How Can Functional Medicine Help Me?

As many of my patients know, I run a busy chiropractic office in Austin, Texas… but I also have a thriving Functional Medicine practice that allows me to consult with and help people all over the US and abroad.

Still, many of my you have been asking me questions surrounding Functional Medicine and what it entails.

My philosophy to health is pretty simple: Move Well, Eat Healthy and Cultivate Happiness.

As a chiropractor, my goal is to make sure that your spine is healthy, your joints are mobile and you have no physical limitations in movement. Functional Medicine allows me to address the other 2 components: eating well and cultivating happiness.

In this article, I’d like to discuss my approach and how it works.

Conventional medicine has a doctor for every part of your body. There are cardiologists for your heart, gastroenterologists for the digestive system, neurologists for the brain and nervous system, podiatrists for your feet, and ophthalmologists for your eyes.

Due to specialization, conventional medicine often focuses on individual body systems, rather than trying to understand the whole person and ultimately that individuals underlying causes of disease and chronic illness.

In light of this, symptoms are used to name a disease and find a corresponding drug. That’s typically your treatment.

  • High blood pressure gets you blood pressure lowering pills.
  • High cholesterol, gets you cholesterol lowering pills.
  • Infections of any kind almost always get you antiobiotics
  • Imbalanced hormones, gets you hormone replacement therapy.
  • Etc. Etc. Etc.

Basically, your symptoms are treated with no regard for the “cause”.

In functional medicine, the goal is to view your body as an interconnected whole, within a larger environment.

In other words, your health is the sum of all nongenetic (your external environment) and genetic (internal environment) exposures in your lifetime, starting from the moment of conception to death. It encompasses the food we eat, the air we breathe, social interactions, lifestyle choices and inherent metabolic and cellular activity.

Functional Medicine doctors recognize that in order to treat one part of the body, all other parts must also be considered. This breaks apart artificial divisions of the body.

What Functional Medicine Addresses

I have a hierarchy of importance for which factors to address when starting with a patient:

  1. Diet, Lifestyle and Environment.
  2. Nutrient imbalance, gut and HPA-axis
  3. Cellular Dysfunction, Toxic Burden, Hormone Imbalance
  4. Chronic Infections and Immune Dysregulation
  5. Treating symptoms for diseases that cannot be fixed

Diet, Lifestyle and Environment 

As a good rule, any doctor interested in improving health should begin with diet, lifestyle and environment. It is what it is and there’s no way to self-medicate, supplement or artificially create what life requires.

Nutrient Imbalances, Gut Infections or Dysbiosis and HPA-axis

There are two reasons why we address this next:

First, these factors are often at the root of, or at least strong contributors, of other pathologies such as hormone imbalances (Low T, Thyroid problems, PCOS, etc), cellular dysfunction (Energy balance, Diabetes, Heart Disease, Weight) and immune dysregulation (autoimmune disease, cancer, arthritis, tissue repair).

Second, even if there are other problems occurring, this will lead to a significant clinical improvement towards helping any other condition.

I believe that up to 80% of health problems can be addressed by simply getting #1 (Diet, Lifestyle, Environment) and #2 (Nutrient imbalances, gut infections or dysbiosis and HPA-axis) in check.

Cellular Dysfunction, Toxic Burden, and Hormone Imbalance

In some cases we have to dig deeper. This involves assessing methylation, heavy metals, mold/biotoxins, impaired detoxification, thyroid, sex and metabolic hormones. Again, most of these problems can be addressed by improving diet, lifestyle, nutrient imbalances, gut health and stress.

Chronic Infection and Immune Dysregulation

Some patients have infections (Lyme, co-infections, parasites) that are pretty nasty and almost always require a more specialized and even integrated (Medical Prescription) approach.

How can you get started?

If you’re interested in a functional medicine consult, here’s my flow:

The consult has 2 parts: A 20 minute case review and an hour to 2 hour case review

STEP ONE: INITIAL 20 MINUTE CONSULT

After purchasing an initial consult, we will setup a time for us to meet over the phone or in person. During this 20-minute appointment, I will interview you to determine which lab tests to order for your Case Review, based on your chief complaints and your history.

This appointment has two purposes: to make sure that I have all of the information needed to gain a comprehensive understanding of the factors affecting your health and to give you a head start on your treatment before you meet with me.

The exact lab testing ordered after the Initial Consult depends on your individual circumstances, but may include:

  • A comprehensive blood chemistry panel. This is the single most efficient, effective and affordable tool for quickly evaluating your health. It screens for a wide range of conditions, including several types of anemia; gut, viral and bacterial infections; insulin resistance and hypoglycemia; liver and kidney issues; and thyroid and adrenal problems. It offers important clues for how to structure and focus your treatment to get the best results. It also provides a baseline of biomarkers that can be used to objectively track the progress of your treatment over time.
  • Additional blood tests for specific conditions, such as high cholesterol, hypothyroidism, autoimmune disease and gluten sensitivity.
  • Advanced stool testing to screen for parasites, fungal overgrowth, bacterial infections, intestinal inflammation, dysbiosis and a deficiency of beneficial gut bacteria.
  • Urine organic acids testing to screen for small intestinal bacterial overgrowth, fungal overgrowth, problems metabolizing fat or carbohydrates, B-vitamin status, methylation issues, detoxification capacity, oxidative stress and neurotransmitter metabolism.
  • Urine hormone testing for adrenal and sex hormone status.

You will also be provided the Case Review health history paperwork to complete.

This paperwork includes:

  • A detailed health and medical history questionnaire
  • A survey of your chief complaints and most important health goals
  • An assessment of your most troubling and frequently experienced symptoms
  • A diet survey and questionnaire
  • A survey of your current supplements and medications

Once we’ve received your lab results and completed the Case Review paperwork, I will give you specific protocols to start working on before moving on to part 2: the case review consultation.

This typically occurs between 60 and 90 days after the Initial Consultation, because some of the labs we use take up to 8 weeks to deliver the results to us after receiving your sample.

STEP TWO: THE CASE REVIEW CONSULTATION

The Case Review Consultation is a 60-minute to 120-minute in-person, phone or video appointment.

Prior to the consultation, I will have reviewed the results from the labs that were ordered along with your Case Review paperwork, medical history, diet and supplement survey, assessment forms and relevant prior lab work. I will also create a Report of Findings, which is broken into three parts:

  • A summary of the underlying patterns that are contributing to your symptoms.
  • An outline of the suggested treatment plan, including dietary, supplement and lifestyle recommendations.
  • Recommendations for further testing (this will typically be minimal, if necessary at all, because of the completeness of the Case Review process)

During this visit, I will present the Report of Findings as well as your treatment plan. I will also review all of your test results with you and answer any questions you have about the findings or the treatment plan.

High Blood Pressure & Natural Solutions

Do you have high blood pressure?

If so, don’t worry (too much)!

While blood pressure, or hypertension, has recently been found to be the most important risk factor for premature death [1], there is good news.

We now know that a poor diet and a sedentary lifestyle is the primary cause of hypertension. And given the fact that many of us are afflicted with this unhealthy condition, it’s good to know that we can actually do something about it!

It’s estimated that the majority of Americans over the age of 60 have clinical hypertension. What’s interesting is that if you were to compare that to modern hunter gatherers of the same age, this number is drastically lower [2].

What’s the difference?  Modern hunter gatherers still incorporate the types of food into their diets that our bodies were evolved to process in a healthy manner AND they live an active lifestyle – full of exercise.

In this article, we’re going to discuss how to tackle high blood pressure naturally.  It’s certainly worth trying at least; before you pump your body full of prescription drugs that only treat the symptom of hypertension, and not the underlying cause.  As we’ll discuss later, these drugs also come with their own, oftentimes dangerous, set of symptoms.

What Is High Blood Pressure and How Is It Measured?

High blood pressure is an unfortunately common condition where the force of your blood against your artery walls is high enough that it can eventually cause health problems like heart disease.

Blood pressure is physically caused by two factors:

  • The amount of blood your heart pumps and
  • The amount of resistance to blood flow in your arteries.

So, the more blood your heart pumps and the narrower your arteries, the higher your blood pressure.

