CHOLESTEROL & THE FRENCH PARADOX

A b o u t C h o l e s t e r o l , H e a r t D i s e a s e , A g e i n g

A u t h o r F r a n k A C o o p e r , N u t r i t i o n i s t

P r e f a c e - C h a r l e s T M c G e e , M D

All author royalties are donated to UNICEF

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Conditions of Use

This book is intended for informational purposes only and is protected under Freedom of Speech. It is not intended as medical advice nor should it be construed as such. This is a not-for-profit publication and author royalties for the printed book are donated to UNICEF - The United Nations Children’s Fund. The images used in this book were provided by JupiterImages and/or Clipart.com, and these entities hold the copyright and all rights of the images. See www.clipart.com

Disclaimer

Nothing in this book is intended to diagnose or treat any disease. It is not a substitute for any treatment that may have been prescribed by your doctor or qualified health professional. If you suspect that you have a medical problem, seek professional medical help. Always work with a qualified health professional before making any changes to diet, prescription drug usage, exercise activities, or lifestyle changes. The information in this book is not supported by conventional medicine or medical doctors. The information contained in this book is provided as-is and the reader assumes all risk from the use, non-use or misuse of this information.

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C o n t e n t sACKNOWLEDGEMENTS ...................................................................................................................................... 5

PREFACE BY CHARLES T. MCGEE, MD .......................................................................................................... 6

PART 1: EXPLORING THE MYTH ....................................................................................................................... 8

CHAPTER 1 THE FRENCH PARADOX .......................................................................................................... 9CHAPTER 2 THE MEDICAL WORLDS ......................................................................................................... 11

Research Doctors ......................................................................................................................................... 11Practicing Doctors ......................................................................................................................................... 12Pharmaceutical Industry Doctors .................................................................................................................. 13

CHAPTER 3 LET’S TALK CHOLESTEROL .................................................................................................. 14Is Cholesterol Clogging Your Arteries? ........................................................................................................ 14New Research into Cholesterol .................................................................................................................... 16

CHAPTER 4 WHAT LEVEL OF CHOLESTEROL IS NORMAL? ................................................................... 19Recommended Cholesterol Guidelines ........................................................................................................ 19Do You Have Coronary Heart Disease, or High Cholesterol? ...................................................................... 20Cholesterol Tests are Inaccurate .................................................................................................................. 21Scanning & Imaging Your Arteries................................................................................................................ 21

CHAPTER 5 CHOLESTEROL LOWERING DRUGS – ARE THEY SAFE? ................................................... 24Naturally Derived Statins .............................................................................................................................. 24Synthetic Statins ........................................................................................................................................... 24Statin Side Effects ........................................................................................................................................ 24Muscle Inflammation / Deterioration ............................................................................................................. 25Kidney Damage (Rhabdomyolysis) .............................................................................................................. 25Nerve Damage (Polyneuropathy) ................................................................................................................. 26Memory & Cognitive Damage ....................................................................................................................... 26

CHAPTER 6 STATIN USERS, CASE EXAMPLES ........................................................................................ 29Medical Case – Chief Executive Officer, Serious Muscle & Memory Problems, USA ................................. 29Medical Case – Business Executive, Serious Muscle Breakdown, Australia ............................................... 29Medical Case – Company Director, Cognitive Memory Damage, USA........................................................ 30

CHAPTER 7 ALTERNATIVES TO STATIN DRUGS ..................................................................................... 35Summary of Statin Side Effects .................................................................................................................... 35Policosanol / Sugar Cane Wax Alcohols ...................................................................................................... 35Red Yeast Rice ............................................................................................................................................. 36Ayurvedic Medicine for Cholesterol-Lowering .............................................................................................. 36Plant Sterols.................................................................................................................................................. 37Naturopathic Physicians ............................................................................................................................... 37

CHAPTER 8 WHO DETERMINES CHOLESTEROL GUIDELINES .............................................................. 39CHAPTER 9 DOES HEART DISEASE RUN IN THE FAMILY ....................................................................... 42CHAPTER 10 WOMEN AND CHOLESTEROL ............................................................................................. 44

Older Women with Elevated Cholesterol Live Longer .................................................................................. 44Pregnant Women - Special Alert .................................................................................................................. 46Research Data for Women ........................................................................................................................... 47

CHAPTER 11 CLINICAL TESTS FOR YOUR HEART .................................................................................. 49C-Reactive Protein ........................................................................................................................................ 50Homocysteine ............................................................................................................................................... 50Lipoprotein(a) ................................................................................................................................................ 51

CHAPTER 12 BLOOD PRESSURE / HYPERTENSION ............................................................................... 53Risks of High Blood Pressure ....................................................................................................................... 53Salt Formulations .......................................................................................................................................... 56Magnesium – An Essential Nutrient.............................................................................................................. 56L-Arginine, Nitric Oxide and Vasodilation ..................................................................................................... 57

CHAPTER 13 SMOKING ............................................................................................................................... 59Free Radical Damage / Inflamed Arteries .................................................................................................... 59Collagen Damage and Haemorrhage Stroke ............................................................................................... 59Surgical Risks for Smokers ........................................................................................................................... 59

PART 2: A HEALTHY HEART ............................................................................................................................ 61

CHAPTER 14 WHY HEART DISEASE IS DECLINING ................................................................................. 62Heart Attack Epidemic 1920 - 1968 .............................................................................................................. 62Vitamin and Mineral Deficiencies 1920 - 1968 ............................................................................................. 62

CHAPTER 15 IMPROVED MEDICAL & SURGICAL TECHNIQUES............................................................. 64Angioplasty ................................................................................................................................................... 64

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Coronary Stents ............................................................................................................................................ 65Chelation Therapy ........................................................................................................................................ 65

CHAPTER 16 IRREGULAR HEARTBEAT / ARRHYTHMIAS ....................................................................... 68Artificial Sweeteners and Irregular Heartbeat ............................................................................................... 68Bread Preservatives - Calcium Propionate #282.......................................................................................... 68

CHAPTER 17 FRENCH CUISINE ................................................................................................................. 70French Cuisine - Eating Food in Season ...................................................................................................... 72

CHAPTER 18 WINE & PHYTONUTRIENTS ................................................................................................. 73The French Paradox Is Born......................................................................................................................... 74The Copenhagen Heart Study ...................................................................................................................... 74LDL Cholesterol ............................................................................................................................................ 75Phytonutrients in Foods – Powerful Antioxidants ......................................................................................... 76Microwave Cooking Destroys Phytonutrients ............................................................................................... 77

CHAPTER 19 WINE ALLERGIES.................................................................................................................. 79Sulphur Dioxide, Sulphites, Preservative #220 ............................................................................................ 79Low Preservative and Organic Wine ............................................................................................................ 81

CHAPTER 20 INFLAMMATION IN THE ARTERIES ..................................................................................... 82Foods That Heal ........................................................................................................................................... 84Foods Causing Inflammation ........................................................................................................................ 84Eating Out / Travelling .................................................................................................................................. 87

CHAPTER 21 OILS & FATS (LIPIDS) ............................................................................................................ 89Trans Fats / Hydrogenated Vegetable Oils .................................................................................................. 93Interesterification / Interesterfied Fats .......................................................................................................... 94Palm & Coconut Tropical Oils ....................................................................................................................... 95

CHAPTER 22 MEDIA REPORTS .................................................................................................................. 97CHAPTER 23 THE FRENCH PARADOX UNRAVELLED ........................................................................... 109CHAPTER 24 ACTION PLAN - YOU AND YOUR PHYSICIAN .................................................................. 112

Action Plan & Recordkeeping ..................................................................................................................... 113Reminder Checklist ..................................................................................................................................... 116

CHAPTER 25 READER COMMENTS ......................................................................................................... 117Before We Finish ........................................................................................................................................ 118

APPENDIX 1 MY LIFE JOURNEY WITH CHOLESTEROL ......................................................................... 120APPENDIX 2 CHOLESTEROL: HOW IT BECAME A DISEASE ................................................................. 124APPENDIX 3 THE HISTORY OF FATS & OILS (1900 TO 2000) ................................................................. 129

Interesterfied vegetable oils ........................................................................................................................ 131REFERENCES ............................................................................................................................................... 133

INDEX ................................................................................................................................................................. 136

ABOUT THE AUTHOR ................................................................................................................................... 139CHOLESTEROL & THE FRENCH PARADOX– BACK COVER .................................................................................... 140

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ACKNOWLEDGEMENTSACKNOWLEDGEMENTS

This book could not have been written without the generous support of a number of people, who helped bring this book to completion.

I would like to thank a very special person, my wife, for her support and encouragement from start to finish, and to my children for their patience, and to my family in North America for their feedback.

I owe a special gratitude to Dr Uffe Ravnskov in Sweden, a world-renowned expert on cholesterol, for providing an in-depth knowledge of cholesterol, and for introducing me to a number of very talented doctors in the global medical community.

In the USA, my special thanks to Dr Charles McGee for contributing his real life experiences as a practicing MD and providing valuable content to the book and writing the Preface; Dr Kilmer McCully for information on Homocysteine and vitamin deficiencies; To Dr Duane Graveline for his knowledge concerning the risks of statin drugs in regards to cognitive damage; Dr Mary Enig, an expert in nutritional sciences, for providing important data on lipids (fats and oils); Dr Joel Kauffman, an expert in medicinal chemistry, whose knowledge of organic and synthetic chemistry was invaluable; and Dr Edwin Frankel at the University of California (Davis) for providing important data on oxidised lipids, free radicals and oxidants.

In Australia, I would also like to say thanks to Dr Herbert Nehrlich in Australia for proofing the early drafts and getting me on the right track from the outset, as well as providing excellent ideas on content. Also to Dr James Khong in Melbourne, who runs the Wellness Clinic medical practice for his constructive comments.

In the sports fitness field, my gratitude to Director Paul Marasco at Fit-To-Go Personal Training for his considerable experience, ideas and support, and also to Joshua Birch at Fitness First.

And a warm thanks to my industry colleagues, for taking time from their busy work schedules to read progressive drafts of the book, providing valuable comments and real life experiences, and for their encouragement to bring this book to completion. Thanks to Laurence, Graeme, Michael, Raymond, David, Stephen and Steve, Francois, Edward, Alan, Blair, Chris, and Martin.

I would also like to express appreciation to Rosie Waitt and Margaret Johnston for their assistance in the literary assessment of the manuscript in preparation for publishing, and to Patricia White for her linguistic contribution and the finishing touches.

There are of course a number of other contributors who provided valuable input and feedback at different times during the progress of the book, to whom I would like to convey my warmest thanks.

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PREFACE by CHARLES T. MCGEE, MDPREFACE by CHARLES T. MCGEE, MD

Frank Cooper and I share a common interest in the cholesterol theory; we both have sky high cholesterol levels. As younger men we were taught this put us at high risk of sudden death. Then we investigated the theory and found it lacking. There is no clear cause/effect relationship between cholesterol levels and heart attacks. Actually the theory has leaked like a sieve from the very beginning.

In Cholesterol & The French Paradox Frank has done a fine job of putting the cholesterol theory to rest. Frank's stated purpose in writing this book is to simplify the subject for non-health professionals. He has done a good job.

Heart attacks kill more people in developing and industrialized nations than anything else. The cholesterol theory has dominated thinking on the subject for decades and is still promoted by commercial interests. However, in scientific publications the theory is eroding in favor of newer concepts such as the oxidation theory, arterial damage from high Homocysteine levels, rupture of fatty plaques and the role of inflammation. Articles on these topics make interesting reading. They begin by bowing down in praise of the cholesterol theory, then move on to present something more useful. Authors seem to know the cholesterol theory is so entrenched that if they attacked it, their paper would never see the light of day.

My personal introduction to another way of looking at the cholesterol theory began when I had dinner with Linus Pauling 30 years ago. Dr. Pauling told me there wasn't much evidence to support the theory and that cholesterol would take care of itself provided a person was well nourished in all of the materials the body needs. He conveyed this to me while eating a large juicy steak and I ate a less tasty fish dish. Pauling, the only person to be awarded two individual Nobel Prizes, lived an active life right up to his death at 93.

I discovered books by Dr. Paul Dudley White, founder of the specialty of cardiology. Dr. White wrote he once was asked his opinion of the cholesterol theory. He responded he couldn't believe in the theory because it was not consistent with the history of the disease. Nobody asked for his opinion again.

What White was referring to was that the very first heart attack in the world proven by autopsy was in England in 1878 (a time when nearly everyone who died was autopsied in the name of medical science). White graduated from medical school in 1910 but didn't see a heart attack victim until 1921. By 1950 the heart attack had become the leading cause of death, apparently coming out of nowhere. Dr. White knew that during all of this time (and later) dietary intake of cholesterol and saturated fats remained the same.

Inspired by these giants in science I searched the medical library for studies on cholesterol. I found the theory was based on a very weak association between blood cholesterol levels and heart attacks that was seen only in middle aged men with genetically high levels. A few years later I asked a cholesterol researcher from Stanford University what he thought about exceptions to the cholesterol theory. He replied he didn't know of any.

Well, here are a few:

� Cholesterol intake has been constant for over 100 years, as the death rate from coronary heart disease has risen and fallen sharply.

� There is no association between blood cholesterol levels and heart deaths in women despite TV ads for statin drugs showing women keeling over because of high cholesterol levels.

� No heart attacks were seen in more than 15 primitive life style cultures that consumed high fat diets. � Scientific studies failed to show that lowering blood cholesterol levels lowered overall death rates which,

after all, should be the ultimate goal of any preventive effort. � Half of people dying of a heart attack have cholesterols in the "normal" range. � Eating more cholesterol does not raise blood levels of cholesterol. � Eating less cholesterol does not drop blood levels of cholesterol significantly. � It should be obvious we are omnivores. We have the biochemistry to handle carbohydrates, proteins, and

fats. � And of course there is the French Paradox discussed in this book.

How current low-fat dietary guidelines came into being deserves comment. The Consensus Development Conference on cholesterol was held at the National Institutes of Health in Washington, DC, in 1984. Attendance

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was by invitation only. Most attendees made their living researching cholesterol, hardly an unbiased and open minded group.

By that time over 15 studies had been completed with the goal of proving that reducing cholesterol levels would reduce heart attack deaths. However, the presenter who reviewed this work apologized at the beginning saying that in every study something "ridiculous" happened that prevented expected results from being observed. After two days of less than convincing presentations the chairman announced a consensus had been reached. He called a press conference and recommended low fat, low cholesterol diets for everyone.

Belief in the cholesterol theory has led to illogical actions through the years as large commercial interests became involved. Manufacturers of margarines and vegetable oils launched advertising campaigns pointing out that their products don't contain cholesterol or saturated fats (little was known at the time about harmful trans fats these products contain and only animal products contain cholesterol or saturated fats). Pharmaceutical companies launched a huge educational program encouraging physicians to prescribe a series of what turned out to be ineffective cholesterol-lowering drugs.

Cholesterol phobia caused sales of beef to fall in half but only temporarily because Americans really love beef. Egg sales fell a devastating 40% and stayed there for years. When egg producers advertised the truth that eggs had never been shown to be harmful to anyone they were taken to court and convicted of false advertising by a judge who believed the testimony of cholesterol researchers.

In 1995 the first statin study was presented. Researchers proudly proclaimed this was the first study in which heart attack deaths dropped without seeing a counterbalancing increase in deaths from other causes. To me this only served to expose lies the public was told for 40 years that cholesterol-lowering drugs were of benefit.

This is but a small part of the cholesterol issue. What remains at the end of the day is a tale of false hopes, biases, and manipulation by commercial interests. This book explores the cholesterol/coronary heart disease connection from several angles. Frank does a good job presenting information on how basic science research can be exploited by financial interests. I especially agree with him that people are going to be the healthiest when they consume fresh whole foods and shun refined and processed foods. That advice is far more useful than current recommendations to cut down on cholesterol and saturated fats which reduces intake of some of our most highly nutritious foods.

Charles T. McGee, MD Coeur d’Alene, Idaho, USA Author of Heart Frauds

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Part 1: Exploring the MythPart 1: Exploring the Myth

CHAPTER 1 THE FRENCH PARADOX

The French Paradox is the unexplained riddle of how a nation of alcohol-quaffing, croissant-munching gourmands stays healthy and slim, while a disproportionate number of health-obsessed Americans are obese and at cardiovascular risk.

The French Paradox has baffled American dieters and scientists, puzzled by the ability of the French to remain trim while downing buttery croissants, creamy brie and decadent pastries.

Nutritionally speaking, the French have been blessed: They eat all the butter, cream, fatty liver pate, pastry and cheese that their hearts desire, and yet their rates of obesity and heart disease are much lower than the USA and UK. The French eat three times as much saturated animal fat as Americans, and only a third as many die of heart attacks. It doesn’t make sense.

Scientists struggled to come up with a few hypotheses: Firstly it was attributed to the French tradition of drinking red wine. This got winemakers excited for a while, but no one could find any real basis for this theory, because the French do not have a monopoly on drinking red wine.

After the wine argument, scientists latched on to olive oil, but this didn’t explain the butter or brie which the French eat plenty of.

Some researchers suggested that the French Paradox was due to garlic and onions but the French don’t have a monopoly on eating that either. Others say that the French eat smaller portions and eat more slowly. The list goes on and on.

So whilst Americans are worried about elevated cholesterol, and focused on low fat foods, and regularly taking cholesterol-lowering medication – the fact is - they are still twice as likely to have a heart attack as the French.

Clearly, the Americans think this is all unfair, and the French think it's wonderful. To them it’s simply Bon Appetit!

Why is the French Paradox so important? Because for many years we have been told that cholesterol is a leading cause of coronary heart disease, clogging our arteries, and causing heart attacks and strokes.

But if this actually correct, how do we explain the French Paradox?

That’s what this book is about; it explains the French Paradox, and how you can benefit from knowing what the French know, and most importantly, why cholesterol and saturated fats are not the causes of heart disease.

We look at the ‘hard to find’ information on cholesterol and heart disease, and introduce you to doctors around the world who have spent years studying heart disease. Their data is in the public domain, and it supports the French Paradox. However their findings conflicts significantly with what you have been told by the major drug and food corporations.

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The reality is that there is no notable association between cholesterol and heart disease. In other words, the population develops heart disease at about the same rate, regardless of whether you have high or low cholesterol.

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This book will certainly be a welcome relief to anyone with elevated cholesterol. And if your cholesterol is low, then it’s important to know that your chances of developing coronary heart disease are the same as the rest of the population.

Cholesterol & The French Paradox was written to provide a thorough, clear, and concise explanation of the complex issues surrounding heart disease. It demystifies the medical discourse that accompanies coronary heart disease, and encourages us to assume greater control of our own health.

Before We Begin

The subject of cholesterol is not terribly exciting, so throughout this book I have used some Australian colloquialisms and expressions to add a bit of life to the chapters. The Australian language has some amusing forms of expression that is part of the country’s cultural heritage. I have also used clip-art pictures to help illustrate important points. Some of them have a humorous twist to give the book some extra life.

Please note that this is a not-for-profit book, and all royalties received are donated to UNICEF. The real recognition for this book belongs to the talented doctors and researchers who provided the information that made this book possible.

Frank Cooper, Nutritionist, Australia www.frankcooper.com.au

CHAPTER 2 THE MEDICAL WORLDS

When I was first tested for cholesterol – I was 25 years old – and my cholesterol level was a staggering 13.2 mmol/L or 504 mg/dl under the USA system of measurement. I realized back then that I needed to understand what cholesterol was all about for the sake of my own health, but the information that I required was impossible to find at that time. My really serious investigations into cholesterol began some years later in the year 2000.

To cut a long story short, I spoke to a number of highly-regarded doctors in both the USA and Europe who had done serious research into cholesterol, and heart disease.

What I had hoped to find, was an in-depth understanding of how cholesterol functions, how it damages arteries, and how to protect oneself from this dreaded curse. But I actually found something quite different. What I found was a medical field that was polarised on the subject of cholesterol and heart disease.

I also found conflicting views within the medical community on a large range of medical issues, not just on cholesterol, which contrasted sharply with my lifelong perception of the medical community. My lifelong view would be the same as yours, which is based on experiences with the family doctor, the odd visit to a specialist, and the occasional stint in a hospital. These life experiences gave me a ‘shop front’ view of the medical world, where patient meets doctor.

But when you actually enter the medical world, you find a world of politics, lobby groups, and vested interests.

Whilst it was never my intention to examine the medical field at large, it soon became clear that to write a book on cholesterol, that’s exactly what I had to do.

In the case of cholesterol, what I found were doctors who had done serious research into cholesterol, who didnot believe cholesterol was the cause of heart disease. This was in stark contrast to family doctors working in medical practices, who generally believed that cholesterol does cause heart disease.

In fact the gap in thinking between medical researchers and medical practitioners on the subject of cholesterol was so great, that the only parallel I could draw was back to the days when most people thought the world was flat, and a few thought it was round.

This gap in thinking was a concern for the poor unsuspecting patient, who was getting only one perspective, which might well be wrong.

To explain further, the medical world is divided into camps, and there is a big gap between each. To be fair, there are other important camps too, like the dedicated and hard working nurses and hospital staff who are the unsung heroes in the medical world, but we are focusing here on the doctors.

Let’s have a quick look at each of these different camps:

Research Doctors

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The research oriented doctors are an interesting group indeed. Medical researchers are more like scientists looking for answers, motivated to finding creative solutions, to make new breakthroughs, often looking for that ’holy grail’ within their area of specialization. Many are dedicated and passionate about what they do, and some practice medicine to fund their personal efforts in conducting research. Some are zealots who have very strong beliefs in what they are doing but that comes with the territory.

These research doctors are rarely motivated by money, except to have enough to fund their research. There are only small numbers of these doctors, but relative to their size, they make a big impact. They certainly need to be dedicated to their cause, because whenever they discover something that threatens the status quo in medicine, or something that threatens the pharmaceutical companies, they are ridiculed and ostracised.

A typical example of this ridicule was the research done by two Australian doctors, Barry Marshall and Robin Warren. They discovered that the bacteria Helicobacter pylori in the stomach caused stomach ulcers, and that this ailment could easily be eliminated with a course of antibiotics. They published their findings in the British Medical Journal The Lancet in 1983. Their discovery however, threatened a lucrative pharmaceutical business which had built a large business to remedy this chronic ulcer ailment. In fact, the #1 and #2 top selling drugs in the 1980’s were for ulcer/stomach drugs. Being threatened, the pharmaceutical manufacturers responded with a counter-attack to discredit the research findings by Marshall and Warren. So influential were the pharmaceutical companies, that it took ten years before the medical field accepted that these two doctors were absolutely correct, and started prescribing antibiotics for curing ulcers. By that time the patents on these #1 and #2 top-selling gastric drugs had expired, and the pharmaceutical companies had moved on to a more lucrative market. That exciting market was to be the cholesterol-lowering business.

So how would you feel if you were Drs Marshall or Warren, and had discovered something that would bring improved health to millions of people? And then the entire medical fraternity - including your colleagues - debunks you. Well, that often happens whenever a medical discovery threatens the business of health, and there are countless medical researchers who have felt the wrath of the medical industry. Fortunately, these two dedicated researchers were recognised for their fine efforts in 2005 and awarded the Nobel Prize for Medicine.

Practicing Doctors

Most of us are familiar with a local family doctor. We call them MD’s in the USA. In Australia we call them GP’s which means General Practitioners. These are the hard working doctors who practice medicine. They have been trained to practice medicine based on what they learned in medical school. Nutrition is not normally part of that training although some study that later.

These doctors are very busy running private clinics with all the same pressures of any small business person. Generally these family doctors have limited time to study the original research coming from the medical researchers, as they work long hours tending to patients. Many work tirelessly and the job is stressful and demanding. These doctors are heavily targeted by the pharmaceutical companies, as they are authorised to ‘prescribe’ drugs. They are exposed to volumes of information from the pharmaceutical companies and medical associations who keep them up to date with information, sample drugs, newsletters, books, and conferences.

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Supporting the practicing family doctors, are the trained specialists and surgeons who are focused on specialised areas of medicine, like the Cardiologists who focus on heart disease, and Surgeons who make life saving decisions in the operating theatres.

Pharmaceutical Industry Doctors

There is another group of doctors that work in the ‘Business of Disease’ for the major pharmaceutical corporations. Some are directly employed by the corporations in executive positions within sales, marketing, public relations, production etc. Others are employed as ‘independent consultants’ on a ‘retained basis’ to provide ‘medical reports’ which help support the marketing efforts of drugs.

The pharmaceutical corporations have huge financial budgets that run into billions of dollars. They provide generous research grants to universities, and funding to medical associations like the American Heart Association. They also have significant political clout with governments in the USA and UK because they control vast enterprises, and make generous political donations.

So let’s get back to the Research Doctors and Practicing Doctors.

When I spoke to the Research Doctors who had done serious research into cholesterol, many were of the view that cholesterol did not cause heart disease. These doctors were extremely learned on the topic of cholesterol, and were able to defend their views with logic and a lot of facts.

By contrast, when I spoke to Practicing Doctors, many were of the view that cholesterol did cause heart disease. Regrettably, few could explain in scientific terms exactly how cholesterol managed to cause heart disease. In their minds, cholesterol had always been associated with heart disease. There was no need to be able to explain why, because it just was.

This gap in thinking between these two medical worlds is of great concern. And it’s clear that many cholesterol patients are receiving only one point of view, being the one from their local family doctor.

The purpose of this book is to ensure that anyone who is worried about cholesterol and heart disease, is aware of the broader picture portrayed by the research doctors, medical practitioners and the pharmaceutical companies.

You may find all this a bit strange, but medical research tends to run 15-20 years ahead of medical practice. So it takes a long time before ‘new wave’ thinking becomes accepted by the mainstream medical community. But if you are like me, you may not want to wait that long.

In Summary:

� The medical community is conflicted on a large number of medical issues. � The medical world, is a world of politics, lobby groups, and vested interests, just like any other industry. � Research doctors who threaten the status quo are ridiculed and ostracised. � Practicing medical doctors, who prescribe drugs, are heavily targeted by the pharmaceutical companies.

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� Most doctors who work in the ‘Business of Disease’ for the major pharmaceutical corporations are employed as ‘independent consultants’ to provide ‘medical reports’ to help support the marketing of drugs.

CHAPTER 3 LET’S TALK CHOLESTEROL

Let’s take a moment to explain why we ‘mere mortals’ have this material called cholesterol swirling around our arteries. Cholesterol is an essential material found in the human body, and our liver produces most of it.

The liver produces approximately 3 grams of cholesterol (about ½ teaspoon) every 24 hours. Once produced, this cholesterol circulates within the bloodstream combining with proteins to become Lipoproteins. That’s because cholesterol won’t dissolve in water or blood, so it needs to be wrapped in something that’s water soluble, which is what the Lipoprotein is. Just as an envelope holds a letter, protein is the envelop that holds cholesterol, which enables it to be delivered to the cells throughout the body. So think of Lipoprotein as the combined envelope and letter.

Lipoproteins come in different sizes, and you may have heard of the LDL type which is the Low Density Lipoproteins, and the HDL type which is the High Density Lipoprotein.

Mother Nature gave us cholesterol for a number of essential-to-life processes. For example, cholesterol is found in large quantities in every one of the trillions of cells in the human body. It is also a key building block for the proper functioning of nerve tissue and brain cells. In fact, cholesterol is one of the primary organic molecules in the human brain and makes up nearly 8% of the dry weight of the brain. In other words, it’s essential to your ability to think, remember, and to act. Cholesterol is also the precursor molecule for the production of testosterone, oestrogen, cortisol and other hormones which are essential for a healthy life. Putting it another way, you would not be alive if you did not have cholesterol.

Cholesterol is also a waterproof substance, and the individual cells in the body use cholesterol to make themselves waterproof. Each cell in the body needs a waterproof exterior, to stop viruses and other nasties from invading the cell, and cholesterol provides this. It’s like the paint used on a house to keep it waterproof.

Most people are not aware that brain cells and nerve cells require significant quantities of cholesterol. That is why reducing your body’s cholesterol level below your natural level by taking prescription drugs, may be a dangerous strategy. Later we will look at some of the serious mental side effects experienced by people who have lowered their cholesterol through prescription drugs.

Is Cholesterol Clogging Your Arteries?

Most people have been told that if you eat fatty foods which are high in saturated fats and cholesterol, they will clog your arteries, which can lead to a heart attack or stroke. This is a very simplistic understanding of cholesterol which has been around for a long time.

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The medical term for this ‘clogging’ of the arteries is atherosclerosis, which means an abnormal thickening of the artery wall. People with this condition are often referred to as suffering from coronary heart disease (CHD), cardiovascular disease (CVD), or coronary arterial disease (CAD). These are all

different versions of a similar disease condition in which the opening of arteries is narrowed along with other complications that can lead to a heart attack or stroke. However, for the sake of simplicity, we will refer to this condition as Coronary Heart Disease (CHD) throughout this book.

Let’s look at how the idea of fatty foods and heart disease got started:

In 1953 a well-known American called Ancel Keys PhD, was convinced that high levels of fat consumption, resulted in high levels of heart disease. Keys had distinguished himself during World War II, by developing a high-calorie food package (dried biscuits, dried meat etc) that was named after him as the “K Ration”. He therefore had a degree of notoriety with the US Government and Defence officials that few PhD’s enjoyed.

To prove his cholesterol/heart disease theory, Keys conducted a multi-country research project where he looked at fat consumption and heart disease. He then compiled his research data, and presented a compelling linear chart, showing how high fat and high cholesterol correlated directly with heart disease for six leading countries. His charts were well received, because the USA was being plagued by heart attacks at that time, and the nation was looking for answers. Keys had answers, and they seemed to make sense. So his findings were published and re-published many times, and finally, became accepted right up to the US Congress.

It was not evident at the time, but Keys’ charts showed only 6 of the 26 countries that he had assessed. He chose these 6 countries so his graph looked very linear, like a “sales chart” used by a sales manager. However, if he had included the other 20 countries such as France, Italy, Spain, Sweden, Holland etc, then his graph would have looked very scattered (i.e. all over the place) and the link between high fat diets and CHD would have been less compelling. It took twenty-five years before anyone discovered the missing data.

