The People's Perspective on Medicine

895 The Great Cholesterol Myth

Tune in to our radio show on your local public radio station, or sign up for the podcast and listen at your leisure. Here’s what it’s about:

We’ve all heard that high cholesterol is a prelude to a heart attack. But doctors and patients alike may have been misled into focusing on this single risk factor among more than a hundred others. Our guests have scoured the medical literature and concluded that we need to re-think our approach to cholesterol and heart disease.

What is the optimal diet to reduce your risk of heart disease? (And why don’t you need to worry about the cholesterol in your breakfast eggs?) Our guests give surprising–but evidence-based–advice on healthy living.

One further note: The New York Times blog this week describes the Sidney Diet Heart Study showing more cardiovascular mortality among the volunteers getting less saturated fat.

Guests: Jonny Bowden, PhD, CNS, is a nationally recognized expert on nutrition, weight loss, and health. He is the author of several best-selling titles, including The 150 Healthiest Foods on Earth. His website is

Stephen Sinatra, MD, FACC, is a cardiologist and educator. His Heart MD Institute ( is an educational platform focused on prevention and proactive lifestyle changes to live a healthier life. He is the author of Reverse Heart Disease Now and The Sinatra Solution. The photo is of Dr. Sinatra.

Drs. Bowden and Sinatra have joined forces to write The Great Cholesterol Myth, Why Lowering Your Cholesterol Won’t Prevent Heart Disease–and the Statin-Free Plan That Will. Get the details on what tests make sense, what you should eat and which supplements they recommend.

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free for four weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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First time that I’ve been on this site, love it and will be looking forward to getting more emails and information!!

I believe they suggested:
For healthy people with exception of those taking Coumadin who must consult doctor:
Co Q10 — 100mg
Magnesium — 400 mg
D-Ribose — 5 grams which is 1 teaspoon
L-Carnitine — 500mg to 1 gram
Omega 3 (DHA or EPA)– frm 1 gram up to 3-4 grams
Curcumin — Terry Naturally brand name 1-2 capsules
Resveratrol where trans resveratol is 900mg
Vitamin C
Pantothen B Vit
for severe heart failure or those awaiting heart transplant:
Co Q10 –300 to 600mg
Magnesium — 400 to 600mg
D-Ribose — 5 grams OR 1 teaspoon 3 times daily
L-Carnitine — 1 to 3 grams

While I heard what Dr. Sinatra had to say about continuing a statin in the event of a heart attack, I have found my own blood flows more easily eating a relatively small amount of cinnamon daily.
I will never have that issue come up since I have no intention of ever taking a statin no matter who wants to order it.
My blood sugar levels are borderline so I do test fairly regularly. I used to have a hard time getting blood from a finger/thumb for the test … until I started eating the cinnamon. It is probably less than 1 tsp per day.

One of the “Awesome Foursome” supplements mentioned on the show is L-carnitine.
However recently Dr. Michael Lauer of the National Institutes of Health appeared on the Diane Rehm Show. According to Dr. Lauer, new research showed that gut bacteria break down carnitine to produce a substance called TMAO “which seems to promote the development of hardening of the arteries.” Dr. Lauer and another doctor on the show advised against taking L-carnitine supplements. You can find the full transcript online of the Apr. 12, 2013, show “New Research on Red Meat and Heart Disease.” The doctors defined red meat as meat from a mammal.

>>With the latest report of atherosclerosis in mummies that are up to 4000 years old it makes you wonder if there is anything at all we can do. . . .They would have been enjoying the now very popular paleo diet.