Luckily, blood pressure is easy to measure.  When you read your blood pressure, it’s expressed as a measurement with two numbers, in units of millimeters of mercury (mm Hg), expressed as a fraction.  120/80 or “120 over 80”, for example.

The top number is your “systolic pressure” and is a measurement of the amount of pressure in your arteries when your heart is contracting.

The bottom number is your “diastolic pressure” and is a measurement of your blood pressure between heart beats.

According to the American Heart Association, high blood pressure is diagnosed when your systolic pressure is above 120 mm Hg or your diastolic pressure is above 80 mm Hg [3].

Why Do We Care?

Symptoms of high blood pressure can include nosebleeds, headaches and shortness of breath.   The majority of people are asymptomatic and, unfortunately, you can live with high blood pressure for years and not have any symptoms – until you actually get your blood pressure measured by a clinician.  Even if you don’t have symptoms, damage to your blood vessels and your heart continues.  If you don’t control your blood pressure, your risk of serious and deadly health problems including heart attack and stroke [4, 5].

Conventional Treatments

Rather than address the underlying causes of high blood pressure, conventional physicians prescribe a number of various drugs to treat hypertension.  These include:

Diuretics

Diuretics – also called water pills – trigger your kidneys to remove sodium and water from your body by increasing your rate of urination.  This eases the pressure on your arteries by lowering your blood pressure.  Diuretics can include:

  • Diuretics are the first and most commonly prescribed medication to treat high blood pressure.  Not only do they decrease fluids, but they also cause your arteries to relax.  Thiazides are often prescribed with other drugs to lower blood pressure.
  • Loop diuretics. Loop diuretics work by interfering with the movement of salt and water across certain cells in your kidneys – forcing them to pass more fluid.  As your kidneys pass more fluid, less remains in your blood stream thereby reducing your blood pressure.
  • Potassium sparing diuretics. Potassium sparing diuretics are commonly used in combination with other types of diuretics to ensure that your potassium levels remain at a safe level.

While diuretics are generally safe, they do have some side effects, including [6]:

  • Hyperkalemia and hypokalemia (too much or too little potassium).
  • Hyponatremia (low sodium).
  • Dizziness
  • Headaches
  • Dehydration
  • Muscle cramps
  • Gout
  • Impotence

Beta Blockers

Beta blockers are used widely for high blood pressure, either alone or in combination with other medicines.  Beta blockers act by lowering your heart rate and are typically prescribed to people who also have angina, heart failure or who’ve already had a heart attack.  There are several side effects associated with beta blockers, including [7]:

  • Trouble breathing.
  • Swelling of the face, lips, tongue and throat.
  • Very slow heart rate.
  • Swelling in the legs or feet.
  • Trouble sleeping.

ACE Inhibitors

Angiotensin-converting-enzyme (ACE) inhibitors are pharmaceutical drugs used primarily for the treatment of hypertension.  ACE inhibitors work by preventing your body from creating a hormone known as angiotensin II.  Angiotensin II has three main effects, including:

  • Constriction of blood vessels.
  • Re-absorption of water by your kidneys.
  • Release of aldosterone, another hormone that causes water re-absorption by the kidneys.

To summarize, ACE inhibitors essentially relax blood vessels and helps to reduce the amount of water re-absorbed by the kidneys [7].  Both of these mechanisms work to lower your blood pressure.  Side effects of ACE inhibitors include:

  • Hypotension (low blood pressure)
  • Dizziness
  • Dry cough
  • Swelling of the lips, eyes and tongue.
  • A decline in kidney function.

Calcium Channel Blockers

Calcium channel blockers (also called calcium antagonists) are another commonly prescribed medicine to reduce blood pressure.  They work by relaxing and widening the blood vessels by affecting muscle cells in the arterial walls. There are both short-acting – which work quickly but only last a few hours – and long-acting – which are released slowly but provide a longer effect [8].   Side effects of calcium channel blockers include:

  • Rash
  • Drowsiness
  • Nausea
  • Foot and lower leg swelling
  • Headache
  • Heart palpitations

Lifestyle Factors

So now that we know a little more about the drugs that conventional practitioners prescribe to treat the symptom of high blood pressure, let’s discuss the lifestyle factors that actually contribute to the underlying cause.  As I mentioned before, high blood pressure is virtually nonexistent in modern hunter gatherers.  While diet, sleep, stress and whether you smoke all contribute to cause high blood pressure, let’s focus in on diet because that packs the biggest bang for the buck (smoking arguably rivals diet when it comes to high blood pressure, but let’s assume, for this discussion, that you’re a non-smoker).

So, what is it in our diet that causes high blood pressure?

Let’s dig a little deeper into the diet-blood pressure connection and focus on sugar and mineral and nutrient imbalances.

Sugar

Our modern diet is full of sugar – from fructose in fruit juices to high fructose corn syrup in soda and sweetened cereal to sucrose in candy – it’s everywhere in our modern, processed foods.  In fact, a lot of this sugar is “hidden” in some foods we don’t even realize or think about – baked goods made from white, “enriched” flour, alcoholic beverages like beer and wine, and in condiments and even crackers.  The list goes on and on.  A recent study by Louisiana State University looked at over 800 people with some form of hypertension in an effort to find out how sugary drinks affected blood pressure.  The study found that people who drank one less serving of a sugary drink per day had a measurable decline in blood pressure after a year and a half [9].

Mineral and Nutrient Imbalances

A healthy diet plays a major role in blood pressure control.  Specifically, obtaining the right amounts of sodium, potassium, magnesium and calcium in our diets are crucial to maintaining low blood pressure.  Too often, however, our modern diets lack in in some minerals – especially potassium, magnesium and calcium – and too high in others – namely sodium.  Throwing these mineral balances out of whack with a poor diet full of processed foods will do a number on your blood pressure.

The Natural Fix For High Blood Pressure

So, how do we attempt to fix high blood pressure without resorting to prescription drugs?

I would maintain it’s quite simple, really.  Maybe as easy as 1-2-3.

  • If you smoke, quit. This is really a no brainer as smoking and the use of tobacco products are extremely poor for your long-term health.  You all should know this so I won’t waste too much time extolling the virtues of a smoke-free lifestyle.
  • Clean up your diet. How do we avoid the sugar and mineral and nutrient imbalances that play a huge role in high pressure?  I would recommend adopting a paleo, or ketogenic or other ancestral diet.  Eat meat and vegetables.  Limit your dairy to start and avoid all processed foods, alcohol and sugar of any kind.  There are a ton of great resources online on how to get started but the main advice is: stick to the outside of the grocery store.  Give it a shot for 30 days.  Not only will your blood pressure go down, you’ll lose weight and, if you make it through the first week, you’ll feel so good you’ll wonder why you haven’t been eating this way your entire life.
  • Work on your sleep and exercise. Finally, if you’ve made it through steps one and two, take a look at your sleep habits and start to adopt some easy to stick to exercise routine.  Try starting with a 30 minute walk each morning and going to bed at the same time every night (even on the weekends).    

Drastic lifestyle changes can be tough to implement, but I would maintain that they are entirely worth it.  Especially compared to the high blood pressure “band-aids” that are prescription drugs.   The potential side effects from these blood pressure medications we talked about before are just no fun.  I challenge you to give yourself a couple months to try making it through the steps I outlined above.  If you can, I can almost promise you’ll not only feel great, but you’re blood pressure will drop measurably.

If you have any questions on any of the information I presented in this article, or to talk to me about a consultation to try to implement some of the natural high blood pressure fixes I talked about, contact me today.

Statin Drugs: Are They Worth the Risks?

Statin Drugs: Are They Worth the Risks?

Statins (cholesterol lowering medications) are one of the most commonly prescribed medications in America. Approximately one in every four adults over age 40 take these drugs to lower their cholesterol levels.

It is no secret that statin drugs are recommended left, right and center to people with elevated cholesterol levels, to those with existing heart problems and even to healthy people as a primary form of prevention.

