Dr. Jonny Bowden

Category: Cholesterol & Heart Health

  • My 7-Point Program For Preventing Heart Disease

    Pay attention to these seven action items, and you just may find that you don’t need to worry quite so much about cholesterol after all.

    1. Eat an anti-inflammatory diet. The fruit and vegetable kingdom is teeming with natural anti-inflammatories like quercetin (apples and onions) and curcumin (turmeric). Drink green tea and pomegranate juice. Balance your protein and fat with tons of vegetables. And eat dark chocolate—it’s cocoa flavanols help lower blood pressure and keep the cardiovascular system healthy.

    2. Reduce grains, starches, sugar and omega-6’s (vegetable oils).  Every one of these has the power to increase inflammation—a lot!

    3. Manage Your Stress. Stress is an enormous risk factor for heart disease, and is inflammatory as well. Find a way to manage it. Anything from regular walks in the park to deep breathing exercises to warm baths can help.
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    4. Exercise. It’s probably the best anti-aging (and heart protective) drug on the planet.

    5. Drink only in moderation. And if, like me, you don’t process the word “moderation” very well, don’t drink at all.

    6. Don’t smoke. Probably the number one recommendation for heart disease prevention.

    7. Supplement wisely.. Antioxidants like vitamin C protect against oxidative damage (one of the promoters of heart disease) while omega-3’s (particularly EPA and DHA from fish oil) are among the most anti-inflammatory molecule on earth. And curcumin does just about everything—it’s an anti-inflammatory and antioxidant.

    No program in the world will eliminate risk. Wearing seat belts doesn’t guarantee a bolder won’t fall off the overpass and crush your car. But that doesn’t mean wearing seat belts is a bad idea. If an action can considerably reduce the risk of something bad happening, that’s really all we can ask from it.

    The 7 recommended actions above will do that.

    To me, that’s smart medicine.

  • What Can We Learn About Saturated Fat from Home Depot?

    What Can We Learn About Saturated Fat from Home Depot?

    I’m attending the annual American College of Nutrition conference, and I’m listening to a lecture by one of the leading researchers on low-carb diets, Professor Jeff Volek, RD, PhD— and suddenly, I’m thinking about paint.

    Yes. Paint. The kind you get at Home Depot.

    See, Volek was making the case—supported by a ton of published research—that the effect of dietary saturated fat in your body is almost completely dependent on what it’s eaten with.

    And the best example of that is mixing paint.

    See, the color white produces a certain result when you mix it with black, a different result when you mix it with blue, and an entirely different result when you mix it with yellow.

    And so it is with saturated fat.

    As Volek explained, saturated fat in the context of a low carb diet, is a wonderful source of fuel and the body will be delighted to use it as such. Mix that saturated fat with sugar and carbs—i.e. the typical American diet—and all bets are off.

    Here’s why: There is an association between saturated fat and an increased risk for some diseases—but the association isn’t with saturated fat in the diet. It’s with saturated fat in the blood.

    If that seems like a minor distinction to you, let me explain why it’s anything but minor.

    The saturated fat you eat has very little effect on your blood levels. (In this way, it’s similar to dietary cholesterol which has practically no effect on the blood levels of cholesterol that your doctor measures.) Eating a lot of saturated fat doesn’t drive up your blood levels of saturated fat, just as eating eggs doesn’t drive up your LDL. And cutting back on saturated fat doesn’t drive your blood levels down.

    What sends your blood levels of saturated fat skyward is…. the sugar you eat with it. Or the starch, or the processed carbs, or whatever else drives your blood sugar up through the roof. Therefore, as researchers writing in the Netherlands Journal of Medicine pointed out, the best way to lower saturated fat in the bloodstream is to lower sugar in the diet.

    If you’re eating a ketogenic diet—or a very low carb diet that keeps you “flirting” with ketosis—saturated fat is going to have absolutely no negative effects on your health. In fact, the absolute worst thing you could say about saturated fat is that it’s neutral—essentially harmless. Unlike olive oil or fish oil, saturated fat doesn’t have a resume of studies saying we should eat more of it—but, contrary to popular belief, the research does not support that we should eat less of it.

