In Martha Stewart's "Living" this month, there is an article on heart disease. It starts with this intro:
For years, few women realized the dangers of heart disease. But the dark ages are over. "We've finally gotten the message across," says Ellen Gordon, a cardiologist and clinical professor of medicine at the University of Iowa. "Women know the risks, and they also know what to do about them, from exercising and eating a healthy diet to keeping an eye on cholesterol and blood pressure." There have been some real payoffs. The number of women (and men) with a dangerously high level of the "bad" cholesterol- a key trigger of cardiovascular disease- fell by about a third between 1999 and 2006, according to a report by the Centers for Disease Prevention published in November. Smoking rates continue to decline. Yet there's still progress to be made: Heart attacks have become more common in women under 55 in the past two decades, according to a recent study conducted by the University of Southern California and the University of California- Los Angeles.
Does anyone else see a problem here? We did it, we lowered cholesterol! But, oops, heart attacks have become MORE common in younger women for the past twenty years or so.
Sign vs. Cause
My favorite thought on cholesterol comes from Sally Fallon, where she compares cholesterol to police in a high crime area. In areas where crime is higher, the police force is larger. However, the police are a sign that something is wrong, not the cause of it.
So what exactly is cholesterol, and why are we all so afraid of it? Cholesterol is the body's healing substance. When there is damage in the body, cholesterol is what our body sends in to fix it up.
People who have suffered from heart attacks often DO have higher cholesterol. And that makes sense. There was damage in the body that led to atherosclerosis (hardening of the arteries), so the body sent cholesterol to help repair the damage.
When people use cholesterol lowering drugs and other methods to lower their cholesterol, they are lowering one factor that shows up in people who have had heart attacks. But if they are just lowering the sign that something is wrong, and not the cause, then heart attacks will continue occur.
Cholesterol in Food
Another confusion comes in because cholesterol is a substance that is found in our food. Eggs and meat, for example, are a source of cholesterol. It's easy to worry that if you eat cholesterol, it may end up in your blood. This is not the case however. Chris Masterjohn says, "There is no direct connection between the amount of cholesterol you eat and the concentration of cholesterol in your blood." For me, something that really hit home when I was studying about cholesterol and its role in the body was this: mother's milk, that perfect food we feed our babies to help them grow and thrive, has high concentrations of cholesterol. Our bodies are able to digest cholesterol from food without significantly increasing cholesterol in the bloodstream.
So, what does all this mean? The medical community is focusing on the wrong thing here. That's how we can end up doing everything "right"- lowering our cholesterol, and still end up with heart disease and heart attacks.
For further reading on this subject, check out these sources:
Nourishing Traditions by Sally Fallon
Good Calories, Bad Calories by Gary Taubes
Real Food by Nina Planck
In Defense of Food by Michael Pollan