However, it’s not our aim to question Keys’ work, and he clearly believed in his hypotheses. It’s pretty normal to use the KISS principle – Keep It Simple Stupid – when you are dealing with something very complicated. And to Keys’ credit, he was one of the very first people to ‘raise the alarm’ about the dangers of man-made trans fats, the chemically modified vegetable oils.

In looking back now, it’s clear that most of the momentum for the anti-cholesterol campaign, came from major food conglomerates and pharmaceutical companies with huge marketing budgets. They are the major beneficiaries of the bad cholesterol theory and have generated hundreds of billions of dollars in sales. The theory is now so strongly ingrained in the population, that it is considered gospel, and beyond questioning. For a more detailed understanding of how cholesterol became the feared substance that it is today, see APPENDIX 2 at the back of this book.

However, there is now a lot of research that demonstrates that cholesterol is not the cause of atherosclerosis.

To understand how cholesterol is implicated in the blocking of the arteries, let’s look at a simple analogy. Just stop and think for a moment, about how you would repair a damaged plaster wall in your house. You would repair the damage with some sort of plaster filler to smooth it over. The human body also repairs damage to the artery wall with special filler, called plaque** which is a fatty material that includes various components like calcium, lipids, proteins, cholesterol etc. Plaque is only about 5% Cholesterol.

**For the detail conscious reader, it useful to explain that plaques begin to form in arteries when normally harmless “native” LDL travels inside the walls of arteries and becomes oxidized. The immune system recognizes this unusual oxidized LDL as foreign, and attacks it, causing an inflammatory response. Materials are deposited to form a fatty looking deposit called a plaque. If a crack forms on the surface of one of these plaques (called a rupture) a normal healing process begins with the deposition of platelets to form a clot. If the clot grows large enough to shut off the artery, then heart muscle cells will die downstream, and this process is called a heart attack.

So the aim of the cholesterol contained in this plaque is to help repair the arteries, not to damage it.

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� Yet for many years, cholesterol has been blamed for damaging the arteries. Cholesterol was implicated because it was found in the arteries during autopsies. When early medical researchers discovered cholesterol and other fatty material in the arteries, they assumed that they were directly to blame for clogging up the arteries. However these materials were merely being used by the body to help repair the arteries.

The big question is what’s actually causing the damage to the arteries?

In general terms, it appears that there are a number of factors that inflict damage to the walls of the arteries. The known ones include hydraulic wear and tear, oxidised LDL getting into the artery wall, elevated Homocysteine levels, viruses and other organisms, and certain chemicals like nicotine. And when any of these damage the artery wall, it initiates an inflammatory response at the site of the injury. In a nutshell the inflicted area becomes inflamed, and then heals up. But if the inflammation is too severe or too prolonged, then a plaque may form, to protect the inflicted area.

This is of course a simple explanation to a complex healing process.

New Research into Cholesterol

To gain a good understanding of the relationship between cholesterol and heart disease, there are some interesting books and research papers available. One of the most significant research contributions comes from Dr Uffe Ravnskov in Sweden, a medical doctor and researcher who is a world-renowned expert on cholesterol.

Ravnskov studied Ancel Keys’ research, and other cholesterol studies and trials. He re-assessed many of the cholesterol trials that were conducted over the past few decades in the USA and Europe, and found flaws and inconsistencies in the results of these trials. Few medical researchers had ever bothered to seriously analyse these trials, and the media and medical community had simply accepted their findings without investigating their legitimacy.

Ravnskov was very disturbed by the fact that the data collected in these trials was poorly recorded and collated, some trials were inconclusive, and some of the conclusions were blatantly misinterpreted.

What Ravnskov discovered when he rechecked the data from a number of these trials, was that people with elevated cholesterol were only slightly more ‘at risk’ of developing heart disease - than the general population. The difference was so slight, that it wasn’t worth worrying about.

He also discovered that people with Familial Hypercholesterolemia were overly represented in these earlier trials. People with this condition have a cholesterol level in the 10 to 20+ mmol/L range.

Ravnskov rightly concluded that if this condition affects only 0.5% of the general population, then these people should constitute only 0.5% of the participants in a cholesterol trial. So he recalculated the data in a number of these trials after ensuring these people were represented at 0.5%. After re-calibrating the data, he discovered that the general population develops heart disease at the same rate, regardless of whether they have high or low cholesterol.

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But he also discovered something else. That trials measuring cholesterol, often involve people with elevated cholesterol levels and symptoms of arteriosclerosis - otherwise why would you bother participating in a cholesterol trial. And therefore these people were heavily over-represented in many of the trials. This over-

representation distorted the trial data, which resulted in the incorrect conclusions that high cholesterol causes coronary heart disease.

From his investigations Ravnskov concluded:

� That elevated cholesterol does not result in increased heart disease. � Lowering your cholesterol will not lengthen your life. � Older women with high cholesterol live longer than other women. � The prudent diet, low in saturated fat and cholesterol cannot lower your cholesterol.

And what about LDL and HDL, the so called good and bad cholesterol?

From all the analysis that Ravnskov did, he could not see any association between either LDL or HDL cholesterol, and heart disease. For 99.5% of the population, cholesterol levels including LDL and HDL levels are simply not indicators for heart disease.

As a result of these findings, Ravnskov wrote a book called ‘The Cholesterol Myths’ which is available from Amazon and other booksellers. It throws conventional thinking on cholesterol….out the window. You can read excerpts of his book at http://www.ravnskov.nu/myth1.htm

I had the pleasure of meeting Dr Ravnskov on one of my overseas trips, and spent some hours with him discussing cholesterol. Dr Ravnskov has clearly devoted many years of research to the understanding and education of cholesterol, and for no commercial gain whatsoever. His knowledge is extraordinary and I have never met anyone so informed on the subject, and so precise. Meeting him was a great experience.

Dr Uffe Ravnskov with Sally Fallon a well known American author on nutrition

I first became aware of Ravnskov’s book through my cardiologist. He was obviously impressed enough to buy several copies and loaned me one. But few cardiologist or family doctors get to read about this sort of new research, because it gets lost in the mountain of medical reports and research data published every day. It is simply impossible for any practicing medical doctor running a busy practice, to keep up with the latest reports and information about a single topic like cholesterol.

The International Network of Cholesterol Sceptics

However there are many doctors and researchers around the world who have done significant research on cholesterol. Some of their published papers can be found at the website of “The International Network of Cholesterol Sceptics” which is www.thincs.org. This is a serious and genuine website supported by countless doctors who feel that ’enough is enough’ as far as cholesterol is concerned. This website is a virtual ‘treasure chest’ of clinical studies, medical papers, books written by doctors, all on the subject of cholesterol. It’s just a shame that few medical doctors know about this website, and if they did, their busy schedules would probably preclude them from studying it.

So why have you not heard about these doctors and researchers who have found that cholesterol is not a problem? Why are these pre-eminent medical professionals and researchers having difficulty being heard?

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I asked them the question directly and this is what they said. They say it’s due to the marketing power that the giant pharmaceutical companies have over the medical field. The pharmaceutical industry controls a $30,000,000,000 cholesterol-lowering drug business. And there are the huge multi-million $ sponsorship and research payments made by the pharmaceutical companies to the American Heart Association, the American Diabetic Association and research organisations. Regrettably, the financial viability of many of these respected Associations who provide important statistical information and reports to the practicing doctors, is dependent on financial support from the pharmaceutical companies – begging the question as to whether these Associations are really independent.

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The conclusion from this chapter is that cholesterol is a very important substance for your mind and body. If you are eating a healthy diet and your natural cholesterol level is say 5 or 7…..or 10 like mine, then accept that as your normal cholesterol level.

The really big question however, is what’s actually inflaming or damaging our arteries that necessitates the need for cholesterol to repair the damage?

We know that a century ago when people ate a diet rich in animal fats, butter, eggs, cheeses, lard etc there were very low levels of heart disease. Something started happening around 1915, which caused an exponential growth in heart disease. What was it? Was it sugar, hydrogenated trans fats, the refining of our foods, smoking, the abandoning of fresh fruits and vegetables? Let’s read on.

In Summary:

� Cholesterol is an essential material found in the human body, and our liver produces most of it. � Mother Nature gave us cholesterol to facilitate important bodily and mental functions. � Early cholesterol trials were flawed because they included a high number of people with Familial

Hypercholesterolemia and heart disease.

CHAPTER 4 WHAT LEVEL OF CHOLESTEROL IS NORMAL?

What level of blood cholesterol is actually normal? And who determines what is normal? How are these levels determined? Let’s investigate.

Many medical tests are based on “population norms”. This is the traditional way of determining whether your medical test results are somewhere near the general norm of the population.

The better tests are divided into age groups, because test scores vary with age.

If we applied population norms to cholesterol testing, we would look at what is normal for the majority of the population within an age group.

Since the French have such low levels of CHD, it makes sense to use their cholesterol levels as a point of reference. For example, the average cholesterol level for males in the 46-64 age group in France is 6.1mmol/L (235 mg/dl) which is about the same as males in the UK.

Of course, not everyone can be exactly 6.1 and the ‘spread’ for French males would be between 5.1 and 7.1 (equiv 200 – 278 mg/dl) and anyone within that range would be pretty normal.

The reason this data is so important, is because we all deserve to know whether we are normal or not.

It’s interesting that France and the UK are very similar in terms of average cholesterol levels, population, standard of living, and GDP. And they both consume the same amount of saturated fats as a percentage of calories, which is around 26%.

However, the people in France have only one-third the frequency of coronary heart disease. In other words, a male in the UK, has three times the chance of having a heart attack compared to a Frenchman, even though they have the same cholesterol levels.

So we have two countries with the same average cholesterol levels, and yet the UK has nearly three times the rate of coronary heart disease. This is just one example that demonstrates that cholesterol and heart disease are not linked.

Recommended Cholesterol Guidelines

Who determines cholesterol level? The ‘Recommended Cholesterol Guidelines’ are published by the US National Institute of Health, and arbitrarily determined by a group of medical advisors who use data that is subject to considerable interpretation. In a later chapter we will look at the links between these medical advisors and the pharmaceutical manufacturers, which has now caused doubt about the integrity of these Cholesterol Guidelines. What is peculiar about these Guidelines (compared to other medical tests) is that they are not based on ‘population norms’. To repeat, the Guidelines are arbitrarily determined using data that is subject to considerable interpretation.

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What’s concerning is that the cholesterol guidelines over the past thirty (30) years have been pretty rubbery. The fact is that the recommended cholesterol guidelines have shifted around, a classic case of “moving the goalposts”. Let’s go back in time to see why.

In 1974 the US National Institute of Health via its sub-unit called the U.S. National Heart, Blood and Lung Institute, presented the following table in their Handbook for Physicians and Dieticians. This was a table of cholesterol levels, which if exceeded, indicated that your cholesterol was too high for your age group, and you should do something to get it down:

Age Group Cholesterol Australian mmol/L

Cholesterol USA mg/dl

1-19 5.9 230

20-29 6.2 240

30-39 7.0 270

40-49 8.0 310

50+ years 8.5 mmol/L 330 mg/dl

So these were the guidelines given to doctors back in 1974.

One thing that you can see in the above table is that cholesterol levels increase with age. This is quite normal, because our arterial pipes are subjected to a lot of hydraulic pressure, which over the years causes arteries to stretch. And over the years viruses and other compounds attack our arteries as well. Cholesterol’s role is to maintain the strength of our arteries, and keep them in a good state of repair, so that our arteries don’t rupture or burst. So you can expect some increase in cholesterol over the years, and you should be thankful.

However let us ‘fast forward’ to the year 2003 when the NIH decided that anyone above 5.1mmol/L (200mg/dl) is ‘at risk’. The definition of “at risk” is a curious medical term which seems to mean different things to different people.

So where did the latest guidelines of 5.1mmol/L actually come from? That is certainly something that we will investigate in the chapter headed ‘Who Determines Cholesterol Guidelines’.

Do You Have Coronary Heart Disease, or High Cholesterol?

Do you ever wonder whether you actually have CHD?

Many people start to worry about heart disease, after they discover that their blood cholesterol levels are elevated. This is often followed by a period of lifestyle changes centered on a low fat diet, and when that does not work, consideration is given to cholesterol-lowering drugs.

Case in point was my daughter when she turned 23. She had just finished her Law Degree and was commencing a career with a global investment bank and had a thorough medical check-up. She was concerned because her cholesterol level was 9 mmol/L (350 mg/dl) and her doctor had recommended that she take the cholesterol-lowering drug Lipitor, which is one of the more powerful statins drugs. It’s a pretty big step to take this type of drug indefinitely, just because your body is set to higher cholesterol levels.

I explained to my daughter that she had inherited her high cholesterol condition from her grandmother (my mother) who had a cholesterol level of 9mmol/L and had lived an active healthy life until she was 85 years old. I suggested to my daughter that she might like to wait a few years, like another 30-50 years, before making a decision about a drug that had serious side effects.

The idea that my daughter would take cholesterol-lowering medication for the next 50-60 years seems unconscionable, considering there is absolutely no scientific data available to show what happens to someone taking these drugs for 50-60 years. The fact that the manufacturers’ warnings state that Liver Function Tests should be done every 3-6 months for people taking these drugs, should give you some idea that these drugs can damage vital body organs.

I don’t think anyone has a problem with doctors prescribing pharmaceutical drugs when they are used to combat specific diseases and dangerous infections. The issue highlighted with my daughter, is about prescribing non-essential drugs for a condition that is not a disease at all.

If the doctor had said to my daughter “By the way, I need to inform you that some patients do get side effects from statin drugs like Lipitor, and the most common one is muscle pain or wastage, and this could cause pain and stop you from exercising. You also increase your chances of permanent and irreversible damage to the nerves in your fingers or feet. And a small number of patients have lost their mental thinking abilities (cognitive skills) which have affected their ability to hold a job”.

If that had been the conversation between my daughter and her doctor, then she could have made an informed choice. But that is not what happened. She was strongly guided into taking these drugs, except that she happened to have a father who is well-connected into the medical research community with doctors who are experts on cholesterol. I suspect there are a number of young women in the community taking these drugs and who don’t understand the long-term risks.

Cholesterol Tests are Inaccurate

Something that may surprise you is the variability of cholesterol tests. These tests are highly inaccurate, and yet are used by most doctors to determine whether you should be on medication. The reason these tests are inaccurate, is because you cannot measure freeform cholesterol in the blood. Cholesterol in the bloodstream must sit inside a lipoprotein, and that makes it hard to measure. Consequently these readings are highly variable. But how variable are they?

I had been planning to get several cholesterol tests done on the same day, at different clinics, to understand how much these tests varied. Luckily a couple of reporters at The Sunday Times newspaper in the UK did it for me. In The Sunday Times dated 6 March 2005 in an article headed “Deaths Linked To Heart Drugs” there was an article calling for a complete safety review of heart drugs taken by millions of Britons. To help write this article they sent a couple of healthy middle-aged male reporters, for blood tests at different clinics over two consecutive days.

The first reporter Simon Trump had four cholesterol tests done over two days. His readings in mmol/L were 4.77, 5.42, 5.02, and 6.44. This was a significant 35% difference between his low and high scores.

The second reporter George Dearsley had a staggering 60% difference between his low and high scores. His low score was 3.8 mmol/L and the high was 6.1 mmol/L taken in a 24 hour period.

When one of the clinics was quizzed about these differences, their response was simply “that a single test was not always accurate”.

No kidding, but why haven’t we been told? When I discovered how inaccurate these cholesterol tests were, I must confess, I felt rather cheated. I had over the years wasted a lot of time doing these tests, probably 40 in total and keeping meticulously records. I assumed each 10-15% shift up or down was due to some lifestyle change that I had made, never thinking it was due to the inaccuracy of the tests themselves.

Scanning & Imaging Your Arteries

OK, so what do you do if you are worried about whether your arteries are clogging up? Can you get your arteries checked? Luckily there is some excellent computerised technology that can do that.

One of these devices is called a CT Scan, which is a super smart x-ray machine that checks for heart disease. GE’s medical division is a leader in this technology and most major city hospitals have one of these units.

GE scientists understood that arterial plaque is a mixture of cholesterol and calcium, and you can detect calcium on an X-ray. Calcium is defined as a metallic element, which shows up brightly on an X-ray picture.

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So GE built a special low dosage X-rays machine that takes pictures of the calcium build-up in your heart and arteries, and assesses the amount of plaque build-up in the arteries. This smart device actually takes a whole bunch of little X-rays at different angles. The results of the X-rays are run through a computer with some nifty software, and the output is a scoring range from 0 to 500. A newborn baby should have a score of 0 and someone ready for a triple bypass is probably closer to 500. My own score came out at 47, which is pretty good for someone in their 50’s that has very high cholesterol.

I did ask the hospital why these CT Scans were not being used more frequently, and they said it was due to several reasons. Being new technology, it’s not well understood. The original CT Scan introduced years earlier was less sophisticated, and many doctors were not aware that the technology had improved. Also you generally have to pay for this test yourself, and it costs about $400.

� � If you want to learn more about CT Scanning technology, log on to the GE website www.gemedicalsystems.com and check out the Cardiology Section. The products are called Cardiology Imaging, and specifically the unit to look for is the Lightspeed CVCT. I don’t have any bias to GE, but it was the device used when I was scanned. There are other companies who make these scanners and you can find them on the net if you are interested.�

You will also be pleased to know, that there have been further developments in coronary scanning, and Electron Beam Tomography (EBT) is a more recent scanning technology available for cardiovascular purposes. Electron Beam Tomography scanners have three important benefits:

(1) They scan a lot faster. (2) They provide a crisper image. (3) Radiation exposure is far less.

The GE e-Speed product line uses this EBT technology and these devices scan up to 10 times faster than earlier CT Scanners. They create similar images to a CT scan, but the faster “shutter speed” provides better images of the beating heart, arteries and vessels that are constantly in motion. The radiation exposure of the EBT is equivalent to a chest x-ray.

It should be pointed out that some doctors have a negative view of these heart scanners. They were introduced some twenty years ago and the early scanners had limitations. To draw a comparison, your home PC has improved enormously over the past twenty years and so have CT Scanning computers.

Therefore if you are worried about calcium build-up in the arteries, then these scanners are something to consider for assessing your risk for coronary heart disease. Common sense would suggest that before embarking on a long term program of cholesterol-lowering drugs, you should see whether you actually have a problem. Who knows, your arteries might be quite clean and the only way to find out is via scanning.

What I can tell you is that there are many people with poor CT Scan score results (ie arteries showing plaque build-up) who have low cholesterol. A CT Scan alerted these people that they were at risk because of significant plaque build-up, and this allowed them to have take steps to avoid heart disease before it was too late. They were given a reason to adopt a healthier lifestyle. These people thought they were protected by their low cholesterol, but they were wrong.

There are some excellent books available for anyone who wants to learn more about this CT technology, and Track Your Plaque by William R Davis, MD is one I would highly recommend.

In Summary:

� If you are between 46-64 years and your cholesterol is between 5.1 and 7.1 mmol/L then consider yourself lucky, because you are normal.

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� Cholesterol levels in France, UK and USA are all similar, yet the incidence of heart disease in France is about one third. One of many examples that demonstrate that cholesterol and heart disease are not linked.

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� Cholesterol blood tests are highly inaccurate. � To understand the condition of your arteries, CT Scans are available in most cities. � Electron Beam Tomography (EBT) is an improvement on CT Scans.

CHAPTER 5 CHOLESTEROL LOWERING DRUGS – ARE THEY SAFE?

What are the risks for those who take the popular cholesterol-lowering drugs called statins? Let’s investigate both the mild side effects that may make your life unpleasant, and the serious ones that cause irreversible damage.

Naturally Derived Statins

The statins are a class of drug that have been around since 1987 and sold under various brand names. They all work the same way by blocking the body’s production of an enzyme (HMG-CoA) that’s a key ingredient in making cholesterol.

The original statins were naturally-derived and they were the following brands:

� Mevacor, generic name Lovastatin, manufacturer Merck and the first statin to market (1987)

� Pravachol, generic name Pravastatin, manufacturer Bristol Myers (1989)

� Zocor, generic name Simvastatin, manufacturer Merck (1992).

These statins are made through a fermentation process using a particular strain of fungus.

Each of these drugs operates differently. For example, Pravastatin is taken up into the liver and it works by blocking cholesterol production within the liver. It does not readily enter other bodily cells. Simvastatin is quite different because it crosses the blood brain barrier and penetrates into the cells, blocking cholesterol production in each cell.

Synthetic Statins

The pharmaceutical industry is a highly competitive business. After the naturally-derived statins were accepted by doctors and patients alike, the next step was to introduce stronger statins that could reduce cholesterol even further. The only way that could be done was to develop synthetic statin drugs with a modified chemical structure, and these were introduced in 1994. They were:

� Lescol, generic name Fluvastatin, manufacturer Novartis (1994)

� Lipitor, generic name Atorvastatin, manufacturer Pfizer (1997)

� Baycol, generic name Cervistatin, manufacturer Bayer (1998, recalled 2001)

You should be aware that these synthetic drugs have a different chemical structure from the earlier naturally-derived statins and they are also stronger. For those who like comparisons, 10 mg of Lipitor, is the same as 20mg of Zocor, or 40mg of Mevacor/Pravachol.

Top Selling Drugs

So how important are the cholesterol-lowering drugs to the pharmaceutical industry? According to an article in Forbes.com on 27th February 2006, the top selling prescription drugs in the U.S. were:

#1 top-selling drug - Lipitor (cholesterol-lowering)

#2 top selling drug - Zocor (cholesterol-lowering)

And this raises an interesting point. Most people would have thought that the #1 and #2 top selling pharmaceutical drugs would have been for real diseases like Cancer or Diabetes. But that is not the case. The top selling drugs are sold to people who don’t have a disease, but only elevated cholesterol, based on a very questionable statistical link between cholesterol and heart disease which has never been proven.

Statin Side Effects

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Statin drugs have side effects which range from mild to very serious. These side effects may appear when the drugs are first taken, or they may appear months or years later.

Let me tell you about my own experiences with these statins drugs. I first remember trying Zocor, but stopped a few months later because it disturbed my sleep so I felt tired. Then I tried Pravachol but that made my muscles very painful. Thereafter I took Mevacor, which had the same effect. All in all, I took these statins for a total aggregate period of about eighteen months, but ultimately I was not prepared to put up with the side effects.

One of the most frustrating things whilst taking these statins, was asking my doctor the question “Is it not possible that my arteries are squeaky clean? Why must I take this drug?” The answer was “Yes your arteries may be clean, but statistically you are in the high-risk category due to high cholesterol, and it’s current medical thinking to recommend cholesterol-lowering drugs”. Unfortunately at that time there was no way that a doctor could easily look into my arteries, other than via invasive techniques like an angiograph. And that is why the CT Scan was a godsend to me. It enabled me to understand what condition my arteries were in, and helped me decide that cholesterol-lowering drugs were not for me. But let’s get back to these statins.

The statin pharmaceutical manufacturers describe ‘mild’ side effects as including fatigue, nausea, diarrhoea, heartburn, indigestion, headaches, trouble sleeping, constipation, and muscle aching. However to most people like you and I, these are not mild side effects. These are significant side effects, dramatically reducing our quality of life. In addition, for those who are unlucky, there are more serious side effects that can appear at any time which are rarely reported by the drug manufacturers. Let’s look at some that have been well researched and documented:

Muscle Inflammation / Deterioration

Muscle inflammation is one of the most common problems for statin users - ranging from low level pain - to very severe pain that can be debilitating. The problem affects over 20% of people that go onto statins and it stops them from being physically active.

Muscle inflammation is a real problem, because a person cannot exercise and keep fit, if they have painful muscles. The elderly are particularly vulnerable, because they need all their muscle strength to be physically active, and to ward off chronic diseases. For example, osteoporosis is a widespread problem for older persons, and everyone knows that bone density is depleted as soon as a person becomes inactive. This may lead to broken hips, and one health problem just leads to another.

Another thing that you should know is that the heart is a big muscle, and there have been many cases of patients who developed a weak heart by taking statins. For some of these people, the deterioration of heart muscle will lead to heart failure.

A common trait of a healthy person is someone who is active and mobile regardless of age. Unfortunately, statins have stopped a number of people from being active and living normal lives.

Kidney Damage (Rhabdomyolysis)

Kidney damage from statins is caused by the rapid breakdown of muscle. This is a life-threatening condition resulting from rapid muscle breakdown, causing the clogging of the kidneys, leading to kidney failure. It is characterised by abnormally dark urine caused by the release of dead muscle cells into the bloodstream, and causes symptoms of muscle pain, fever, nausea, and general fatigue.

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The statin drug called Baycol mentioned before, was withdrawn from the market because of numerous cases of rhabdomyolysis. The Bayer Company withdrew the drug in 2001 because of reports of some 50+ deaths, not to mention the thousands of patients whose kidneys were severely and permanently damaged. Class action lawsuits were filed against the company in the USA and Germany.

If you must take statins, make sure you report any brown urine to your doctor - immediately. Any symptoms of muscle pain can be a sign of severe muscle breakdown suggesting rhabdomyolysis.

Nerve Damage (Polyneuropathy)

In 2002, another serious condition was uncovered in people who take statins, called Polyneuropathy. Polyneuropathy is a disorder that involves the slow progressive inflammation of your nerves. This follows a study in Denmark led by Dr D. Gaist, MD, PhD. He found that people who took statins for two or more years had more than a 26-fold increase in Polyneuropathy. A real concern was that some patients' symptoms did not improve after stopping the drugs. The symptoms of Polyneuropathy are:

� Sensation changes (usually the arms, hands, legs or feet), such as pain, burning, tingling, or numbness � Facial weakness � Swallowing difficulty, speech impairment � Hoarseness or changing voice

These findings by Dr Gaist suggest that statins might have a toxic effect on peripheral nerves. Remember we mentioned earlier that cholesterol is made by your body, and used to build and maintain the outer membrane of each cell in the body, including nerve cells? This raises the question of the risks of interfering with the body’s cholesterol making abilities.

Memory & Cognitive Damage

But the side effect that shocked me most was the loss of cognitive memory and thinking ability. The brain needs a lot of cholesterol to function properly. The dry weight of the brain is around 7% pure cholesterol so you need sufficient cholesterol to keep this organ functioning at full throttle. So some people react badly if they lower their cholesterol by artificial means, by taking statin drugs. These patients may experience the following problems:

� Cognitive memory impairment � Transient amnesia � Personality changes � Depression

Let’s explore this further. Up to now, patients had assumed that any deterioration of their memory, or thinking ability, after starting statin medications, was simply coincidental with “getting on in years”, and never made the association that these symptoms might be a side effect of a medication. Physicians similarly tended to discount patient reports for the same reasons, never suspecting that the medication the drug companies have been promoting so enthusiastically, could be connected with the relatively common complaint of memory problems found in older people.

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However, as doctors started prescribing statin drugs to younger patients in their 30’s and 40’s, cognitive memory problems began appearing in some of these younger people. It now seems certain that statins cause memory and thinking problems in some percentage of patients. Regrettably the damage is permanent in many cases.

Dr Duane Graveline

Dr Duane Graveline in the USA was one of the first to ‘raise the alarm’ that statins could cause some people to lose cognitive functioning. Dr Graveline has a very interesting background, as he trained as a NASA Astronaut and Flight Surgeon, as well as working as a family doctor. The problems he discovered were permanent loss of short term memory (i.e. you can’t remember what someone told you 10 minutes ago) and serious bouts of Transient Amnesia (i.e. you walk around aimlessly for a few hours and cannot recognise people who you know).

Duane told me that he knew of some executives including CEO’s who had lost their high level jobs, because of cognitive memory problems attributed to statin drugs. Clearly this is not the sort of thing that any top business executive wants to experience.

Dr Duane Graveline presents his findings at a Conference in Washington.

Dr Graveline has written a book about his experiences which is called “Lipitor, Thief of Memory” and is available from Amazon.com. Also visit his website www.spacedoc.net

It’s interesting that some people experience side effects immediately after commencing taking statins, whilst for others, the side effects happen 12-36 months later. This delayed reaction is a very interesting phenomenon. Based on what I have read, it seems that these delayed side effects occur when the patient switches from one brand of statin to another. So someone taking a naturally-derived statin like Zocor might be OK, and then switches to a synthetic statin like Lipitor, and suddenly problems occur.

Dr Jay Cohen, MD, has written a couple of very interesting books for people that take pharmaceutical drugs like the statins. One is called OverDose: The Case Against The Drug Companies. It helps doctors and patients gain a better understanding for the correct dosage, when taking statin drugs. He explains how easily patients can overdose on pharmaceuticals. Relevant to this chapter is a paragraph on page 16 from his book which states:

‘Pfizer developed Lipitor to be extremely powerful in lowering blood cholesterol levels, so that with aggressive marketing, Lipitor could surpass better established, more proven competitors. With 48,791,000 prescriptions filled in 2000, Lipitor has accomplished this, but it has triggered more reports to me about side effects than the other five drugs in its class combined. Perhaps this is because the standard dosage of Lipitor is so strong; it is far stronger than many patients actually need or can tolerate.’

Dr Cohen has written a book that is of interest to anyone taking statins called What You Must Know About Statin Drugs & Their Natural Alternatives and he has some useful information on his website www.medicationsense.com

Dr Beatrice Golomb, MD

Public concern about statins is generally on the increase, and the US National Institute of Health commissioned an independent study that will subject statin drugs and their side effects to scientific scrutiny.

Dr. Beatrice A. Golomb, MD, affiliated with the University of California at San Diego is heading this study involving 1000 participants. Dr Golomb is an MD and she has also done a PhD in Statins. She is one of the most highly respected researchers in the USA on the subject of statin drugs and cholesterol.

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Dr Golomb was quoted in the Wall Street Journals’ Magazine called Smart Money back in November 2003 in an article called The Lipitor Dilemma and here are some of her comments:

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‘There are people who experience significant quality-of-life-affecting adverse effects from these (statin) drugs. The potential for severe side effects should be much, much clearer than it currently is.

Statins may cause cognitive problems simply because they lower cholesterol. Cholesterol is the main organic molecule in the brain and constitutes over half the dry weight of the (fatty lipids in the) brain, Golomb says.