We have been led to believe that statins lower cholesterol levels and by extension reduce the risk of heart disease and stroke. While statins indeed reduce cholesterol levels, this is only a part of the entire puzzle. The problem is: the proof that this ‘cholesterol lowering outcome’ prevents any major cardiovascular event such as heart attack or stroke, simply doen’t exist. Cholesterol levels, unless they are drastically off the charts, are not a very strong predictor of your heart disease risk.

Another fact is that the benefits of statins are mostly overstated, whereas the associated risks are often underreported.

How do statin drugs works?

Your liver produces cholesterol through a pathway called the mevalonate pathway – that involves an enzyme HMG-CoA reductase. Statin drugs block the production of this enzyme and lower the cholesterol production in the liver.  The picture below shows this process.

However, things don’t end here. Besides cholesterol, the mevalonate pathway (with the enzyme HMG-CoA reductase present at the base of it all) is also involved in the production of other non-sterol compounds such as CoQ10 (ubiquinone), dolichols, heme-A, selenium containing proteins, sex hormones, corticosteroids, bile acids and vitamin D. [1]

So, when you are using statin drugs, you are not only lowering your cholesterol levels (the simmering debate is whether we really need to?) but also disrupting the production of so many other compounds that are essential for cell growth, and maintain heart, muscles, brain and immune health.

Do statins drugs really work?

Well, statin drugs do what they are meant to do; they lower your cholesterol levels. But does this mean you are getting any healthier? Or that your risk of getting a heart disease or stroke is decreased? That will be one wrong assumption; with no real scientific backing at all.

In my previous article, we discussed the importance of cholesterol in the body and that lowering cholesterol has no real significance on your heart health.

On the other hand, there is a plenty of evidence that statin drugs come with many serious side effects. We will talk about these side effects in details, but first, it is time to address the most controversial question.

Do statins really prevent heart disease?

First, it is important to know that your cholesterol levels play a minor role, if at all, when it comes to your risk of developing heart disease or getting a heart attack. Chronic inflammation (prompted by oxidative damage, stress and excessive consumption of sugar and processed foods) contribute much more to this risk.

We blame cholesterol because it is found at the site of inflammation, injury and damage but that is only because it is there to help in its anti-oxidant and anti-inflammatory capacity. Cholesterol is also easy to blame because you can significantly lower it by using medications.

Secondly, evidence suggests that statins may actually increase your risk of developing atherosclerosis and heart problems.

Research and clinical trials prove that taking statins is nothing sort of a gamble – only favorable in some patients and under narrow circumstances. That brings us to the use of statins in primary prevention and secondary prevention.

Statin drugs in primary prevention: In people without any pre-existing heart condition

A study examined the effect of statins in people who have never suffered a heart attack or stroke; which is mostly the case as statin drugs are commonly prescribed at the first sign of elevated cholesterol.

Not surprisingly, the analysis found that statins do lower cholesterol in most of these people. But only a very few people will dodge a cardiovascular event (a heart attack or a stroke) because of the cholesterol lowering outcome. More specifically, [2]

  1. 1 in 60 (1.6%) prevented a heart attack
  2. 1 in 268 (0.4%) prevented a stroke
  3. 1 in 67 (1.5%) developed diabetes
  4. 1 in 10 (10 %) suffered from muscle damage

In addition, the drugs don’t show any benefits whatsoever when it comes to extending the lifespan.  A 2010 meta-analysis of the clinical trials examined whether stains have any effect on longevity in a high-risk primary prevention scenario. The study found that statin therapy does not significantly reduce all-cause mortality risk among high-risk people without any with clinical history of coronary heart disease. [3]

Statin benefits are obviously overstated!

In 2015, a study published in Expert Review of Clinical Pharmacology indicated that both the safety and life-saving ability of statin drugs have been exaggerated. The researchers stated that statins effectively reduce cholesterol levels, but do not offer any impressive cardiovascular disease outcomes, also adding that statin researchers use ‘statistical deception’ to embellish claims about their effectiveness. [4]

For example, statins actually benefit only 1% of the population; meaning these drugs will prevent a heart attack in only one out of 100 patients. This is the absolute risk. But this figure is certainly not presented as is, but by using another statistic called the ‘relative risk’. This results in creating an illusion that statins prove effective in 30-50% of the population.

The study authors, Dr. David M. Diamond and Dr. Uffe Ravnskov explained further “In the Jupiter trial, the public and healthcare workers were informed of a 54 percent reduction in heart attacks, when the actual effect in reduction of coronary events was less than 1 percentage point.”

“In the ASCOT-LLA study, which was terminated early because it was considered to have such outstanding results, there were heart attacks and deaths in 3% of the placebo (no treatment) group as compared to 1.9% in the Lipitor group. The improvement in outcome with Lipitor treatment was only 1.1 percentage point, but when this study was presented to the public, the advertisements used the inflated (relative risk) statistic, which transformed the 1.1% effect into a 36% reduction in heart attack risk.” [5]

John Abramson, MD (of Harvard Medical School and author of Overdosed America), and James Wright, MD (of University of British Columbia) analysed 8 clinical trials on the effect of statins versus placebo. They reported in the journal Lancet that the absolute risk reduction of 1.5% is insignificant. [6] The analysis further suggested that:

  • Statins should not be prescribed in women of any age or for men older than 69 years (as a primary prevention.)
  • Men considered high risk and aged 30-69 years should be counselled that about 50 patients need to be treated for 5 years to prevent one cardiovascular event.

Clinical data do not support the use of statin therapy in primary cardiovascular prevention. On the other hand, plenty of evidence points to the fact that statins actually “augment cardiovascular risk in women, patients with Diabetes Mellitus and in the young”. [7]

So, the question is whom do the statins work for anyway?

Statin drugs in secondary prevention: In people with pre-existing heart condition

Studies suggest that statins are effective in people who already have had heart attacks or cardiovascular events. However, even for this set of population the efficacy of statins is not very remarkable.

As this analysis showed, 5 years of daily statin treatment could only save 1 out of 83 people. The therapy prevented stroke in 1 out of 125 people and prevented non-fatal heart attack in 1 out of 39 subjects. At the same time, use of statins over this period caused diabetes in 1 out of 5 people and muscle damage in 1 out of 10 people. [8]

But how do you know where to draw the line? Let’s simplify this.

Statins can be beneficial in some patients with pre-exiting history of developing coronary heart disease, that is when used a secondary prevention. This is where the potential risk is quite high. But if you fall in the low-risk category with no prior history of a heart problem, proceed with caution.

Again, it pays to remember that cholesterol is not a causative factor in heart disease and trying to lower it by using statins, especially in elderly and women, is simply unwarranted. Consult an expert healthcare professional to help you understand your benefits and associated risks, and decide if the gamble is worth.

Statins are beneficial, even needed, if you have familial hypercholesterolemia

Familial hypercholesterolemia is a serious genetic condition where the affected person has high levels of blood LDL cholesterol. Here, the body is not naturally equipped to remove excess LDL from the blood. The condition is present at the time of birth and can cause heart attack and other cardiovascular problems at quite an early age.

Side effects of statins: Worth the risk?

Statins exert a wide range of adverse effects that more than offset the modest benefits.

Revisiting the 2015 study by Diamond and Ravnskov, the authors stressed that cholesterol lowering consequence of statins is often associated with an increased risk of cancer. They also highlighted that most statin trials are concluded within a span of two to five years. This period is not long enough to record the development of most cancers.

Coming back to the question: Do Statins Really Prevent Heart Disease? On the contrary. Let’s find out.

  1. Statins and heart disease risk

A 2015 study published in Expert Review of Clinical Pharmacology showed that statins may actually trigger atherosclerosis and heart failure. The study highlighted various mechanisms to show statins may aggravate your heart problems and concluded that statins work as mitochondrial toxin that “impair muscle function in the heart and blood vessels through the depletion of coenzyme Q10 and ‘heme A’, and thereby ATP generation.” [10] Let’s take a look.

  • Statins supresses CoQ10 production

Statin drugs target mevalonate pathway to control cholesterol production. But this important pathway is also involved in the synthesis of CoQ10 – a coenzyme present in every cell of the body.