    We have much more important dietary challenges to be concerned with than reducing our intake of saturated fat. In fact, one major study at Harvard showed that swapping saturated fat for the almighty carbohydrate actually increased the risk for heart disease!

    The only concern I have about saturated fat from animal products has nothing to do with the fat being saturated. It has to do with the quality- or lack of quality—in factory farmed meat. Fat tissue in mammals is like a safe house for toxins. We store all the crap we’re exposed to—from hormones to pesticides to environmental poisons—right there in our fat cells, and that’s true for cows and humans. So when you eat fat from toxic, factory farmed animals, you’re consuming those toxins.

    And therein lies the problem.

    It has nothing to do with the fat. If a crop of broccoli was contaminated with e. coli would you think broccoli was unhealthy? The only thing that makes animal fats “unhealthy” is the stuff the animals are exposed to if they’re factory farmed. No one has the slightest thing to fear from saturated fat that comes from grass-fed animals.

    My opinion: Concentrate on getting a lot of great fat from omega-3’s, omega-9’s (olive oil), a tiny bit of cold-pressed omega-6, vegetable saturates like coconut oil (I like Barlean’s) and palm oil (I like the sustainable kind that comes from Malaysia).

    And for goodness sake, stop worrying about saturated fat.

    If you’re inclined to worry about your food and the food you feed your family, you’d be better advised to focus on the foods that really rob you of your health: high glycemic, processed carbohydates.

    The very same foods that make us fat, sick, tired, and depressed.

  • Dr. Jonny Speaks at the American Nutrition Association

    Dr. Jonny Speaks at the American Nutrition Association

    Dr. Jonny Bowden discusses the myths surrounding cholesterol at this talk given for the American Nutrition Association.

     

    https://www.youtube.com/watch?v=YGOpjPNtjes

  • Cholesterol Does Matter… But Not In The Way You Might Think

    Cholesterol Does Matter… But Not In The Way You Might Think

    Since the publication of “The Great Cholesterol Myth”, I’ve been known for taking the position that cholesterol doesn’t matter.

    But a casual conversation with a crew member at a Chicago TV station made me realize that cholesterol does matter– only not in the way you might think!

     

  • Why Cholesterol Matters… and Why it Doesn’t

    When you saw the title of this article, did you do a double take? I wouldn’t blame you a bit.

    For over a decade I’ve been calling “naked emperor” (a nicer way to say “B…s…t”) on the cholesterol establishment, an industry worth well over 31 billion dollars a year (but who’s counting) the sole purpose of which seems to be perpetuating the myth that cholesterol causes heart disease, while at the same time promoting the message that statin drugs should be in the water supply.

    (I exaggerate, but not by much.)

    In 2012, cardiologist Stephen Sinatra and I published a book (The Great Cholesterol Myth) in which we argued that cholesterol was a poor predictor of heart disease, was certainly not the cause of heart disease, and that trying to lower your risk for heart disease by lowering your cholesterol was like trying to lower your risk for obesity by taking the lettuce off your Big Mac. (I actually said that on the Dr. Oz show and I still smile when I think of it!)

    So what in the world do I mean when I now say, “cholesterol matters”?

    Glad you asked.

    The other day I was getting ready to appear on the morning show on WHN in Chicago. The segment was on healthy oils and fats, and I was setting up my prop table with samples of good oils and bad oils. On the table was a bottle of crummy generic vegetable oil—which I brought along as an example of what not to cook with. The label on this junk food oil proudly proclaimed “NO CHOLESTEROL”.

    One of the crew stopped by my table, picked up the bottle, and snorted. “No cholesterol, huh?” he said. “Must taste like crap”.

    OK, where do we begin?

    Cholesterol matters, not as a blood test, but as a cultural meme. We are so deeply, profoundly entrenched in the myth that cholesterol is “bad”, that my poor clueless crew member assumed that anything that didn’t have this “bad” thing in it must be some kind of horrible tasting “health food”. (Cholesterol, by the way, is tasteless.) We cling to the notion that lowering the Satanic Molecule will make us healthy, lowering our risk for cardiovascular disease and early death.