For me this was the most helpful People’s Pharmacy show I’ve ever heard as I am disposed to having a heart attack by heredity and am already suffering hardening of major arteries and calcification inside my heart while dealing with a severe motor-cell brain injury so taking many of the drugs and supplements discussed in this show, but (like Jennifer above) have little idea how much to take or know how to spell some of the recommended supplements. Now I do. ocor for years and had been buying CoQ10 just because I’d heard it had heart benefits, but stopped due to the expense. After reading this, I plan to resume taking CoQ10 in spite of the expense.
JB – tutorjb1

I am a fan of The People’s Pharmacy and generally find the interviews to be intriguing and informative. I couldn’t agree more with the idea that individualized sources of specific fats including coconut oil, butter and lard should not be demonized as they each have certain benefits that may not be completely understood. I also agree that statins may not be appropriate for all people.
However, and this is a gigantic however: The comments with regard to canola oil are completely unfounded and delivered with such casual disregard that not only does the validity of this anecdotal “fact” become questionable but so does the credibility of the source. The statements “Canola oil is a disaster in the human body” and “Canola oil is better for machines” have essentially no scientific merit.
The editorial staff of The People’s Pharmacy is ultimately responsible for the accuracy of the messages contained in these interviews, just as “This American Life” was responsible for “Mr. Daisey and the Apple Factory.” I hope that in the future such statements will be challenged during the interviews and also followed up with scientific information so that The People’s Pharmacy can remain a trusted source for information.
PEOPLE’S PHARMACY RESPONSE: Quite right. That is precisely why we asked Dr. Walter Willett about canola oil in a subsequent show, #897.

If your on an anticoagulant, remember, all things can be adjusted for. If you start something new, like flax seed or any other supplement known to affect coagulation, check your INR 4 to 7 days after starting your new supplement and adjust accordingly.

Thank you SO much for doing this program!!!!!!
My husband for the last few years had been having unexplained frequent spells of nausea and headache–just not feeling well. Within the past year Maria Emmerich’s book SECRETS TO A HEALTHY METABOLISM and Dr. William Davis’ WHEAT BELLY COOKBOOK have drastically changed the way I cook and the way we eat. My flour canister no longer has flour in it, and my sugar canister no longer has sugar in it! My chief fat is coconut oil. Instead of grain flour, I’m using almond flour and some coconut flour. I use a lot of eggs. When I use dairy products, I no longer use fat-free. It takes some doing to make the transition–nut flours cannot simply replace wheat flour in a recipe. We eat lots of fresh vegetables and fruits too. But we are ENJOYING our food in this new way of eating!!!!!
PAYOFF: In the past few months, my husband has been feeling consistently well and without intending to, has lost the 20 pounds he had gradually accumulated since college days. We are both 73 years old.

The poster above doesn’t understand the time frame/diet of the mummies studied. I fear his conclusion is widespread.
The oldest mummies studied (Egyptians) were from civilizations that were only 4,000 years old. This is the time of the Neolithic Era which began about 12,000 years ago in the Middle East. In the Americas, it came later. These Ancient Egyptians ate a very high grain diet and this ushered in among other things, reduced stature and iron deficiency. Dental disease became rampant for the first time in history.
The “now very popular paleo diet” a.k.a. Stone Age diet, is from an earlier pre agricultural time that ran from 2 – 2.5 million years ago to approximately 13,000 years ago. Domesticated grains, legumes and dairy products were not yet available in the Paleolithic Era.

I loved the March 9 interviews on cholesterol and the heart. Other research supports their concern that sugars are really the problem behind so much inflammation. Why then is D- Ribose a suggested supplement when indeed it is a simple sugar?

Awesome information that should be listened to by every American interested in being much better informed on the subject, and in being a much stronger well informed self advocate in working with the medical professionals. Thank you People’s Pharmacy!

With the latest report of atherosclerosis in mummies that are up to 4000 years old it makes you wonder if there is anything at all we can do. These mummies were from varying civilizations, diets, climates and long before smoking, processed foods and sugar came into the diet. They would have been enjoying the now very popular paleo diet.
That 33% had calcium deposits it’s possible this is just a natural part of aging and we should enjoy as much life as we have sans medication.

That’s because your grandfather wasn’t sitting in front of a tv all day…and he was lucky.