Doctors need to be educated, Golomb says. If there’s any good news about these drugs, you can be sure that the $18 billion-a-year statin industry is going to ensure that people hear those good things. There’s no corresponding interest group to ensure that people hear the other side.’

Coenzyme Q10

Clearly anyone who is taking statin drugs should be worried about the risks. If you fall into this category, there is an interesting book called ‘Reversing Heart Disease’ by Dr Julian Whittaker. Whittaker advises that if you have no option but to take a statin drug, then at least take 200 milligrams of Coenzyme Q10 every day. This is because a particular enzyme that statins inhibit in the body to reduce cholesterol production (HMG-CoA), is also the enzyme involved in the body’s manufacture of Coenzyme Q10, so your Coenzyme Q10 levels drops.

Coenzyme Q10 is essential for energy production in the mitochondria of our cells – it is to the cell, what a spark plug is to an engine. The heart, the busiest of all muscles, has extreme energy requirements and must have high levels of Coenzyme Q10. Studies have shown that patients with heart failure have measurable deficiencies in Coenzyme Q10, and the degree of disease progression, correlates directly with the degree of Coenzyme Q10 deficiency.

Canadian labelling for statin drugs clearly warns of the dangers of Coenzyme Q10 depletion, and that it could lead to impaired cardiac function in some patients. To put it bluntly, there is a lot of information and research that confirms that statin users should always take Q10 supplements to reduce the side effects of statins as discussed in this chapter.

In Summary:

� There are 2 types of statin drugs, naturally-derived and synthetic. � Muscle inflammation is the most common side effect. � The worst side effect is losing your cognitive thinking, and the ability to remember things. � Anyone taking statins should take 200mg of Coenzyme Q10 to protect the heart.

CHAPTER 6 STATIN USERS, CASE EXAMPLES

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When it comes to important medical matters like heart disease, very few people bother to get a second opinion. This is rather surprising because medical mishaps are the 5th leading cause of deaths, and it’s generally caused by mis-diagnosis, human error, or drug complications. Consequently you as a patient cannot totally abdicate your responsibilities for your own good health.

Many patients feel that getting a second opinion on a medical problem is an insult to their doctor. However, nothing could be further from the truth. Most doctors are dedicated to providing advice to the best of their abilities, but recognise that there are specialists in the medical field who are more knowledgeable. Medicine is extremely complex and it’s impossible for a doctor to know everything.

To understand why it’s wise to get a second opinion for important medical conditions, let’s look at some real life examples of people whose lives have been changed by taking cholesterol-lowering drugs. Some of the names have been changed to allow anonymity:

Medical Case – Chief Executive Officer, Serious Muscle & Memory Problems, USA

This CEO of a large US company began taking Lipitor at the time of an angioplasty operation. Sometimes called balloon angioplasty, this procedure uses a small balloon at the end of a catheter, which is inflated at a narrow point within an artery, and expands that section of the artery, to improve the blood flow. His recovery seemed normal, until two things happened to this 54-year executive, several years later. Generalised muscle pain was one, including the diagnosis of severe rhabdomyolysis with rapidly rising muscle enzyme levels. A physical revealed severe rhabdomyolysis muscle cell breakdown. The second problem was a profound loss of short-term memory. “Odd” memory glitches had occurred during the preceding year but he had passed them off as due to lack of concentration.

He barely survived the rhabdomyolysis and still suffers constant pain and weakness, but his major problem is persistent and probably permanent cognitive impairment. (Imagine having a business meeting in the morning and not remembering the items discussed a few hours later) According to his wife, his doctors concur that the damage was somehow caused by Lipitor, a likelihood supported by the failure of extensive testing to show the presence of tumours, stroke or Alzheimer's.

Today, this formerly successful CEO is now “cognitively impaired” and unable to work, testing below the 1st percentile for short-term memory and cognition. He has now been off Lipitor for over a year with little or no improvement in his short-term memory. His case is one of the rarely reported instances of persistent and possibly permanent cognitive disturbance associated with statin drug use.

Of special interest is the fact that three uneventful years passed before this person’s Lipitor associated problems surfaced in the form of his first “memory lapse,” and another year was to pass before the dreaded complication of rhabdomyolysis began. This is a sobering observation for those who would seek comfort from the fact that they have been taking a statin drug for a year with no problem.

This case was excerpted from the book, Lipitor Thief of Memory, Statin Drugs and the Misguided War on Cholesterol, by Duane Graveline, MD and Lee Richardson © 2004

Medical Case – Business Executive, Serious Muscle Breakdown, Australia

Philip is a well-educated business executive, and holds a senior management position with an international company. A hard worker in his late thirties, he is successful in his career and has a young family.

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One day, Phil saw his local family doctor, who suggested that he should have his cholesterol checked, “just to be sure”. A few days later, Phil gets the bad news. The test results showed a cholesterol level of 7.2, and his ‘bad cholesterol’ was particularly high. “Phil you’re a walking time bomb” said his doctor “We need to get your cholesterol down. We better get you onto a low fat diet ASAP”.

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Suddenly Phil’s life started to change. Being a walking time bomb was rather stressful, and he commenced on a low-fat diet immediately. Of course, anyone who knows anything about cholesterol knows that a low-fat diet doesn’t lower cholesterol for most people. So the next visit to the doctor’s office was predictable. “Phil, your low fat diet hasn’t reduced your cholesterol, I’m going to prescribe you a widely used cholesterol-lowering drug – we called them statins - that have an excellent track record for reducing cholesterol”.

So Phil took his daily statin medicine, comforted to know that his cholesterol was now being managed.

But not long thereafter, Phil started to get muscle pain. He thought it was probably temporary and it would disappear. It might have been due to too much exercise, he thought. But the pain got worse. So he discussed the condition with his doctor, who didn’t see the connection between the statin drug and muscle wastage – which is amazing because it’s listed as a common side affect. So finally Phil is referred to a specialist, who also has no idea of what the problem is, and he suggests that a sample of muscle be taken from his leg so it can be analysed.

Phil thought this would be a simple procedure and he’d take a day or two off work. However, Phil is actually off work for over two (2) weeks, because the muscle sample they took was a larger then he thought leaving a significant scar. The result of the muscle-sampling tests is negative, meaning they could not find anything wrong with his muscles.

So Phil gets referred to another specialist who looks at his situation and says, “Phil, it appears the cholesterol-lowering drugs you are taking, are causing a muscle wastage condition called Rhabdomyolysis. I’m taking you off the Lipitor”.

So Phil goes off the Lipitor. Problem is, weeks later his blood tests shows that he is still wasting muscle at an alarmingly high rate.

Phil’s experience is rather common.

Author’s Comments - Who was it that once said “If it isn’t broke then don’t fix it”.

Medical Case – Company Director, Cognitive Memory Damage, USA

Andrew was a successful businessman in California producing organic food on a large scale and employing hundreds of people. He was one of the top people in his field. Like many business owners, he worked long hours and reaped the financial rewards. He loved his business, and was supported by his wife and his son in the business.

But now Andrews’s life is very different. His successful business has collapsed. For the past two years, Andrew has spent most of his time at home. And he was only 56. And the financial resources that were to carry him and his wife through retirement - are no longer.

Andrew’s life was affected by serious cognitive problems caused by the statin drugs. Let’s look at his story.

Andrew was 51 when his doctor advised him that he should do something about his elevated cholesterol - it was around 240 (6.2mmol/L). He was prescribed a popular statin drug called Pravachol and a year later it was changed to Lipitor. What Andrew and his doctor did not know, was that these powerful drugs can have side effects, and some are mild and some are very serious. In his case it would be serious, and something that few doctors had heard about – memory loss.

In Andrews’s case, he would forget simple things or instructions. This change did not happen overnight but occurred progressively over a two-year period. For a while it went unnoticed because of Andrews’s excellent interpersonal skills. However, ultimately it reached the point where he struggled to solve daily business problems because of his short term memory loss.

It was Andrews’s son who first mentioned to his mom that his father was not his usual self at work, but he could not quite put his finger on it. Andrews’s condition progressively got worse. And as his cognitive ability suffered, so did the business. By the time Andrew was 54 he could no longer run the business, and the lack of strong leadership within the business, ultimately caused the business to fail. The family lost everything and their lives were turned upside down.

I spoke to Andrews’ wife to understand what had happened. She was very forthcoming about her husband’s ordeal. She said, "Frank, if you met my husband today in a social setting, you might think there was no

problem. He is very outgoing and has excellent social skills and people enjoy his company. At a restaurant or a party you wouldn’t pick it. But if I ask him to get a glass of water or the car keys - he forgets. If I give him any sort of directions to do something, he can’t do it because he forgets. And problem solving activities that he zipped through in the past, are now impossible. My husband has been clinically tested, and we have been told he cannot do any kind of job. My husband is really upset about being home all day and not able to go to work. We've lost everything".

She also stated that her husband’s cardiologist had written a letter, confirming that the statins seemed to have caused his memory loss.

Kathy and her family had clearly suffered a great deal. Her husband has no future career prospects, the family's business is gone, and their financial assets have disappeared.

Probably the only option left for her, was to take legal action against the pharmaceutical manufacturer, which she pursued for a while. But all the law firms she approached would not touch her case, because taking on an international pharmaceutical company is just too risky. The law firm could lose millions. These huge pharmaceutical companies have unlimited cash for defending any legal case, and they have access to an unlimited number of medical experts from the many medical associations that they generously support.

Clearly this is an extraordinary story. The fact is, Andrew should today be leading a happy healthy life, and running a successful business with his son. Andrew’s original cholesterol of 6.2 was ‘spot-on’ normal for the 46-64 age group. Unfortunately Andrew and Kathy’s life is changed forever, because their doctor was simply doing the right thing. That is, following the recommendations that he should lower his cholesterol with statin drugs.

Some Other Real-life Examples

After this touching experience, I thought I would have a look on the Internet to investigate this cognitive memory condition further, and see if there were any others suffering from these conditions. It did not take me more than a few seconds to find a website on statins and memory problems. Below I have extracted several examples from this website. You may still be able to visit this website and I hope you still can. www.covina.com/messages/general/messages/3986.htm

52 Year Old Accountant, Alabama

I took Lipitor 10mgs daily for about two months during the summer. By the end of that time my short-term memory had gotten so bad that I could not read a four-digit number, look away and repeat it. That is devastating for a CPA. When I stopped taking it there was a big improvement in my memory, but not full recovery. I have had a brain MRI that showed no damage, but other testing does show a loss of memory. Now about 15 months later I have still not fully recovered. There are other symptoms that are part of this, which reduce my workload and consequently my income, that are also quite unpleasant. This has changed my life for the worse. At age 52, I have been forced to greatly reduce my workload and consequently my income.

45 Year Old Teacher, North Carolina

I have been taking Pravachol for five years now. I stopped taking the drug immediately when one of my colleagues told me that she was experiencing memory loss using Lipitor. I am a teacher, and I have been having severe problems with memory to the point that I consider myself totally impaired some days. I have lost my train of thought mid-sentence. I have had speech impairment and I sometimes stagger. I made my decision to quit taking this drug after verifying the numerous side effects listed in the PDR. I did experience side effects, but I never considered my severe memory problems were related to this drug.

43 Year Old, New York

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Memory loss is one of my own chief complaints. The medical community does not admit to any link between statins and the many symptoms that others and I have posted on this message board.

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Authors Comments - It’s alarming that a number of these people above, did not have a heart attack, or even any signs of heart disease. Many had normal levels of cholesterol, based on the population norms. Some were free of heart disease, and yet, were prescribed a drug that severely degraded their health and well-being. They cannot sue their doctor, and they cannot sue the drug companies, because there is no way to prove the cause and effect.

Statin Overdose / Underdose

The use of pharmaceutical drugs has been described as ‘controlled toxicology’. Toxicology is defined as the scientific study of the toxic or harmful effects of drugs and other substances on the human body. At high dosages the drugs become toxic and cause damage. At low dosages the drugs are ineffective. The correct dosage is somewhere between these two points, where you achieve maximum effect with minimal harm.

The patients who we discussed in the preceding few pages, showed classic symptoms of drug toxicity.

Dr Jay Cohen’s book OverDose reported that there was an urgent need for drug companies to define proper dosage guidelines for statin drugs. These guidelines should take in account the patients’ age, sex (males and females metabolise drugs differently) and body weight. Dr Cohen supports the prescribing of drugs, but he says the dosage must be carefully determined. This is not happening, and therefore many people overdose on statins leading to mild side effects at best and irreparable damage at worst.

Dr Cohen notes that companies like Pfizer, market their top-selling drug Lipitor at a powerful initial dose, so that Lipitor will impress doctors and patients, by its ability to reduce cholesterol more than any other statin drugs. But as patients’ change over to Lipitor, they are exposed to an increase in toxicity, and may experience side effects. Some of the severe case examples we explored before, were people who swapped to Lipitor.

To explain this further, someone on 10mg Mevacor which is a milder statin, who swaps to 10mg Lipitor, is effectively increasing the dosage (4X) fourfold. The toxicity of 10mg of Lipitor equals 40mg of Mevacor. But no one explains it to them that way. These patients assumed 10mg is 10mg. Many doctors assumed that as well.

Most patients that we covered earlier who experienced side effects, were well educated individuals, and many would have investigated the risks of side-effects with statins. And most would have assumed that the information they read about statin side-effects, was accurate. Unfortunately it is not.

So why is the published data on side effects, so different from the reality?

I struggled with this question myself, until I discovered the research conducted by Dr Jay Cohen and his explanation goes something like this:

The US Food & Drug Administration (FDA) is the drug watchdog whose role is to protect the consumer. It collates data on adverse drug effects, and it gathers this information from doctors who fill in a form called the FDA MedWatch, which is designed to alert the FDA of any drug side effects. And if all side effects were recorded on the MedWatch form then we would get accurate information.

But Cohen then goes on to explain what actually happens in the real world. Firstly, many people who have adverse reactions to a drug do not tell their doctors, they simple stop taking it. And the ones who do talk to their doctors, will likely be prescribed another type of drug which may be more agreeable with the patient. The chance of the doctor thinking "Oh, I better fill in the FDA Medwatch form and send it to the FDA” is unlikely as the doctor is too busy. Cohen states that only 1 in 20 adverse side effects are reported to the FDA. And these exclude those patients who just stop taking the drug at their own initiative and did not tell their doctor.

I thought I would check the FDA website www.fda.gov and see what it said about Lipitor. I came across a 16 page report on Lipitor which is document # 0155G247-2 dated 2001. In this white paper document, under the heading of ‘Adverse Reactions’ this is what it said:

“Lipitor is generally well-tolerated. Adverse reactions have usually been mild and transient. In controlled clinical studies of 2502 patients, less than 2% of patients were discontinued due to adverse experiences attributable to Lipitor. The most frequent adverse events thought to be related to Lipitor were constipation, flatulence, dyspepsia, and abdominal pain.”

Quite honesty, this entire statement is wishful thinking.

To really understand the severity of the problem with drug reporting, let me share an example which explains how infrequently side effects are recorded. It was for a heart drug called Digoxin. The article explained how the FDA had received (an average) of only 82 adverse reports per year. Yet Medicare records showed that there were 28,000 hospitalizations per year due to Digoxin reactions. That meant that the FDA had received formal notification for just 1 in every 300 cases. This is why the published data on drug side effects cannot be relied upon.

As a rule of thumb, whenever you read about the frequency of drug side effects, multiple it by 10X. So if it says 2% then it’s really 20%.

Back in 1995 when I was taking statins, I clearly experienced muscle pains, but my family doctor told me it affected less than 1% of people. And I remember thinking that maybe these muscle pains were partly my imagination, or that I needed to be a bit tougher, so I kept taking the medication. Ultimately, I gave up taking the statins without telling my doctor.

In Dr Cohen’s latest book called What You Must Know About Statin Drugs, he encapsulates a huge amount of research on statins and their side effects, and on page 79 he states:

“The majority of people tolerate statins pretty well, but many others suffer side effects. More than half of the people who start statins quit treatment within a year, and after a few years, only 25 percent remain on the drugs.”

Dr Cohen has written this book to explain the correct dosage for all the statins including Zocor, Lipitor, Crestor etc. In short, the correct dosage is one where there are no side effects. He also explains the effectiveness of different dosages. For example, 10mg of Lipitor reduces LDL cholesterol by 39%, yet 20mg reduces it to only 43%. So why double the toxicity to go from 39% to a 43% reduction?

Or, is it worth taking 80mg of Lipitor to achieve a cholesterol reduction of 60%? Dr Cohen suggests that maybe just 5mg to get a 25% reduction is all you need, and that reduces your statin toxicity by a factor of 16X. Drugs are toxic.

Cohen’s book also reviews the latest ‘high performance’ statin drug called Crestor (rosuvastatin). This super statin is so powerful, that just 1mg per day will reduce cholesterol by a whopping 34%. This new drug is receiving a lot of attention, and a phenomenal number of adverse reports and complaints. Some doctor’s say that it is ‘a disaster waiting to happen’ for susceptible patients.

The important thing to remember, is that the number of cases of statin side effects, is far greater then what is being reported, and the best way to protect yourself from the dangers of overdosing, is to take the correct dosage. Cohen’s book will help you to determine that.

Better Controls

A number of medical professionals are asking for better controls in the prescribing of pharmaceutical drugs where long-term drug treatments are concerned. In some countries, if a patient is considered ‘at risk’ of say coronary heart disease by the local doctor, then they are referred to a specialist like a Cardiologist. The Cardiologist then determines whether long-term medication is required.

Regrettably in many countries these controls are non-existent, and any medical doctor can prescribe powerful statin drugs that the patient must take for the rest of their life, without any consultation to a higher-trained cardiologist. Whilst some family doctors are knowledgeable in coronary heart disease, others are not, and the poor patient is ‘at risk’ as we noted from some of the examples earlier.

FDA MedWatch

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Consumer complacency is another reason why drug ‘side effects’ receive little media coverage. If we don’t report our negative experiences with drugs to the government, then the government cannot inform the public about the magnitude of the problem. Clearly if no one is complaining, then everything must be OK.

FDA MedWatch provides safety information on all drugs and medical products regulated by the U.S. Food and Drug Administration, and allows consumers to report ‘serious adverse events’ associated with the use of FDA regulated pharmaceutical drugs, medical devices, special nutritional products, and cosmetics. It’s also a helpful website for consumers to investigate problems associated with pharmaceuticals. To visit the site see www.fda.gov/medwatch

In Australia a comparable Government website allows consumers to report any ‘adverse effects’ from pharmaceutical drugs. Visit www.tga.gov.au and on the homepage you will see a heading that says ‘Report Problems’.

I would encourage anyone to be proactive in the reporting of problems associated with pharmaceutical drugs. These problems are those that individuals experience themselves, or on behalf of aging parents who may find it difficult to report these adverse drug events. It will only take several minutes on the internet, and your efforts will be of real value to others in the community.

In Summary: � Doctors are increasingly prescribing statins to younger people, and placing them ‘at risk’. � Some patients suffer statin side effects, and some more fortunate do not. � Muscle pain and inflammation seems to be the most common problem. � Neural, memory, cognitive and amnesia problems occur less often. � Dr Jay Cohen has done some great research into statin overdosing. � Report any adverse drug side effects to the US FDA or Australian TGA.

CHAPTER 7 ALTERNATIVES TO STATIN DRUGS

Many people have concerns about taking pharmaceutical drugs, and look for natural alternatives. Consequently a very large health supplements industry has developed to provide options.

The reality is that anyone taking cholesterol-lowering statin drugs is subjected to ‘Russian roulette’ because of a long list of side effects that affect some percentage of the population as documented by the FDA, NIH and research groups. Many of the side effects develop slowly as neural and muscle cells gradually deteriorate, resulting in irreversible damage. A summary of the side effects are noted below:

Summary of Statin Side Effects

� Liver damage - Hepatitis

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� Kidney damage - Rhabdomyolysis � Nerve damage - Polyneuropathy � Facial weakness � Swallowing difficulties � Speech impairment � Hoarseness or changing voice � Cognitive memory damage � Transient amnesia � Personality changes � Depression � Chest pain � Weakens heart muscle � Birth defects if taken during pregnancy � Swelling hands, feet, ankles, or legs � Nausea � Extreme tiredness � Unusual bleeding or bruising � Loss of appetite � Abdominal pain � Flu-like symptoms

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While there are many side effects to statin drugs, it needs to be emphasized that there are people who can take these drugs without any problems.

What needs to be explained in terms of the statistical data available, is that for every 100 people who take statins, 5% will derive some benefit, and 95% will derive no benefit but be exposed to all the risks and costs. Some of this 95% will be like those healthy people we discussed in an earlier chapter, who took statins to gain better health, and whose health was destroyed as a consequence. For these reasons, there are a number of people who seek alternative ways to reduce their cholesterol.

Fortunately the health supplements industry offers alternative solutions for cholesterol-lowering that may appeal to some readers. These natural products do lower cholesterol with little side effects, but are not as powerful as the statins drugs. They provide a ‘middle of the road’ option for cholesterol lowering, without the risks.

Let’s look at the options:

Policosanol / Sugar Cane Wax Alcohols

Policosanol is a patented product that is remarkably safe and effective at reducing cholesterol levels. It is made from the wax alcohols derived from sugar cane. The non-patented versions are simply called sugar cane wax alcohols.

These wax alcohols have been well tested for over 10 years and have no known toxicity, even when taken in high doses. Animal toxicity studies with doses up to 1500 times the normal human dose (on the basis of body weight) have shown no negative effects on the animal’s reproduction capabilities, growth, or development.

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One of its advantages over statin drugs, is that it does not appear to interact with other drugs, a common problem for anyone taking multiple pharmaceutical prescriptions. Studies have also shown it to decrease the stickiness of platelets in the blood, and reduce inflammation on the lining of the arteries.

Adverse side effects are rare and the most common is weight loss, which occurs in a small percentage of people.

The normal dosage is 10-20mg per day which provides a reduction of around 15 - 21% in cholesterol levels. Taking more is not more effective. Always take Policosanol as directed.

Red Yeast Rice

Red Yeast Rice is a fermented rice product that has been used for centuries in Chinese cuisine, and as a medicinal food to promote "blood circulation". This product is white rice fermented by a strain of red yeast called Monascus Purpureus. It has long been used in Asian style foods for colouring, and is the red colour in Chinese spare ribs, and to make red sake.

What is unusual about this fermented food product is that it contains a compound which is identical to the statin drug, Lovastatin, launched by Merck under the brand name Mevacor. So we have a statin drug developed in a laboratory in 1987 that is later discovered to be identical to a compound found in food.

Interestingly, when Red Yeast Rice was found to contain Lovastatin, the US Food & Drug Administration (FDA) moved to make Red Yeast Rice a drug, and removed it from the unregulated shelves of the health food stores. This action by the FDA was clearly to protect Merck.

But in the Dietary Supplement Health and Education Act of 1994 (Public Law 103-417), the US Congress saw fit to remove all ‘dietary supplements’ from the auspices of the FDA. So the FDA ruling on Red Yeast Rice was overturned in 1999 by the Court of the District of Utah.

It’s important to note that Red Yeast Rice is still a statin drug, albeit in a natural form and at a lower dosage.

Lovastatin is a serious drug, with real side effects, and Red Yeast Rice is Lovastatin. Some people are inclined to think that ‘over-the-counter’ means ‘safe’ but this is incorrect. As for all statins, there is a risk of side effects and people taking Red Yeast Rice supplements should always have their liver enzymes checked regularly.

One of the better known brands of Red Yeast Rice sold in the USA is called Cholestene. If you do take Red Yeast Rice, then make sure you also take 100mg CoQ10 daily to protect the heart.

Ayurvedic Medicine for Cholesterol-Lowering

Another interesting supplement for cholesterol–lowering is called Shuddha Guggulu, a herb used in Ayurvedic Medicine.

Ayurvedic Medicine is the old traditional system of medicine that is native to the Indian subcontinent, and includes medicinal herbs and protocols for treating a broad range of conditions.

Shuddha Guggulu is a gum-resin from a tree that grows in India and Arabia, and is used to reduce total and LDL cholesterol levels. I came across this herb at a dinner, where I met a senior executive employed by a Top 4 Global Consulting firm, who travels internationally on a regular basis. He was born in India and was very familiar with Ayurvedic medicine.

He explained that his cholesterol level was 6.5 mmol/L, and was now down to 3.5mmol/L. He started taking it three years ago and had not experienced any side effects. He found he could take it any time, either with meals or an empty stomach. The recommended dosage is one 500mg Shuddha Guggulu capsule in the morning and evening.

He buys his cholesterol-lowering Shuddha Guggulu from an Indian company called Himalaya Herbal Healthcare. He has personally met the CEO of the company, and was impressed by their products, which are sold worldwide including the USA. The website is www.himalayahealthcare.com

The product is readily available over-the-counter in India and Malaysia, and readers based in that region who seek a natural cholesterol-lowering alternative, may wish to investigate this product.

Plant Sterols

Plant sterols have been promoted by food manufacturers, for their ability to reduce cholesterol levels. But how beneficial are they? Let’s have a closer look.

Plant sterols are natural substances found in plants, with chemical similarities to cholesterol, and both sterols compete for absorption in the digestive tract. Consequently if we eat fruits and vegetables which naturally contain plant sterols, then we reduce the amount of cholesterol that the body will absorb, and vice versa. In other words, in a balanced diet the body will metabolise some combination of cholesterol and plant sterols, as they compete for absorption. Sitosterol is the most common plant sterol and you will see it in some margarines.

The problem that I see however, is encouraging people to eat a heavily processed food like margarine to get their plant sterols. Margarine and processed vegetable oils have a strong association with cancer, heart disease, macular eye disease etc. We will talk more about their dangers a little later, and look at why the French use safer fats like butter, duck fat, virgin olive oil, that are less susceptible to oxidative damage.

Another concern is that there are some people who suffer from a rare metabolic disorder called sitosterolaemia, caused by elevated plant sterols in the blood, which leads to premature coronary heart disease.

In general, plant sterols are GRAS – Generally Recognised as Safe – but the enthusiastic claims as a margarine additive is more hype then fact. My suggestion is – if you are keen to take plant sterols – then take them as a supplement in a capsule, or eat more vegetables.

Naturopathic Physicians

� The field of complementary medicine has grown significantly in recent years, with notable increases in the number of patients visiting naturopathic practitioners. So let’s have look at how they treat cholesterol.

Naturopaths see cardiovascular disease in the broader context of the human body. They recognise that cholesterol is not a disease in itself, but merely a statistical indicator, and there are risks of liver and kidney damage resulting from the long-term use of cholesterol-lowering pharmaceutical drugs.

They see elevated cholesterol as a likely consequence of an under-performing liver, resulting from a diet of de-natured foods and poor lifestyle choices. They see the problem in terms of poor bile flow, where cholesterol backs up in the body, as a result of poor diet and lifestyle. By the way, the medical word for ‘bile’ is chole which is part of the word cholesterol. Or putting it another way, bile is rich in cholesterol.

Naturopaths prefer to use very safe methods to facilitate the movement of cholesterol from the liver and gall bladder into the digestive tract, for subsequent elimination. The treatment includes:

(1) Mild herbal medicines to reduce fatty liver and to ‘tone up’ the liver. (2) Mild herbs to improve bile flow from the gallbladder to the intestines. (3) Bulk herbal laxatives to remove excess cholesterol from the intestines.

The herbal medicines used typically include Globe Artichoke, Dandelion Root, Milk Thistle, which have been used traditionally by English speaking naturopathic practitioners, and a long history of safety. We are also seeing Chinese and Indian herbs being introduced into western countries, like the Shuddha Guggulu herb that we mentioned earlier.

The overall aim is to have an efficient liver and gall bladder, to release the cholesterol-rich bile into the digestive tract, for subsequent elimination from the body.

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An example of an herbal cholesterol-lowering medicine used by naturopathic practitioners in Australia, is CholestraHealth from MediHerb Limited. This is a cholesterol-lowering formulation prescribed by naturopaths and nutritionists as well as some doctors. It is a soluble powder that is taken twice a day with food or water, and contains the following active ingredients

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Globe Artichoke Extract 4.4 grams Increases bile flow to facilitate cholesterol elimination Psyllium 4.0 grams Absorbs cholesterol in gut for elimination Phytosterol Complex 1850mg Reduces cholesterol absorption in the gut Lecithin 1200mg Emulsifies fat in the gut Sugar Cane Wax Sterols 10mg Reduce cholesterol production in the body

CholestraHealth would provide a moderate reduction in cholesterol, and I would expect a persons’ cholesterol level to drop on average between 12-18% with this formulation.

When taking herbal products, it’s very important to buy those from companies with excellent quality control. That’s because herbs are very different from pharmaceuticals, in that there is more ‘batch variability’. For example, when wine growers talk about good and bad years they are really talking about variabilities due to temperature, rains, soil type etc. This applies to herbal medicines as well, and there is a lot of blending and testing required for herbs to produce a ‘standardised’ product. This requires an in-depth knowledge of phytomedicines, expensive manufacturing equipment, and superior quality control.

An important philosophy held by Naturopathic practitioners is that you should do everything possible to maintain a healthy liver. The liver is considered the most complex organ in the human body, and it is responsible for more critical functions then any other organ. For this reason, naturopaths are extremely cautious in seeing patients take pharmaceutical drugs that may be toxic to the liver. The liver has no backup, so if it fails, your only options are a transplant, or a journey to the next world.

Sandra Cabot, MD, and naturopath Margaret Jasinska, wrote a book called Cholesterol:The Real Truth that provides a further understanding of how naturopathic physicians approach the issue of cholesterol.

In Summary: � Red Yeast Rice is a diluted form of the statin called Lovastatin. � Policosanol decreases the stickiness of platelets in the blood, and reduces inflammation in the arteries. � The Ayurveda herb (gum resin) called Shuddha Guggulu is available in India and Asia. � Naturopaths focus on healthy bile flow, rather than absolute cholesterol-lowering. � Multi-formulated cholesterol-lowering supplements may be an option.

CHAPTER 8 WHO DETERMINES CHOLESTEROL GUIDELINES

Over the years most people have accepted the need to lower their cholesterol without really questioning the source or validity of the “Recommended Cholesterol Guideline of 5.1mmol/L”.

