing activities, like watching comedy films and TV shows. At the end of the year it was found that the drug takers had increased their 'good' cholesterol by just three per cent, whereas the gigglers had increased their HDLs by twenty-six percent.

? Step up your intake of dietary fibre Several studies have shown that diets rich in roughage help to reduce excessively high blood cholesterol levels. These facts have circulated around the world, and yet recent surveys reveal that the average American adult still consumes less than half the ideal daily intake of fibre.

? Avoid fried foods and processed foods rich. Most of the commercial foods sold in fast food restaurants are rich in trans fats. These lipids occur only in small quantities in nature, and enter our diet only through the high temperature cooking of hydrogenated vegetable fats. These increase the risk of coronary disease because they raise the levels of 'bad' cholesterol and lower the levels of 'good' HDLs. For this reason it's wise to avoid eating fried foods, and the processed, 'hyperpalatable' foods sold in supermarkets and fast food outlets. The consumption of these foods in America is thought to cause twenty thousand deaths each year from heart disease.

? Increase your intake of nuts Researchers from Lorna Linda University in California have found that diets augmented by the addition of a handful of nuts will reduce the blood levels of 'bad' cholesterol by seven percent. One reason is that nuts contain plant sterols, which reduce the uptake of cholesterol in the gut. Scientists at Pennsylvania State University have made a special study of the nutritional virtues of nuts. They knew that walnuts contained substantial quantities of omega-3 fatty acids which are known to reduce the levels of LDLs and lower the risk of heart disease. So they devised a three year trial in which they studied twenty-two subjects with high levels of 'bad' cholesterol and saw how dietary changes affected their reaction to experimental stress, generated when they were either asked to deliver a speech, or immerse their feet in icy cold water. Both these interventions raised their blood pressure, increased their output of stress hormones and boosted their blood cholesterol levels. These biological changes were less marked when their diets were supplemented with walnuts or walnut oil.

We clearly need to revise our views about cholesterol. The blood levels of this vital body constituent should be always be adjusted by natural means and never controlled by drugs. This is a lesson which must be learnt by both patients and doctors, who should recall the advice of Sir Willian Osler, the great Canadian physician, who said: 'One of the first duties of the physician is to educate the masses not to take drugs.'

? Donald Norfolk 2011
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