    None of it is true.

    The point here isn’t to reargue why it isn’t true. Trust me on this for now—it’s not.

    But huge masses of people continue to believe it is, and that’s why it matters. Those same people also believe that saturated fat is bad and dangerous. Why? Altogether now, class: Because saturated fat raises cholesterol. Which, as we all know, causes heart disease.

    See where I’m going with this?

    Continuing to believe that saturated fat causes heart disease, cholesterol clogs your arteries, and statin drugs are the 21st century’s version of penicillin—costs all of us. The belief in the dangers of cholesterol allow doctors to continue to practice medicine as a paint-by-numbers affair, allows them to continue treating numbers rather than patients, blood tests rather than diseases, and symptoms rather than causes.

    Your cholesterol is 240? Get out the script pad. Never mind the fact that statin drugs have only been shown to be beneficial (and modestly so at that) in middle aged men with previous heart disease. Never mind that there’s not a single research study showing a single woman’s life has ever been extended by statin drugs. Never mind that research shows that higher cholesterol is protective in older people. Never mind that we’re measuring cholesterol with old-fashioned, out-of-date tests. Never mind that several major studies published in august, conservative journals like the Annals of Internal Medicine and the American Journal of Clinical Nutrition  have exonerated saturated fat of any involvement in heart disease.

    And never mind that the side-effect profile of statin drugs includes memory loss, muscle pain, fatigue, and loss of libido. (Is it really a coincidence that we have an epidemic of “erectile dysfunction” in middle-aged men precisely when millions of those same men are on statin drugs? Maybe it is. But it doesn’t pass the smell test.)

    So cholesterol matters. To many people.

    And therein lies the problem.

    I believe we’ve been on the wrong track in our attempts to extend life by lowering this critical, vital molecule.

    I believe that the dietary recommendations of the last forty years have been built on a house of cards that crumbled when saturated fat was found “not guilty”.

    And I believe that the true promoters of heart disease—and practically every other degenerative disease you don’t want to get—are inflammation, stress, and oxidation. By obsessively focusing on cholesterol, we’ve taken our collective eyes off the things that really matter when it comes to health.

    I also believe that sugar—not fat—has always been the culprit in the modern diet.

    Now getting that message out there—in a sea of well-funded, establishment attempts by virtually every major health organization and pharmaceutical company—has not been easy

    But we’ve been doing it.

    More and more doctors are getting on board, more and more books are being written detailing how we got on the wrong path, and more and more research is emerging to support the position that we’ve been wildly, bone-headedly wrong about fat and cholesterol. And that research is getting harder and harder to ignore or explain away.

    But cholesterol still matters because so many people think it does.

    Which means people like me—and Dr. Sinatra, Dr. William Davis, Dr. David Perlmutter, Drs. Michael and Mary Dan Eades, Dr. Uffe Ravnskov, Dr. Chris Masterjohn, Chris Kresser, many of our friends in the Paleo movement, and so many others to numerous to mention—have our work cut out for us.

    Let the games begin!

  • Saturated Fat Is Making a Comeback!

    Saturated fat is making a comeback.

    I know, I know. It’s hard to believe. After forty years of never being able to hear the term “saturated fat” without the modifier “artery-clogging”, after being told for more than four decades that saturated fat is “bad” fat that will lead to high cholesterol and heart disease, after obsessively banishing animal fats from our diet and replacing them with “healthier” fats like canola oil (insert “rolled eyes” here), the tables are finally turning, the tides are finally shifting, down is up and up is down, and in the Alice in Wonderland world of nutrition, eating fat is “in” again.

