Dr. Nick Campos

One of the first things doctors learn in rudimentary physiology class is that, when it comes to preventing heart disease, high HDL or “good” cholesterol is more important than low LDL or “bad” cholesterol. In fact, HDL levels are four times greater than LDL levels in their ability to predict the development of coronary atherosclerosis. Basic, basic, basic physiology.

But an interesting thing happens between doctor school and practicing–it’s called influence from the outside world. In the case of doctors, that influence often comes from pharmaceutical industry. C’mon Campos, not another evil pharmaceutical industry story (hey, I haven’t written one yet, please). No, no–it’s more like another example of how we’ve come to worship outside factors when it comes to our health. Check this one out.

Recent research published in the New England Journal of Medicine shows that no matter how much bad cholesterol is lowered in the blood, it’s the amount of good cholesterol that still reigns supreme. Yes, the concentration of your HDLs (high density lipoproteins) plays a vital part in preventing cardiovascular diseases, like heart attacks and strokes.

Yeah, so? Well if you haven’t heard yet, those hyper-pedastalized miracle drugs known as statins are some of the most prescribed drugs of our day. Statins work by lowering LDL (low density lipoproteins) levels in the blood, and this, it has been promised, will lower our risk of heart disease. Great! Prescribe them like crazy. People don’t work out. People don’t eat right. Who cares? Give ’em statins. You’ve got boderline high cholesterol. Statins. You’re almost diabetic? Statins. You’ve seen the cholesterol commercial and you’re concerned? Statins.

Statins. Statins. Statins.

Well I’ve got news for you. You want to lower your risk of cardiovasular disease? You’ve got to watch what you eat and work out, period. Oh yeah…it’ll help if you quit smoking too, but how about just starting with exercise? You see, I’ve got a real problem with the idea of looking for magic bullets. They are illusions, people–ILLUSIONS! They give false security and false hopes. Nothing in life is free. You’ve got to work for everything. Exercise. Diet. That’s the real answer. Not statins.

OK, I’ll be fair. For people who have dangerously high levels of LDLs–if I was their MD–I’d give them statins for a very brief period, and I’d absolutely prescribe heavy doses of lifestyle management (read: nutrition and exercise). But I wouldn’t perscribe statins for people with boderline normal cholesterol levels as some Dr. Idiots are recommending (also read this–effin’ scary).

According to Dr. Philip Barter of the Heart Research Institute in Sydney, one of the lead authors of the study, “Even when LDL is taken down to very low levels, the kind of levels people say should be the aggressive targets, having a low HDL is still associated with a substantial increase in risk. (emphasis mine)” So, basically, you’ve got to work to bring your HDL levels up to par. And here’s the beauty: It’s the ratio of total cholesterol to HDL that really matters (see this brilliant explanation here), where total cholesterol = HDL+LDL. Therefore, HDL+LDL/HDL. So, if you bring up your HDL levels, you don’t need statins. Duh.

OK, here’s how you can raise your HDL levels–exercise regularly, eat wholesome foods, take essential fatty acids, and moderate your smoking and drinking habits. And you can naturally decrease your LDL levels by decreasing saturated fat intake, maintaining good body composition, increasing dietary fiber, and increasing aerobic exercise. Booyah!

But wait…fugdat. Ain’t there a drug I can take, Homey?

Sure Pfizer is working on one. It’s called torcetrapib. Oh wait. It killed people in a large drug trial. Oh well–I guess you’ve gotta work out. Says Barter again: The alternative is to “become lean and become very active. That’s probably as effective as anything we have at the moment. But most people who try don’t succeed,” Barter said. “The biggest frustration is that we don’t have the magic bullet like we do for the LDL.”

Ah yes, the ‘ol magic bullet. Well, keep looking–it’s your time, your money, and your health. If you want to believe, then be my guest. But I’ll just be over here dancing with the Tooth Fairy.