Ask him how much stock he owns in drug companies.
I refused to take statins over ten years ago, when Baycol was making me feel really bad. Why would I want to live a long time feeling bad just to have a lower number on a paper?
Shortly after that they pulled Baycol off the market, I heard people were dying from that particular recipe.
I find it hard to believe that docs are stupid or ignorant, but they are being squeezed financially, so maybe drug company benefits are involved. Also, the side effects and conditions caused by statins are huge money makers for Pharma companies, just ED drugs alone are huge. I have reason to believe that statins are directly responsible for many ED cases and damage is not restored after stopping the statins. No one will fund this research, but I suspect it from anecdotal evidence.
My doc is OK with me not taking statins as long as I am able to tell him each year that I am aware that he thinks I should take them and I am aware of the risks. I did some research at the time I stopped Baycol, my third brand of statin, and found NO studies that showed that having a lower total cholesterol resulted in fewer or less severe heart attacks in persons who had not experienced a heart attack already. I am not a professional researcher and I only looked at journals publish in English. I asked my doc for citations, he found none either.
I am 63, near normal weight for my height and take no meds at all, except occasional NSAID and a vitimin D supplement. I feel fine, walking is my only exercise. Sounds like you are in good shape, tell the doc what you think, be sure he knows what his partner found; they don’t always have time to read the charts carefully. Enjoy life!

I lower my cholesterol through diet, low sugar and no bread, moderate amount on vegetables fats, through flax seed oil, walnut, cashews. I fought my doctor four years ago, when I develop leg pain in three days from taking a Statin.
Diet and exercise, daily walking, got my blood sugar, cholesterol, and liver function back to normal range. Still working on losing weight. I have been using the Lose It App. if is free and very helpful

In 2010 I suffered a severe heart attack. The attack was quite a surprise given that I am not much over weight, not sedentary, eat what I think is a healthy diet, have low blood pressure and do not smoke. The wonderful doctors at UNC were able clear the blockage within 27 minutes of reaching the ER! Since then I have been exercising everyday and taking atrovastin, Metropolol (a beta blocker) and Effient (a Plavix like anti-coagulant).
Thursday night I got up from the sofa to go to the kitchen. About 1 minute after getting up I felt dizzy and walked to the table to sit down. I never made it; I crashed into the counter and got banged up pretty badly. The next day after work while I was seated getting a haircut chair I passed out. When I came to the folks in the salon had already called 911. I was pretty dizzy and felt sweaty. They gave me a bottle of water but I still felt bad. I passed out again and woke up coughing having vomited the water I drank. Apparently I was also convulsing.
When the ambulance came they took my blood pressure and checked my heart. My heart was OK but as I already knew, my blood pressure was extremely low. The EMT decided to take me to the hospital. At the hospital I was given a CT scan to rule out brain issues and then admitted for observations. I was released the following day with no clear idea of what caused the sudden bouts of fainting. One of the doctors suggested that I was dehydrated from not drinking enough and exercising. I suppose that is possible, but my routine had not changed in 2 years.
After reading Gary Taubes’ Good Calories Bad Calories I have tried to maintain a lower carbohydrate diet. I have been making bread substituting about 1/4 of the flour with milled flax seed. Turns out that, according to the Mayo Clinic website, flax seed can lower blood pressure and also interact with blood thinners. I knew that grapefruit juice interacted with many medications but never suspected flax seed.

I was very glad to listen to this show and hear this information finally working it’s way into the mainstream. I follow the Paleo/Primal diet and there were many aspects of the show (low sugar, low carb, low grain diet and avoiding excess Omega-6, getting enough Omega-3, not to mention the crazy idea that maybe saturated fat isn’t bad for you!) that reinforced my feeling that I am doing the right thing.
Last year’s blood panel was outstanding after a year of Paleo. Low LDL, high HDL, low triglycerides, low inflammation, blood sugar values and organ functions all very normal. Not to mention I feel great and lost weight. I find the Paleo diet much easier to follow than a high carb low fat diet because I am not hungry all the time the way I was before. It’s really hard to lose weight when all you can do is think about food and when you can next eat it. Paleo regulated my appetite control center and my blood sugar swings. It’s pretty hard to feel unsatisfied when you polish off some grass fed beef shanks in a savory tomato sauce, baked sweet potato with grass fed butter, and a big salad with nuts, blue cheese (not technically paleo) balsamic & olive oil vinaigrette, and dried cherries. Life is good!