But who determines these cholesterol guidelines used by doctors? Where does this magic level of 5.1mmol/L (USA 200mg/dl) come from?

And why are the cholesterol guidelines not based on population norms?

I thought we would go to the source, to see who determines these guidelines, and how they are calculated. The source is the U.S. Department of Health & Human Services which is the U.S. Government's principal agency for overseeing the health of all Americans and providing essential human services. It manages a staggering budget of US $ 700 Billion.

The Department has a Unit called the National Institute of Health (NIH) which provides leadership for national programs in diseases, that has a subgroup called the ‘Expert Panel for High Blood Cholesterol’ that provides cholesterol guidelines published in a 300-page report. So it looks like this:

U.S. Department of Health & Human Services

National Institute of Health

Expert Panel for High Blood Cholesterol

300 Page Cholesterol Report

The Expert Panel for High Blood Cholesterol is made up of a group of medical advisors, and publishes a report on cholesterol every few years with their guidelines. The latest recommendations are contained in a 300-page report called “The Third Report of the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III or ATP III)”. You will find this Report on the NIH website.

This 300-page Report is extremely detailed and few people would read it from cover to cover. However, I had a 14-hour flight to the USA and thought I’d read it. And I read it cover to cover. I also discussed it with some medical doctors whilst I was in the USA, to get their views.

In a nutshell the Report is extremely comprehensive, and a great deal of valuable research data has been assembled, which is a credit to the researchers that worked on this project. Research is of course a different process, from the interpretation of the research, which leads to the final recommendations.

The concern in reading this Report, is that it only mentions those cholesterol trials that supported the cholesterol/heart disease theory, and excluded the trials that did not support the cholesterol/heart disease theory.

Also the recommendations contained in the Report are rather favourable towards cholesterol-lowering drugs, and thereby severely undermines the excellent research effort which was made. In fact, any person reading the recommendations in this Report would think it was written by the pharmaceutical manufacturers.

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Basically, the Report encourages a relentless drive by doctors, health care workers and pharmacists to promote the benefits of lowering cholesterol at all costs to their patients. Since most people cannot lower cholesterol through diet, the only solution is cholesterol-lowering drugs.

In making these recommendations for the increased use of cholesterol-lowering drugs, there was little mention of the ‘side effects’ of these drugs. It is hard to understand, how a 300 page report on cholesterol, would not include a detailed review of the numerous research reports published that explain the serious risks from cholesterol-lowering drugs.

And that is why most people in the healthcare industry, simply presume that these drugs are totally safe. Little wonder that there are so many doctors writing prescriptions for statin drugs in good faith, if they are not alerted to the severe side effects of these drugs by the National Institute of Health.

Some aspects of the Report were impossible to rationalise logically. For example, the Report praised the cholesterol-lowering drug Gemfibrozil (sold under the brand name Lopid, Jezil) stating they provided an impressive 37% reduction in heart attacks. However if you dig deep enough into the report, you will find that ‘all-cause’ mortality is actually higher for people taking Gemfibrozil, because of its toxic side effects. What this means is that people taking Gemfibrozil may reduce their chances of having a heart attack, but are more likely to die sooner than necessary because of liver toxicity, kidney failure, suicide, or other causes.

Surprisingly, there was no ‘out of the box’ thinking in the Report. For example there was no reference whatsoever to other countries like France with the same average cholesterol levels as the USA, probing why they do not have problems with coronary heart disease. There was no mention of natural cholesterol-lowering alternatives like Policosanol. No mention of naturally derived statins versus synthetics. No reference was made to the 10 year Nurses Study, which demonstrated a huge 40% drop in heart disease for nurses consuming 450 grams (1 Lb) of raw nuts per week. In effect, the Report was incomplete.

The real problem with this Report, is that it does not explain how the new cholesterol guideline of 5.1mmol/L (USA 200mg/dl) is determined?

Yet this is the Report that is the Reference Guide for doctors in the USA, who use it to determine whether a person’s cholesterol level is elevated, to determine whether they need to prescribe you with lifetime prescriptions of cholesterol-lowering drugs.

Now if the Report was only used in the USA that would be one thing. But what actually happens is that this Report becomes the basis for the global pharmaceutical industry, to prepare its marketing collateral to market these drugs globally to doctors in Australia and elsewhere.

And a big problem with this Report is its integrity, because most of the doctors on the Expert Panel have links to US pharmaceutical companies. This is a real concern because cholesterol-lowering statins are the most profitable drugs being sold in the world today.

You probably didn’t catch it, but USA TODAY first published a story on the 16th October 2004 which condemned this blatant conflict of interest. The headline said:

Cholesterol Guidelines Become Morality Play (Associated Press)

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They lead influential medical groups, starred at prestigious meetings, published in top journals and were undisputed giants in their field. But when these famous doctors advised the government recently on new cholesterol guidelines for the public, something else they had in common wasn't revealed. Eight of the

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nine were making money from the very companies whose cholesterol-lowering drugs they were urging upon millions more Americans. Two own stock in them. Two others went to work for drug companies shortly after working on the guidelines. Another was a senior government scientist who moonlights for 10 companies and even serves on one of their boards.

Consumer groups and others now are questioning not only the advice these doctors gave but also their fundamental ability to act in the public's best interest. It comes as some of these companies lobby the government to let drugs at the centre of this controversy — statins such as Lipitor and Zocor — be sold over the counter.

The article is quite detailed, and has some really strong critiques in terms of conflicts of interest and lack of transparency, so see if you can still find it on the internet. It’s a typical example of the numerous ‘feather nesting’ arrangements within the medical field. This lack of transparency and ethics has been condemned by many people in the medical community, and raises many questions about the validity of the cholesterol guidelines published by ‘medical authorities’ like the US Institute of Health, the American Heart Association etc who employ doctors that moonlight for the pharmaceutical companies.

Certainly your own doctor will do what’s best for you and that’s not in question. However, much of the reference data provided to your doctor on cholesterol comes from sources that are increasingly open to question.

One thing to remember about cholesterol is that it is not a disease; it is simply a statistical marker. Yet many people think that high cholesterol is a disease. It’s not. Fact is, if you had no cholesterol in your body you would be dead. Cholesterol is an essential compound that your body needs, and the decision to tamper with it, should be as much your choice, as your doctors.

In Summary:

� The Expert Panel for High Blood Cholesterol is intent on reducing cholesterol levels at any cost, via a mass education campaigns to doctors and health workers.

� The new cholesterol guidelines mean that over half the US adult population has high cholesterol and will be coerced into taking medication.

� The validity of the new cholesterol guidelines is now in doubt, because of the financial links between the advisors who created the new guidelines, and the pharmaceutical companies.

� Cholesterol is not a disease; it’s simply a statistical marker.

CHAPTER 9 DOES HEART DISEASE RUN IN THE FAMILY

Doctors often ask the question “Do any of your family members, suffer from heart disease?” And most patients respond with a “yes” to this question, and then start to worry about heart disease.

I remember years ago, being asked this question, and how it affected me. In my case my uncle died of a heart attack at 49. My other uncle died at 51 of a suspected heart attack. My first cousin collapsed sitting behind his desk in the office and died of a heart attack in his early forties. And I remember at the time thinking, heck, I’m a sitting duck with my high cholesterol. I haven’t got a chance. The question of my family history and heart disease was paramount in my mind for some years.

But then one day a doctor said to me “Frank, with 40% of people dying of heart disease and stroke, it’s absolutely normal that some members of your family would be affected by heart disease”. This doctor reminded me that a percentage of any family would die of heart disease and cancer, and that it was simple statistics. Thereafter I started thinking about CHD in a more pragmatic way.

Fortunately, I can take some comfort in the fact that I have been better prepared with the knowledge of the causes of coronary heart disease, and therefore better able to protect myself. I had the benefit of knowledge, which sadly my uncles did not have. They died at a time when no one knew what caused heart disease.

The question about whether you have heart disease in your family is a relevant one, but you and your doctor need to be sure that the real level of risk is clearly communicated. Often when a doctor says you are “at risk” it scares the hell out of most people. But that may be more to do with your perception of risk, than your doctor’s perception of risk.

So the next time your doctor says that you are ‘at risk’ for some medical condition, try to understand the level of that risk. Just ask.

One thing that does run in the family is Familial Hypercholesterolemia

Familial Hypercholesterolemia (FH) is an inherited genetic condition, and people with this condition typically have cholesterol levels in the 9 to 20 mmol/L range. FH affects less than 0.5% of the population. Some documents say its 1:250 and others say 1:500, suggesting no one is too sure. FH has not been well researched, because these people represent such a small element of the population.

Very few studies have been conducted on Familial Hypercholesterolemia, and most of what has been researched seems funded by large drug companies, with their conclusions related to the need to take cholesterol-lowering drugs.

One of the very few studies done on people with FH, was lead by Dr Eric Sijbrands of the Department of Vascular Medicine and General Internal Medicine, Academic Medical Centre, in Amsterdam. His team traced a Dutch family tree with the FH gene back to a single couple in the 19th century, and studied some 250 descendents across multiple generations, totalling some 7000-man years. His team determined that the descendents lived to normal ages during the 19th century and into the 20th century until 1915; thereafter death rates rose beyond the ‘normal average’ reaching a peak from 1935-1964, and thereafter death rates fell. This trend correlates with the general trend in coronary heart disease which rose around 1920 and peaked around 1968, which suggests that the factors which lead to the increase in CHD in this period, affected FH people much more then the general population.

There is an actual test that you can take that confirms that you are FH. However anyone who is consistently 9mmol/L or greater can be reasonably assured that they have FH.

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When I was first diagnosed with FH some twenty-five years ago, the doctors explained to me that my liver was making to much cholesterol, which caused elevated cholesterol levels in my blood. However we now know this is not the case. The actual problem is that people with FH have a gene defect that inhibits their ability in

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carrying cholesterol from the blood into the cells. In other words, its not that we FH people make too much cholesterol, we just don’t absorb cholesterol very well at the cell level, so our blood count reading is higher.

People with Familial Hypercholesterolemia, including myself, should ideally consume less cholesterol in the diet since we are unable to absorb cholesterol as readily as the average person.

In Summary:

� With 40% of people dying of heart disease and stroke, it’s obvious that some members of your family will be affected by heart disease.

� Familial Hypercholesterolemia (FH) is an inherited genetic condition in the 9 to 20 mmol/L range.

CHAPTER 10 WOMEN AND CHOLESTEROL

You may recall in an earlier chapter, that when my daughter was 23 years old, that her doctor had recommended that she take the cholesterol-lowering drug Lipitor. This example highlights the fact that many doctors today, feel its ‘good medicine’ to prescribe statin drugs to increasingly younger patients, who are expected to take these drugs for life. In my daughters’ case, that could mean the next 60 years. But there are no trials to demonstrate the safety of taking these drugs for 60 years.

Although many long-term cholesterol trials have been conducted, very little data has been published that relates specifically to women. This is really surprising, in fact quite odd, because a woman’s metabolism is very different from that of a man.

So why is there so little information relating specifically to women and cholesterol?

Is it that no one specifically bothered to compare men and women? Or was it because it suited the sponsors of these trials, the real beneficiaries, to disregard the specific results for women, because women are not affected by cholesterol?

Older Women with Elevated Cholesterol Live Longer

Dr Uffe Ravnskov was one of the first researchers to look at the data from cholesterol trials, and analyse how women scored, and he was unable to see any notable association between cholesterol and CHD. He was also surprised to discover that older women with elevated cholesterol, actually lived longer. Cholesterol was actually beneficial to these women!

Fortunately there is data now emerging that shows that cholesterol is of benefit to women, and that women with very low cholesterol, may be worse off. But this has not being highlighted by the pharmaceutical companies in the product information given to doctors or the public.

An interesting article was written in the USA media Newsday dated 6 July 2004 which highlights this concern about how women have been mis-informed. It was headed “We’ve been Bamboozled” and here is part of the Newsday story:

If you're a woman like me who worries about your blood cholesterol level, there's something you should know. Buried in the back pages of a leading medical journal recently was a study that raised serious questions about whether cholesterol-lowering drugs are useful for women who are otherwise healthy.

The study didn't get a lot of media attention. But its results were surprising - especially considering how many millions of women are taking drugs known as statins to lower their cholesterol. Women like me, who've had it drummed into us that heart disease is the leading cause of death. And who've been told repeatedly that cholesterol is a major risk factor.

The paper, published in the Journal of the American Medical Association, examined the results of 13 carefully selected clinical trials and teased out the effects on women. It wasn't easy: At least 80 percent of the participants were men.

The researchers found that for women who are taking statins as a preventative measure – i.e. they've never had cardiovascular disease but may be at risk - it wasn't clear the pills bestowed any benefit. That's because so few women in this group have heart attacks to begin with. For women who have cardiovascular disease, the drugs reduced the risk of another heart incident - but did not reduce overall deaths.

The risk for total mortality was not lower in women treated with lipid-lowering drugs (statins) regardless of whether they had prior cardiovascular disease or not, Dr. Judith M.E. Walsh and Dr. Michael Pignone wrote.

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And when doctors talk about heart disease risks for women, they mention high cholesterol in the same breath as high blood pressure, diabetes, obesity, smoking and family history.

Wright, the Canadian researcher, suggests a distinction should be made. The weakest risk factor is cholesterol, he said. The correlation is extremely weak and even becomes negative as you get older. He said the message about cholesterol has been distorted.

We've been bamboozled, he said.

Dr. Beatrice Golomb, an assistant professor of medicine at the University of California at San Diego who has done research on cholesterol and statins, says no study has ever demonstrated that statins extend life for women. The people who benefit are middle-aged men who are at high risk or have heart disease, she said. The mortality benefits don't extend to the elderly or to women.

Yes, heart disease is the leading cause of death in women – but only when women 75 years and older are included in the figures. Take those women out and the picture changes.…..For women aged between 35-74, cancer is the No. 1 threat, killing almost twice as many women as heart disease, according to national statistics.

But news stories like this are rarely published. So let’s take a moment to understand what this really means:

For women aged between 35-74, cancer is the # 1 threat, killing almost twice as many women as heart disease.

But heart disease is the # 1 cause of death in women.

On the surface these statement are confusing. But what it means is that women who do live to a ripe old age will likely die from heart disease. Those women who die before their time at a younger age, generally die of cancer.

Let me share something with you to put this into context.

During the two years it took to write this book, my dear mum passed away at 85 years of age. She had been doing well, but tripped over the hose in her garden, fell, and broke her hip, which required a major hip operation. At 85 years, a hip operation is very serious, and she had a heart attack after the operation, and passed away peacefully in her sleep three days after the operation.

My mums’ passing is an example of someone who lived to a nice old age, but who ‘technically’ died of heart disease. And therefore people like my mum who do live to a nice old age, typically die of heart disease. So statistically heart disease is the number #1 cause of death in women. In my mind however my mum died peacefully of old age and not heart disease.

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For those readers who appreciate factual data, below are figures from the Australian Census (2004) which shows the mortality per 100,000 women for Cancer and Cardiovascular deaths, within age groups.

Age Group Cancer Deaths Cardiovascular Deaths including Stroke

35-44 492 152

45-54 1400 370

55-64 2,533 698

65-74 3,652 2,065

75-84 5,293 7,825

85+ 3,003 13,508

(Source – Australian Census 2004, deaths per 100,000 women)

You can see from the above chart, that women aged between 35 and 74 years shown in the lightly shaded area, have a far greater risk of dying from cancer. For example, in the Age Group 45-54 there were 1400 cancer deaths per annum as compared to 370 cardiovascular deaths per annum.

On the other hand, women 75 and older are more likely to die from cardiovascular problems.

The problem here is that the food and pharmaceutical companies play on women’s fears, advertising that heart disease is the number #1 cause of death. Whilst this is statistically correct, the reality is that most women who die before they reach old age, will die from cancer.

Pregnant Women - Special Alert

There is something that young women must know, and that’s the risks of taking statins during pregnancy.

Researchers from the U.S. National Institute of Health found that statin use during the first trimester of pregnancy is associated with severe central nervous system defects. Their findings, published in a research letter in the New England Journal of Medicine dated April 8, 2004, showed that 20 of 52 babies exposed to statins in the womb were born with malformations:

“We can't tell whether the defects were caused by the use of statin medications, but other birth defect studies suggest that these are the kinds of problems that occur if the embryo does not get enough cholesterol in early pregnancy to develop normally," said one of the study's authors, Dr. Maximilian Muenke, a senior investigator and chief of the medical genetics branch at the National Human Genome Research Institute in Bethesda, Md.

Muenke added “These medications are already considered contraindicated in pregnancy, and the Food and Drug Administration (FDA) requires that all statin prescriptions carry a warning about taking them during pregnancy. The FDA took this action because it was recognised that cholesterol synthesis was essential for foetal development, and because animals given statins during pregnancy had offspring with a variety of birth defects," he said.

The real problem, according to Dr. Nancy Green, medical director for the March of Dimes Foundation that is focused on baby health, is that about half of all pregnancies are unplanned, so exposure to (statin) drugs can happen inadvertently before a woman even knows she's pregnant.

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To finish this chapter, I would like to relate a real life story from Dr Charles McGee who is the author of the book Heart Frauds and who wrote the Preface to this book. This example is both funny and serious:

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“An 86 year-old women, a retired Physician, literally came running into my office with a lab slip showing the results of her blood tests. Her Specialist had told her that she was at ‘high risk’ for a heart attack because her blood cholesterol level was elevated at 360mg/dl (equiv 9 mmol/L). She had caught me in the hallway between patients, and she was angst and frightened, and asked me what she could do to bring her cholesterol down”.

So I asked her “What do you think your cholesterol has been running all of your life? And she replied “Well I suppose it has been about this high for many years, probably most of my life”. So I said “That’s a safe assumption. How much damage do you think it has done so far?” She was forced to answer that no apparent damage had been done. I went on to tell her not to worry, and that there were steps she could take to protect herself.’

Clearly women have been misled into believing that cholesterol is dangerous, when in fact it’s not. And to be fair to practicing medical doctors, they have not been told either. Most of the medical doctors that I spoke had never seen any data to explain that cholesterol levels were inconsequential to women. No doubt my daughters’ physician was only trying to do the right thing, when she spoke to my daughter about taking Lipitor to reduce her cholesterol.

These cases of the 86 year-old retired physician, and that of my young daughter, are two examples of women frightened by the fear of cholesterol. The unfortunate truth is that there are millions of healthy women who have been frightened into believing they have a cholesterol problem, where no problem exists.

Research Data for Women

It is difficult for women to find credible information concerning cholesterol and statin drugs. In discussing this frustration with a retired medical doctor who had a background in research, he offered me this advice:

“Nearly all drug research data comes from researchers that are directly or indirectly employed by the pharmaceutical companies and the ‘driving force’ is to sell drugs. Even university research is mostly funded by the corporations. In my opinion the least valuable research comes from countries where the top 10 pharmaceutical companies operate including the USA, Switzerland and the UK. These countries earn billions from pharmaceuticals and employ thousands of people and are beholden to these industries. My suggestion is that you look at cholesterol research done in countries that are not beholden to the pharmaceutical corporations, and ideally, where the research is funded by government”

I thought the suggestion was sound but the adage ‘easier said then done’ also came to mind. Anyway, I did go looking and I did find some interesting studies. The best written was a research paper published by a Canadian group called Women and Health Protection (WHP) that receives funding from Health Canada. This group is a coalition of community groups, researchers, journalists and activists concerned about the safety of pharmaceutical drugs as it relates to women, and their website is www.whp-apsf.ca They published a paper in June 2007 called Evidence for Caution: Women and Statin Use and it is a paper that every practicing medical professionals should read. It is very well written and the authors Rosenberg and Allard should be congratulated for the completeness of their work. Let me quote their conclusion at the end of the document:

“We have assessed the impact of statin use in women starting from the assumption that if a woman is put on a drug for the rest of her life, the reasons for doing so must be based on the highest quality, most credible data possible. There must be solid evidence of advantage over harm and careful analysis of any serious adverse outcomes that may arise immediately or with years or decades of use or when used in conjunction with other drugs commonly prescribed for women. In other words, a Canadian woman should be able to take a pill, safe in the knowledge that its benefits and safety were tested on women like her. She should embark on a long-term commitment to a drug therapy with the understanding that she is highly likely to derive a clear advantage in terms of health and longevity and feel confident that information about any risks will be explained to her in meaningful and accessible language. These expectations have not been met. Instead we have found a pattern of overestimation of benefit and underestimation of harm.”

The actual document is 25 pages in length and is easy to read. It can be found at www.whp-apsf.ca/pdf/statinsEvidenceCaution.pdf

In Summary:

� No study has ever demonstrated that cholesterol medications extend life for women.

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� Cancer is the #1 cause of death for younger women, and up to the age of 75. � For women over 75 years, CHD and stroke are the #1 cause of death. � Statin drugs can place women ‘at risk’ through side effects. � Child-bearing women should never take statins because of the grave risks to their newborn.

CHAPTER 11 CLINICAL TESTS FOR YOUR HEART

The reality is that many people with low cholesterol levels are well underway to developing heart disease. In fact, many patients having coronary bypass operations have low cholesterol. Sadly, some of these people spent years doing everything possible to keep their cholesterol low, and had been given a false sense of security. Most of these patients were not aware of the major risk factors that lead to coronary heart disease, and therefore did not take protective steps whilst they still had time.

Let’s look briefly at specific blood tests which are extremely useful for determining your risk profile for CHD.

We will overview each test now, and then discuss each test in more detail thereafter.

Regardless of whether you have elevated cholesterol or not, anyone over forty (40) years of age should get these blood tests done to determine their risk for developing CHD:

C-Reactive Protein– This is a substance produced by the body when arteries become inflamed, and is a more powerful predictor of a person's risk of a heart attack or stroke, than LDL cholesterol.

Homocysteine– Homocysteine has received considerable attention in the past few years because a high level of this amino acid in the bloodstream is associated with damage to the arterial walls.

Lipoprotein(a) – Cardiac patients with high levels of Lipoprotein(a) in their blood are 70% percent more likely to have a heart attack than those with lower concentrations.

It would make sense to get all three blood tests done together, so that only one sampling of your blood is needed.

Also, there are a couple of simple tests you can do at home on a regular basis. One is Blood Pressure and the other is Resting Heart Rate:

Blood Pressure – Elevated blood pressure is a concern when it is too high, because it increases your risk of stroke, and may suggest some narrowing of your arteries. The human body is conditioned for some increase in blood pressure as we grow older, and the majority of people can prevent or control high blood pressure, by adopting a healthier lifestyle.

Resting Heart Rate – Resting heart rate is a strong predictor of CHD particularly in men. A heart rate below 64 beats per minutes is protective, whilst men with a heart rate of over 80 beats per minute have a significantly higher risk of CHD by a factor of three. Resting heart rate is most accurately measured just before you get out of bed in the morning. Accuracy is even greater when you take your resting heart rate three mornings in a row, and average them.

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There is a small chart below that you can use to record your scores and keep as a future reference. I have included my own scores, as a comparison to the recommended levels. Remember that we are comparing those in the 46 – 64 age range, and younger people will have slightly lower values.

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Test My Score

YourScore

Recommended Age Group 46-64

C-Reactive Protein 0.4 < 1.1 mmol/L

Homocysteine 5 < 8 mmol/L see notes B6,B12, Folate

Lipoprotein(a) 0.21 < 0.30 mmol/L (see notes Vitamin C)

Blood Pressure 120/70 < See Blood Pressure chapter

Resting Heart Rate 60 < 64 beats per minute

You may like to have a more in-depth understanding of these tests, and how they came to prominence. Let’s do that now:

C-Reactive Protein – Inflammation in your arteries is a serious problem, and this test may pick it up. The background here is that researchers at the Brigham and Women’s Hospital in Boston, a teaching affiliate of Harvard Medical School, found that a simple blood test for C-Reactive protein (CRP), which is a substance produced whenever arteries become inflamed, was a very powerful predictor of a person's risk of a heart attack or stroke. The eight year-long study which appeared in the 14 Nov 2002 issue of the New England Journal of Medicine, involving 27,000 women, was the largest research effort to date, linking C-Reactive protein to heart disease.

Dr Paul Ridker, Director of the Center for Cardiovascular Disease Prevention at the hospital and lead author of the study said, "We found that individuals with high levels of C-reactive protein but low cholesterol, were actually a higher risk than those with low C-reactive protein and high cholesterol".

This study helped confirm what Ridker and other medical researchers have suspected for years - that inflammation of the arteries is a fundamental cause of cardiovascular disease, and leads to weakening of the arterial plaques, which result in heart attacks and strokes.

Whilst CRP is an excellent test to detect inflammation, its main drawback is that it is a general indicator of inflammation, which may be due to other causes like arthritis, cancer, acute infection etc. Nevertheless, elevated CRP levels will alert you that there is a problem somewhere, and in the absence of anything obvious, it’s likely to be inflammation in your arteries.

Homocysteine – In 1972 Dr Kilmer McCully discovered that cholesterol and clogged arteries were not the causes of CHD, but rather the symptoms. McCully's theory linked the amino acid - Homocysteine - directly with heart disease.

However the medical community ignored his discovery at that time, because it challenged the conventional thinking, which was that arterial plaque was caused by diets high in saturated fats and cholesterol. Anyone who believed otherwise was ridiculed.

In his endeavours to do the right thing by publishing his findings, McCully was ostracised by the medical community, and then banished from doing research work at Harvard University. He also lost his medical job at the Massachusetts General Hospital and found it impossible to find employment for over 2 years in the USA. He finally secured employment in Scotland. It’s a well known fact that universities and hospitals receive significant research grants from large pharmaceutical corporations and food manufacturers. Any radical discoveries that challenge the ‘status quo’ can cause research grants to evaporate very quickly. Certainly, McCully’s discovery threatened the cholesterol movement and money talks.

Times have now changed for McCully and in the last few years his discovery of Homocysteine has become well accepted by the medical community. McCully has received numerous awards for his research into Homocysteine including the 1998 Linus Pauling Functional Medicine Award.

An interesting study done on Homocysteine was with 15,000 doctors participating in the Physicians’ Health Study. The result was that those doctors with a Homocysteine level of 15 mmol/L or higher had a heart attack rate three times (3X) as high as those with lower levels, over a period of just five years.

I met Kilmer McCully and his wife Martha over dinner when I was in Washington attending a Conference. I was really taken aback by their ‘life experiences’ from the time that Kilmer discovered the link between Homocysteine and heart disease, and his subsequent banishment from his medical research post. It was quite heart rending, and it is unconscionable to think that doctors who make these sort of discoveries, are treated in this way.

McCully’s book, The Heart Revolution, explains how deficiencies in Vitamin B12, B6 and Folate can elevate Homocysteine levels into the danger zone, and how easily you can fix the Homocysteine problem with these vitamin supplements. In fact, specific B12/B6/Folate supplements are now available to ensure that your Homocysteine levels are kept in check.

One of the interesting vitamin formulations I discovered in the USA, was Vitamin B12/B6/Folate in a ‘Sublingual’ form, which is made to dissolve under the tongue like a lozenges. These Sublingual vitamins go directly into the bloodstream, so that you get the maximum benefit of these B vitamins. Studies show that when B vitamins are taken via the stomach, only 10% is absorbed by the body, whilst ‘Sublingual’ vitamins can deliver up to 90%. Sublingual vitamins are very new and your local health store may not carry them if you live outside the USA. In which case, you may decide to order them from the USA.

The technique of delivering a drug or vitamin sublingually under the tongue is not new. People with Angina have been doing it for years, taking Nitro tablets under the tongue to provide immediate relief of chest pain. There are tiny ducts under the tongue that carry the Nitro directly into the blood stream. These tiny ducts are suitable to deliver ‘mcg’ sized vitamins like B6/B12/Folate straight into the bloodstream.

In summary, high Homocysteine levels are the result of either a nutritional deficiency or a genetic abnormality.People who live on high quality fresh foods like in France and Italy, are unlikely to be deficient in B12, B6 or Folate. However, many people have low intakes of fresh fruits and vegetables and hence the need to take B12/B6/Folate supplements. The picture looks as follows:

Poor Diet Causes Nutrient Deficiency

B6, B12, Folic Acid Deficiency Occurs

Homocysteine Levels Rise & Inflame Arteries

Fatty Deposits Build Up In Arteries

Lipoprotein(a) – Cardiac patients with high levels of Lp(a) in their blood are 70% percent more likely to have a heart attack than those with lower concentrations. These were the findings from an Oxford University study headed by Dr John Danesh and published in April 2000 in the journal of the American Heart Foundation - Circulation.

Fortunately, Dr Matthias Rath and Dr Linus Pauling conducted a lot of research into Lipoprotein(a), and found Vitamin C deficiency as the primary culprit. If you’re Lipoprotein(a) score is elevated, then start adding Vitamin C to your diet as a supplement. You can learn more about Lipoprotein(a) by visiting Dr Raths’ website www.dr-rath-research.org where you will find some useful white papers on both CHD and cancer.

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The Vitamin C and Lp(a) connection suddenly made sense when I read an excellent book called Fats that Heal, Fats that Kill written by Dr Udo Erasmus. He is a world-renowned expert on oils and lipids and his website is www.udoerasmus.com He explained that Lp(a) and LDL look very similar, and measurements on which cholesterol dogma is based had erroneously included Lp(a) with LDL. He explains that LDL has been wrongly blamed for damage actually done by Lp(a). This was an important finding because it explained how LDL gained the notorious reputation, that really should have been blamed on Lp(a).

People who liberally consume or cook with lemons and other citrus fruits (i.e. like France and Italy) that are high in Vitamin C, rarely have elevated Lipoprotein(a) levels.

In Summary:

� You should get a complete “coronary” profile by getting the results for all of the above tests and record them for future reference.

� If you are out-of–range on these blood tests, then you should see a health professional to investigate diet and lifestyle improvements. After three months of modifying your lifestyle, get retested.

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� If you are still out-of-range after re-testing, then consider getting a CT or EBT Scan to investigate the condition of your arteries.

CHAPTER 12 BLOOD PRESSURE / HYPERTENSION

I was initially reluctant to include a chapter on blood pressure, because it’s a well covered subject. However I was encouraged to include it because people who worry about CHD often worry about blood pressure. But where to start?