CoQ10 plays an indispensable role in the production of ATP, the energy currency, in the mitochondria. Without CoQ10, our body won’t be able to produce any bit of energy. The co-enzyme is also a powerful anti-oxidant and protects the arteries from oxidative damage and ensuing inflammation. It is easy to see how these properties translate into heart health benefits?

Your heart needs the maximum energy funding to continue beating nonstop – pumping oxygen and nutrient-rich blood across the body. This is the precise reason why heart has the highest concentrations of CoQ10 as compared to any other organ in your body. Now, statin drugs deplete your body of CoQ10. Low CoQ10 levels, especially in the heart, contribute to the onset and progression of congestive heart failure (CHF) and heart attack. More on the role of CoQ10 in our next article.

  • Statins and muscle pain

Statins have adverse effects on skeletal muscle – ranging from mild muscle pain, muscle fatigue to more serious rhabdomyolysis. Statin drugs inhibit the production of CoQ10 levels, an action that impairs the energy production in the muscles. This causes muscle weakness and fatigue.

A 2013 study concluded that musculoskeletal Conditions, arthropathies, injuries, and pain are more common in people who are on statins than non-users. The study explained that among other factors, the blocking effect of statins on the synthesis of COQ10 as well as the selenoproteins may be at play here. [11] Selenoproteins such as glutathione peroxidase play a pivotal role in averting oxidative damage in the muscle tissue.

One rare, but extremely dangerous, side effect of statins is a condition called rhabdomyolysis. In this condition, damaged muscle tissues break-down and release a protein called myoglobin into the bloodstream. Too much of myoglobin in the blood can cause damage to the kidneys. The most telling symptoms of rhabdomyolysis include intense muscle pain throughout the body, muscle weakness, dark colored urine and general feeling of being sick. The risk of rhabdomyolysis increases with the increased dose of statins.

  • Statins block vitamin K2 synthesis

Statins inhibit the production of vitamin K2. The vitamin is known to mobilize calcium into the bones and keep it away from arteries and soft tissues – thus preventing calcium deposition and build-up of plaque in the arteries.

Vitamin K2 activates matrix Gla-protein, that prevents calcification in the arteries. [12] Vitamin K2 also activates osteocalcin – a protein that holds onto calcium and directs it towards the bones – making bones stronger and less prone to fracture.

  1. Statins and cognitive functions decline

It is simple. Your liver makes cholesterol because the body needs it for so many things (to make vitamin D, bile acids and all kinds of important hormones).

When your cholesterol levels drop too low, as with long-term and high dose statin users, your body would seek it from other cholesterol-rich sources, for example the brain.  Your brain contains about 25 % of the cholesterol in the body. It plays a critical role in the transmission of neurotransmitters and facilitates communication between the neurons, which helps us to think and affects how well we learn new things and make memories. When cholesterol dips too low in the brain, a lot of patients on statins suffer memory loss and decline in their cognitive faculties.

We know that statins work by reducing cholesterol production in the liver. A 2009 research by Yeon-Kyun Shin, an Iowa State University scientist, demonstrated that statins may also keep the brain from synthesising cholesterol.

Shin tested how the release of neurotransmitters by the brain cells is affected both in the absence and presence of cholesterol. When he measured the protein function in the brain with cholesterol in attendance, there was a fivefold increase in the protein function. Shin further explained that cholesterol alters the shape of the protein to stimulate thinking and memory. [13]

In 2009, a research published in the Journal of Lipid Research concluded that “the long-term effects of statin therapy could lead to transient or permanent cognitive impairment in patients who already have low levels of brain cholesterol.” [14]

This is a huge cause of concern in the elderly because with age, there is a lot less production of cholesterol in the brain already. In addition, cholesterol as well as phospholipid levels are reduced in the patients with Alzheimer’s Disease. The study showed that statins influence the expression of genes involved in neurodegenerative processes and suggested a potential mechanism that triggers statin-induced cognitive impairment in vulnerable patients.

  1. Statins and risk of diabetes

Statins increase your risk of diabetes through many mechanisms.

Studies show that long-term statin therapy increases the risk of new-onset diabetes, possibly by damaging the functions of pancreatic beta cell and by reducing insulin sensitivity. [15] [16] In addition, statins elevate blood sugar levels. The drugs also inhibit the production of CoQ10, a nutrient that helps to control blood sugar levels.

  1. Statin and cataracts

Cataract, the cloudiness in the eye lens, is a leading cause of reduced or blurred vision among the elderly. It is primarily caused by oxidative damage induced by free radicals.  Studies show that statins increase the risk of developing cataracts. [17]

A recent 2016 study hinted at the possibility that increasing use of statins could be contributing to “rising rates of cataract surgery.” [18]

So, are statins any good?

  1. Yes, statins do lower cholesterol levels but this outcome does not translate into any significant cardiovascular protection, especially in people without any history of coronary heart disease.
  2. Statins are effective in reducing heart attacks and death (from heart disease) in people with existing heart problems; especially in middle aged males.
  3. Statins shouldn’t be prescribed to elderly people or to women.
  4. People with active liver disease should not be prescribed statins.
  5. Pregnant and breast-feeding women should not take statins.
  6. Statins are extremely dangerous for children in particular, except in familial hypercholesterolemia (a rare genetic condition).
  7. Statins may have anti-inflammation properties but they don’t influence the size of cholesterol particles.

So, what should you do when you are diagnosed with elevated cholesterol? Making lifestyle changes is a safer and much more effective approach over pharmaceutical interventions. This is the single most important method to reduce the oxidative stress and bring down inflammation – thus lowering your risk of cardiovascular problems.  Needless to say, lifestyle modifications (such as weight loss, eating right, maintaining blood sugar levels and refraining from smoking) also improve overall quality of life.

Our next article in this series focuses on how to naturally reduce your cholesterol levels – with the help of right supplements and introducing relevant lifestyle changes. Stay tuned.

Cholesterol – Friend or Foe?

Cholesterol has earned quite a mighty reputation over the last few decades; and not in a good sense. Synonymous with plaque formation in the arteries and heart disease, cholesterol has possibly become one of the most dreaded words a doctor can bring up.

But do you really need to worry about cholesterol?

In the my previous article, we unravelled some big and popular myths surrounding saturated fat and explained how despite the low-fat craze, the rate of heart disease in the country is on the rise.  It is now time to explore some startling truths about cholesterol – possibly one of the most feared and misunderstood molecules there is.

What if I told you that cholesterol is your friend? And that you would die without it? And most importantly, how cholesterol is not the main player in the development and progression of heart disease, as we are led to believe?

  • Half of the people with heart disease do not have high cholesterol levels.
  • Half of the people with high cholesterol levels do not have heart disease.
  • Total cholesterol levels are a poor predictor of heart attacks.

If cholesterol is not the main underlying cause of heart disease, what is? Is there another factor at play?

Before we shed some more light on these facts, lets cover some basics on cholesterol.

What is cholesterol?

Cholesterol dr daniel functional medicine

Cholesterol is a soft, waxy substance found in every cell of the body. Your liver produces about three-quarters of your body’s cholesterol. (And as typically believed, cholesterol is not essentially a fat; it is a sterol – made up of steroid and alcohol.)

So, what makes cholesterol so important that it is found in every cell around the body?

  1. An important constituent of the cell membranes. It gives them just the right structure and stiffness while also maintaining their flexibility.
  2. Facilitates communication between the cells.
  3. Helps in smooth functioning of brain and nervous system; helps in nerve transmission and particularly important for memory formation.
  4. Acts as a precursor (starting raw material) for the production of vitamin D and many steroid hormones such as estrogen, progesterone, testosterone, cortisol and aldosterone.
  5. Helps in making bile acids, that helps the absorption of fat from the intestine.
  6. Acts as an anti-oxidant and anti-inflammatory. It helps repair damaged and inflamed tissues (including arteries).

Being fat soluble, cholesterol can’t mix freely with water. Since water is mostly blood, cholesterol needs some help to float through the blood stream; and it does with the help of Lipoproteins.

Lipoproteins are small spheres made up of proteins (apolipoproteins), phospholipids, triglycerides and cholesterol. Like submarines, these small packets carry cholesterol from one place to another in the blood.