    Of course, eating fat was never “out” to begin with, at least in some circles. The classic cookbook Nourishing Traditions by Weston Price Foundation director Sally Fallon and biochemist Mary Enig makes generous use of natural, traditional foods like full-fat dairy, cheese, and grass-fed meat. Atkins never swayed from his position that it was perfectly OK to eat fat and that the real problem in the American diet was sugar and starch. Researchers such as Eric Westman, M.D., at Duke and Jeff Volek, R.D., Ph.D, at the University of Connecticut have done study after study showing that higher fat / lower carb diets do none of the harm we were taught they do. Their studies show that properly done high fat diets produce a wealth of benefits including improved body composition and lower triglycerides.

    And “cholesterol skeptics” like myself have argued for years that the demonization of saturated fat has been based on little more than the dual notions that 1) saturated fat “raises” cholesterol, so therefore, 2) saturated fat causes heart disease. (The first is partially true, the second is completely false. More on that in a the next paragraph.)

    We now know that the effect of saturated fat on cholesterol is far more complex than we previously thought—it actually raises HDL cholesterol (which is mostly good), lowers LDLb cholesterol (which is very clearly bad) and raises LDLa cholesterol (which is pretty much neutral). So your overall cholesterol number may well go up when you consume saturated fat, but you’re actually healthier!

    Furthermore, we also know that cholesterol is turning out to be a piss-poor predictor of heart disease, so the whole issue of saturated fat’s effect on cholesterol becomes kind of a moot point.

    The issue of saturated fat and heart disease, however continues to be of concern to many people, but even that concern is beginning (thankfully) to fade in light of recent research. Not long ago, Patty Siri-Tarino, Ph.D., and Ronald Krauss, M.D., of the Children’s Hospital Oakland Research Institute published a seminal study that showed clearly that the amount of saturated fat people eat predicts exactly nothing about their risk of cardiovascular disease. “Intake of saturated fat was not associated with an increased risk of coronary heart disease or stroke, nor was it associated with an increased risk of cardiovascular disease”, they wrote.

    More recently, two separate studies, both published in the Annals of Internal Medicine —one by Rajiv Chowdhury, M.D., and one by Lydia Bazzano, M.D., Ph.D — essentially came to the same conclusion.

    So does this mean you should go out and eat nothing but bacon, butter and steak?

    Not so fast, grasshopper.

    While saturated fat has never, in my mind, been the culprit in anything, it’s important to remember that saturated fat behaves differently in the body depending on what it’s eaten with. If you’re eating a crummy, typical American diet high in processed carbs, starches and sugars, you probably should eat a low-fat diet.

    But you shouldn’t be eating that kind of diet in the first place, at least not if you care about your health.

    It’s also important to remember that fat—in general—is where toxins are stored. So if you’re eating fatty animals that were raised in horrific feedlot farm conditions, cattle that was fed grains, antibiotics, steroids and other hormones, that stuff’s going to wind up in their fat, and, if you eat it, it’s going to wind up in you. So although I have zero fear of saturated fat and consume copious amounts of it in my own diet, what I do NOT consume is feedlot meat—not because of the saturated fat, but because of the steroids, antibiotics and hormones it comes with. If the only meat available to me was the crap they serve in fast food restaurants and the stuff they sell in most grocery stores, I’d probably become a vegetarian.

    Fortunately, grass-fed meat—which is a health food—is becoming much more widely available. Michelle recently discovered grass-fed meat at one of our favorite stores, Target. Yup, Target When she first told me about it, I figured something had to be wrong, but a little digging revealed that the source of Target’s meat is an absolutely wonderful farm called Thousand Hills Cattle.

    These guys are the real deal—they truly care about their animals and their meat, and they produce an absolutely first-rate product that tastes as good as any meat I’ve ever eaten. And it’s 100% grass-fed, not “finished” on grain, as many other “grass-fed” meats are. Kudos both to Thousand Hills farms and to Target for making it available. Yes, it’s about a buck more than crappy meat. It’s worth it ten times over.

    Earlier in the article I mentioned that “properly done” high-fat diets have the potential for enormous health benefits. (I’m currently working on a book with Steven Masley, MD, on just this topic—it will be published by Harper Collins in 2016. Stay tuned.)