I had a Blood Pressure Monitor at home that I bought some years ago. In it were some notes I had made over the years, as well as an Operating Manual.

The Operating Manual stated that “Standards for assessment of blood pressure have been established by the World Health Organization (1971) and Normal Blood Pressure is anything below 140/90 mmHg. When we say 140/90 it means that when the heart beats, the pressure increases to 140, and when the heart relaxes the blood pressure drops back to 90. Hence 140/90.

Risks of High Blood Pressure

High blood pressure is a real problem because it places excessive stress on the arteries (i.e. hydraulic damage) and it can damage the arteries, the heart and the kidneys. At the extreme you could ‘blow a pipe’ somewhere in the cardiovascular pipeline which could be fatal.

One thing you need to know, is that blood pressure goes up and down like a yoyo at different times of the day. This is why it’s best to take your blood pressure readings on three different days (and preferably at morning, midday, night-time) to get your ‘average’ blood pressure. The easiest way to do this is to buy a quality Blood Pressure Monitor. You can get an excellent one for around $150. That way you can check your blood pressure at various times and know your real average.

Let’s have a look at the current recommended blood pressure guidelines published by the JNC. The Joint National Committee (JNC) on Prevention, Detection, Evaluation and Treatment of High Blood Pressure is a coalition of leaders from 46 medical bodies and associations like the American College of Cardiology, American Heart Association, etc. which publishes guidelines on blood pressure. In 1997 their guidelines were as follows:

BLOOD PRESSURE GUIDELINES (1997)

Optimal Level 90/ 60 - 120/80

Normal 120/ 80 - 130/85

High Normal 130/ 85 - 140/90

Stage 1 hypertension (mild) 140/ 90 - 160/100

Stage 2 hypertension (moderate) 160/100 - 180/110

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To the surprise of many researchers, in 2003 the JNC elected to merge the Normal and High Normal categories

shown in the shaded areas above, and gave it a new name called Prehypertensive. As a result the new Blood

Pressure Guidelines since 2003 are as follows:

BLOOD PRESSURE GUIDELINES (2003)

Normal 90/ 60 - 120/80

Prehypertensive 120/ 80 - 140/90

Stage 1 Hypertension (Mild) 140/ 90 - 160/100

Stage 2 Hypertension (Mod-High) 160/100 - Higher

So just to repeat, the new category called Prehypertensive is a merger of the previous ‘Normal’ and ‘High Normal’ categories. This was supposedly a precautionary measure, and on the surface, that may seem alright.

However, a large number of doctors, dieticians and researchers have strongly criticised this newPrehypertensive category, because they believe it has created a new category of disease out of thin air. It sets the stage for more sales of hypertension drugs, by once again ‘shifting the goalposts’.

It’s actually a very big problem because anyone who had normal blood pressure of say 125/80 is now diagnosed as Prehypertensive. So overnight the JNC has categorised millions of otherwise healthy people with a diagnosed medical condition called “Prehypertensive” and you may be one of them!

A major failing of the JNC recommendations is that there is no adjustment for blood pressure and age. Everyone knows that blood pressure increases gradually with age, so if your blood pressure is 125/80 and you are a 20 year old then you might be concerned, but if you are a 70 year old then you should be delighted. So the new JNC guidelines are fundamentally flawed because they treat people of all ages as being the same. They are not the same.

And so a large number of medical professionals think these new guidelines are completely misguided. They feel the old guidelines were appropriate, because they allowed some flexibility for ‘age related’ increases in blood pressure. Unfortunately these medical professionals are no match for Committees like the JNC which have huge funding support from the pharmaceutical industry, and who are able to bulldoze their guidelines into place.

It’s another example of how the big pharmaceutical companies have created another disease, for which life-long medications are needed. For the pharmaceutical companies, it’s a bonanza. It means an entirely new market for their blood pressure drugs.

Whilst many practicing medical doctors may feel bulldozed into adopting these new guidelines, it’s really not their role to question a Committee of experts. The job of a medical doctor is to practice medicine using the guidelines that are set down by the experts; otherwise they are exposed to potential litigation.

Dr Marcia Angell, MD

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But not every doctor will be bulldozed, and some will even risk their relationship with the medical profession, by being openly critical. One who is well known is Marcia Angell, M.D. who was the former Editor-in-Chief of The New England Journal of Medicine and is a member of Harvard Medical Schools’ Department of Social Medicine.

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Marcia has written a book called The Truth About Drug Companies which explains the efforts by the pharmaceutical companies to create diseases. She explains how they lobby Congress, Universities, the American Heart Association etc with huge financial grants and donations to influence outcomes. This is a hard hitting book which highlights a long list of problems in the medical field, and how the average ‘person in the street’ is the victim.

Her book talks about ‘the nearly limitless influence that the large pharmaceutical companies have over medical research, education, and how doctors do their jobs’ and she argues for essential long-overdue changes to the pharmaceutical industry.

Let’s visit a couple of paragraphs from her book:

Once upon a time, drug companies promoted drugs to treat disease. Now it is often the opposite. They promote disease to fit their drugs. Nearly everyone experiences heartburn from time to time. The remedy used to be a glass of milk or an over-the-counter antacid. But now heartburn is called ‘acid reflux disease’ or ‘gastro esophageal reflux disease’ and marketed, along with the drugs to treat it, as a harbinger of serious esophageal disease – which it is usually not.

Similarly, most young women experience at least some pre-menstrual tension from time to time. Eli Lilly’s launch of Sarafem made pre-menstrual symptoms a disease – now called premenstrual dysphoric disorder (PMDD). It is not yet officially recognised in the psychiatric diagnostic manual, but given the influence of the industry, I would not be surprised if it is in the next edition.

On page 85 she gets to blood pressure drugs and writes….

Recently, for instance, the market for blood pressure medication was increased when an expert panel changed the definition of high blood pressure (hypertension). For many years it was defined as a blood pressure above 140/90. But this panel decided to recognise something called Prehypertensive. This, they said, is a blood pressure between 120/80 and 140/90. Overnight, people with blood pressures in this range found they had a medical condition Although the panel recommended that Prehypertensive generally be treated first with diet and exercise, human nature being what it is, many people will almost certainly prefer to be treated with drugs.

Another fascinating book which investigates these concerns is called On The Take: How Medicine’s Complicity With Big Business Can Endanger Your Health 2005 by Dr Jerome Kassirer, MD. This book offers an unsettling look at the pharmaceutical and medical industry and explains why Medicine’s cosy ride with Big Business can endanger your health.

It takes phenomenal courage for these medical doctors to criticise the problems in the health sector. The moment they do, they are condemned by their peers. It’s not a very pleasant experience and I have spoken to several doctors who have been down that path. These doctors are to be admired, because patients need to know that a leading cause of deaths is pharmaceutical drugs.

However let’s get back to understanding blood pressure.

What Causes High Blood Pressure?

High blood pressure for 90% of the population is primarily a lifestyle disease caused by an electrolyte imbalance, poor dietary habits, smoking, being over-weight, lack of exercise, excessive alcohol, and chronic stress.

It is not the purpose of this book to investigate the many causes of high blood pressure, as there are other books dedicated to this complex subject. However the second half of this book will offer guidelines for lifestyle improvements which will go a long way towards lowering your blood pressure.

There are a range of supplements available that can help lower blood pressure. Let’s discuss some of the more popular natural options now:

Salt Formulations

A large percentage of the population has high blood pressure due to a mismatch in the electrolyte minerals - sodium, potassium, magnesium - that are involved in controlling blood pressure. By simply adjusting the dietary intake of these electrolyte minerals, many people have reduced their blood pressure, and avoided the need to take blood pressure medications.

To understand why electrolytes are important, let’s look at how things have changed over the past 100 years. This chart compares the daily intake in the year 1900 with the year 2000:

Mineral Year 1900 Year 2000 Change

Sodium intake daily 1 gram 5 grams 500% increase

Potassium daily 6 grams 2 grams 66% down

Magnesium daily ½ gram ¼ gram 50% down

Although these figures are approximate, you can see that there has been a huge increase in sodium intake, due to the addition of sodium chloride (salt) to processed foods. It is therefore prudent to reduce our salt intake, as well as to consider the new healthy salt formulations that are available.

One of the newer salt formulations is called PanSalt, which was developed in Finland to help reduce heart attacks. It tastes just like salt, except that it is only 56% sodium chloride as compared to normal table salt which is nearly 100% sodium chloride. PanSalt’s formulation is:

Sodium Chloride 56% Enhanced electrolyte functioning Potassium Chloride 28% Enhanced electrolyte functioning Magnesium Sulphate 12% Enhanced electrolyte functioning Lysine Hydrochloride 2% Lysine is a useful essential amino acid Silicon Dioxide 2% Harmless anti-caking agent Potassium Iodide 0.0036% Iodine is needed for a healthy thyroid

These salt substitutes can contribute valuable minerals such as magnesium and potassium. Importantly, it includes iodine which is absent in many salt products and very important for a healthy thyroid. I mention iodine specifically because we often see patients at the clinic that have an underperforming thyroid condition. Some are due to low iodine levels.

It is noteworthy that in Finland, McDonalds use PanSalt instead of normal table salt because it is a healthier alternative. PanSalt can be used to replace traditional table salt, and for cooking. The PanSalt website states that the product has been tested with various classes of antihypertensive medicine and found to be non-interfering, or even contributed to their effectiveness. See www.imi.com.sg

Magnesium – An Essential Nutrient

Magnesium supplements have helped many people reduce blood pressure who were deficient in this mineral. It’s a well known fact that Calcium encourages blood vessels to contract which increases blood pressure, whereas Magnesium helps blood vessels relax and decreases blood pressure. You may be aware that there is a range of drugs called ‘Calcium Channel Blockers’ that doctors prescribe to block the flow of calcium into the blood vessels. Magnesium counteracts the effects of Calcium and has been called the ‘Natural Calcium Channel Blocker’.

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Magnesium supplements are readily available at health food shops and pharmacies. I take a 300mg magnesium supplement, but everyone is different, so my suggestion is to buy a leading product and follow their recommended dosage. Magnesium is very safe supplement, but anyone with kidney impairment must check with their doctor first.

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Certainly if you have high blood pressure due to magnesium deficiency, then you will find that out quickly by taking magnesium. Allow about 3 weeks for the magnesium to take effect.

L-Arginine, Nitric Oxide and Vasodilation

If you haven’t read about Nitric Oxide then I recommend that you do.

Nitric Oxide is a gaseous molecule made up of one Nitrogen and one Oxygen and often referred to simply as NO. It should not to be confused with Nitrous Oxide N20 which is better known as Laughing Gas.

The Nitric Oxide story hit the front pages in 1998, when three doctors were awarded the Nobel Prize for their research into this molecule produced by the body that helps blood flow, and its ability to relax and enlarge blood vessels, and in doing so, reduce blood pressure. Check out www.nobelprize.org and look under the Medicine prize winners for 1998 announcing the Awards to Robert Furchgott, Louis Ignarro and Ferid Murad for their discoveries concerning "nitric oxide as a signalling molecule in the cardiovascular system".

The research done by these doctors led to the development of a range of drugs like Viagra which fundamentally increase the levels of Nitric Oxide in the blood stream.

Nitric Oxide is an interesting topic and you can familiarise yourself with its properties by looking it up on the internet. Dr Louis Ignarro who shared the Nobel Prize also wrote a book called NO More Heart Disease which explains how Nitric Oxide can prevent Heart Disease and Strokes, and helps with male erectile dysfunction. He explains how the amino acid called L-Arginine assists the body in making adequate levels of NO. Although his book is a bit hyper on Nitric Oxide, it is nevertheless a very interesting read.

So the relevance of increasing the body’s production of Nitric Oxide, is its ability to relax and enlarge blood vessels, which has the effect of reducing blood pressure. The point that Dr Ignarro makes is that rather than taking some pharmaceutical drug to lower your blood pressure, which will have risky side effects; it’s safer to take a daily 3 grams of the amino acid L-Arginine.

Note that some researchers at John Hopkins Medicine working with mice found that the enzymes that make Nitric Oxide could protect the heart from damage caused by heart attack or high blood pressure, but they also found that the enzymes could cause overgrowth and enlargement of heart muscle tissue which could promote heart failure. I’m not sure how comparable mice are to humans, but there are a lot of people taking L-Arginine for a variety of reasons including cardiovascular, impotence, and memory loss, and there haven’t been any concerns reports to date. Certainly the safety of L-Arginine is many times higher than the risky blood pressure pharmaceuticals that are available.

Omega 3 Fish Oil

Fish Oils are an excellent supplement, and there are dozens of double-blind studies of hypertensive patients that demonstrates the benefits of these valuable Omega 3 oils. Fish Oil helps to keep the blood thin, which reduces stress on the arteries, and eases blood pressure. Fish Oil has the additional benefit of reducing blood coagulation (clotting) that helps to reduce the risk of a heart attack. In addition, it has anti-inflammatory properties that reduce the inflammation in the lining of your arteries that causes the build-up of plaque. You need to take 1 teaspoon daily, which is the equivalent of 5 capsules. However even 3 capsules will be beneficial.

For those who do not want to take blood pressure medication, it’s nice to know that there are natural solutions available. Clearly diet should be your first option, then natural supplements, before you resort to taking prescription drugs that may have risky side effects and do not address the underlying problem.

Please note that anyone taking aspirin, warfarin or any other blood thinning drugs, must first check with their doctor before adding Fish Oil supplements. That’s because you can have too many blood-thinners in your bloodstream, which could be serious if you had a bleeding episode from an accident or haemorrhage stroke.

Learning About High Blood Pressure

There is actually a lot you can do to lower your blood pressure through natural means. To get an in-depth understanding of how to reduce your blood pressure, an excellent starting point is a book called Reversing Hypertension by Julian Whitaker, MD. He discusses numerous ways of lowering blood pressure and offers many helpful tips. He also explains the pharmaceuticals options that you have available, including their benefits and risks. I think this book is a must for anyone worried about blood pressure. A paragraph from his book summarises his thinking on blood pressure and his concerns about prescription medications to address what is largely a lifestyle problem:

“Furthermore, seven large, well-respected studies have demonstrated that anti-hypertensive (blood pressure) drugs offer no significant protection against heart disease in patients with mild to moderate hypertension. Beginning a lifelong course of drugs without thoroughly exhausting safer, saner measures is, in my opinion, unconscionable.”

In summary, many people can benefit from lowered blood pressure by following the guidelines explained by ‘out of the box’ doctors like Whittaker who have done extensive research into this condition. Those with the financial means (and the time) may even consider spending a couple of weeks at his Whitaker Wellness clinic in the USA.

High blood pressure is a complex subject and some people may require assistance to get it down. Fortunately there are many physicians (conventional and naturopathic) who understand the causes of high blood pressure, and how to lower it without drugs. In Australia for example, you can find a list of medical doctors that are holistically trained at the Australasian Integrative Medicine Association website www.aima.net.au and you can find complementary health practitioners (ie Naturopaths etc) at the Australian Traditional Medicine Society website www.atms.com.au

In Summary:

� Buy yourself a quality Blood Pressure Monitor. � The new Prehypertensive guidelines mean that most people now have a medical condition. � PanSalt is a high quality salt substitute. � Magnesium supplements have helped many people reduce blood pressure. � Omega 3 Fish Oils are a valuable nutrient for everyone. � Nitric Oxide and L-Arginine is worth investigating.

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CHAPTER 13 SMOKING

Years ago, cigarette smoking was a very fashionable thing to do. If we go back to the time of the Second World War, 1945, a lot of people smoked, and a lot of people had heart attacks.

Whilst it may be hard to believe today, in 1945 some 72% of the adult male population smoked in Australia. The USA and Britain had comparable levels.

Around 1970 the US government decreed that “Smoking was a health hazard” and the anti-smoking campaign began in earnest. Many nations like Australia joined the anti-smoking campaign, which was hugely successful, because by 2001 only 21% of the Australian adult male population smoked. After 2001, smoking declined further, and most office buildings and public amenities have become ‘non smoking’ environments.

The reduction in smoking since 1970, and the reduction in CHD since that time, has a strong correlation.

The big problem with smoking is the reduction of oxygen into the lungs. The lungs are basically an exchange mechanism with oxygen going upstream into the body, and carbon dioxide leaving the body. The surfaces of the lungs are the point of exchange, and coating this surface with a thick layer of tar, dramatically reduces this process. It means that one day when your body demands extra oxygen, and your heart is unable to get enough oxygen, that a heart attack can happen.

Free Radical Damage / Inflamed Arteries

Cigarette smoking causes free radical damage to the arteries, attributable to the nasty ‘oxidants’ from smoke, nicotine, and petrochemical exposure. These chemicals attack the artery wall, leading to inflammation of the arteries. This inflammation becomes progressively worse, and your body’s natural repair response is to deposit cholesterol and other materials at the point of inflammation, to protect the artery wall.

It’s similar to what happens if you scratch your skin and a scab develops to protect it. The depositing of cholesterol in your arteries happens whenever inflammation occurs in the arteries, regardless of whether you have low cholesterol or high cholesterol. In the long run, with continuous inflammation in your arteries, more cholesterol will deposit in your arteries resulting in a build-up called plaque. Over enough time, the plaque will narrow the arteries, and you will only need one rogue blood clot to ‘block off’ that artery. Should that happen around the heart, you will have a ‘heart attack’. Should it happen around the brain, you will have a brain attack, which is generally referred to as ‘a stroke’.

Collagen Damage and Haemorrhage Stroke

Another problem with smoking is that it reduces collagen levels in the body. Smoking weakens the collagen fibres inside the walls of your arteries, which are there specifically to keep your arteries strong and flexible. Think of collagen fibres as the polyester and steel fibres inside the tyres of your car. Those fibres give the tyres strength, and stop them from getting a puncture hole or blow-out.

When you realise how much hydraulic pressure your arteries are under as your heart pumps, then the idea of weakening the collagen in your arteries by smoking, does not make much sense. To put it bluntly, you risk bursting a pipe. You may have known of someone affected by a cerebral haemorrhage, which is a type of a stroke, where a blood vessel is ruptured, causing bleeding into the surrounding areas. These strokes that involve a rupture to the artery wall have a high fatality rate. So you can see why smoking is particularly dangerous, because it weakens the walls of your arteries and blood vessels, and your risk of a haemorrhage stroke increases exponentially.

Surgical Risks for Smokers

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Another problem for smokers, is that they are ‘dangerous candidates’ for any major surgery, because of their depleted collagen. When surgeons stitch together tissue, say joining arteries during a heart bypass operation,

they require strong tissue with plenty of collagen. But when a Heart Surgeon stitches the arteries of a smoker, then the risk of those stitches tearing away during and after the operation, are greatly increased. Surgeons just don’t like to operate on people who are heavy smokers.

Mini-Strokes

Often when we think of a stroke we naturally assume it a life-threatening event. However, some people suffer from mini-strokes, which are called Transient Ischemic Attacks. Mini-strokes are temporary disturbances of blood flow that generally last for under an hour, and so do no damage. However they may cause temporary weakness in the face or leg, possibly dizziness, loss of balance etc and then the impending little clot or blockage clears up. However, people who suffer from these mini-strokes need to understand that their arteries are somewhat unstable, suggesting inflammation. The subsequent chapters on reducing inflammation in the arteries should be mandatory reading for these people.

It is not quite clear whether it’s the tobacco itself that causes all these problems, or the chemical additives used in the manufacture of cigarettes. Some people are of the view that much of the problem is with the added chemicals in tobacco. Who knows?

Clearly if you still smoke, then your motto must be “I’m here for a good time, not a long time”.

In Summary:

� Smoking reduces oxygen uplift to the body, forcing the heart to work harder. � Smoking damages collagen fibre in the arteries that keep the arteries strong. � Smokers are ‘a higher risk’ for complications when undergoing surgery. � Smoking causes inflammation in the arteries which accelerates plaque build-up.

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PPaarrtt 22:: AA HHeeaalltthhyy HHeeaarrtt

CHAPTER 14 WHY HEART DISEASE IS DECLINING

It is very likely that anyone living today would have lost a parent, or a grandparent to a heart attack. But people living today are the lucky generation as far as CHD is concerned, because fatal heart attacks peaked in 1968 and dropped rapidly thereafter. I can remember back to that period of time, when a surprisingly high number of people were dying of heart attacks, and many were in their working careers.

Heart Attack Epidemic 1920 - 1968

So let’s look at why CHD was at epidemic levels from 1920 to 1968, and investigate why people who lived during this period, were badly affected.

During the period from 1920-1968 there were things that were fashionable, that are not fashionable in 2005. One was smoking that we covered earlier. The other was packaged processed foods, laden with white sugar, white flour and other ‘nutrient depleted’ ingredients, that caused the per capita intake of vitamins and minerals to drop dramatically.

To understand the consequences, we need to go back 100 years, say to the year 1905, when heart attacks were relatively unknown. At that time, industrialization was happening everywhere, and the rise of major food manufacturers led to a significant shift in eating habits.

Vitamin and Mineral Deficiencies 1920 - 1968

By 1920, there was a huge decline in the consumption of fresh fruits and vegetables, and vitamin/mineral deficiencies were widespread.. Processed and packet foods became trendy and convenient, manufactured with refined white flour, white sugar, vegetable oils, and ingredients that were depleted of their nutrients. The result was that many communities experienced widespread problems with serious deficiency diseases including:

� Rickets - Disease in children characterised by deformation in bones from lack of Vitamin A. � Beriberi - Serious nerve degeneration disease caused by lack of Vitamin B1. � Pellagra – Serious disease affecting the nervous system caused by lack of Vitamin B3. � Goitre – Condition of the thyroid caused by lack of Iodine. � Xerophthalmia – A serious eye disease caused by a lack of Vitamin A.

These are just some of the serious diseases that occurred due to vitamin or mineral deficiencies that resulted from over-processing of the food supply.

When most of us think of life-threatening diseases, we tend to think of viruses, bacteria and other microscopic life forms that are lurking and ready to attack our immune systems like Smallpox, Influenza, Malaria etc that have killed millions of people.

But diseases caused by poor eating are equally life threatening, and they were caused by the lack of just one (1) of these vitamins or minerals:

� Vitamin A � Vitamin B � Iodine � Iron

So after 1920 as the major food processing conglomerates gained market share, widespread malnutrition (i.e. nutrient deficiency) started to emerge, with serious health consequences, including CHD.

To get a sense of the problems at that time, let’s look at a typical community in Canada in 1933, and the actions that they took.

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In 1933, the population of Newfoundland in Canada suffered from multiple nutrient deficiencies. The government, aware of the vitamin/mineral losses from wheat milling, banned the consumption of white wheat flour. However, the population didn’t like whole-wheat flour any longer, and the programme failed. So in 1944 the government started fortifying white flour with vitamins B1 and B2, niacin, iron and the results were remarkable. For example, Beriberi was eliminated completely, and infant mortality in the first year of life fell from 102 deaths per 1000 births to 61 deaths per 1000 births in 1947.

In the United States during that time, Pellagra caused thousands of deaths annually, mainly in the communities relying on corn flour as the main staple food. In 1938, bakers began fortifying corn flour with B vitamins and iron, and thereafter Pellagra disappeared.

Once it became clear that deficiencies in vitamins and minerals caused disease, governments soon legislated the mandatory fortification of processed foods with vitamins/minerals. The legislation for fortification occurred over a number of decades, and the most recent additions were Calcium which was introduced in the 1980’s, and Folic Acid (Folate) which was introduced in 1998.

Today, most people are aware of the US RDA (U.S. Recommended Daily Allowances) for vitamins and minerals, which are shown on all food packaging.

Consumers themselves have also taken a strong interest in vitamin supplements, which became popular in the 1970’s. And this awareness for adequate nutrients led to the increased consumption of whole foods like wholegrain breads for example. Today it is rare to see people eating only white bread, whilst in the 1950’s and 1960’s it was the norm. Generally speaking, most people are much more food conscious these days.

In countries like Australia today, most people get adequate nutrients in their diet by eating healthy foods including fruits, vegetables and whole grain cereals. Consequently the rate of heart attacks has dropped significantly and life expectancy has increased dramatically.

So earlier generations lived through a period of significant nutrient deficiencies, and coupled with high levels of tobacco smoking, those living during that time experienced many serious diseases including CHD. Sadly it meant that many of us never had the joys of getting to know our grandparents, as many died by the time they reached their sixties.

So let’s sum up the 1920-1968 period to understand why people today are very lucky, and why they have less reason to worry about CHD, then their parents or grandparents:

In Summary:

� Prior to 1968 heart attacks reached epidemic levels. � Many people suffered serious deficiencies in vitamins and minerals leading to a plethora of diseases. � Governments have mandated that essential vitamins removed in food processing, are added back. � Since 1968 heart attacks are down by 30-40%.

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CHAPTER 15 IMPROVED MEDICAL & SURGICAL TECHNIQUES

Many people are concerned about CHD because it has affected their lives in some way. Maybe a parent, an uncle, or a close family friend has had a fatal heart attack, or suffered a stroke, or needed a heart bypass operation.

However, the encouraging news about CHD is that it peaked in 1968 and has dropped by a third since then. The credit for this lowering is not due to any single initiative.

There is no doubt that governments deserve some praise for initiating the anti-smoking campaigns, as well as introducing the fortification of foods, which involved the mandatory addition of essential vitamins and minerals into processed foods. Also people themselves have opted for better foods, and a good example is the way that fresh vegetables today have largely displaced canned vegetables which were popular in the past. Supermarkets have also done an excellent job in developing ‘supply chain’ systems to allow fresh fruits and vegetables to be distributed quickly over long distances. This provides consumers with ample choice, and it’s now up to the consumer to take advantage of the broad choices that they have in fresh foods.

Another contributor to the reduction of CHD, is the advances in medical diagnostic tools. They include a broad range of CT, EBT and MRI scanners that help doctors to look inside arteries, to see potential blockages that may need to be treated. This has helped doctors to understand the extent of any patients’ cardiovascular problems and to treat these conditions more effectively.

Blood clot dissolving drugs have also been a great help. These are used in emergency situations when a heart attack or stroke occurs, and have allowed many people to live another day. These people are often thankful that they were ‘in the right place at the right time’ because these drugs need to be administered very quickly after a heart attack or stroke.

Surgery also played a role, particularly to treat patients with very serious life-threatening heart conditions. Let’s look at how surgical techniques have evolved over the years:

Coronary Artery Bypass Surgery (CBAG)

In 1970, coronary artery bypass surgery was introduced, commonly abbreviated as CABG and referred to informally as ‘cabbage’ by doctors. This was a major operation where the entire rib cage was opened, and the risks of complications were considerable, including high death rates. Of course we have come a long way in thirty years and improved surgical techniques are making this operation quicker and less traumatic, but it’s still a major operation with significant risk of complications.

Controversy still exists over indications for bypass surgery. Studies from Harvard cardiologists appeared in the Journal of the American Medical Association a few years ago showing 85% of people advised to have bypass surgery or an angioplasty, didn’t need the procedure.

Angioplasty

In 1977 doctors introduced a technique called angioplasty, which involved passing a catheter with an expandable tip up the aorta to the coronary arteries.

This technique expanded the artery at the narrowed area, and succeeded in helping a number of people return to a normal life, by improving blood flow through the arteries. It was far less invasive then CBAG surgery, and patients could return to work after a couple of days.

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For many patients this ballooning technique was effective for a while. However, often the ‘treated’ area would become obstructed again, and the problem of poor blood flow would return. So surgeons needed a device that would hold the artery open, some sort of brace.

Coronary Stents

In 1987 an innovative brace was introduced, which was called a Coronary Stent. This was also put in place with a catheter. This stent was a little metal concertina device made of stainless steel, which surgeons placed at the affected part of the artery, to hold it permanently open. This device helped many patients who otherwise might have needed more serious bypass surgery.

These stents generally stay open, but plaque can build up on the inside walls of the stent and plug them up. The latest step has been treating the stents with certain chemicals to try to reduce this problem.

So surgeons can take some credit for prolonging the lives of patients, particularly those with advanced heart and cardiovascular disease. Heart surgery is of course a huge business, and there is concern from various doctors about over-servicing of patients with surgery, who should have been treated with less invasive techniques.

The hard-hitting book “Heart Frauds – Uncovering the Biggest Health Scam in History” by Charles McGee MD, provides a view of what happens, when heart surgery becomes very big business. Dr McGee argues that 80% of angiograms and heart bypass operations in the USA are unnecessary. This represents a real dilemma for patients, who out of necessity, need to adopt a “buyer beware” attitude when dealing with surgeons.

There are many doctors who support McGee’s views on surgical over-servicing, and who believe that other treatments would have been more effective and safer. They consider CBAG and coronary stents a piecemeal treatment, which fixes only one or several restricted portions of the body’s blood vessels, whilst the same degenerating conditions continue to exist throughout the patients’ entire cardiovascular system.

These doctors prefer to use a different treatment for CHD, which has a lot more ‘reach’ into the cardiovascular system, which is called EDTA Chelation Therapy.

Chelation Therapy

EDTA Chelation Therapy is a treatment for reducing CHD which you have probably never heard of, yet it’s used by a number of doctors for reducing arterial disease.

EDTA Chelation Therapy is in fact the preferred option for some 2000 medical doctors in the USA for treating CHD. They feel it’s a safer and more effective treatment, compared to invasive and risky operations like the angiogram, angioplasty, coronary stents, and CBAG operations.

However, EDTA Chelation Therapy is described by the American Medical Association and the American Heart Association, as an unproven therapy. This is on the basis that there are no valid trials conducted, that proves that it works. And a number of opposing doctors call it quackery. But there are simply too many qualified medical doctors using EDTA Chelation for it to be dismissed.

EDTA Chelation is a rather safe intravenous therapy approved for the treatment of heavy metal accumulation in the body. It has been used since the 1950s and remains the standard treatment for lead poisoning. So people with heavy metal toxicity, including lead, cadmium, arsenic, and even radioactive elements, have been treated with this therapy. And it’s officially approved for that purpose.

But it’s not officially approved for arterial disease. Yet doctors have used it with over a million (1,000,000) patients in the U.S., with significant improvements being reported in conditions like angina and atherosclerosis.