Lipoproteins are classified depending on the type of proteins that carry the lipid molecules. There are many types of lipoproteins, for example, chylomicrons, very low-density lipoprotein (VLDL), low density lipoproteins (LDL) and high density lipoproteins (HDL). Chylomicrons and VLDL mostly carry triglycerides but also contain small amounts of cholesterol.

Low-density lipoprotein (LDL): LDL carries cholesterol from the liver to cells and tissues, including the arteries. LDL is also called “bad cholesterol” because it is known to contribute to atherosclerosis – excessive build up plaque or fatty materials within the arterial wall that hardens and clogs the arteries. Atherosclerosis is one of the major risk factors for heart diseases and stroke. We will come back to this in a minute and talk how all LDL is not same and all LDL is not bad.

High-density lipoprotein (HDL): HDL picks up surplus or unutilized LDL cholesterol from tissues and arteries and carries it back to the liver. It is either broken-down into bile acids or used for other purposes. Again, you know HDL as “good cholesterol but the fact is some HDL is not so good.

But, it is too simplistic a view and something not very useful when it comes to predicting your risk of a heart problem. It is because there is more to LDL and HDL than meets the eye.

LDL, HDL and their sub-fractions

Both LDL and HDL cholesterol are further classified into many sub-fractions; depending on their density and size. Some of these sub-types are good while some are downright dangerous. And every time you are getting a three-part lipid panel which gives you a LDL cholesterol value (LDL C), it tells you nothing about your heart health. Why? Let’s find out.

  • LDL A: These are large, fluffy molecules that are harmless as long as they are not oxidized (by free-radicals.)
  • LDL B: These particles are small, hard and dense. They are more likely to become oxidized and stick to the arterial walls – causing inflammation.
  • Lp (a): These are very small particles – the sticky form of cholesterol and considered the most damaging of all.

In a healthy body, Lp(a) particles are fairly harmless. In fact, they circulate around the body and repair damaged blood vessels. It’s when there is an excess oxidative damage to the blood vessels, Lp (a) clusters around the damaged site and gets oxidized. But Lp (a) particles are highly inflammatory and tend to stick to the arterial wall.

Studies suggest that Lp (a) are more firmly trapped in the walls of arteries [1], where it binds to certain amino acids and triggers inflammation – resulting in the formation of plaques. Lp (a) also promotes blood clotting – loading up the new plaque even more and causing the blood vessels to narrow down further. Presence of Lp(a) particles is a strong risk factor for cardiovascular diseases.

While no drugs currently exist that can lower Lp(a), the good news is some supplements can help.  We will talk about these supplements in the subsequent articles in this series.

Similarly, all HDL is not created equal. While HDL-2 particles are large and light-weight with anti-inflammatory and anti-atherogenic properties, not much is yet known about HDL -3; but it is generally believed that these particles are protective in nature.

Total cholesterol, triglycerides and high density lipoprotein cholesterol (HDL-C) levels are typically measured to assess the risk of potential cardiovascular disease. These measurements are further used to determine low density lipoprotein cholesterol (LDL-C) – considered one of the most important marker for heart disease. But clearly, it is a very poor marker. It is because your LDL C reading can’t tell the difference between large and small LDL particles.

Testing LDL-P (LDL particle number), LDL particle size and lipoprotein(a) is a would be a much effective strategy in assessing your heart health.

LDL particle size: Stronger predictor of heart disease risk

Studies show that it is the particle size that determines the risk for coronary heart disease. People with higher levels of small and dense LDL particles floating in their bloodstream have an increased risk of heart disease than people with LDL with higher concentration of large, fluffy, cotton-ball like molecules in their blood. [2]

The number of LDL particles (LDL P)

The number of LDL particles (LDL P) is also very important and is considered a better predictor of a potential heart problem than LDL cholesterol levels (LDL C).

In most cases, LDL C and LDL P are concordant. But not always. Sometimes they can be discordant also, meaning it is possible to have:

  • High LDL C but low LDL P (not high risk) [3]
  • Low LDL C but high LDL P (increased risk)

Let’s look at scenario 2. What if a person with this type of cholesterol pattern gets their total cholesterol measured, but not the particle number? With low LDL C reading, they will not be considered high risk, which is clearly misleading.

What causes elevated LDL particle number?

People with high triglyceride levels, metabolic syndrome, fully blown type 2 diabetes, poor thyroid functions and chronic infections typically have elevated LDL particle number. There is another genetical condition called ‘Familial hypercholesterolemia’, where LPL particle numbers are found to be increased. It is a condition where body is not naturally equipped to remove excess LDL cholesterol from the blood.

A diet rich in low-fat but high in carbohydrates not only increases your triglyceride levels but also boosts the numbers of small-LDL particles.

Of course, LPL P is not the only factor when it comes to predicting the risk of heart disease. There are other strong factors at play that increases your likelihood of having a heart attack; for example, genetics, dietary choices and lifestyle (that includes elements like lack of physical activity, smoking, alcohol intake etc.). Conditions like diabetes also increases this risk.

Unfortunately, most conventional doctors simply look at the total cholesterol levels and LDL C and make their diagnosis, while entirely dismissing the size and type of LDL particles. If you are found to have elevated LDL cholesterol levels, you will be prescribed statins – the cholesterol lowering drugs. Why is this bad? Statins dugs do more harm than good and most importantly, studies show that low cholesterol increases the risk of death, especially in women and older adults [4] [5]. Low cholesterol is also implicated in depression and suicide [6]; hardly surprising as the brain is the most cholesterol-rich organ in the body.

New cutting-edge cholesterol tests – such as Vertical Auto Profile (VAP) test or the Lipoprotein Particle Profile (LPP) test – are now available. These tests are designed to measure your Lp (a) levels and also identify whether you have large or small LDL particles. These are the numbers that truly matter.

Dietary cholesterol and blood cholesterol

Can eating more cholesterol increase your blood cholesterol levels? In other words, do your scrambled eggs end up elevating your serum cholesterol and damaging your arteries?

What you need to know that for most people, if not all, the effect of dietary cholesterol on serum cholesterol is not very significant. The production and uptake of cholesterol in the body is a very well-regulated process. In other words, when you eat more cholesterol, your body produces less of it.

According to the Framingham study, one of the largest studies on cholesterol, people whose diets were rich in cholesterol did not have higher cholesterol levels in their blood than people who consumed less. Many other studies have also confirmed that people with heart disease have the same cholesterol levels as people who do not have heart disease.

This indicates that cholesterol is not the main culprit and there is another factor that is at work.

If cholesterol is not the primary cause of heart disease, what is?

Chronic inflammation, not cholesterol, is the real danger

We all have experienced inflammation at one point or another; for example, when you bang your knee, sprain your ankle or get a cut on your finger.

Whenever there is an injury or infection, our body kick-starts a chain of bio-chemical events, that prepares the site of injury for repair, restoration and healing. Blood rushes to the site of injury. Your immune system gets into an alert mode – sending specialized immune cells and other chemicals to neutralize the invading pathogens such as bacteria and viruses. This is when you experience those tell-tale signs of inflammation such as pain, heat, swelling and redness.

This is acute inflammation, a type where symptoms are visible and painful but temporary. These symptoms go away as soon as the trigger is gone. This is a natural and important part of your body’s natural healing mechanism.

What happens if you are continuously exposed to the triggers that set off acute inflammation? It sends your immune system to an over-drive where it keeps launching and relaunching inflammatory responses. This is when long-term, chronic inflammation sets in.

Chronic inflammation is believed to be the root cause of many serious, degenerative Conditions – including insulin resistance, type 2 diabetes, obesity, arthritis, asthma, auto-immune disorders and neurodegenerative diseases such as Alzheimer’s and Parkinson’s.  And yes, it contributes majorly to cardiovascular disease; by damaging the arteries or more specifically the endothelium.

What causes chronic inflammation?

Oxidation (induced by free radicals) and sugar are two main culprits when it comes to identifying the root cause of inflammation.