Both my former and current GP (at the same practice) recommend a 10mg statin (Simvastatin) to maintain total LDL below 100. While it does work, definitely notice side effects including cognitive / memory, ED, etc. Also take 10mg Zetia but it clearly does not appear to keep LDL in check as the statin does. Stopped taking the Simvastatin two months ago and checked cholesterol. Followed up last week and of course total LDL is back above 100 (135), so of course the GP wants me to immediately resume 10mg Simvastain at bedtime every night.
I have also been working with a PA in the same practice who ordered a more extensive lipid profile back in January that showed my LDL is primarily the big, fluffy type and not the small, nasty variety (hence I immediately stopped taking the statin). I’m not sure that my GP is aware of this, although it should be in my chart / record, but I have no interest in restarting any meds to force my LDL below 100 again.
My question is around how best to approach this with my GP – I really like him and have otherwise been very happy (we are the same age and relate very well). He just seems to be very adamant that I need to take a statin to push my LDL below 100. Otherwise I am in excellent health – walk 15-20 miles a weEk, run four time a week, power lift three times a week, very strict with what I eat, you get the picture. I just appear to have this genetic predisposition to LDL numbers above the current ‘normal’ range..

For the Magnesium, which version do you recommend – maleate, citrate, or in combination with potassium? Thanks!

Natokinase. It’s an enzyme derived from fermented soy. It acts to break down fibrin which is a protein involved in blood clotting.

March 9th program on cholesterol was amazing. The sugar component in our diet definitely needs a review.
My book club just finished reading the THE COKE MACHINE and the information in that book should make us all rethink our view of COKE and sugar. The move from 6 oz to larger and larger, from a simple
drink on a hot day to a bottle on the dinner table that substitutes for milk.. it is all there.
So I am going to eat my left over deep fried smelt and not feel a bit guilty.

This was a good introduction to the complicated history of vascular disease and what Americans need to do now to avoid it. Asking cardiologists to figure out what is causing vascular disease is like asking many specialists to back off and take a broad view of the diseases they treat – unbiased views are hard to find. Well, what do you expect from a profession where “familial” is usually bad, “positive” is frequently deadly and “negative” is usually normal.
Mr. Smith, your chlamydia test is positive – thank you doctor, that is the first positive thing a doctor has ever said about me.
There were some chemical errors in the discussion today but the major thrust about saturated fats reveals the flawed research on fats done in the 60’s and 70’s to make soybean and corn farmers and their industry more profitable.
Sugars can not possibly be the major problem with vascular disease or Hungary and France would have almost as much disease as we do instead of about 30% (also much less diabetes and obesity).
I would appreciate hearing what today’s guests as well as Dr. Nissen would do with a 13 year old teen, LDL of 365 and non-smoking father who developed unstable angina and extensive coronary disease at age 29 with similar cholesterol numbers. You might want to refer to the idea of multiple risk reduction.
The sources of supplements, food and medications are important. Several statins are problematic but so too are the totally unregulated chemicals from China and other parts of the world – which were recommended today without much critical thinking.

Would you please post the recommended amounts for the supplements on the March 9th radio broadcast. I listened to the 7am and the 4 pm shows today in hopes of being able to write them down, but I still was not fast enough. I have been eating a vegan diet for almost two yrs now, am a 61 yr old female with lymphoma and am trying to keep the “the nasties” from coming back. These are the supplements I am interested in:
CoEnzyme Q10
L Caratine
Omega 3
Cur cumin (sp)
Visveritol (sp)

Wonderful show. Very informative and I want to look up the suppliments mentioned. Not sure of ‘nattto’ and ribose’ and trans-resveratol. Did I get them right?
I already take CoQ10 and L Carnitine.
My cardiologist says that statins make the plaque in blood vessels much more stable and unlikely to break off and clog something. Comment on this?

“Natokinates” (spelling?) mentioned on your program. What are they?
PEOPLE’S PHARMACY RESPONSE: “Nattokinase” is a soy product used as a supplement.

Excellent information and very helpful. My husband is a physician and has been saying this for years much to the dismay of his colleagues. I listen to all your shows. Keep up the great job!

About 10 years ago my PCP told me that 50% of his heart attack patients had normal cholesterol. My grand father consumed more fat for breakfast than most people do in several days, had his alcohol every day and never had heart problems. Yes…..there are other factors.

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