by Dr. Mercola 
“Statin Nation II: What Really Causes Heart Disease?” is the sequel to the documentary “Statin Nation: The Great Cholesterol Cover-up .” However, it stands well on its own, even if you didn’t see the original film.
For many decades, the idea that saturated fats caused heart disease reigned supreme, and diets shifted sharply away from saturated animal fats such as butter and lard, toward partially hydrogenated vegetable oils and margarine.
However, as people abandoned saturated fats and replaced them with trans fats, rates of heart disease continued on a steady upward climb. And, the more aggressive the recommendations for low-fat diets, the worse this trend became.
Last year, butter consumption  in the US reached a 40-year peak, and the resurgence of butter has been attributed to a shift in consumer preferences away from processed foods and back toward natural foods.
This is a positive trend, showing that the old myth claiming that saturated fat is bad for you is finally starting to crumble. People are also starting to recognize that refined sugar is far worse for your heart than dietary fat was, and processed low-fat foods are typically loaded with sugar.
The French Paradox
According to the film, the long held view that saturated fats and cholesterol caused heart disease came under closer scrutiny in the 1990s, when researchers like Kurt Ellison with the Boston University started taking notice of what became known as the French Paradox.
The French eat a lot more fat than many other nations, yet they don’t have higher rates of heart disease.
For example, in the UK people on average eat 13.5 percent of their total calories as saturated fat, whereas the French eat 15.5 percent saturated fat, yet their rate of heart disease deaths is about one-third of that in the UK — just 22 heart disease deaths per 100,000 compared to 63 per 100,000 in the UK.
Icelanders also consume higher amounts of saturated fat — on average 14.6 percent, but their rate of heart disease deaths is also lower than the UK, just 34 per 100,000.
The film reviews a number of statistics from other countries, including Denmark, Lithuania, and Portugal, which defy the idea that saturated fat consumption is associated with heart disease. The data simply doesn’t bear this out.
Here’s another startling example. The American Heart Association recommends keeping your saturated fat consumption below seven percent of your total calories, ideally around 5 or 6 percent.
Lithuania is very close to being on target, with a saturated fat consumption rate of 7.7 percent of total calories, yet Lithuania has one of the highest heart disease mortality rates in the world — 122 per 100,000.
Cholesterol Is Not a Major Factor in Heart Disease
Like saturated fat, cholesterol has also been wrongly demonized despite the fact that 60 years’ worth of research has utterly failed to demonstrate any correlation between high cholesterol and heart disease.
Despite this, many, even most health professionals still cling to the idea that cholesterol raises your risk for heart disease, and that strategies that lower cholesterol also lower your heart disease risk.
Fortunately, limitations for cholesterol will likely be removed from the 2015 edition of Dietary Guidelines  for Americans, which would be a welcomed change.
Cholesterol is actually one of the most important molecules in your body; indispensable for the building of cells and for producing stress and sex hormones, as well as vitamin D.
It’s also important for brain health, and helps with the formation of your memories. Low levels of HDL cholesterol have been linked to memory loss and Alzheimer’s disease , and may also increase your risk of depression, stroke, violent behavior, and suicide.
What You Need to Understand About HDL and LDL Cholesterol
While cholesterol is typically divided into HDL/”good” and LDL/”bad” cholesterol,” there’s really only one kind of cholesterol. The division into HDL and LDL is based on how the cholesterol combines with protein particles.
LDL and HDL are lipoproteins, meaning fats combined with proteins. Cholesterol is fat-soluble, and blood is mostly water, so for it to be transported in your blood, cholesterol needs to be carried by a lipoprotein, which is classified by density.
Large LDL particles are not harmful. Only small dense LDL particles can potentially be a problem, as they can squeeze through the lining of your arteries. If they oxidize, they can cause damage and inflammation.
Thus, it would be more accurate to say that there are “good” and “bad” lipoproteins (opposed to good and bad cholesterol). Dr. Stephen Sinatra , a board certified cardiologist, and Chris Kresser , L.Ac., an integrative medicine clinician, have both addressed this issue in previous interviews.
Some groups, such as the National Lipid Association, are now starting to shift the focus toward LDL particle number instead of total and LDL cholesterol, in order to better assess your heart disease risk. But this approach has not yet spread into the mainstream.
Statins Are Prescribed Based on an Incorrect Hypothesis
Since the cholesterol hypothesis is false, this also means that the recommended therapies — low-fat, low-cholesterol diet, and cholesterol lowering medications — are doing more harm than good. Statin treatment, for example, is largely harmful, costly, and has transformed millions of people into patients whose health is being adversely impacted by the drug. As previously noted by Dr. Frank Lipman:1
“[T]he medical profession is obsessed with lowering your cholesterol because of misguided theories about cholesterol and heart disease. Why would we want to lower it when the research2 actually shows that three-quarters of people having a first heart attack, have normal cholesterol levels, and when data over 30 years from the well-known Framingham Heart Study3 showed that in most age groups, high cholesterol wasn’t associated with more deaths?