Free radicals are highly reactive molecules that interact with and damage fragile cellular structures like membranes, proteins, lipids, mitochondria and the DNA. It is important to know that some free radicals are naturally produced as by-products when our body processes oxygen and nutrients (carbohydrates, proteins and fats) to generate energy. But many external factors also contribute to excessive production of toxic free radicals that causes oxidation; such as:

  • Poor diet (processed food, refined carbohydrates like sugar and flour, vegetable oils)
  • A diet lacking in whole, fresh foods
  • Smoking and excessive alcohol consumption.
  • Environmental exposure to toxins like heavy metals, insecticides and pesticides.
  • Lack of physical activity and exercise
  • Stress
  • Poor or lack of sleep
  • Chronic infections

Chronic inflammation and heart disease

Chronic inflammation causes heart disease by damaging the coronary arteries – blood vessels supplying oxygen-rich blood to the heart muscle. And at the centre of all this excitement lies the endothelium – a layer of cells that lines the interior surface of the arteries.

Endothelium is only one cell deep. Being the innermost layer, it is in constant contact with the bloodstream, that also carries LDL particles among other things.

It is time to pause for a while and talk a bit about the anti-inflammatory properties of cholesterol. Yes, that’s right.

Cholesterol has amazing anti-oxidant, anti-inflammatory and toxin-fighting characteristics. So, whenever arteries are damaged or inflamed, along with white blood cells and fibrins, the body also rushes LDL cholesterol to the damaged site. It helps neutralize the free radicals, repair cellular damage and make new cells to replace damaged, dead cells.

We can now see why cholesterol is viewed as the major player in the formation of plaque and increased risk of coronary heart disease. It is because cholesterol is always found at the site of injury or damage. In fact, it is there to do its job – to repair and patch the damaged arteries. Instead we blame this protective mechanism to be the cause of atherosclerosis. The truth is cholesterol is just one of many players participating in plaque formation and resulting development of heart disease or peripheral arterial disease.

When LDL cholesterol becomes a challenge?

It is when LDL cholesterol gets oxidized in the presence of free radicals or sugar, it becomes a problem.

As we noted earlier, some small and dense LDL particles [LDL B and LP (a)] are highly inflammatory and more prone to oxidative damage. Since they are also smaller in size, they are able to penetrate the endothelium, get trapped there and trigger a cascade of events that promote further inflammation in the arterial wall – ultimately leading to atherosclerosis.

It is worth mentioning again that small LDL particles penetrate the endothelium and get trapped there – and this is what drives further damage and inflammation within the endothelium.

  • Oxidized LDL, posing as a threat, stimulates the immune system to send monocytes to the site.
  • Monocytes, though helpful, also secrete inflammatory chemicals that release adhesion molecules – helping monocytes to stick to the damaged endothelium.
  • Monocytes transform into macrophages (also called ‘eater cells’) that chomp on oxidized LDL.
  • These fat laden macrophages are now called foam cells, that keep consuming the oxidized LDL until they burst open – releasing toxins and accumulated fats.

Over time, this process evokes further response from the immune system – resulting in more and more injury and inflammation. This creates a vicious cycle of damage difficult to break until the inflammation is contained. When foam cells (oxidized LDL filled macrophages) die, it results in fatty streaks along the arterial walls, that eventually result in the formation of plaque.

Plaque, the thick deposit of fats, can slow or completely block the flow of blood to the heart and other areas of the body like brain – causing heart attack or even stroke.

The levels of inflammatory markers like C-reactive protein (CRP), are a better predictor of heart problems than total cholesterol levels.

What you need to remember most from this article

  • Every cell in our body needs cholesterol.
  • Dietary cholesterol has no effect on serum cholesterol for most people.
  • Low cholesterol levels are linked to risk of death and dementia, especially for women and older adults.
  • Total cholesterol levels are worthless in calculating the risk for heart disease. It is because LDL cholesterol comes in many sizes – from large and fluffy to small and dense – each with varying effect on health.
  • It is important to determine the size and number of LDL particles.
  • It is only when LDL gets oxidized, it triggers inflammation.
  • Chronic inflammation, not cholesterol, is robust predictor of heart disease.

Chronic inflammation is the underlying cause of atherosclerosis and heart disease. From this perspective, the best approach to mitigate the risk of cardiovascular disease would be to eliminate culprits that are causing inflammation in the very first place. Adopting a healthy lifestyle (with healthy food choices, plenty of exercise and staying overall active) would be a good starting point.

What happens when your LDL cholesterol are found to be elevated? Chances are your doctor will put you on statins – cholesterol lowering drugs.  What is wrong with statins? Stay tuned for our next article in this series.

Bad Facts or Bad Fats? The Diet Heart Hypothesis

According to 2017 Heart Disease and Stroke Statistics Update from the American Heart Association, heart disease remains the primary cause of death in the United States, even as the death rate from heart disease is going down. [1]

The report also revealed some other eye-opening statistics

  • The number of adults with heart failure rose by 800,000 over five years.
  • In the U.S, more than 1 in 3 adults (92.1 million) suffer from heart diseases.
  • Every year about 790,000 people in the U.S get heart attacks and about 114,000 are killed.
  • As of 2013, cardiovascular diseases were the most common cause of death in the world.
  • Americans had more than 350,000 out-of-hospital cardiac arrests and nearly 90 percent of these events were fatal.
  • It is expected that the number of people with heart failure will rise by 46 percent by 2030. Heart failure is a condition where the heart is not able to pump blood across the body as efficiently as it should.

What happens when you are diagnosed with a heart problem?

Chances are you will be asked to stay away from butter, eggs, meat, cheese and bacon; or essentially everything that has to do with saturated fat and cholesterol. It is because one notion has dominated our collective thinking for the last 60 years that a diet high in saturated fat and cholesterol damages your heart and increases your risk of heart disease

So, where did it all start? This brings us to the ‘Diet-Heart Hypothesis’ – an over-arching belief that has dictated Americans dietary recommendation for decades.

What is Diet-Heart Hypothesis?

Avoid saturated fats and cholesterol because they choke our arteries. This sounds a familiar advice. And why not. This has been the cornerstone of dietary advice for more than 50 years. In a nutshell, ditch your butter, lard, eggs, cream, bacon, red meat and switch to low-fat and vegetable oils if you want to maintain your heart health and live longer.

But what if this all is a big mistake? What if we tell you that saturated fats and cholesterol don’t increase your risk of cardiovascular disease?  What if opposite is true?

The western diet comprising of processed food is largely to be blamed for the obesity, diabetes and heart disease epidemic we are facing today. But everyone from your cardiologist, nutritionist, family doctor, media and even your neighbour will tell you that saturated fat and cholesterol are your number one enemy and would cause heart attacks and cardiovascular disease.

But with saturated fat intake at an all-time low, how would you still explain the rise of cardiovascular problems in the country?

It all started when Ancel Keys, a scientist at the University of Minnesota, published a paper that supported an idea: Saturated fat raises LDL cholesterol in the blood, which causes heart disease – giving rise to diet heart hypothesis.

The traditional diet heart hypothesis predicts that when you replace saturated fats with vegetable oils, it will lower accumulation of cholesterol in the arterial walls – slowing the progression of atherosclerosis and reducing the risk of coronary heart disease.

Needless to say, the theory was immediately lapped by the health authorities, media and public alike. Its wide acceptance immediately demonized the saturated fat and cholesterol. Never in the history of medicine and nutrition a dietary advice has single-handedly transformed our dietary choices as this one.

As it turns out, it was all based on bad science.

Debunking the diet-heart hypothesis

Firstly, the diet heart paradigm has never been established in a randomized controlled trial. A relationship between saturated fat intake and cardiovascular risk has never been proven.

Secondly, an overwhelming body of evidence suggests otherwise. Ironically, the advice to reduce saturated fats from the diet has, in fact, may have contributed to our heart problems. What’s more, the studies show that saturated fats are protective, lower cholesterol levels in blood and contribute to weight loss. Surprised?