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So EDTA Chelation therapy is currently being used in the US for heart disease, circulatory disorders (including circulatory loss of vision like macular disease), diabetic arterial disease, decreased mental function from vascular disease, and intermittent claudication (leg pain on exercise), neurological disorders, and other degenerative diseases.

Let’s have a look at how EDTA Chelation works. The chemical EDTA (Ethylene Diamine Tetra Acetic Acid) which is approved by the US Food and Drug Administration is given as an intravenous drip over two to three hours. EDTA binds with toxic minerals such as lead, aluminium, arsenic and cadmium, and the complex then travels through the blood to the kidney where it is excreted. Somehow this treatment greatly improves the condition of the arteries as plaques are reduced for reasons that are not fully understood. Certainly reducing toxic metals in the body can’t hurt, but how it helps improve blood flow in the arteries is still unknown. Some chelating doctors feel that Chelation helps to normalise the bodily functions, and by achieving that, the body takes over to heal itself in ways not fully understood.

Most people treated with EDTA Chelation therapy begin with at least 20 sessions at a clinic lasting 2-3 hours. Because EDTA Chelation is not approved by the American Medical Association, these treatments are not covered by medical insurance. So it’s likely to cost between $2,000 and $3,000 for enough IV drips to see if it might work.

Opponents of ETDA Chelation therapy point to a lack of double blind studies showing it to be effective. Several double blind studies have been started, but were never finished. In one case a study in a military hospital lost its investigators when they were shipped out to the Gulf War. In another, funding ran out. Basically the problem with Chelation therapy is that there is little money to be made, and most drug trials are funded directly or indirectly by the pharmaceutical giants. Pharmaceutical companies have little to gain with Chelation therapy, as the patents on EDTA ran out decades ago.

Doctors who trust Chelation therapy, claim that it has a powerful effect on the body almost immediately, and patients begin to notice improvements after just several treatments. Blood flow starts to improve and blood pressure is lowered.

One particular advantage that Chelation has is its reach into the extremities. Whilst heart surgery may help with blood flow around the heart area where surgeons can reach, there are many patients who have poor blood flow to the extremities like the feet. Chelation can reach into the very small arteries and capillaries, where surgeon cannot reach. In fact, there have been many patients with severely restricted blood flow to the feet that were scheduled for amputation surgery, who kept their limbs because they were introduced to Chelation ‘in the nick of time’.

American College for Advancement in Medicine

The American College for Advancement in Medicine (ACAM) is the major driver for education and advancement of EDTA Chelation therapy. The ACAM is a not-for-profit medical organisation dedicated to educating medical doctors and other health care professionals about diagnostic procedures for complementary and alternative medicine. Their website is www.acam.org

It’s obvious that the medical field is highly polarised on Chelation therapy. Those against it call it quackery. Those who support it, feel very positive about its benefits, and cannot understand why it’s not a mainstream therapy used by the entire medical profession.

One author who is pro-chelation wrote “It is clear that most of the opposition to EDTA is due to the threat this therapy represents, not to the patients' health, but to the bank balances of orthodox physicians, the pharmaceutical companies, and the surgical hospitals. Treating cardiovascular diseases is big business, bringing in tens of billions of dollars each year.” “On the other hand, this therapy (EDTA) is highly recommended by scores of MDs, cardiologists, cardiac surgeons, professors of surgery, vascular surgeons, chiefs of cardiology departments, professors of clinical medicine, and on and on... an impressive array of eminent physicians and surgeons. Could they all be quacks?”

A Canadian Experience

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For your interest, I spoke to a friend of mine who lives in Canada. We hadn’t spoken for a few years, and I was telling him about this book, and he asked me whether I knew much about chelation, and then went on to tell me his story which I will share with you.

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He was 58 at the time and had been suffering from intermittent claudication in his legs, which is a bit like angina of the legs, meaning that the blood isn’t getting through to the extremities due to plaque build-up in the arteries. He saw one doctor who wanted to operate on his legs and do a type of ‘bypass’. Then he went to another doctor who wanted to put stents in his legs. He was not too excited about either treatment, because he felt this would only fix some of the blockages, and would not be a complete solution. Normally this sort of claudication occurs in many places within the arteries and capillaries, and simply to remove a few of the larger blockages, is often just a temporary fix.

He then went on to explain that EDTA Chelation Therapy was approved in Canada for treatment for arterial diseases and that he was one of the first people to get this treatment after it was approved. The treatment involved intravenously flushing a synthetic amino acid solution called Calcium Di-Sodium EDTA through the arteries and is performed at the local doctors office or a clinic. He had around 50 treatments which is a lot, but he is a heavy smoker. He stated that prior to Chelation he struggled to walk to the corner store without severe pain in the legs. Today, 5 years later he can walk an 18-hole golf course. This colleague called it the Roto-Rooter treatment, named after the American product of the same name that you pour into drains to unclog them.

Of course in the medical field this is called anecdotal evidence, and an anecdote is defined as “a short account of an entertaining or interesting incident”. However each day there are thousands of people getting Chelation from medical doctors who swear it’s a safer option than surgery.

Chelation Websites To Visit

The medical doctor who made me aware of Chelation, suggested I have a look at the excellent work done by Dr Garry Gordon who is a well known expert in EDTA Chelation. Dr Gordon’s website is www.gordonresearch.comDr Gordon ran a large Chelation therapy clinic for a number of years in the USA, and from this experience he developed an oral form of Chelation Therapy called ‘Beyond Chelation 1’ that you can buy. He claims it’s as effective as the intravenous treatment, but must be taken for the long haul, as it works much slower than when taken intravenously.

If you would like a better understanding of how chelation works, have a look at the 30 minute video at Dr Elmer Crantons website www.drcranton.com Dr Cranton also wrote the book called Bypassing Bypass Surgery foranyone seeking a more in-depth understanding of chelation.

The interesting thing about Chelation is the number of doctors who use on themselves on a regular basis, for keeping their arteries free from the build-up of heavy metals and calcium.

If you have an interest in Chelation, you might also like to look at an innovative Chelation product that has received endorsement from Dr Sherry Rogers, MD who is well-known for her books on environmental toxins and their dangers. Visit www.detoxamin.com

We will know more about the effectiveness of EDTA Chelation Therapy for cardiovascular disease, once the US Governments’ National Institutes of Health, completes the $30M Chelation Study which concludes in 2008. You can read more about this trial by visiting http://nccam.nih.gov/news/2002/chelation/q-and-a.htm

The most important point to remember from this chapter, is that anyone who is diagnosed with heart disease should seek more than one opinion. Often there are other options available, as different modalities leap-frog each other. This may mean speaking to several medical specialists to get their views. It may cost a bit more, but what price do you put on good health.

In Summary:

� Heart attacks peaked in 1968, and are now down by 30-40%. � Coronary stents have helped patients who otherwise might have needed bypass surgery. � A lot of unnecessary bypass and balloon procedures are being done, so get a second opinion. � EDTA Chelation Therapy is used by a number of doctors in the USA for treating CHD.

CHAPTER 16 IRREGULAR HEARTBEAT / ARRHYTHMIAS

Irregular heartbeat (called arrhythmias) is not typically associated with CHD. However, those who experience this condition normally worry about their “ticker”, and start thinking they may be ‘at risk’ of heart disease. For that reason, it’s worth discussing irregular heartbeat.

Irregular heartbeat affects a number of people. In some cases it may be due to do the physical pumping mechanics of the heart, and that’s clearly a matter for a heart specialist. But a number of people suffer from occasional bouts of irregular heartbeat which comes and goes without any real problem. However, they are a real concern to anyone experiencing this condition, particularly if it becomes a regular occurrence.

The first time I had an arrhythmia attack was one afternoon at the office, and I remember calling my doctor as I was concerned. I think I was 40 years old at the time. He suggested that it would probably subside, but if not, to give him a call a few hours later. Of course my heart rhythm was back to normal a couple of hours later and I didn’t think much about it.

Artificial Sweeteners and Irregular Heartbeat

Being the analytical type, I thought about what I might have eaten or some logical reason why it occurred. The only thing different that day, was taking some artificial sweetener with my tea prior to the attack. I had never taken artificial sweetener before, and could not see how this little sweetener tablet in my tea could cause irregular heartbeat.

Several days later I also had tea with some artificial sweetener, and three hours later I had another irregular heartbeat episode. So I realised then, that I was reacting to artificial sweeteners, which I avoided thereafter.

It was some years later that I started seeing medical reports that implicated artificial sweeteners like Aspartame (NutraSweet) and Sucralose (Splenda) with irregular heartbeat, and neural problems. If you would like to learn more about the neural problems associated with artificial sweeteners, then a very good book is called Sweet Deception written by Dr Joseph Mercola.

Anyway, after I stopped eating artificial sweeteners, I had no problems with irregular heartbeat for several years. And then it started to happen again. The irregular heartbeat occurred every few days, and I started to think my ticker was losing its robustness, and wondered whether I might become a candidate for a pacemaker.

Bread Preservatives - Calcium Propionate #282

It took me some months to discover the cause, which turned out to be Calcium Propionate, which is food chemical #282. Propionate is a preservative and food chemicals #280-283 are all made with Propionate.

Not many people are familiar with food chemicals but they number over a 1000. The next time you buy a loaf of bread, have a look on the label, and see if Propionate is listed or the numbers 280-283. Propionate is a chemical that was added into the bread by manufacturers a few years ago, as a preservative. It causes irregular heartbeats in some people, headaches in others, and asthma in others.

Complaints on one of the TV “Current Affair” programs highlighted the effect of Calcium Propionate 282 on some people, and some bakeries removed this additive from the ingredients list. In Australia, Brumby’s bakeries and Bakers Delight, claim that their breads are free of this chemical.

Regrettably, the larger bakeries that supply 95% of the Australian population through the supermarkets, have been slow to remove this chemical, as their priority is extending the shelf life of their product.

Many types of bread sold in supermarkets have preservatives, either in some form of Propionate, or more deviously as Cultured Whey. You can make Propionate by growing it in a whey culture, and current food laws allow bakers to show simply ‘Cultured Whey’ under the ingredients, without mentioning what the culture is.

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Cultured Whey is a very deceptive method of adding preservative into bread and baked goods, because few people would realise that it is the chemical called Propionate. Breads made with Cultured Whey are allowed to say ‘all natural ingredients’ but they cannot say ‘preservative free’. Most people would assume ‘all natural ingredients’ means ‘preservative free’, but that is an incorrect assumption. If you are shaking your head at this point, I am not surprised, because the food labelling laws are heavily weighted to the manufacturer, not the consumer.

Propionate is found in the entire range of baked goods that manufacturers want to keep mould-free, including bread, bread rolls, hamburger buns, tortillas, cakes etc. But as one nutritionist pointed out “If mould which is a basic form of life, cannot survive on a crust of bread acknowledged as the staple of life, then how can we?”.

It’s difficult to avoid food chemicals unless you live in a country where food chemicals are banned or restricted. Italy is one of the toughest in terms of restricting food chemicals, and Europe generally has a good track record. In Australia and the USA the food chemicals business is flourishing, and is very evident across the entire food chain. The worst are the fast foods, so lets have a look at the ingredients of one of the popular fast food hamburgers focusing just on the bun alone:

The stated ingredients of the hamburger bun are: Enriched bleached wheat flour (malted barley flour, thiamine, riboflavin, niacin, iron, folic acid), water, high fructose corn syrup, vegetable oil (partially hydrogenated soybean oil), yeast, salt, wheat gluten, calcium sulphate, ammonium chloride, ascorbic acid……..

Now if you stopped at this point it might be edible but let’s keep going……...…..azodicarbomide, diacetyl tartaric acid esters of mono- and diglycerides, corn flour, soy flour, calcium peroxide, mono- and diglycerides, propionic acid, phosphoric acid, ethoxylated mono- and diglycerides, silicon dioxide, sodium stearoyl-2-lactylate, fungal enzymes, calcium propionate as a preservative.

The incident of irregular heartbeat affects many people, and it’s in your interest to try to uncover the cause by trial and error to see if its food chemicals. Regrettably the majority of people are not aware that the cause may be a food chemical reaction, and some are prescribed unnecessary prescription drugs instead.

If you really want to understand food chemicals, and read about practical real life stories from real people, then visit a website called http://www.fedupwithfoodadditives.info/ This website was created by Sue Dengate in Australia. Sue is a mother who became frustrated watching her family suffer from poor health due to food chemicals. She has written a number of books on the subject of Food Chemicals, and publishes this website.

Magnesium

Another cause of irregular heartbeat is insufficient magnesium in the diet. Magnesium is a very abundant mineral, and up until 100 years ago, our diet supplied abundant quantities.

In general, people who eat lots of fresh foods including fruits and vegetables, get sufficient magnesium. But most people, who live on a typical western diet of highly processed foods, are lacking in magnesium. People low in magnesium often suffer from muscular related symptoms, such as leg muscle cramping, eye twitching, and irregular heartbeat. Remember the heart is simply a large muscle. So unless your diet is very good, you will probably benefit from taking magnesium supplements. A most insightful book on this subject is called The Magnesium Factor by Mildred S Seelig, MD.

In Summary:

� Many people experience irregular heartbeat from time to time. � Artificial sweeteners are known to trigger irregular heartbeat. � Food preservative Calcium Propionate #282 can trigger irregular heartbeat. � Magnesium supplements can help relax the heart.

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CHAPTER 17 FRENCH CUISINE

Why do countries like France, who eat plenty of cholesterol rich foods like cheese, cream, butter, meats etc have such a low incidence of CHD? This is called ‘The French Paradox’ and clearly the French think this is great.

The French have fascinated me ever since I was a youngster, so allow me to reminisce a little on my own life experiences.

Let me tell you about my experiences with the French whilst living in French Canada.

Montreal, Quebec

My introduction to the French way of life occurred when my family moved to Montreal when I was 10 years old. Everything in Montreal was French including the people, the language, and the food. For several years I attended a French school which catered for a small handful of English students. My school friends had names like Henri, Claude, and Christien.

Later when I started my working career, I lived in downtown Montreal where everyone spoke French. My apartment was immediately above a traditional French restaurant downtown. I remember the owner quite well; a charismatic Frenchmen. This was a French restaurant with a first class cuisine, with well prepared dishes made from fresh foods and meats, and a broad range of French wines. It was the sort of cuisine where everything was painstakingly prepared in the restaurant kitchen. Just good fresh food.

It was a really exciting time of my life living in downtown Montreal, considered a very cosmopolitan city by world standards.

I remember the charismatic French journalist who lived in the apartment next to me. Whenever I walked up the stairs he would see me through his open front door holding a glass of red wine and say in his French accent “Frooonk, why dooon’t you come over for some red wine and we relax”.

The reason I remember him vividly was because he was a French Separatist, who liked writing press articles, suggesting that Quebec should separate from the rest of Canada. Separatists are French people who feel that the Province of Quebec (including cities like Montreal) should separate from Canada and become its own nation.

The gusto behind the Separatists movement started back in 1967 when French President Charles De Gaulle visited Montreal and uttered the now famous words “Vive le Quebec Libre!” (Long Live Free Quebec!). This kindled the emotions of a number of French people, and after that it was on for ‘young and old’ and the Separatist movement took off like a rocket.

The reason I remember my journalist neighbour so well, was actually somewhat amusing. I came home from work one day and he looked a bit distressed. When I asked him what was wrong, he led me downstairs to the street and showed me his car, which had a bullet hole which had gone right through the back window. The bullet had gone in one side, and straight out the other. Clearly he had found this to be a rather unnerving experience. Obviously some pro-Canadian supporter, thought that a bullet through his car window, might temper his over-zealous Separatist notions.

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During this period of my life I did develop a very good understanding of the French people, their behaviour, and their lifestyle. I had some terrific friends who were French and really enjoyed their company. I had also noticed the French were pretty particular about their food and wine.

One thing that was very clear to me back then was that the French certainly seemed to enjoy life a lot more than English Canadians. Some people would say that the French worked to live, whereas many English Canadians lived to work. The French intuitively understood what we today call ‘work life balance’.

I really enjoyed Montreal and the French way of life, but when my employers offered me a job in New York City, I decided to go. After that I went to Sydney Australia and my ties with the French world came to an end.

Monte Carlo, Monaco

My reconnection with the French world occurred some years later when I was a Director with an international consulting practice. As a global partnership, we met twice a year for international conferences which were held in rather interesting locations. This particular conference was in Monaco, a small independent country between France and Italy.

This was one of those pleasant trips, travelling from Australia with British Airways First Class with a sleeper bed. The final leg of the journey was a helicopter ride along the Mediterranean coastline landing right next to my hotel in Monte Carlo. A very civilised mode of travel, I recall. Monte Carlo was buzzing with a lot of visitors, because it was the week of the Grand Prix car race, a major annual event.

When I arrived in Monte Carlo, I had to meet one of my fellow Directors - a Frenchmen from our Brussels practice - to finalise the agenda for our 3 day conference. Afterwards we went for dinner at a nearby French restaurant.

The first thing that I noticed about this restaurant was the trays of fresh vegetables and fruits, stacked up near the front entrance. I had never seen that before, and it seemed a bit untidy. Later I learned that French people like to know how fresh the food is, and so the fresh fruits and vegetables are often displayed in public view.

The meal at this restaurant was superb, the best I had ever had.

Plates were brought out progressively including meats, fish, savoury green beans, potatoes, onions, carrots, eggplant, salad vegetables, cheeses, crusty bread etc.

What really struck me, was whilst each dish tasted fabulous, the flavours seemed to get back to natural fresh ingredients like olive oil, cream, lemon, real stock, pine nuts, tomato, cheese, spices etc. I could not taste the chemical additives used in restaurants back home, where artificial flavourings like MSG, Glutamates, HVP, Disodium Guanylate, Disodium Inosinate are extensively used.

The other thing I noticed was that the food was carefully prepared. Nothing was burnt or over-cooked, the food was delicately cooked. So we had a superb meal with several glasses of French wine.

The next day I woke up and felt absolutely great, with no lingering headache as would be the case back home. There was nothing in the meal that could hurt you. Just good fresh produce, served in a traditional way to deliver maximum flavour, and providing plenty of carbohydrates, protein, oils, minerals, vitamins, and phytonutrients in one complete package. This experience was repeated at other restaurants that I visited during my stay in Monte Carlo.

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The interesting thing about real French cuisine is that it is very traditional and hasn’t changed much for hundreds of centuries. On the other hand, the English speaking countries have been jumping around from one diet to another, in the illusive pursuit of good health. When you look back now, you have to agree it’s almost a joke! We in Australia and the USA have tried it all. Pasta foods were the craze for a while but fell out of favour, beef was taboo but now its fine provided its grass fed, carbohydrates were the rave but are now linked with diabetes and Syndrome X, protein was ignored for years but its very vogue thanks to Dr Robert Atkins, and low-

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fat foods (with lots of sugar) has been the rage for a number of years but the new craze is low glycaemic index foods.

During all this time, the French have stuck with tradition and did what made sense all the time, quality fresh foods, eaten in the season they grow, always carefully prepared, and never overcooked.

It’s worth having a closer look at the French cuisine, and there are many fine French cookbooks available. So let me provide you with some important observations about their attitude to food, and their sense of tradition:

French Cuisine - Eating Food in Season

� The Spring, Summer and Autumn each deliver a different variety of produce. That’s why French restaurants change their menu every few weeks.

� The French prefer fresh food that has been recently harvested, which is at its peak in flavour and texture. � They love to shop at the farmers markets, to carefully select fruits and vegetables, and to converse with

vendors to get a feel for what’s fresh today, and what’s coming up. � Fruit is a staple of French life, normally eaten in season. Nuts are also seasonal, and once again these

are best when freshly harvested. � They rarely refrigerate fruit and prefer to buy it fresh every few days.

Not surprisingly, the French spend a greater proportion of their income on food then English countries do. To them food is one of the most important aspects of life. It’s not something that you compromise on.

The French are very conscious of the seasons and intuitively know when each fruit and vegetable is harvested. And when the harvest is finished and winter sets in, the French have learned to use stored foods and heavier foods to see them through the cold period.

Interestingly, the French consider supermarkets ideal for buying packaged goods, but they would rarely buy fruit there. Supermarket fruit is often tasteless, waxed, and are kept for long periods in cold storage. These are all no-no’s to the sophisticated gourmet.

In terms of eating habits, they say the French eat very slowly and deliberately. This is true in the sense that the French tend to serve multiple courses at each meal, each quite small, and with a short break between each. This ensures that you eat slowly. Also because they often drink wine, and wine needs to be savoured, this also slows things down. So I don’t think the French are naturally slow eaters, but their approach of serving several smaller course, certainly slows the pace.

Let’s face it, if you are served a hamburger for lunch, you better whip it down pretty fast, because if you don’t, it will get cold and soggy. A pizza puts you under similar pressure.

People often accuse the French of being arrogant and they may well be. But if I look at the long history of their cuisine, and the reverence that they have for food, then I can certainly understand why they might view the dining habits of English speaking western countries, with some disdain.

In Summary:

� French cuisine is very traditional, and has not changed for many centuries. � French cuisine focuses on quality fresh foods, and minimal processed foods. � French cuisine uses animal fats and olive oil; but minimal vegetable oils. � The French prefer to shop twice a week to buy food that is at the peak of freshness.

CHAPTER 18 WINE & PHYTONUTRIENTS

It’s essential that we review the subject of wine because the French Paradox centered on the consumption of red wine. The benefits of drinking 1 or 2 glasses of red wine per day, was one of the main reasons given to explain the French Paradox. In France, wine is part of everyday life, providing valuable nutrients like vitamins, minerals, and phytonutrients.

The history of wine goes back a long way, and certainly to the days of the Roman Empire, and countries close the Mediterranean such as France and Italy, have been consuming wine for thousands of years. In these countries, wine is considered a food consumed on a regular basis along with meals.

Nevertheless, it’s important to remember that there are many people in the world who don’t drink any alcoholic beverages, and we must respect them for their views. This may be due to religious, ethical or other genuine reasons.

So this chapter has been specifically written for people who enjoy wine in moderation, and the exciting news is that wine does protect against CHD.

But before we investigate the benefits of wine, let’s take a short trip back over the past 100 years, including the period of Prohibition that affected North America, and look at how wine drinking was affected over that time.

Prohibition

Alcohol Prohibition is an important piece of history, an attempt ‘by law’ to prohibit the selling and drinking of alcoholic beverages. It originally started in the USA in 1905, and slowly gained momentum until half the USA was under prohibition in 1916, and the entire country was under Prohibition by 1920. It ran for 13 years although some states were under Prohibition for up to 28 years.

Up north in neighbouring Canada, full Prohibition lasted for just three years (1917-1920). Not surprisingly the Province of Quebec, consisting mostly of French Canadians, continued to allow the selling of wine and beer during Canada’s Prohibition. This was clearly due to the strong cultural ties between France, and the French Canadians.

Proponents of Prohibition might argue that it was beneficial, and there is no doubt that hard liquor was a real problem at that time. Nevertheless, government regulations can create as many problems as they solve, and the destruction of the US wine industry was an unfortunate consequence of Prohibition.

As you would appreciate, Prohibition changed people’s attitudes to alcoholic beverages, so that by the time Prohibition was lifted, many consumers had a negative view on all alcoholic beverages, including wine. Some of those negative views still prevail today which we must respect.

So wine sales in North America were absolutely devastated by Prohibition, and the local US wine-making industry did not recover until around 1970.

It’s interesting to note that the rise and fall of heart attacks in the North American between 1920 and 1970 was inversely proportional to alcohol consumption. In other words, as alcohol sales dropped around 1920 we saw heart attacks increase. As alcohol sales increased in 1970 we saw heart attack rates drop. Coincidence? Maybe.

In terms of my own experiences, I remember back in the early 1970’s when I was living in Montreal and later in New York, that I rarely consumed wine. However, when I moved to Australia I found myself consuming wine several times per week. Wine was an accepted part of the Australian lifestyle, and readily available everywhere.

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So France and Australia have something in common as far as wine is concerned, because neither country had Prohibition, and consequently wine sales continued over the century without any impediments.

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The French Paradox Is Born

It was Professor Serge Renaud’s paper, published in 1992 in the British medical magazine called The Lancet,which helped bring wine back into favour around the world. Renaud, a Cardiologist working at the University of Bordeaux, reported that up to 2-3 glasses of red wine per day could reduce the risk of coronary heart disease by 40%. That was for men. For women he recommended 1-2 glasses per day maximum.

He coined the phase ‘The French Paradox’ when he observed that the French, with a diet rich in cholesterol and saturated fats, had significantly less coronary heart disease than other advanced countries. He attributed this to the fact that the French were high consumers of red wine.

To prove his idea, Renaud conducted a study involving 34,000 middle-aged men living in France. In an article in The Journal of Epidemiology in 1998, he reported a 30% reduction in death rates from all causes by drinking 2-3 glasses of wine per day, and a 35% reduction in CHD, and an 18-24% reduction in cancer. When Renaud was interviewed he said “Growing up around Bordeaux, you know instinctively that wine is good for you, my grandparents, their friends, all lived to be 80 or 90. I knew there was some special reason”.

The Copenhagen Heart Study

In 1994/5 we saw the release of ‘The Copenhagen Heart Study’ from Denmark headed by Dr Morten Gronbaek, which was published in the British medical journal The Lancet. This was the first study to analyse alcohol consumers within the three distinct groups of wine, liquor and beer. The study covered 13,000 men and women aged 30 to 70 in Copenhagen over a twelve-year period from 1976 to 1988.

The report analysed the death rates associated with moderate intakes of wine, beer, or spirits and found that:

� Wine – Increased longevity (+) � Beer – No Change � Spirits – Decreased longevity (-)

This was a very significant finding, because various scientists had suggested that the French Paradox was attributed solely to the ethanol alcohol in the wine, which was acting as a relaxant and anti-clotting agent. This would have meant that any alcoholic beverage including beer or spirits, should have produced the same results. But that was not the case. The Copenhagen Study proved that there was something different about wine. But what was it?

The answer came from food scientists who understood ‘free radicals’ and oxidation.

Dr Edwin Frankel

In the USA during this same time period, and even a few years earlier, Dr Edwin Frankel and his colleagues at the U.S. Department of Agriculture in Illinois, and the University of California (Davis), had been doing a lot of study into free radicals, the oxidization of lipids/fats, and antioxidants.

Without wanting to get too complicated, free radicals are ‘reactive’ molecules that have lost 1 of their 2 electrons, so they steal an electron from another molecule. When the ‘attacked molecule’ loses its electron, it becomes a free radical itself, beginning a chain reaction.

This process is known as oxidation, and was first discovered in foods when lipids like oils and fats became rancid. This is why food manufacturers use antioxidants to stop the food from going rancid.

When this same oxidation process occurs in the human body it can damage or destroy living cells in the body. Of course the death of just one cell goes unnoticed, but over time, many cells are destroyed.

So ‘free radicals’ can be pretty nasty, and will oxidize lipids, proteins, and even your DNA. Of particular interest to us is its effect on CHD, as free radicals in the bloodstream can damage the arteries.

What Frankel’s group found, was that oxidized LDL Cholesterol is high in by-products which could damage the delicate lining of the artery walls. However, he also observed that phytonutrients found in plant foods, were powerful antioxidants that had a counter-effect.

LDL Cholesterol

For those interested in the detail, cholesterol travels in the bloodstream surrounded by protein, hence the name Lipoprotein. Low Density Lipoproteins called LDL, unfairly nicknamed ‘bad’ LDL cholesterol carries the majority of the cholesterol that travels in the bloodstream. And if you believe what you’ve read, then you would believe that LDL cholesterol is the main source of damage to the arteries. The theory is that the more LDL cholesterol in your bloodstream, the greater the risk of heart disease, and therefore reducing LDL cholesterol has been the main goal for the medical profession.

However, a number of respected cholesterol researchers consider this to be absolute nonsense. Their view is that LDL cholesterol is essential to the human body so how can it be bad? What you will learn in this chapter, is not to worry about your LDL levels. Your real concern should be the amount of oxidized LDL. Once you understand this, you will understand why people with elevated LDL cholesterol can have healthy arteries, and why people with low levels can get heart attacks.

To cut a long story short, the research done buy Frankel and other scientists was a very important finding, because it explained why LDL cholesterol caused arterial damage to some people, and not in others. And it helped to explain why the risk of CHD was greatly reduced in populations who consumed plenty of fruits and vegetables, rich in antioxidants. Or putting it simply, if the amount of oxidized LDL in the arteries, exceeded the amount of antioxidants needed to neutralize them, then damage to the artery walls would be a likely consequence.

Fortunately Dr Frankel had developed some very sensitive laboratory testing techniques, and he was ready to test wine.

What he and his group at the University of California reported in the British Medical Journal – The Lancet – in 1993 was that the phytonutrients in wine, particularly the phenolic compounds called the Flavonoids, significantly inhibited the oxidation of LDL cholesterol in human blood.

This was an important discovery because they demonstrated that wine had high levels of phytonutrients with powerful antioxidants that could neutralize free radicals.

In addition to providing a scientific explanation to the ‘French Paradox’, this research showed that oxidized LDL could damage the artery wall, which causes the formation of plaque in the artery wall, leading to the clogging the arteries. And it explained why people in France consuming high levels of red wine, rich in phytonutrients, were more protected.

So what does Frankels’ LDL findings really mean? It means that you don’t need to worry about your LDL cholesterol. And you don’t need to worry about your HDL:LDL ratios either.

Whilst the entire HDL:LDL cholesterol story sounded plausible for a while, it doesn’t hold up to scientific scrutiny. However, expect the LDL ‘bad cholesterol’ story to continue for a few more years, as it has a lot of momentum, and its a good money spinner for a number of the stakeholders.

What you really need to worry about, is how effectively your body handles oxidized LDL cholesterol. Unfortunately there is no clinical test available, so all you can do is make sure you are getting plenty of anti-oxidants from phytonutrients.

For those who don’t drink alcohol, you’ll be pleased to know that non-alcoholic grape juice does contain phytonutrients, but not as much as red wine. That’s because grape juice is made from the pulp and not the skins. Red wine provides higher levels of phytonutrients because the entire grape including the skins is crushed and fermented. The grape skins are present during the fermentation process to give the wine its rich red colour, and it’s that rich red colour that provides most of the phytonutrients.