In fact, for older people, deaths were more common with low cholesterol. The research is clear – statins are being prescribed based on an incorrect hypothesis, and they are not harmless.”
Statins Can Wreck Your Health in a Number of Ways
The film points out that research shows statins promote calcification of your arteries, and even though arterial calcification increases heart disease, these studies seem to be largely ignored by mainstream health professionals. Sherif Sultan, a professor of Vascular and Endovascular surgery who is featured in the film, notes that many people have in fact improved their health by getting off statins.
That certainly doesn’t surprise me, considering the fact that studies have discovered a wide variety of problems associated with statin use, and virtually all of these problems are being downplayed or ignored altogether by conventional medicine.
Odds are actually very high — greater than 100 to one — that if you’re currently taking a statin, you probably don’t need it. Based on my own review of the evidence, the ONLY subgroup that might benefit from statins are those born with a genetic defect called familial hypercholesterolemia. Dr. Sinatra believes males with obstructions in their left anterior descending coronary artery might also benefit. For all others, statins are more likely to do you harm than good.
For example, research shows that statins:
Deplete your body of CoQ10:
Statins deplete your body of CoQ10, which accounts for many of their devastating results. Although it was proposed to add a black box warning to statins stating this, the US Food and Drug Administration (FDA) decided against it in 2014. If you take a statin, you MUST take supplemental CoQ10, or better, the reduced form called ubiquinol.
Increase insulin resistance:
Insulin resistance promotes chronic inflammation in your body, and inflammation is the hallmark of most diseases. In fact, increased insulin resistance can lead to heart disease, which, ironically, is the primary reason for taking a cholesterol-reducing drug in the first place. It can also promote belly fat, high blood pressure, heart attacks, chronic fatigue, thyroid disruption, and diseases such as Parkinson’s, Alzheimer’s, and cancer.
Increase diabetes risk:
By raising your blood sugar, statins also increase your diabetes  risk. When you eat a meal that contains starches and sugar, some of the excess sugar goes to your liver, which then stores it away as cholesterol and triglycerides. Statins work by preventing your liver from making cholesterol. As a result, your liver returns the sugar to your bloodstream, which raises your blood sugar levels.
Drug-induced diabetes and genuine type 2 diabetes are not necessarily identical. If you’re on a statin drug and find that your blood glucose is elevated, it’s possible that what you have is just hyperglycemia — a side effect, and the result of your medication.
Unfortunately, many doctors will at that point mistakenly diagnose you with “type 2 diabetes,” and possibly prescribe another drug, when all you may need to do is simply discontinue the statin in order for your blood glucose levels to revert back to normal.
By inhibiting the synthesis and function of vitamin K2 in your body, statins can raise your risk for atherosclerosis, heart failure, stroke, and other health problems. If you take a statin, a vitamin K2  supplement (MK7) is highly recommended.
Squalene reduction caused by the statin can also raise your risk of immune system dysfunction.
Interfere with the mevalonate pathway:
The mevalonate pathway is the central pathway for the steroid management in your body.
Statins are toxic to the energy centers of your cells, called mitochondria. They impair heart muscle mitochondria function, disrupt ATP production (adenosine triphosphate, the energy molecules of your body), and alter intracellular signaling proteins.
Interfere with selenium-containing proteins:
Selenoproteins, such as glutathione peroxidase, are crucial for preventing oxidative damage in your muscle tissue. Blocking glutathione peroxidase unleashes free radicals and inflammation, which can damage muscle tissue, including your heart muscle.
What REALLY Causes Heart Disease?
Statins  really have nothing to do with reducing your heart disease risk. In fact, this class of drugs can actually increase your risk for heart problems — especially if you do not take ubiquinol (CoQ10) along with it to mitigate the depletion of CoQ10 caused by the drug. Taking extra vitamin K2 is also advisable.
Statins decrease CoQ10 for the identical reason they lower cholesterol, they impair the pathway your liver uses to make both of them. I believe this is probably its greatest toxicity as CoQ10 is absolutely essential for mitochondrial health. My new passion is understanding this at a fine molecular level as I’m convinced it is the core for the treatment and prevention of most cancers and the slowing down of the aging process. So if you are concerned about these issues, then I couldn’t warn you more strongly to avoid statins.
Knowing that saturated fat and cholesterol have nothing to do with heart disease finally frees you to take a serious look at what does cause this potentially lethal condition. While the film focuses on how things such as cortisol, stress, and telomeres can influence heart disease, for most people heart disease is a result of poor lifestyle choices; some of the most important of which include the following. All of these things are well within your control, and don’t cost much (if any) money to address.
A diet too high in sugar, trans fat, and oxidized cholesterol, and too low in healthy fats:
Added sugars , and processed fructose in particular, are a primary driver of metabolic dysfunction and heart disease. One recent 15-year long study, which included data for 31,000 Americans, found that those who consumed 25 percent or more of their daily calories as sugar were more than twice as likely to die from heart disease as those who got less than 10 percent of their calories from sugar.