  • A 2010 meta-analysis of 21 prospective cohort studies found no significant evidence for concluding that dietary saturated fat puts one at an increased risk of heart disease. [3]
  • A 2010 Japanese study followed 58,000 men and women for an average of 14 years. The researchers found that is no association between saturated fat intake and mortality from heart disease. In fact, people who ate more saturated fatty acids were less likely to die from stroke. [4]
  • In 2012, researchers at the Norwegian University of Science and Technology followed 52 087 adults, aged 20-74, for 10 years. They found that women with high cholesterol levels had lower ‘all-cause mortality risk’ than those with lower cholesterol. They also discovered that in women lower cholesterol levels increase the risk for heart disease.

The study authors concluded that “clinical and public health recommendations regarding the ‘dangers’ of cholesterol should be revised. This is especially true for women, for whom moderately elevated cholesterol (by current standards) may prove to be not only harmless but even beneficial.”  [5]

  • In 2013, Aseem Malhotra, an eminent London cardiologist, reasoned that reducing your saturated fat intake increases your risk for obesity and cardiovascular disease. The article ‘Saturated fat is not the major issue’ was published in the British Medical Journal. [6]
  • In 2014, a meta-analysis, published in the Annals of Internal Medicine, summarized evidence about associations between fatty acids and coronary heart disease. The review used data from nearly 80 studies and found no evidence to support the current guidelines that encourage people to consume polyunsaturated fatty acids while reducing their intake of total saturated fats. [7]
  • Now, a recent 2016 analysis published in BMJ again threw major doubts on the diet heart hypothesis. This analysis is based on the old data from Minnesota Coronary Experiment, a five-year research that began in 1968 but the results were never published. These results are found to be consistent with Sydney Diet Heart Study, an Australian study from the same time.

The 2016 analysis showed that [8]:

  • People who consumed corn oil had lower cholesterol levels than the people eating diets rich in high saturated; but this didn’t improve their survival.
  • Ironically, older participants with lowered serum cholesterol were found to have higher risk of death.
  • Even more shocking was the observation that people consuming lots of vegetable oil were more likely to show signs of a heart attack upon autopsy than those eating more saturated fat.

The study authors concluded:

“Available evidence from randomized controlled trials shows that replacement of saturated fat in the diet with linoleic acid effectively lowers serum cholesterol but does not support the hypothesis that this translates to a lower risk of death from coronary heart disease or all causes. Findings from the Minnesota Coronary Experiment add to growing evidence that incomplete publication has contributed to overestimation of the benefits of replacing saturated fat with vegetable oils rich in linoleic acid.”

Despite all this evidence, this unproven theory has been aggressively promoted for more than four decades. All this time we were assured that saturated fat is the primary cause of obesity, diabetes, and heart disease crisis and to cut back on fat intake to 30 % of the total calorie intake and saturated fat to 10 %.

What happens when you replace saturated fat with more carbohydrates and vegetable oil?

With the low-fat diet craze, we are now eating a lot more carbohydrates than ever before; and this includes grains, whole grain pasta, fruits and starchy vegetables, not to mention highly refined processed foods.

What is wrong with excessive carbohydrates?

In the body, carbohydrates are metabolized into glucose – which causes pancreas to release insulin. While insulin signals muscle, liver, and fat cells to pick up and absorb glucose from the bloodstream and keep blood sugar levels in check, it also helps the body to store fat. When you eat high amounts of carbohydrates, your body releases more insulin and after a point your cells become resistant to the effect of insulin (eventually causing insulin resistance, if you continue eating carbohydrate laden meals).

Consequently, your muscle and liver cells stop utilizing the available glucose, which is then stored or rather trapped in fat cells. So, insulin sends signals to the fat cells to store fat and to lock it there – following a carbohydrate-rich meal.

It’s also important to note that insulin is sensitive to both carbohydrate and protein, but not fat. When you eat carbohydrate rich meal, insulin is released and signals the body to burn carbohydrates as fuel instead of using fat. And when you eat fat, you produce no insulin and the body turns to fat to produce energy. This association is known as carbohydrate-insulin hypothesis.

So, when you swap saturated fat with carbohydrates, (especially refined carbohydrates), you are increasing your chances of developing insulin resistance, obesity and type 2 diabetes. It also increases the levels of triglycerides and small LDL particles, while reducing HDL cholesterol. X

Nina Teicholz, a journalist who launched an extensive research into the saturated fat and cholesterol theory, told the Wall Street Journal:

“The real surprise is that, according to the best science to date, people put themselves at higher risk for these Conditions no matter what kind of carbohydrates they eat. Yes, even unrefined carbs. Too much whole-grain oatmeal for breakfast and whole-grain pasta for dinner, with fruit snacks in between, add up to a less healthy diet than one of eggs and bacon, followed by fish. The reality is that fat doesn’t make you fat or diabetic. Scientific investigations going back to the 1950s suggest that actually, carbs do.” [9]

Sugar, not the fat, was the culprit all along?

With you remove fat from diet, the flavour goes for a toss too. The food industry replaced the saturated fats with added sugar to save the lost flavour. While on one hand, saturated fat was being significantly reduced in our diet, added sugar in the modern diet has been at an all-time high. These added sugars – including table sugar, high-fructose corn syrup (HFCS), brown sugar, honey, agave nectar or maple syrup – are added to processed foods to enhance their flavours and texture while also increasing their shelf-life.

Indeed, weight gain is just the tip of the ice-berg when it comes to counting the ways sugar can harm. It causes inflammation and increases risk of cardiovascular disease, damages liver and leads to Alzheimer’s disease (dubbed as type 3 diabetes by many).

New research suggests that increased sugar consumption could be an independent risk factor for metabolic syndrome – a cluster of health Conditions characterized by elevated blood pressure, high triglycerides, low HDL levels, high blood sugar levels and obesity.  Metabolic syndrome can lead to type 2 diabetes, which further increases inflammation and increases risk of heart diseases, stroke and even cancer.

Meanwhile, we also switched to vegetable oils. It is well-known that over-heating vegetable oils create toxic oxidation products – that cause oxidative stress and inflammation. For this reason, vegetable oils were made solid and more stable through a process called hydrogenation, leading to the production of trans fats.

Studies show that trans fats are even more harmful for heart health. Found in readymade baked goods, salad dressings, margarines, micro-wave popcorn, French fries and chips, trans fats promote inflammation, the root cause of many chronic ailments including heart disease, stroke, insulin resistance and diabetes. Trans fats are also known to trigger nutritional deficiencies and impair immune system functions. Research from the Harvard School of Public Health and other sources indicates that trans fats can cause harm in even small amounts, “for every 2% of calories from trans-fat consumed daily, the risk of heart disease rises by 23%.” [10]

As the Food and Drug Administration is mobilizing a ban on trans fats, the bad news is food manufacturers are resorting back to using regular vegetable oils.

Certainly, these are not the health problems we bargained for when we whole-heartedly embraced the idea that saturated fat/cholesterol cause heart attacks while ditching butter, cheese, eggs and red meat along the way.

Key to lose weight and reduce your risk of heart disease? Limit your carbohydrate and sugar intake while switching to lowly-processed saturated fats along with plenty of fresh vegetables.

The Truth About Saturated Fat and Cholesterol

Your body needs saturated fat in healthy amounts to carry out a range of functions vital for health. Most importantly, saturated fats act as building blocks for cell membranes, hormones and hormones like substances. Fats keep us fuller for a long time. They also play an important role in carrying fat- soluble vitamins A, D, E and K; vitamin D deficiency, in particular, is considered a risk factor for cardiovascular events (heart attack, congestive heart failure, peripheral arterial disease, stroke), diabetes and high blood pressure. [11] [12]

Adequate saturated fats are also important for:

  1. Heart health: as they help the body to lower levels of lipoprotein a or Lp(a), increase HDL cholesterol and contribute to overall weight loss.
  1. Bone health: as they help in calcium absorption
  1. Liver health: as they stimulate the liver cells to dump their fat reservoirs and also protect the liver from the toxic effects of alcohol and NSAIDs, commonly used to manage chronic pain and arthritis. Liver is one powerful detox machinery in our body and considering its other important functions in fat storage, metabolism and efficient absorption of nutrients, maintaining liver health is absolutely important to manage weight and maintain overall health.
  1. Brain health: as the myelin sheath, the protective coating around the neurons, is made of saturated fats (and cholesterol). The brain needs fats for proper functioning and repair.
  1. Immune health: as they help the white blood cells to identify and kill invading pathogens including viruses, bacteria and fungi.