    What do I mean by “properly done”? Here are the Cliff Notes:

    If you’re eating a diet rich in whole, unprocessed foods..
    If you’re consuming plenty of vegetables, some low-sugar fruit like berries, and plenty of fiber from beans, legumes, nuts and non-starchy veggies
    If you’re consuming wild (as opposed to farmed) salmon or grass-fed (as opposed to feedlot farmed) beef..
    ..then the amount you need to worry about the fat in your diet—including (but not limited to) saturated fat– is exactly zero.

    As Walter Willet, M.D., Ph.D., the esteemed nutritional epidemiologist and head of the nutrition department at the Harvard School of Public Health has said on numerous occasions:

    “The percentage of calories from fat in a diet (is not) related to any important health outcome.”

  • Busting Myths About Calories + Cholesterol

    Two of my favorite myths to bust are…

    1. The myth that cholesterol causes heart disease.
    2. The myth that all calories are the same.

    Earlier in the year I was interviewed by Jonathan Bailor and here are the myths we busted together…

    The Great Cholesterol Myth

    • The four major promoters of heart disease (none of them are cholesterol).
    • Why cholesterol is vitally important to your health.
    • The real #1 killer of people in developed nations.
    • Why statin drugs often do more harm than good.
    • The new test everyone with “high cholesterol” should take.

    The Calorie Myth

    • Why 128 calories of broccoli are totally different than the 128 calories from a slice of bread.
    • How a “cheat” day/meal every week can ruin your diet.
    • Why simply “eating less and exercising more” won’t help you reach your weight loss goals.
    • How to know if you have a delayed food sensitivity that is causing you to gain weight.

    Source Materials

    In The Great Cholesterol Myth Stephen Sinatra, M.D. and I give readers a 4-part strategy based on the latest studies and clinical findings for effectively preventing, managing, and reversing heart disease, focusing on diet, exercise, supplements, and stress and anger management.
    The Great Cholesterol Myth Cookbook just came out this month! It contains 100 delicious and nutritious heart healthy recipes that will prevent and reverse heart disease and give you back the foods you thought were gone forever.
    The Calorie Myth by Jonathan Bailor comes out on December 31st.

  • Controversial New Heart Disease Documentary Comes Under Attack

    Do you have any interest in heart disease, saturated fat, cholesterol or statin drugs?

    Because if you— or anyone you know or love—is affected by any of those topics, there’s a documentary I really want to urge you to watch.

    And by the way– the Australian heart establishment lobbied like crazy to keep this from being shown on the Australian Broadcasting Company network.

    But they failed.

    Usually I hate books or articles that imply conspiracies with titles like “The secrets THEY don’t want you to know”, but in this case, the “THEY” was very real, and “THEY” really did do everything humanly possible to keep ABC from airing the documentary.

    “THEY” even got the Prime Minister involved.

    And yes, the effort failed and the documentary did indeed make it on the air—but it hasn’t stopped the establishment from a massive campaign to discredit the producer, the journalist, and every expert that was featured in the program, including myself.

    Here’s what happened.
    (more…)

  • A Moving Apology From a Mainstream MD

    Dr. Attia was a mainstream surgeon who swallowed all the mainstream stuff about diabetes and obesity until he received an unexpected diagnosis that changed his life.

    Although the realizations that he comes to—the weight gain is driven by hormones, not calories, and that diabetes and obesity are metabolic diseases of carbohydrate metabolism—is stuff the folks I hang around with have been saying for well over a decade, the turn-around by this mainstream, respected doctor, his personal journey and his poignant apology to all the patients he inadvertently harmed by swallowing all the mainstream malarkey about diabetes and obesity is something that you’ll really want to see.

  • Conventional Cholesterol Tests are Obsolete

    As many of you know, I’ve been traveling around a bit, speaking about our best-selling book “The Great Cholesterol Myth”, and one of the things I’ve been saying is that conventional cholesterol tests are obsolete, a message I repeated recently on the Dr. Oz show as well as The Doctors.

    And one of the questions I’m frequently asked is this: What tests should I pay attention to?