On the whole, the odds of dying from heart disease rose in tandem with the percentage of added sugar in the diet regardless of the age, sex, physical activity level, and body-mass index.
Trans fat  may promote heart disease to an even greater degree than sugar. Structurally, trans fats are synthetic fatty acids produced during the hydrogenation process. (They are not present in either animal or vegetable fats.) Trans fats prevent the synthesis of prostacyclin, which is necessary to keep your blood flowing. When your arteries cannot produce prostacyclin, blood clots form, and you may succumb to sudden death.
Also, while dietary cholesterol is fine, oxidized cholesterol is not. Oxidized cholesterol forms when polyunsaturated vegetable oils (such as soybean , corn, and sunflower oils) are heated. This oxidized cholesterol causes increased thromboxane formation — a factor that clots your blood.
So, if you want to protect your heart, avoid all hydrogenated oils and vegetable oils, and replace them with healthy saturated fats such as coconut and coconut oil, avocados, butter, animal fats like lard, and raw nuts.
Lack of exercise:
Exercise protects against heart disease  primarily by normalizing your insulin and leptin levels, and it is indeed potent medicine. A 2013 meta-review, which included 305 randomized controlled trials and nearly 339,300 people, found “no statistically detectable differences” between exercise and medications for heart disease, including statins.
Lack of sun exposure:
Vitamin D  is very important for reducing hypertension, atherosclerotic heart disease, heart attack, and stroke. In one study, vitamin D deficiency increased the risk of heart attack by 50 percent. What’s worse, if you have a heart attack and you’re vitamin D deficient, your risk of dying from that heart attack creeps up to nearly 100 percent. Ideally, you want to maintain a vitamin D level of 50 to 70 ng/ml year-round, or 70 to 100 ng/ml if you’re trying to treat heart disease.
Lack of grounding to the earth:
Grounding  effectively alleviates inflammation because it thins your blood and infuses you with negatively charged ions through the soles of your feet. It also helps thin your blood by improving its zeta potential, which means it improves the energy between your red blood cells.
Research has demonstrated it takes about 80 minutes for the free electrons from the earth to reach your blood stream and transform your blood. Since heart disease is primarily caused by inflammation, regularly grounding yourself to the earth is a simple way to combat inflammation without spending a penny.
Identifying Risk Factors for Heart Disease
If you want to understand what causes heart disease, you have to look at what causes damage to your artery walls, interferes in disease processes, and causes blood clotting. When the endothelial wall is damaged, repair mechanisms are set into motion, creating a “scab.” To prevent this scab from dislodging, the endothelial wall grows over it, causing the area to become thickened. This is what is called atherosclerosis.
There’s no fat (cholesterol) “clogging the pipe” at all; rather the arterial wall is thickened as a result of your body’s natural repair process. So what causes damage to your arteries?
One of the primary culprits is sugar and fructose  in particular. So eating a high sugar diet  is a sure-fire way to put heart disease on your list of potential health problems. Meanwhile, total cholesterol will tell you virtually nothing about your disease risk, unless it’s exceptionally elevated (above 330 or so, which would be suggestive of familial hypercholesterolemia, which, in my view, would be about the only time a cholesterol-reducing drug would be appropriate).
Two ratios that are far better indicators of heart disease risk are:
- Your HDL/total cholesterol ratio: HDL percentage is a very potent heart disease risk factor. Just divide your HDL level by your total cholesterol. This percentage should ideally be above 24 percent. Below 10 percent, it’s a significant indicator of risk for heart disease.
- Your triglyceride/HDL ratios: This ratio should ideally be below 2.
Additional risk factors for heart disease include:
- Your fasting insulin level: Any meal or snack high in carbohydrates like fructose and refined grains generates a rapid rise in blood glucose and then insulin to compensate for the rise in blood sugar. The insulin released from eating too many carbs promotes fat and makes it more difficult for your body to shed excess weight, and excess fat, particularly around your belly, is one of the major contributors to heart disease.
- Your fasting blood sugar level: Studies have shown that people with a fasting blood sugar level  of 100 to 125 mg/dl had a nearly 300 percent increase higher risk of having coronary heart disease than people with a level below 79 mg/dl. I personally believe your fasting blood sugar should be below 80 and is something that you should regularly monitor. You don’t need a doctor’s order for it as you can easily purchase blood (finger prick) tests on Amazon. I personally check mine and my blood ketone levels on a regular basis.
- Your iron level: Iron can be a very potent driver of oxidative stress, so if you have excess iron levels  you can damage your blood vessels and increase your risk of heart disease. Ideally, you should monitor your ferritin levels and make sure they are not much above 80 ng/ml. The simplest way to lower them if they are elevated is to donate your blood. If that is not possible you can have a therapeutic phlebotomy and that will effectively eliminate the excess iron from your body.
Sources and References
- 1  Care2.com December 29, 2014 
- 2  JAMA. 2011;306(19):2120-2127 
- 3  Arch Intern Med. 1993;153(9):1065-1073 
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