Red Versus White Wine

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The original announcement of the ‘French Paradox’ highlighted the benefits of red wine. However there have been some reports stating that white wine is equal to red wine, in terms of its phytonutrients.

In checking this question with Dr Frankel, he told me that any claims that white wine was comparable to red, was absolute nonsense. He said “It contradicts our hypothesis that red wine is much more beneficial than white wine, because it contains five times (5X) more phenolic compounds than white wine.”

Based on Frankel’s research, and that of Dr Serge Renaud, it’s clear that red wine is your very best option.

In summary, the research undertaken by Frankel and his colleagues was extremely valuable, because it helped explain the benefits of the French and the Mediterranean cuisine, which is based on lots of fresh fruits, vegetables, and red wine, all with plenty of phytonutrients. It also provided a scientific explanation for the French Paradox.

Wine Serving Sizes

The guideline for daily wine consumption varies from country to country so check what applies to you. The average in many countries is 1-2 standard size serves for women, and 2-3 serves for men. Remember that a bottle of 750ml of wine is classified as around 7.5 serves. Common sense should always prevail and small-framed people should consume less. It is also important that pregnant women do not drink alcohol. And remember, you should never drink and drive!

To finalize our discussion on wine, it’s worth noting the comments by Australian Philip Norrie, MD. Philip is a medical doctor who owns his own vineyard called Pendarves Estate. He has written a number of books and articles on wine. In his book called Wine & Health – A New Look at an Old Medicine he says:

Wine is man’s oldest medicine, having been used as such by the medical profession for more then 5000 years…….Consumed in moderation, wine is our most potent preventative medicine; it has the potential to reduce death rates from all causes by up to 50%. There is no man-made, patented medicine that can claim as high a success rate as can the consumption of wine in moderation.

That sums it up very nicely. So enjoy the medicinal benefits of drinking red wine in moderation as part of a healthy overall diet.

You know, I tried very hard to see whether there were any good books written on the subject of wine, particularly one covering its medicinal qualities. The best book I found was called The Miracle of Wine written by Frenchman Michel Montignac and printed by Montignac Publishing. His book does a terrific job explaining the history of wine including its impact on Christianity and Islam, how wine evolved, its nutritional value, the dangers of excesses, and other important aspects. It’s worth getting if you have an interest in the subject of wine.

Phytonutrients in Foods – Powerful Antioxidants

Phytonutrients that are found in wine, are constituents of plant foods. Phyto is a Greek word for plant and phytonutrients are the substances that give plant foods their glorious colours. The green in broccoli, the blue in blueberries, the yellow in pumpkin, the red in cherries, are all foods that are high in phytonutrients.

It’s only in recent years that scientists discovered phytonutrients (sometimes called phytochemicals) and there are four thousand (4,000) of them. Scientists admit that they know very little about them, and new ones keep emerging all the time. For example the compounds called Flavonoids are a large sub-group in their own right. But there are really too many phytonutrients to remember, unless you study food chemistry. So don’t worry about all the different names, just eat 5-6 daily serves of fruits, vegetables, and a little wine, and you will get plenty of phytonutrients.

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What has been determined though, is that people, who consume high levels of phytonutrients, are associated with lower levels of CHD. That’s because phytonutrients have powerful antioxidant qualities, which are anti-inflammatory agents that can protect the artery walls from free radicals.

Continuous activity by ‘free radicals’ in the arteries, produces by-products that damage the arteries’ inner lining. This causes inflammation of the artery wall. The body then activates a healing process by covering the affected area with a calcium/cholesterol material which we know as plaque. This process repeats itself many times, and the end result is arterioscleroses.

Fortunately the human body has its own enzyme systems, which produce antioxidants that ‘neutralise’ free radicals. However the principal source of antioxidants appears to be from fruits and vegetables.

Colours Are Important

As a rule, the richer the colour of any fruits or vegetables, the higher will be their antioxidants. So blueberries are near the top of the list, and potatoes are near the bottom. A red onion is higher up the list then a white onion. And the skins are important, because in an apple or a grape, most of the antioxidants are in the skins.

The next time you fill your supermarket trolley, just stop for a moment, and make sure that you have plenty of colours. And when you serve a plate of food, make sure its bursting with different colours. It’s not very hard to do, and it makes the plate look far more interesting. If you don’t do the shopping and cooking in your household, then have your partner read this section of the book.

And by the way, when we talk about fruits and vegetables, it’s preferable that they are fresh. You fallback option is buy frozen, and your last resort is canned or dried. So if it’s difficult to buy fresh blueberries and raspberries because they are out of season, buy frozen.

Phytonutrients are such a complex array of chemical compounds, that it’s difficult to put them into a capsule. Nevertheless, chemists and marketeers have been hard at work to produce phytonutrient supplements. For example, Resveratrol is the phytonutrient found in red wine that is now sold in capsules in a bottle. Resveratrol’s only ‘claim to fame’ is that it was found to be a component of red wine in a laboratory, and someone had the idea that maybe it was the magical ingredient that gave red wine special health properties. The fact is that resveratrol has never been shown to have any positive health benefits to humans if taken as a supplement. By the way, it won’t do you any harm; it’s just a waste of money.

There are thousands of different phytonutrients, and many work together as a team. That’s why supplementation with a single phytonutrient like resveratrol is likely to cause an overdosing/underdosing effect, which can leave you worse off. Also, why forego the joys of eating blueberries, cherries, raspberries, kiwi fruit and other delicious fruits and vegetables, and red wine, which are all rich in phytonutrients.

However, if you have a poor diet, or finding it hard to eat well, then consider taking dried foods like Wheat Grass and Spirulina that include all the phytonutrients as found in nature.

In summary, if the food on your plate looks white and anaemic, then it is.

The French cuisine is worth noting. It calls for generous servings of colourful fruits and vegetables, and eaten ‘in season’ when the phytonutrient levels are at their peak. Colours are the go!

Microwave Cooking Destroys Phytonutrients

A word of caution if you use a microwave. A study published in the Journal of the Science of Food and Agriculture in 2003 highlight some serious concerns with microwave cooking and its destruction of phytonutrients. Researchers from the Spanish Scientific Research Council CEBAS-CSIC found that microwave cooking destroys antioxidants in a big way. According to Dr. Cristina Garcia-Viguera, co-author of the study, microwaved broccoli loses 97% percent of the Flavonoids whereas steamed broccoli loses only 11%.

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So to preserve the phytonutrients in your fresh foods, your best option is steaming, then boiling, and your last option is the microwave.

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Unfortunately there is very little study done into the effects of microwave radiation on food, but the few that have been done are very condemning. These studies conclude that it’s in your best interest to scrap your microwave oven. Or, use it to heat your plates! On the other hand, conventional government and medical wisdom is reassuring, and tends to portray these concerns about microwaves as alarmist and pseudoscientific.

If you do a little research on the internet, and investigate the ‘dangers of microwave cooking’ then you can draw your own conclusions.

In Summary:

� The French Paradox was coined by Cardiologist Serge Renaud, of the University of Bordeaux. � Renaud reported that 2-3 glasses of red wine per day could reduce the risk of CHD by 40%. � The Copenhagen Heart Study also determined that moderate wine drinking increased longevity. � Research by Dr Edwin Frankel found that red wine is healthier than white. � Phytonutrients are constituents of plant foods that give plants their glorious colours. � Phytonutrients have powerful antioxidant qualities. � The richer the colour of any fruits or vegetables, the higher the antioxidants. � Antioxidants protect the artery walls from free radical damage, preventing CHD. � Microwave cooking severely destroys antioxidants according to several scientific reports.

CHAPTER 19 WINE ALLERGIES

In the previous chapter we looked at the beneficial properties of wine. However, some people have problems with wine, including headaches, sinus problems, flushing, and other negative reactions.

Wine allergies can be linked to some of the chemicals that are used in the process of making wine, and to a lesser extent the natural phytochemicals contained in the grape itself. Since most people can eat grapes without a problem, it would suggest that the phytochemicals in grapes are an unlikely culprit. Therefore the focus must be on the chemicals added during the winemaking process.

There is a long list of chemicals used in producing wine, and they include pesticides used in the vineyard, and sulphites used as preservatives during the winemaking process. No one really knows what part each chemical plays towards allergies, and in any event we know from research that people react differently. But at the end of the day if you suffer from wine allergy, that is the only thing that matters.

So let’s look at why wine can be a problem to sensitive wine drinkers:

Sulphur Dioxide, Sulphites, Preservative #220

Many people including myself are affected by Sulphur Dioxide. This is a chemical that goes under different names including “Sulphites” and “Preservative 220” that has proven to be a primary cause of allergies for wine drinkers. Note that any food additive number between 220-228 will be a type of sulphite.

As a rule, sulphite levels are higher in white wine than red wine, because red wine has natural tannins that act as a preservative. Another rule is that sulphites are highest in sparkling and dessert wines. This means that those affected by sulphites should consider drinking red wine first, then white wine, and avoid drinking dessert or sparkling wines.

Sulphites are measured in parts per million or PPM. In most countries a standard bottle of wine can have up to 250ppm of sulphites, and at that level a sensitive person can expect a nasty headache or sinus reaction after just one glass. Some winemakers try to get it below 125ppm. A low-sulphite wine would be less than 60ppm. As a rule, the traditional winemaking countries like France and Italy use less sulphites. This explains why some people can tolerate Mediterranean wines, but not some wines made in the USA and Australia where vineyards use more chemicals.

Oak and Fire Retardant Chemicals

It’s interesting that some people are sensitive to wines made with oak. This could be due to the natural tannins found in most timber and oak in particularly high in tannins. And unfortunately there are a number of nasty cleaning agents used to clean the inside of oak barrels.

There has also been a few cases of oak being contaminated with fireproof chemicals. There was an interesting news article called “Flame Retardant Chemicals Ruin Wine” that explained how researchers in Europe had found a chemical called 2,4,6-Tribromophenol in the oak used in wine transport and storage. This is a ‘fire retardant’ chemical used in wood furniture, building materials and other wood products.

I’m not suggesting for a moment that everyone should avoid oak-made wine, because wine and oak are virtually synonymous. But a number of people are clearly affected by oak and they need to know why.

Unwashed Grapes

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It’s wise to wash fruits and vegetables prior to consumption, to remove residues of pesticides that are implicated with diseases like cancer. However you may not be aware that the grapes used in winemaking are normally not washed. This may come as a surprise to many people, who would naturally assume that grapes are washed after picking but prior to vat fermentation, to remove all traces of pesticides. Sadly that is not the case. The obvious question is “Why not wash the grapes?” Unfortunately this is not possible, as grapes are

normally ‘machine harvested’. In machine harvesting, the grape skins are damaged by the picking equipment and grape juice is released. In other words, the collection containers are filled with damaged grapes in a sort of liquid mush, and there in no way that the grapes can be washed. There are a small number of boutique wineries that hand-pick and wash the grapes but they are the exception.

The solution to this problem is to use safer pest-control methods in the vineyard with materials that are organic, natural or GRAS. Similarly to use safer chemicals in the winemaking process for cleaning and production purposes. The good news is that there are quite a few wineries doing this.

Does Wine Contain Histamines?

This is a commonly held belief that is not accurate. Histamines are molecules released by the human body when exposed to some types of allergen which might be pollen, dust or sulphites. When the human body reacts to an allergen like sulphites, the immune system triggers a cascade of events, and one of those is the release of histamines by the cells and tissues, which cause the familiar redness to the skin, headaches or other. Histamines are a part of your immune system – but they are not in the wine. Some wines may contain small amounts of ‘amines’ but these are not histamines.

There is an ‘amine’ in wine called Tyramine that is known to cause headaches and ill effects in some people, by causing blood vessels to constrict, and heart rate and blood pressure to increase. It is found in wine, chocolate,soy sauce, yeast extracts, processed meats, and if these food affect you, then Tyramine is the likely culprit.

Wine does contain other trace phytonutrients such as tannins, salicylates and other compounds, and there are some people - statistically around 1% of the population - who have heightened levels of chemical sensitivity.

Ethanol Alcohol in Wine

Wine contains ethanol that the human body breaks down to its primary constituent – acetaldehyde - that is toxic in high concentrations. Acetaldehyde diffuses across the brain barrier and upsets delicate brain tissue that can lead to headaches. In those people with a healthy functioning liver, the acetaldehyde will be removed from the body before it any damage is done. At the quantities of 1-2 glasses of wine per day, the liver can generally clear the acetaldehyde without any problem, particularly if wine is consumed with food which delays alcohol absorption.

However there is an important caveat. Anyone who has had Hepatitis or some other liver disease at some stage in their life will usually have a weak liver. These people often struggle to break down ethanol quickly, resulting in the prolonged accumulation of acetaldehyde in the body. I have had patients in clinic with compromised livers, and my advice is to limit or avoid all alcoholic beverages. A simple blood test known as a Liver Function Test will readily establish whether your liver is healthy or not.

It’s also important to know that some ethnic groups are more affected by alcohol. People from Europe, who have been drinking wine since 2000 years BC, have genetically adapted to ethanol alcohol. However certain populations such as those of Asian descent, do not have the same genetics for the metabolism of alcohol. These populations have a higher likelihood of experiencing facial redness and flushing, heart rate fluctuations, and symptoms of reduced blood pressure. This is sometimes referred to as 'oriental flushing syndrome'. It is due to a deficiency in the enzyme that breaks down alcohol and consequently acetaldehyde remains in the bloodstream for longer periods. Rough estimates suggest that 50% of Chinese, Japanese, and Koreans are partially deficient in this enzyme.

Screw Caps and Corks

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This is a winemakers’ hot topic. The traditional cork as we know it, has been used for centuries. It allows the wine to breath, and helps the wine to improve over time. However it has a real problem. Cork is a natural product and can cause the tainting of the wine with a bad taste and smell. Statistically it happens 1-in-16 bottles which means that 1 bottle in every 16 is a dud.

That’s a very high risk especially if you have bought a premium wine. For the technically inclined, it occurs when an airborne fungus combines with chlorine molecules, and the subsequent reaction causes the musty taste and smell known as ‘cork taint’. The obvious question, is where do the chlorine come from? It’s found in cork trees that have absorbed pesticide organochlorides such as Chlordane, DDT, and Heptachlor.

The newer Diam cork developed in France fixes the tainting problem. It is a re-manufactured granulated cork which has been sterilised with super-critical Carbon Dioxide CO2 that kills the fungus. However, only a small number of wineries are using Diam corks at this time.

It is clear that the newer screw type closures like the Stelvin cap are gaining acceptance all around the world. Whilst it takes away from the tradition of pulling a cork, this invention does provides a perfect sterile seal, it allows the winemaker to use less sulphites, and it can be opened by a simple twist of the wrist. I personally prefer wines with screw type closures.

Low Preservative and Organic Wine

There are wineries that utilise traditional and sustainable agricultural methods, and produce wines with little or no synthetic chemicals. They specialise in products that appeal to the health-conscious consumer. These wineries have a strong focus on soil and environmental sustainability, and all winemaking equipment is cleaned with environmentally friendly materials.

These wines are usually of very high quality, and may be a little more expensive, but cheap when you consider the significant effort that goes into making such wines. These wines are often made by small boutique wineries and their smaller output means that it is unlikely that you will find their wines in your local wine shop. It’s therefore best to buy these wines direct from the wineries and have them delivered straight from their cellar to your door.

Final Summary

It’s clear when we look at the facts, that wine has certain medicinal qualities. But it is not suitable for everyone.

On the positive side, we have a beverage that is extremely rich in the Flavonoids and thousands of other phytonutrients that provide significant anti-oxidants to assist our health. Wine provides a rich array of trace minerals and vitamins that we need on a daily basis. There are also studies to support the fact that small quantities of ethanol alcohol can act as a relaxant and vasodilator to reduce cardio stress. In other words, in its purist form as a wine with no added chemicals or preservatives, and in moderate quantities, wine qualifies as a medicinal tonic that can contribute to our longevity.

However there are some precautions. All alcoholic beverages require the breakdown of ethanol alcohol in the human body that the liver must detoxify. This can be a problem for anyone with an impaired liver, or for those with a genetic background that is lacking in the enzymes needed to handle alcohol. And there is the question about farm chemicals and sulphite preservatives.

With this extra knowledge about wine, hopefully you can decide whether wine is appropriate to you and your family.

In Summary:

� Sulphites are the biggest causes of allergies. � Ethanol alcohol affects some population group � Screw cap wine closures are allowing wineries to reduce the use of sulphites.

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� Try to buy wines that are made with little added chemicals.

CHAPTER 20 INFLAMMATION IN THE ARTERIES

There is a lot of confusing information about the causes of CHD, and doctors themselves disagree over the causes.

What is universally accepted is that CHD involves the build-up of fatty materials within the walls of the coronary arteries. Fatty looking plaques develop which narrow the interior diameter of the arteries, reducing the opening through which blood can flow. Plaques are of course just the tip of the iceberg, and these patients have arteries that are unstable and prone to inflammation, with all sorts of consequences.

In short, these patients have arteries that are problematic. That’s because the surface of a plaque can rupture causing a blood clot to form. And if a blood clot totally obstructs an artery, then heart muscle cells downstream are deprived of oxygen, and when this occurs, it is called a heart attack.

But what causes these plaques to build up in the first place?

Many Cardiologists now accept that these plaques are caused by inflammation in the arteries, but there is considerable conjecture about what causes the inflammation. Some of the reasons we discussed earlier, was hydraulic wear and tear, oxidised LDL in the artery wall, elevated Homocysteine levels, viruses and other organisms, and chemicals.

The French Paradox highlights the fact that there is a very strong association with inflammation in the arteries, and the foods that we do or don’t eat. Therefore we need to look at inflammation as a specific condition in its own right.

You may not have given much thought about inflammation, which occurs in any part of the body that experiences an injury. For example, we witness inflammation to our skin when we get sunburn, a skin rash, or an infected wound. The inflamed skin is characterised by being red, painful, and swollen.

Inflammation is a key process of our immune system, which protects us from diseases and injuries, and most inflammation tends to clear up in a few days.

You will know when your doctor diagnoses inflammation, by the use of the word ‘itis’.

For example, our skin which in medical speak is Derma, becomes Dermatitis when inflamed. Our joints which in medical speak is Arthro, becomes Arthritis when inflamed. And when the bronchial tubes get inflamed, we have Bronchitis.

The term itis simply means inflammation, but it does not explain the cause of the inflammation. When your doctor says you have bronchitis, it simply means your bronchial tubes are inflamed, but he may not know what the cause is.

Food can cause inflammation. I remember some years ago my father-in-law started to get arthritis in his ankles, and his doctor suggested he might be reacting to wheat. So he shifted to eating only rye bread, and the arthritis condition cleared completely. This is an example of how an allergen in food can cause inflammation.

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The lack of certain foods is another trigger for inflammation. The simple absence of Vitamin C (including the Citrus Bioflavonoids) in the diet, from a lack of fresh fruits and vegetables, caused early British sailors/explorers to die of scurvy after only two months at sea. The lack of vitamin C caused extreme inflammation of the arteries and blood vessels, causing sailors to die an agonizing death.

Clearly, if the lack of Vitamin C causes inflammation to your veins and arteries resulting in scurvy, then you can understand how people who consume too little Vitamin C, may develop ‘low grade’ inflammation in their arteries. And that’s what Dr Matthias Rath in Germany discovered from his research. That people who don’t get enough Vitamin C in their diet, are susceptible to inflammation of the arteries, which can lead to a build up of plaque, leading to CHD.

French and Mediterranean diets have always included fresh citrus fruits which are consumed on their own, or used regularly in cooking. By the way, citrus fruits contain both Vitamin C and Citrus Bioflavonoids, and these together eliminated scurvy and other diseases. So Vitamin C is really just a general term to describe the combined Vitamin C/Citrus Bioflavonoids, and any supplements that you buy should always include this combination.

So as you can see, a lack of vitamins in our diet can cause inflammation to our arteries. Vitamin B6 and Folate deficiency, and its effect on elevated Homocysteine levels, is another trigger that can cause inflammation to our arteries as we saw in Chapter 11. And in the preceding chapter, we looked at how a lack of phytonutrients can allow ‘free radicals’ to run wild, causing damage to our arteries.

So in the typical western diet there are a number of triggers that may inflame your arteries, and each one can do damage. If you have a number of these triggers acting concurrently, then the severity of the inflammation will be worse.

The French cuisine however, provides the nutrients needed to avoid inflammation in the arteries. There are of course other countries like Australia and Italy that eat lots of fresh foods, and who also enjoy low levels of CHD too. But the French stand alone, because of the fact that they eat lots of saturated fats and cholesterol, which are supposedly bad for us. So the importance of the French Paradox, is that it has helped us to stop worrying about fats and cholesterol, and concentrate our efforts in eating generous quantities of fruits, vegetables, and a little bit of red wine.

So a high priority should be to improve our food intake, and try to ‘turn back the clock’ on years of bad dietary habits. And that means we need to understand the differences between foods that heal, and foods that inflame.

Foods That Heal & Foods That Inflame

Some foods are very healing to the body. These are the natural foods like fresh fruits and vegetables. There are other foods that are associated with long term chronic conditions like atherosclerosis and arthritis. These are foods that have been nutritionally depleted through extensive processing, contain oxidised lipids, or trans fats.

Once you get your mind around how foods that are closest to Mother Nature, have healing properties, and those furthest away from Mother Nature can potentially cause disease, then you will understand what you need to do to avoid CHD. The French cuisine relies heavily on fresh foods, which are much closer to Mother Nature then the typical western diet.

Let’s start by looking at examples of foods that appear to have healing qualities that contribute to good health. They are the foods you may have read about in some of the popular diets like Macrobiotics and the Raw Food diet:

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Foods That Heal

These are the foods closest to what Mother Nature intended. Some examples are:

Fresh fruit Eat up to 4-5 pieces per day, spread throughout the day Freshly squeezed juices Fresh means juiced in a juicer and consumed immediately Fresh vegetables raw Raw carrots, lettuce, tomatoes, greens etc Raw fish Sashimi and sushi are good examples Raw or rare beef Carefully prepared using prime quality meats Yoghurt Must have live cultures Butter Unpasteurised if available, else pasteurised Honey Unpasteurised Active honey from New Zealand is one of the best Fermented cheese Naturally fermented cheese made only from milk, salt and rennet Extra virgin olive oil Cold-pressed olive oils without any processing Nuts and seeds Raw unprocessed Red wine High in phytonutrients

Foods Causing Inflammation

On the other end of the spectrum are foods that are associated with inflammation and chronic disease. These are foods that contain trans fats as found in most baked goods like cookies and cakes. They are the highly oxidised foods such as air dried powdered eggs where the cholesterol is exposed to lots of oxygen. And it includes rancid fats and oils that have oxidised, such as those found in the deep fryers used in cafes and take away food shops. Examples are:

Powdered eggs Used in some packaged foods, and in restaurants French fries (chips) Cooked in trans fats or interesterfied fats Fast food meals Loaded with highly processed oils and fats White flour Totally depleted of all nutrients from processing Instant mash potato Totally depleted of all nutrients, with added chemicals Salad dressings Most dressings are high in processed fats Margarine Heavily processed vegetable oils Vegetable oils Liquid polyunsaturated oils found in clear bottles Vegetable oils (solidified) Heavily hydrogenated with trans fats

These are just a few examples of the foods that can cause poor health and trigger the mechanisms that can lead to inflammatory diseases. These foods should be eaten rarely.

Foods In The Middle

Most foods are somewhere between these two groups. These are foods that have undergone some amount of cooking or processing. They do provide valuable sources of energy, vitamins, minerals and other important nutrients. Some examples are:

Steamed Vegetables Better than boiling them in water Oven baked beef Cooked at moderate temperatures Boiled Egg Boiling limits the max temperature Poached Fish Poaching fish in water, limits the max temperature Bread Try to buy the ones with no added chemicals

84Dried Fruits Choose the sun dried type; avoid those with preservatives

Soups Valuable source of minerals particularly if home made

This list of Neutral foods is only an example, to give you the idea. These neutral foods provide important nutrients.

It’s very difficult to be prescriptive when it comes to food, and it’s a complex subject as well. The main purpose of this chapter is to provide some examples to help you develop a framework in your mind, about the role that food plays in CHD and other chronic diseases.

One Person’s View

It’s interesting how people view what is healthy or not. In our family a typical day may mean a couple of boiled eggs for breakfast with rye bread and a cup of tea, mid morning some fresh fruit or nuts, at lunch maybe a tuna sandwich with a freshly squeezed orange juice and an espresso coffee, mid afternoon some fruit or nuts, and for dinner maybe salmon and vegetables and a tossed salad and some red wine.

Yet I was reading a small booklet, written by someone recommending ways to eat properly to avoid CHD, and it was completely lacking in fresh foods. The recommendation for breakfast was Egg Beaters (egg whites in a carton) and a cranberry muffin with pre-made orange juice, for lunch a Veggie Burger and canned soup, and for dinner Pasta with Tomato Sauce and six slices of bread, and some snacks during the day including popcorn, low fat cookies, and some bread with cream cheese.

This form of daily food intake can cause arthritis (too many wheat products) and CHD (no fresh fruits or vegetable to provide phytonutrients). Not surprisingly the writer of the book had suffered from arthritis and heart disease for many years. Certainly this person’s intake was better than a diet of waffles, cokes, chocolate bars, cakes, hamburgers, fries, milk shakes, sundaes etc which some people eat each day - but it is still a long way from what the French consider proper food. I’m not mentioning this to undermine this person’s efforts, which are commendable in terms of changing habits developed over many years, but merely to highlight how far society has deviated from fresh foods to packaged foods.

My Cookbook Recommendation

If there is one cookbook that I would recommend, which will heighten your knowledge of good nutrition including many of the traditional ways of cooking, then its Sally Fallon’s book called Nourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and the Diet Dictocrats published by New Trends Publishing. It’s a powerful 600+ page book with some 700 recipes. I bought my copy in the USA, and you can also buy it in Australia.

If you are serious about avoiding CHD, then you will need to expand your knowledge about foods that are associated with health. It’s not the purpose of this book to provide recipes of French cuisine, as there are many wonderful cookbooks available. Books do vary from country to country, so my suggestion is to visit your local bookstore, and select one of the better French or Italian cookbooks that you find on the shelf.

Interesting Diets

In addition to the French cuisine, there are many cuisines from other countries that reduce the risk of inflammation in your arteries, and the Mediterranean countries have a good reputation in this regard. Furthermore, a number of interesting diets have emerged, that focus on good food and good health. Many of these have a strong following, and its all part of a broader education for understanding the alignment between good food and good health. Personally I don’t like diets, which are generally conceived by individuals and tend to come and go, whereas cuisines are based on time proven traditions that have evolved over many centuries. For example the French cuisine, the Italian cuisine etc.

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However let’s take a few moments to look at a few of these diets, to round-up our understanding of how bad foods cause inflammation, and how good foods can reduce and even eliminate inflammation:

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Pritikin Diet - The first person that I remember who really impacted our views on food and CHD, was Nathan Pritikin. He emerged in the 1970’s and believed that heart disease was caused by too much fat in the diet. Pritikin was convinced of the merits of the low fat diet, and he did a good job in educating people to eat as little fat/oils as possible, recommending that your diet contain only 10%. Although today many experts consider his diet too extreme, he nevertheless deserves credit for getting a lot of people thinking and questioning the food that they were eating. He was an early catalyst for change in our dietary habits, and deserves a lot of credit for his getting ‘the ball rolling’ as far as food was concerned.

Macrobiotics – Mr. Michio Kushi introduced Macrobiotics in the 70’s. Macrobiotics is based on the ancient Oriental principles of Yin and Yang. It is based on cooking fresh foods that are ‘in season’ to promote good health, and to promote harmony with our environment. In that regard it is similar to the French philosophy of buying lots of fresh food in season.

Macrobiotics followers believe that "you are what you eat" and that foods affect who we are, and how we feel, act and react. Macrobiotics taught us about foods that heal (i.e. anti inflammatory) and foods that cause sickness (i.e. inflammatory). The Macrobiotic diet is highly recommended for people suffering from chronic conditions or ill health. It’s also highly praised by people who have had a scare with cancer and needed to detoxify their bodies. Mr. Michio Kushi has written some interesting books and one worth getting is The Macrobiotic Path to Total Health.

Hay Diet -The Hay Diet has some very smart principles which I personally like to adhere to. It was named after Dr William H Hay, a practicing medical doctor who lived in the USA from 1866-1940. He discovered something about digestion that is really important, but not well known. That is, if you eat a meal with heavy protein foods (i.e. beef, lamb, pork) together with starchy foods (i.e. bread, potato) then you will likely suffer from indigestion and heartburn. If this happens too regularly, then it will lead to a host of inflammatory diseases like irritable bowel syndrome, arthritis, asthma, heart problems, eczema, itchy scalp, psoriases etc. These conditions generally appear as we become older, in our late twenties and older.

Hay determined that the digestive juices produced in the mouth (i.e. saliva) are meant for digesting starches and these juices are alkaline. On the other hand, the digestive juices produced in the stomach are for digesting proteins, and these juices are acidic. Unfortunately, when you combine proteins and starches in the same meal, then the stomach will contain both alkaline and acidic digestive juices, and they neutralise each other, and become ineffective. The result is very poor digestion, and the bigger the meal, the poorer the digestion. This is why heartburn is more likely to occur after a big dinner. What happens thereafter, is that the undigested proteins move further along the digestive tract (which is poorly equipped to digest proteins) causing inflammation to the intestinal wall.

Digestive disorders like irritable bowel syndrome, bloating etc are the first signs that something is amiss. However, for reasons that are not well understood, the inflammation can later move beyond the gut, and move further into the body, leading to inflammation in other parts of the body which manifest themselves as arthritis, asthma, eczema, itchy scalp, psoriases, and possibly even inflammation in the arteries.

And that’s why a hamburger which is essentially meat and bread, or foods like spaghetti and meat balls, cause bloating in many people, because they combine the worst two foods, meat and wheat.

Whether Dr Hay was completely correct in his theory that acidic and alkaline digestive juices neutralise one another, may be arguable. But make no mistake, Dr Hay’s principles of ‘not combining’ protein and starches at the same meal was an awesome discovery, and one that has brought good health to countless people who swear by his teachings.