With all these benefits, it is recommended that 40-50 percent of your calories must come from saturated fats versus a mere 10 % as suggested by mainstream health establishments.

Similarly, you also need cholesterol for many important biological functions. In fact, levels of total cholesterol gone too low increase your risk of cardiovascular disease. Yes, you heard us right.

Stay tuned for our next article in this Heart Health series, where we will talk about the importance of cholesterol and how statins, cholesterol lowering drugs, may actually be doing more harm than good.

How to Prevent Heart Attacks & Sudden Cardiac Death

TV’s most likable dad died from sudden cardiac death last week. Alan Thicke’s massive heart attack was quick and unexpected and many of his closest friends have already come out saying there were no signs whatsoever. As tragic as this is, it’s equally upsetting to know the signs were likely present but no one was looking for them. Of course, this is not something that happens to just TV stars. Everyday people are taken from us in an instant. It’s an all too common scenario.

But it doesn’t have to be. Most specialists agree that heart disease is quite preventable and we now can put ourselves in a position of minimal risk. The key is to know what to look for.

Heart disease continues to be the leading cause of the death in this country and continues to be a threat in taking away those we love when we least expect it. It’s hard to overstate the impact that heart disease has in the US. Consider the following:

  • Heart Disease affects 65 million Americans.
  • 1 million Americans have heart attacks every year
  • 1 person dies every 39 seconds from heart related problems
  • 33-50% of deaths are due to heart related problems
  • 33% of Americans have metabolic syndrome (a cluster of heart risk factors) associated with heart disease, diabetes, obesity and cancer)
  • Total cost of heart disease in the US is estimated at $320 Billion.

To put that last statistic in perspective, the World Health Organization has estimated that ending world hunger would cost approximately $195 billion. It could be argued that the $320 billion spent on treating heart disease in a necessary expenditure, but studies suggest that 80-90% of heart disease is caused by modifiable diet and lifestyle factors; especially when you know the risks!

Herein lies the problem. Heart disease is one of the most misdiagnosed and mistreated Conditions in medicine. Even though medical scientists have discovered so much about what causes heart disease over the past 20 years, the medical establishment is still operating on outdated science from 40-50 years ago. This includes testing and diagnostics. Hint: Normal cholesterol does not mean you don’t have heart disease.

We could spend hours covering all the research that’s been conducted by major universities. I’ll save you the time and provide a synopsis of facts published in some of the best peer reviewed journals in the world:

  1. High Cholesterol is not the primary cause of heart disease.
  2. Diets high in saturated fat and cholesterol don’t cause heart disease.
  3. Consumption of “heart healthy” vegetable oils is linked to heart disease, cancer and many other conditions
  4. Statin drugs don’t reduce the risk of death for most people, and have dangerous side effects and complications.
  5. Statin drugs can save lives for a very small percentage of the population, but they still cause complications.

Thicke, who was 69, was playing ice hockey with his son when he suffered his heart attack on Dec. 13. It happened with no symptoms.

For a heart attack to quickly lead to death, the damage to the heart needs to be great enough to cause the heart to beat irregularly and eventually stop entirely. The irregular heartbeats that result from the lack of oxygen start from the bottom of the heart, and aren’t strong enough to generate blood flow,

When this occurs, the heart becomes very agitated and eventually the heartbeat becomes more of a quiver than strong pump. This is called fibrillation, and is what leads to less blood flowing which then causes the heart to stop.

Heart Attacks Don’t Always Kill Instantly

It’s possible for the heart muscle to lead to irregular heartbeats long after the heart attack happens. A person can also die from a heart attack that causes no irregular heartbeat at all — the heart muscle can be so damaged from the lack of oxygen that the heart can no longer pump enough blood, which can lead to death. For death to occur immediately or shortly after a heart attack, there had to be a very large blockage that damaged a lot of the heart muscle.

Risk factors and symptoms

It’s unclear what symptoms and risk factors Thicke had, if any, before his heart attack. My point is that we shouldn’t wait for symptoms to address them. Especially when it’s something as deadly as heart disease.

It’s widely accepted and most people know that risk factors of heart disease include high blood pressure, high cholesterol and a sedentary lifestyle. But this is literally the tip of the iceberg.

Things you should consider to Get a Grip On Predicting Heart Attacks & Sudden Death:

  1. Family History
  2. Genetic Testing
  3. Biometrics (waist to hip ratio, BMI, visceral fat, muscle mass)
  4. Vitals (blood pressure
  5. Blood chemistry (Cholesterol, Total, HDL, LDL, HDL-P, LDL-P, HS-CRP, ApoA, ApoB)
  6. EKG and Stress Testing
  7. CIMT ultrasound testing

Functional Medicine Assessments & Consultations

Beginning January 1st, I will start offering structured Functional Medicine consults. This will be separate from Family Health Chiropractic and something that is being launched nationally. That said, because you are patients of mine already, I’d like to give you priority over anyone else. I’d also like to offer you a deep discount on this service.

My Functional Medicine consults will be virtual, meaning we can meet via skype or phone and everything including paperwork, testing and diagnostics, treatment and protocols will be handled via my private patient portal. Because my time is already limited, I have to limit the number of patients I accept. NOTE: I promise, these spots will fill up fast so don’t delay. For those of you who don’t get registered, you’ll be put on a waiting list.

To learn more visit here: www.drdaniel.com/consult (Use coupon code: FAMILY for $200 off until spots are filled)

How will this work?

Step 1: Purchase your High Performance Health Assessment & Consultation

As a patient of mine you will be getting a deep discount compared to what everyone else will pay. Merry Christmas 🙂

Step 2: After purchasing your consult you can register at my private portal where you will create a personal account so I can communicate with you securely.

The initial forms you will fill out are likely more comprehensive than anything you’ve experienced before. This should give you an idea of how serious I am about your health. You probably have never had a consult with a doctor like this before!

After you finish filling out the forms, we will schedule a virtual consult and I will begin working on your case. I will identify 3 problem areas that we can begin addressing to improve health and work towards High Performance.

Step 3: You will get a follow up consultation containing specific Functional Medicine labs from the best laboratories in America along with specific action steps to take.

Everyone is going to be interested in improving their health at the beginning of the year. I don’t want to just improve health, I want to focus on High Performance health and this requires something different.

To learn more visit here: www.drdaniel.com/consult (Use coupon code: FAMILY for $200 off until spots are filled)

What is Functional Medicine?

In conventional medicine, there’s a doctor for every part of your body: cardiologists for the heart, gastroenterologists for the digestive system, neurologists for the brain and nervous system, podiatrists for your feet, ophthalmologists for your eyes and yes, chiropractic for your spine and acupuncturists for your points J

Due to this siloing, conventional medicine practitioners focus on individual body systems, rather than the whole person to understand the interrelated causes underlying disease and chronic illness. It looks at symptoms in order to name a disease and find a corresponding drug.

Alternative medicine is certainly more holistic and focused on whole body systems, but it usually falls short in diagnostics and objective testing. Alternative medicine practitioners (massage therapy, nutritionists, chiropractors, acupuncturists, homeopaths, naturopaths, etc) offer treatments that are much safer but not specific.

In functional medicine, we see the body as an interconnected whole, within a larger environment. We recognize that in order to treat one part of the body, all other parts must also be considered. This breaks apart artificial divisions of the body. Functional medicine looks at underlying phenomena that occur across specialties (inflammation, oxidative stress, toxicities, cellular energy problems, etc.) in order to understand the root cause of disease and find the right tools, at the right time, individualized for each person.

The table below compares eight key distinctions between functional and conventional medicine.

If you’re interested in High Performance Health or want to address any risk factors you may have regarding Heart Disease, Diabetes, Immunity, Gut Disturbance, Hormone Imbalances and/or Nutritional Issues, then please consider my functional medicine consults. Spots are limited, so act fast.

To learn more visit here: www.drdaniel.com/consult (Use coupon code: FAMILY for $200 off until spots are filled)

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