LDL cholesterol is a prime risk factor for the #1 killer of men
and women: heart disease. But how low should you go?
Watch the video to find out.
"How Low Should You Go for Ideal Cholesterol Levels? "
Consistent evidence from a variety of sources unequivocally establishes
that bad LDL cholesterol causes atherosclerotic cardiovascular disease---
strokes and heart attacks--- our leading cause of death.
This evidence base includes hundreds of studies involving millions of people.
Cholesterol is the cause of atherosclerosis, the hardening
of the arteries, and the message is loud and clear.
"It's the Cholesterol, Stupid!" noted the editor of the American Journal
of Cardiology, William Clifford Roberts, whose CV is more than 100 pages long,
having published about 1,700 articles in peer-reviewed medical literature.
Yes, there are at least 10 traditional risk factors for atherosclerosis, but,
as Dr. Roberts noted, only one is required for the progression
of the disease: elevated cholesterol.
"Phew!" you say, because you just got back from your doctors
and your cholesterol's normal. Thank goodness. But wait.
Having a normal cholesterol in a society where it's normal to drop dead
of a heart attack isn't necessarily a good thing.
With heart disease, the #1 killer of men and women, we definitely don't want
to have normal cholesterol levels; we want to have optimal levels,
and not optimal by current laboratory standards, but optimal for human health.
Normal LDL cholesterol levels are associated with the hidden buildup
of atherosclerotic plaques in our arteries, even in those
with so-called optimal risk factors by current standards: blood pressure
under 120/80, normal blood sugars, total cholesterol under 200.
If you went to your doctor with those kinds of numbers,
you'd get a gold star and a lollipop.
But if your doctor used ultrasound and CT scans to actually peek inside your body,
overt atherosclerotic plaques would be detected in 38% of people
with those kinds of "optimal" numbers. Maybe those ain't so optimal after all.
Maybe we should define an LDL cholesterol level as optimal
only when it no longer causes disease. What a concept!
When more than a thousand men and women in their 40s were scanned,
having an LDL level under 130, which most lab tests would consider
a normal LDL, left them with atherosclerosis throughout their body.
Atherosclerotic plaques were not found only with LDL down around 50 or 60,
which just so happens to be the level most people had
before we all started eating this way.
The majority of the adult population of the world had LDLs of about 50 (mg),
so that's the true normal.
Present average values should not be regarded as normal.
We don't want to have a normal cholesterol based on a sick society;
we want a cholesterol normal for the human species,
which may be down around 30-70 (mg/dl), which for those who live
outside of the U.S. is an LDL of 0.8 to 1.8 millimoles per liter.
Although an LDL level of 50 to 70 (mg/dl) seems excessively low
by modern American standards, it is precisely the normal range
for individuals living the lifestyle and eating the diet
for which we were genetically adapted over millions of years:
a diet centered around whole plant foods.
No wonder we have this killer epidemic of atherosclerosis,
given the LDL level our
bodies were designed for is less than half of what we presently
consider normal. There is an inappropriate tendency in medicine
to accept small changes in risk factors, but the goal is not
to just decrease risk but to prevent plaques, period.
So how low should you go?
In light of the latest evidence from trials exploring the benefits and risks
of profound LDL cholesterol-lowering, the answer to the question
"How low do you go?" is, arguably, a straightforward "As low as you can!"
But yes, indeed, lower may indeed be better; however, if you've got to do it
with drugs, then you have to balance that with the risk of drug side effects.
The reason we don't just drug everyone with statins,
like put it in the water supply,
is that although it would be great if everyone's cholesterol was lower,
there are the countervailing risks of the drugs.
So doctors aim to use statin drugs at the highest dose possible,
achieving the largest LDL cholesterol reduction possible without increasing
risk of the muscle damage the drugs may cause.
But when you're using lifestyle changes to bring down your cholesterol,
all you get are the benefits. But can you get it low enough with diet alone?
Ask some of the country's top cholesterol experts what they shoot for,
and odds are you'll hear something like an LDL under 70 or so.
Yeah, we should try to avoid the saturated and trans fats
found in junk foods and meat and the dietary cholesterol found mostly in eggs,
but it is unlikely anyone can achieve an LDL cholesterol level of 70 (mg/dl)
with a low-saturated fat, low-cholesterol diet alone.
Many doctors have this mistaken impression.
An LDL of 70 isn't only possible on a healthy enough diet; it may be normal.
Those eating strictly plant-based diets can average an LDL that low.
No wonder plant-based diets are the only dietary patterns ever proven
to reverse coronary heart disease in a majority of patients.
And the side-effects? You get to feel better too!
Several randomized clinical trials have demonstrated
that more plant-based dietary patterns significantly improve
psychological well-being and quality of life, less depression, less anxiety,
better emotional well-being, better physical well-being,
and better general health.