    The Cholesterol Particle Test

    That’s the more modern version of a cholesterol test that takes into account the fact that there are different types of LDL cholesterol and that they behave differently in the body. LDL-a, for example, is a big fluffy molecule that does little if any harm, while LDL-b is a nasty little oxidized particle that causes inflammation and is of great concern. (If your doctor is “treating” you for high cholesterol based only on your total LDL number, he or she is missing the boat and treating a number, not a patient. You need to know what kind of LDL you have: pattern A (harmless) or pattern B (inflammatory). Without the particle test, there’s no way to know.)

    Actually, I lied.

    There is a way to know what kind of LDL you have even without taking the particle test. Best of all, you can do it at home and even better, it doesn’t cost  a dime. It’s a test you can perform yourself if you’ve had a standard blood test in the last six to twelve months and if you can do third grade level math. It’s easy, low-tech, and it provides extremely valuable information—way more than a conventional cholesterol test.

    Triglyceride to HDL Ratio

    Here’s how you do it. Look at any standard blood test you’ve had recently and pick out two numbers: Triglycerides and HDL cholesterol. Both of them will be on the test, guaranteed. The triglyceride number will always be higher (OK, 99.999999% of the time). To find the ratio, simply divide triglycerides by HDL. Bam. You’ve got your ratio. And in a minute, I’ll tell you what it means.

    In case the very thought of math makes your eyes glaze over even if it’s simple division, let’s do a few examples:

    • Let’s say your triglycerides are 100 and your HDL is 50. Your ratio is thus 100: 50, which you can streamline by simply dividing triglycerides (100) by HDL (50) giving you a ratio of 2.
    • Say your triglycerides are 150 and your HDL is still 50. The ratio is now 150: 50, or 150 divided by 50, or 3.

    The triglyceride to HDL ratio is an excellent indicator of heart health. It’s also an excellent marker for insulin resistance (or it’s opposite, insulin sensitivity). You want your triglyceride to HDL ratio to be low—2 or under is wonderful. When it’s high, it’s cause for concern, or, even better, action.

    The triglyceride to HDL ratio—something integrative physicians and health professionals have been talking about for years—recently got a big boost in public awareness. Just this week, the Wall Street Journal published a full page article (“Children on Track for a Heart Attack”) reporting on a study from the Cincinnati Children’s Hospital Medical Center that looked at nearly 900 children and young adults. The study, published in the journal Pediatrics found that higher the ratio of triglycerides to HDL, the greater the likelihood that a child would have stiff and damaged arteries.

    “Stiff vessels make your heart work harder. It isn’t good for you.”

    – Elaine Urbina, head of preventive cardiology at Cincinatti Children’s, and lead author of the study

    Indeed. The triglycerides to HDL ratio is also a great indicator of insulin resistance. In one study, a ratio of three or greater predicted insulin resistance with great reliability, while in another classic study from Harvard researchers, those with a high ratio were 16 times more likely to develop heart disease than those with a low ratio.

    If you’ve read my book, The Great Cholesterol Myth, you know that when it comes to LDL cholesterol measurement, the metrics that matter are not total cholesterol or even total LDL, but the number and size of your LDL particles.

    The triglyceride to HDL ratio is an excellent stand-in for the particle size test. (Your insurance company may not cover the particle test, and you may not feel like springing for the 60 bucks or so it costs to get it, though I highly recommend that if you’re “worried” about your cholesterol you do exactly that. But your triglyceride to HDL ratio is a terrific—and no cost—substitute.)

    Those with high ratios of triglycerides to HDL tend to have much more of the atherogenic LDL-B particles, while those with low ratios tend to have the much healthier LDL-A particles. We would certainly not recommend treatment of “high cholesterol” with a statin drug just based on total LDL, and especially not for a person with a very low (2 or under) triglyceride to HDL ratio.

    The triglyceride to HDL ratio got a lot of attention at the recent conference of the Nutrition and Metabolism Society in San Diego, and—if that recent Wall Street Journal article is any indication– you’ll be hearing about it more and more once the media gets the message from doctors about how important it really is.

    The information it gives you is invaluable, and you can’t beat the cost.