I was absolutely amazed at how effective the Hay principles proved to be. Over the years I had suffered from occasional bouts of digestive discomfort and was never too sure why they occurred. By adopting the simple changes recommended by Dr Hay, these symptoms disappeared. I have also been amazed by a number of colleagues who have followed the Hay Diet, and been blown away by the results.

The ‘bottom line’ is to avoid eating heavy protein foods like meat, with starches like wheat. If you think this is all a bit far fetched, then see if you can think of any animal species in the world that eats meat and starches at the same meal? There is none.

Interestingly, Hay was an American doctor, but it was the British who picked up on his works, and most of the books I have read on Dr Hay, come from the UK. The book called “Food Combining for Health” by Doris Grant is one such book. It’s surprising that his teachings are not more widely understood, because many people have eliminated digestive disorders and other inflammatory ailments, by adopting his simple principles.

Raw Energy Diet - The Raw Energy Diet emerged from the UK in the 1980’s. It was written by author Leslie Kenton who adopted some of the principles from Dr Hay in regards to combining foods, and she added her experiences with raw food.

Her book focuses particularly on enzymes which are present in living raw foods, and their role in the maintenance of optimum health. She investigates why humans are the only species which cook their food, and encourages readers to include raw food in their daily diet. Her ideal objective is for people to consume around 3/4 of their total diet in the form of raw food. Although that’s probably impossible for most people to achieve, it does serve to remind us that raw food should be part of our daily diet. Accordingly, the consumption of 4 to 5 pieces of fruit per day would be an ideal way of ensuring some reasonable daily intake of raw food.

Leslie Kenton later went on to write other books such as The New Energy Diet, The Raw Energy Bible, and The X Factor Diet.

In more recent years, we have seen some excellent diets emerge such as The Atkins Diet, The Zone Diet, The South Beach Diet, as well as books written by Dr Andrew Weil, Dr Joseph Mercola and others. Each has contributed excellent ideas that you can draw from, to suit your own needs.

Of course, there are critics for all these diets. I personally find it disappointing to see the comments by some reviewers, who condemn some element of these diets, and thereby insinuate that the diet is a waste of time. In doing so, these criticisers detract from the fine work that the authors have conducted, and miss the overall point. The point is that the subject of food is very complex, and most of these diets introduce some excellent ideas to help expand our overall knowledge base.

Eating Out / Travelling

As you know, it’s difficult to eat well all the time, particularly when you’re out and about. The food outlets in your community or near your office are generally less of a problem, because you know them, but it gets very tricky if you are travelling away from home. In these situations you often have to take ‘pot luck’.

I’ve successfully managed the art of eating dinner away from home, and most often I get it right. Let me share with you my approach.

When I’m travelling and eating at the hotel, or visiting a restaurant in another city, I’ll often ask the waiter if the chef can prepare something simple for me, and it sounds a bit like this:

“Is it possible for you to grill me a piece of fish or steak without anything on it whatsoever…. no flavouring salt or sauce on top……served with some steamed vegetables without any dressing or garnish whatsoever……a bread roll with some olive oil on the side would be nice…..and a glass of red wine”.

I’ve never had a problem with this request, because it’s so simple, they think it’s terrific. The focus here is on getting fresh food that the chef needs to cook up on the spot, and by keeping it really simple.

The worst thing you can do is order dishes off the menu like Shepherds Pie, Baked Fish with Mornay Sauce, Lasagne etc, as you have absolutely no idea what you’re getting. Most likely it will be laden with dangerous trans fats, cheap processed cheeses, and a potpourri of ‘catering quality’ inputs like processed meats and pre-prepared vegetables, often boosted with food chemicals as flavourings, tenderisers, and preservatives. The odd meal like that isn’t going to hurt you, but if you eat out regularly, then it will take its toll.

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The main purpose of this chapter, was to provide a ‘heads up’ on how bad foods trigger inflammation within the body, including the arteries.

In Summary:

� CHD is caused by inflammation in the walls of the arteries. � Fresh fruits and vegetables reduce inflammation. � Deep-fried foods are cause inflammation. � Dr William H Hay’s food combining principles are very important. � Sally Fallon’s Nourishing Traditions is an outstanding cookbook.

CHAPTER 21 OILS & FATS (LIPIDS)

It is absolutely essential for anyone concerned about CHD to have a basic understanding of oils and fats. They are at the ‘centre stage’ of heart disease, yet are the least understood food group in our diet. Even health professionals receive little education on this subject and consequently there is a lot of confusion about the value of oils and fats.

We mentioned earlier that inflammation in the body is caused by what we eat, and what we don’t eat. This applies especially to oils and fats which make up a substantial 20-40% of our calorie intake. Some oils and fats are very healthy and some are not.

Whilst laypeople call them fats and oils, chemists prefer to call them lipids, and both are correct terms to use. Another thing to know is that the difference between oil and fat is merely a reflection of temperature. For example, olive oil is oil in your kitchen cupboard, but becomes a fat if you place it in the fridge.

There are four Natural Lipids in our food supply and these are the ones eaten liberally in French cuisine and shown in the left column below. And there are two Un-Natural Lipids in our food supply and these are shown in the middle column below:

Natural Lipids Un-Natural Lipids Sources

Omega 3 Oils eating fish and flaxseed

Omega 6 Polyunsaturated eating seeds and nuts

Omega 9 Monounsaturated eating olive, sesame, canola oils

Saturated Fats eating beef, lamb, pork

Hydrogenated / Trans Fats made from seed oil hydrogenation

Interesterfied made from seed oil interesterification

The Un-Natural lipids are the problem ones, as shown in the middle column. These are the hydrogenated oils that contain trans fats, and the newer Interesterfied oils that have been developed as their replacement. Many people actually believe that these Un-Natural oils contribute to good health, because they are made from canola, safflower, peanut, and cottonseed oils, when in fact, nothing could be further from the truth. The fact is that these oils undergo a complex chemical process to change their molecular structure, to make them virtually indestructible, and to provide them with a long shelf life. However they are a disaster to our health.

So let’s start our journey in this really important subject of oils and fats:

Omega 3 Oils

We’ve all heard about Omega 3 oils which are found in many cold-water fish, and in certain plants. What is less commonly known is that patients who survive heart attacks in Europe, are typically given Omega 3 oils to improve their survival rates. That’s because Omega 3 oils are anti-thrombotic which means that they reduce the likelihood of blood clotting, and they are anti-inflammatory and reduce the inflammation levels in the arteries.

Omega 3 is comparable to anti-freeze, because it is stays liquid even at temperatures down to -11ºC (12ºF) which is pretty cold. That’s why fish rich in Omega 3 can swim in freezing waters and not go stiff.

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But Omega 3 oils are highly reactive to oxygen and oxidise (go rancid) quickly when exposed to air. So we need to get them from the food we eat, to ensure they don’t get a chance to oxidise. Fish is a great source. If you don’t eat fish then you should take Fish Oil capsules containing the essential Omega 3 fatty acids known as EPA and DHA. The fish oil capsules sold in supermarkets and health food stores are just fine provided you buy a reputable brand. Adults should take 4-5 capsules, or if you prefer the fish oil in the bottle, take one full teaspoon. Please note that the oil in the bottle starts to oxidise after opening so consume it within 20 days.

Certain plant seeds like the Flaxseed contain a lot of Omega 3. You can buy Flaxseed oil in health food stores, where it is packaged in tightly sealed containers in the fridge, with the oxygen removed and replaced with nitrogen or some other inert gas. Again, consume it in 20 days after opening or place it in the freezer and it will keep somewhat longer. The Omega 3 oil found in Flaxseed is a little bit different from that found in fish, so make sure you still eat some fish or take fish oils.

Please note that anyone taking aspirin or warfarin should check with their doctor before taking Omega 3 supplements, as it is possible to take too many ‘blood thinning’ agents at the same time.

Polyunsaturated - Omega 6 OIls

We all know about the polyunsaturated seed oils such as sunflower or safflower. Chemists are likely to call them Omega 6 oils.

For a number of years, these oils were enthusiastically recommended by health authorities such as the NHLBI and the American Heart Association. They were the ‘Holy Grail’ of oils for a long time and then suddenly dumped. What went wrong?

Polyunsaturated Omega 6 oils are actually very good for you, provided they are contained in the foods they come from, like eating sunflower or safflower seeds. When these oils are within their seeds, and away from air, they keep fresh and don’t oxidise. Sunflower or safflower seeds are a healthy snack, and you can spoon some on to your breakfast cereal, or blend into a smoothie.

Most people buy these polyunsaturated oils at the supermarket, and restaurants buy them in large drums which are labelled Blended Vegetable Oils. Unfortunately these oils are dangerous to your health and its worth knowing why.

Omega 6 is a highly reactive oil that oxidises rapidly once pressed from the seed, and consequently become rancid. Therefore this oil needs to be processed and sanitised, which involves a multi-stage industrial process that goes like this:

The seeds are firstly ground by a grinding machine, and then steam cooked, and thereafter mixed with solvents to dissolve out the oils. The most popular solvents are Hexane or Trichlorethylene and both are very carcinogenic. The oils and solvents are then separated, and manufacturers say that only traces of Hexane remain in the oil. The oil is then refined with the addition of sodium hydroxide and temperatures are increased to over 200ºC / 400ºF. Thereafter the oil is treated with carbon that removes all the Vitamin A, E, F, Beta-carotene, Lecithin, Chlorophyll, and other nutrients. Preservatives and/or anti-oxidant additives like BHA/BHT (butylated hydroxytoluene) are then added. The net result is a sterile oil that’s has a strong association with disease including Cancer, Macular Eye Disease, Diabetes Type 2, and CHD.

The above is only Phase 1 in the process. If the oils need to be made into margarine, or deep-fry oil, or some other specialised product, then it must be subjected to another round of chemical processes known as hydrogenation or interesterfication.

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It’s amazing that after twenty years of listening to the experts about the wonderful properties of these oils, that they have now been sidelined without an apology. If the health authorities on whom we rely, had simply studied the research data properly in the first place, focusing on the difference between oils in their seeds and oils processed in a factory, then a number of people could have avoided many diseases.

Monounsaturated Oil – Omega 9

Oils that are high in monounsaturates are always your best choice, because they are the most stable since they don’t oxidise readily.

The two most trusted monounsaturates are olive oil and sesame oil. In the Mediterranean countries, olive oil is used extensively in many dishes, and sesame seeds are crushed into an oily paste called Tahini which is used in cooking and as a sauce. In Asia, sesame oil is very popular and adds wonderful flavours to many Asian dishes. Canola is a more recent invention from North America.

Olives and sesame seeds are unique because they can be cold-pressed and produce a very good yield of oil. This ease of extraction is why olive and sesame oils have been popular for thousand of years. The only difference today, is that powerful hydraulic presses are used to squeeze out more of the oil, providing a higher yield. But the resulting oil is the same. Let’s review these three oils in more detail:

Extra Virgin Olive Oil has been popular in Europe and is as old as the bible itself. Extra Virgin olive oils are extracted by hydraulic cold-pressing, whereas the Classic and Light versions are extracted using chemical solvents and should be avoided.

Extra Virgin olive oil is great on salads and with bread. It can be used for general cooking including baking cookies and cakes, because the natural olive aroma evaporates during baking.

Be careful if you use it for frying, because it has a low burning point, so you can damage the oil in a very hot frypan which introduces carcinogenic properties. For that reason, the French prefer to use heavier fats for frying like butter, duck fat, and lard, which handle higher temperatures.

Olive oil is 16% saturated plus 72% monounsaturated, and that means 88% of the oil is extremely stable. The remaining 12% is polyunsaturated oil and this is a very small component of the total. That is why olive oil is so stable and does not go rancid.

Canola Oil is a widely used monounsaturated oil, although its health properties are somewhat questionable. It’s been heavily marketed with all sorts of claimed benefits, and the odd Spin Doctor has even suggested that it’s better then olive oil. Those statements are high on marketing, but low on facts. Let’s understand why:

Canola is around 64% stable monounsaturated oil, and 36% ‘reactive’ Omega 3 and 6 oils which oxidise very quickly once pressed from the seed. So unprocessed Canola turns rancid quickly, and therefore needs to be processed in the same way as the safflower/sunflower oils mentioned earlier. That means Hexane is used, all the Vitamin A, E, F, Lecithin, Chlorophyll removed, and unhealthy anti-oxidants are added. The net result is a product that is highly processed.

The history of Canola has its foundations in Canada, and is the marketing name given to genetically modified Rapeseed oil, which was industrial grade oil. However, through genetic engineering, this oil was made acceptable for human consumption. But it needed to be renamed, because the marketing people had difficulty in working out how they might sell “genetically modified rapeseed oil”. That was never going to fly. So they came up with the name “Canola” which was derived from “Canadian oil”.

Canola’s success has been driven by the food manufacturers’ in North America, who required a cheap monounsaturated oil as input into the food manufacturing processes. Canola oil could be grown locally, and was inexpensive.

You can assume that virtually all vegetable oils (soy, corn, peanut) are processed similarly to Canola so keep their consumption to a minimum. By the way, I am told that cottonseed oils are the very worst to eat because cotton crops are sprayed with large amounts of extremely dangerous chemicals.

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Sesame Oil has been very popular with Asian cuisine and is available in both cold-pressed and refined versions. Cold-pressed sesame oil is produced by mechanically pressing the seeds. No chemicals are used to extract this oil. The resulting Sesame oil has a lovely natural caramel colour and contains all the original nutrients.

Sesame has a strong aroma and is excellent for wok cooking. You will find that sesame oils come in both light and dark versions. The dark version comes from toasted sesame seeds and has a very intense flavour which adds to wok style cooking. However the light version is more versatile as you can use it more widely. Sesame is a very stable oil which is attributed to a phytonutrient called sesamin that acts as an antioxidant.

The main problem with Sesame oil is that the labelling is not clear, so you’re not always sure whether it’s cold-pressed or not. So I personally prefer Olive oil because it’s always clearly labelled.

Sesame oil has a long trusted history having been used for thousands of years.

Saturated Fats

When we think of saturated fats, we often think of foods like butter and cheese.

Saturated fats have been blamed for causing heart disease, because they contain cholesterol. The theory is that butter contains cholesterol, which causes heart disease.

But how real is all this? Let’s take a look:

A kilo of butter, which would easily take you a month to consume, contains just 3 grams of cholesterol. That’s the same amount of cholesterol that your body makes every day. Consequently the amount of cholesterol in a few teaspoons of butter per day, is negligible.

Butter also has 40% saturated fat, which is supposedly bad for you. Unless you are French. The French cuisine is generous with butter and cream, and other foods that are high in saturated fats, and the French don’t seem to be getting too much heart disease.

Many people now realise that they have been duped into eating margarine, which is a man-made fat. Consequently, there is now a movement back to natural butter, and away from heavily processed margarines that have a strong association with various cancers.

One fact that few people appreciate, is that the cells in the human body are so reliant on saturated fat, that if you don’t eat it, the body will make it. That’s because the cells in the body require lots of saturated fats to maintain the rigidity of their outer wall, and also to repair themselves. This requirement for saturated fats starts at birth, which is why babies need large amounts of saturated fats to ensure healthy cell development. And why mothers’ breast milk is mostly saturated fat.

Butter can safely be eaten and current thinking is about 1/3 of your fat intake can be the saturated type.

In summary, saturated fats do not cause inflammation within the body, including atherosclerosis. Margarines on the other hand are highly processed vegetable oils, which are associated with a number of inflammatory diseases.

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Trans Fats / Hydrogenated Vegetable Oils

Hydrogenation was a process invented by chemists, which converted liquid oils into a solid fat. The aim was to produce a solidified vegetable fat that was similar to butter and lard, but cheaper and with a longer shelf life.

A consequence of the hydrogenation process is a rather unusual fatty acid called ‘trans fats’ that the human body cannot handle. It’s an impostor fat that gets into the cells of the human body where it does considerable damage. If you have ever had a racoon inside your house you’ll get some idea of the damage it can do. The biggest danger from trans fats is damage to the DNA in the cells.

Trans fats are created when oils are heated to 380 degrees Fahrenheit along with a nickel catalyst, changing the molecular bonds, that turns the oil into a fat. This hydrogenation process is used to solidify vegetable oils to produce margarine, mayonnaise and other high-fat products. The hydrogenation process is readily adjusted to produce the exact level of ‘speadability’ of these products.

For anyone interested in chemistry, the abnormality occurs at double bonds between carbon molecules. Mother Nature only makes what are called “cis” double bonds where hydrogens - attached to carbons at both ends of the double bond - are both on the same side of the molecule. This creates a geometric bend of about 30 degrees at the bond. In the trans double bond the hydrogens are on opposite sides of the molecule which causes the normal bend at the double bond to straighten out into a “trans” configuration.

As most readers now know, trans fats have been identified as a health disaster, and their use is being progressively restricted in a number of countries. Denmark was the first country to restrict their use.

These molecularly modified fats are simply unsuitable for human consumption. Research shows that even 5 to 10 grams of trans fats daily (1-2 teaspoons) will greatly increase your chances of heart disease if you are a male. For women, the concern has more to do with breast cancer. Also, for reasons not fully understood, people who eat trans fats show a much higher tendency for Diabetes Type 2.

Trans fats are found in most baked goods, (i.e. cakes, cookies, biscuits, donuts, packet chips, crackers, tortillas etc) which are tempting foods that we all like to eat. I don’t believe food manufacturers ever intentionally added trans fats to foods, as they were discovered some years later as unintentional contaminants of treated vegetable oils. However the alert on trans fats occurred 25 years ago, and nothing has been done until recently.

At this time the only stance taken by the US Food and Drug Administration is that the ‘intake of trans fats should be as low as possible’ which really means ‘avoid them at all costs’. The reason given by some industry observers, to explain why the US FDA is slow to ban trans fats, is to give industry time to introduce a replacement.

Vegetable oils containing trans fats are used in fast foods outlets, in company canteens, and even in some top restaurants. They come in large drums marked ‘edible vegetable oils’ and are used for pan frying, deep frying, baking cakes and pastries etc.

You never know how much trans fats you’re eating, when you’re eating out. How much trans is in a Shepherds Pie or Fried Rice? That’s the reason why many travelling business people, show a higher propensity for heart disease and Diabetes Type 2, because restaurants use cheap vegetable oils, instead of the more expensive olive oil or butter. A study in 2005 showed these levels of trans fats in popular foods:

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One (1) Serve Trans-fat Per Portion

French Fries 7.8g

Doughnut 5.0g

Cake 4.3g

Potato Chips 3.2g

Cream Biscuit 2.0g

Studies show that just 10 grams of trans fats will greatly increase their chance of a heart attack, but you can see from the above table how easy it would be to consume 20-30grams.

Needless to say, French cooking does not used trans fats. They use normal healthy fats like butter, olive oil, and goose/duck fats and others, that the human body is able to metabolise, because it is in a form that Mother Nature intended.

It was encouraging to see the US Food and Drug Administration (FDA) dictate the mandatory labelling of trans fats on food labels from January 1, 2006. Unfortunately Australia has been ‘dragging the chain’ on trans labelling, and this continue to be a concern to consumers.

There is no doubt now, that trans fats were the ultimately travesty, of an important food group that we call fats and oils. But don’t think that the vegetable oil processors are about to give up their marketplace yet, and allow is to eat the traditional fats and oils that our forefathers used for countless centuries. Trans fat may be on its way out, but its replacement is another factory-made solid oil using a process called interesterfication.

Interesterification / Interesterfied Fats

The problem with trans fats has been known for some years, and consumers are now paranoid about the dangerous health consequences. To fill the void, chemists were busy perfecting a replacement. They needed a low cost way of making a butter-like product from vegetable oils, but without the trans fatty acids, that could be used for making cookies, cakes, pastry, deep frying etc.

The solution lay in a process called interesterification, which has been around for a few years, but had not been commercially exploited. It uses enzymes to change the molecular structure of a vegetable oil, to give it the properties of a fat. Interesterfication can be used to make margarines, shortenings, baked goods, and confectionary etc that requires the texture, mouth feel, and smoothness similar to saturated fats.

So what is Interesterification? To answer this question we need to explain a little bit about oil chemistry and this may not ne of interest to most readers. If you are interested in interesterification see Appendix C.

In simple terms, the interesterification process involves a batch of vegetable oil, to which we add an enzyme that acts as a catalyst to pull apart the molecules, and then some further chemical proceses to re-assemble them in a form that gives them more of the properties of fats like butter or beef fat.

Depending on how you proportion the molecules, will determine whether the chemist makes heavy oils suitable for deep-frying, semi-solid margarines that spread easily on bread, or solidified vegetable shortening suitable for cookies, pastries etc. The end result will be a product that can be made to simulate the properties of butter, duck fat, palm oil etc except that it was made by a chemist rather than Mother Nature.

Why would industry use such a complicated process to make synthetic fats that resemble natural fats? The answer is cost savings as natural fats like butter are much more expensive.

One thing to remember is that the interesterification processes mentioned above, takes place after the purification process that we discussed in an earlier chapter. Let’s remind ourselves of that purification process:

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“The seeds are firstly ground by a grinding machine, and then steam cooked, and thereafter mixed with solvents to dissolve out the oils. The most popular solvents are Hexane or Trichlorethylene and both are very carcinogenic. The oils and solvents are then separated, and manufacturers say that only traces of Hexane remain in the oil. The oil is then refined with the addition of sodium hydroxide and temperatures are increased to over 200ºC / 400ºF. Thereafter the oil is treated with carbon that removes all the Vitamin A, E, F, Lecithin, Chlorophyll, and other nutrients. Preservatives and/or anti-oxidant additives like BHA/BHT are then added.”

So vegetable oils first go through this purification as described above, followed interesterification. Can you see why natural fats like butter, duck fat, lard might be better?

Whilst it is true that interesterfied fats do not contain trans fats, there are many serious problems with interesterification. Firstly it can produce oils that have a strange molecular structure which can potentially damage body cells just as trans fats have done and lead to cancer, macular eye disease, neural cell damage etc. No one knows the consequences of eating interesterfied oils because no long term trials have been done. In any event, cancers take years to develop. Some preliminary testing is suggesting that interesterfied oils have the same risks as trans fats, causing Diabetes and other diseases.

Currently there is no legislation covering interesterification, and you may not see it on any food labels. What I can say, is that if the margarine, cakes, biscuits etc that you buy states ‘vegetable oil’ then you can be absolutely certain that it contains either interesterfied fats, or trans fats. There is simply no other commercially viable way to produce a fat from seed oils that are suitable for baked goods. So if you see ‘No Trans Fats’ proudly displayed on a packet of biscuits made from vegetable seed oils, then you can be certain that its contains highly processed interesterfied, or fully hydrogenated vegetable oils.

So what should we be using instead? Manufacturers should be using unprocessed tropical oils like palm and coconut oil. Tropical oils are saturated fats that are easy to digest and metabolise, and they are very stable and do not oxidise easily. And tropical oils are protective of cell membranes, as compared to processed vegetable oils that have been implicated with cell wall damage in countless studies. What is pleasing to see, is that a number of boutique bakeries and food manufacturers are now using tropical oils increasingly. However, I would expect that the major food manufacturers will place ‘cost pressures’ ahead of ‘health concerns’ and continue to use vegetable oils and fats that are either trans or interesterfied.

Deep Fried Foods

Having looked at how trans fat and interesterfied fats are produced in a factory, lets consider its use in restaurants, cafes, take away food outlets etc that all use deep frying for many of the foods they serve such as French fries.

There is no doubt that a well-fried ‘French fry’ is a tasty experience. It should be crispy on the outside, tender on the inside, and fresh and tasty. This French fry would require fresh oil, and be cooked at a perfect temperature.

The reality for most people is much different. Most French fries - and other deep fried foods - are saturated with grease, and loaded with trans or interesterfied fats. Even the traditional crispy breakfast bacon cooked on a hotplate, has been side-lined by lazy chefs using the deep fryer, and the end-result is bacon that is full of grease.

Having explored how trans and interesterfied fats are manufactured, you now have some idea as to why deep fried foods are an extremely unhealthy option. Furthermore, the oil is used over and over again 100’s times at very high temperatures. In terms of oil destruction, it doesn’t get any worse.

In summary, deep fried foods represent the final step in a succession of damaging processes, that result in highly carcinogenic oils that we unknowingly eat, that have a direct link with cancer and CHD.

Palm & Coconut Tropical Oils

The myth that tropical oils are bad for your health, was initiated by the US soybean industry in 1986, in a classic piece of black propaganda which was entirely effective. In essence, the entire story was based on the fact that a single cow did not thrive whilst eating a diet of processed hydrogenated coconut oil. In other words, the cow was not fed pure tropical oil with its full complement of vitamins and nutrients intake, but it was fed a totally sterile hydrogenated version of tropical oil which will make any animal sick.

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So the solution to all this, is to use natural fats provided by Mother Nature as used for thousands of years. We need to disregard the hype from the Soya Bean industry, Canola industry, the vegetable oil and margarine

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manufacturers etc, and go back to what some people call “The Traditional Diet” which are the foods that our ancestors relied on.

It interesting to note that in Europe for example, bakers have been successfully making baked goods withouttrans or interesterfied fats. So what do they use? Lard and beef fat are the bakers’ favourites in many applications, and tropical oils such as palm or coconut are also used in large quantities.

The reality is that unprocessed tropical oils like palm and coconut are very stable oils, they do not oxidise easily, contain many nutrients, and have unique health properties including being anti-microbial. If you do buy tropical oils, then buy the ones that are cold-pressed. Some companies do hydrogenate tropical oils to make them more solid, and these should be avoided for all the reasons mentioned earlier. If you wish to learn more visit this website www.tfx.org.uk

Let’s have a look at the common lipids used in France:

Description Saturated Fat (Long Chain)

Olive Oil 16%

Coconut Oil 28%

Duck Fat 33%

Lard 40%

Butter 40%

Palm Oil 51%

Beef Fat 55%

You can see from the above table that Olive Oil contains only 16% saturated fatty acids, and the remaining is made from ‘lighter’ fatty acids including Monounsaturated, Omega 6, Omega 3, and Short/Medium chain saturated fatty acids.

Beef fat is the highest with 55% saturated fatty acids.

Interestingly the French use mostly those lipids in the middle of the table which are Duck Fat, Lard and Butter. Duck fat is a very good fat that is only 33% saturated fat, and the remaining 67% is monounsaturated and polyunsaturated.

Further Reading

If you really want to understand oils and fats, which ones are healthy and which are not, then one of the best books available is called Know Your Fats by Dr Mary G Enig. I met Mary at a Conference in the USA and she is certainly an expert on the subject, having spent over 20 years researching lipids, including her early years doing research at Harvard University. She was one of the first to publicly critique the use of dangerous trans fats used by the food processing industry, and pushed for their inclusion on all food labels. That was over 25 years ago. You can find a number of excellent papers written by Mary Enig by visiting the Weston A Price Foundation website at www.westonaprice.org See Appendix 3 to understand the history of fats and oils including Mary Enig’s role.

In Summary:

� Omega 3 oils oxidise quickly when exposed to air, so get them from foods such as fish. � Processed Omega 6 oils are implicated with heart disease, cancer, and diabetes. � Extra Virgin olive oil is your best monounsaturated option. � There is a move back to butter, and away from margarine. � Trans fats are a disaster food, and some countries have now banned them. � Interesterification is a new process to replace trans fats. � Avoid all foods that are deep fried with fats cooked hundreds of times.

CHAPTER 22 MEDIA REPORTS

Over the years, you would have seen numerous press articles on how to avoid heart disease. Many of these articles seemed to contradict one another, leaving the reader uncertain or confused. Sometimes the truth got lost in the translation.

Now that we have investigated the role of inflammation with CHD, it’s easier to understand the logic behind many of these earlier newspaper articles. So let’s revisit some of these do’s and don’ts, and clear up any misunderstandings:

Eggs in the shell

Healthy in moderation

Many people are confused about eating eggs, and whether they are a good or a bad food.

The American Heart Association has effectively banned eggs from the diet, by stating that consumers should limit their total daily cholesterol intake to only 200mg per day, when one egg is 250mg of cholesterol. This is a nice way of saying - do not eat eggs.

The Australian Heart Foundation, a comparable organisation to the American Heart Association, has a different view. It states that eggs are a highly nutritious food, and people should feel comfortable eating them everyday. In fact there are now egg cartons at the supermarket displaying the Heart Foundations’ Healthy Heart logo. Most Australian nutritionists would agree that people would be much healthier if they ate eggs for breakfast 2-3 times per week, instead of sugary packet cereals. The Heart Foundation does advise that those with heart problems do seek advice from their doctor or dietician regarding suggested egg consumption.

Are you confused when two such similar organisations have such a different view? Most people would be.

The big question is, do eggs elevate your cholesterol or not? It is interesting to note that many people attain lower cholesterol levels when they eat eggs, because the body reduces its own cholesterol production when the diet supplies cholesterol. The Atkins diet demonstrated this time and again.

Charles McGee, MD, who wrote the preface of this book, told me an amusing story about eggs that he heard from one of his patients, who worked at a Primate Centre where research was being done on primates.

“There was an old baboon there called George that had a mean and nasty disposition. So the research team came up with a way of getting rid of George by disguising it as research, that might have provided them some notoriety in support of the ‘eggs are bad’ for you theory. They fed old George nothing but hard-boiled eggs for a year, then killed and autopsied him. As they were believers in the cholesterol/heart disease theory, they expected to find Georges’ arteries plugged up with fatty plaque, and they planned to write a paper about the experiment. Well to their great surprise Georges’ arteries were ‘clean as a whistle’ and the paper they had planned, never got published.”

One question is how many eggs should an adult eat per week? There is no ruling but I personally consume around 10 eggs per week, either poached or boiled, occasionally raw, but rarely fried.

The important thing with eggs is how they are cooked. If they are boiled, or poached in water, then eggs are a very healthy food. However if they are heated to high temperatures as occurs when you fry eggs, then you will introduce inflammatory factors. So if you fry your eggs, go very easy on the heat!

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Just so that we are all on the same page, I should mention that we are talking about eggs in the shell. The eggs to avoid are those that are pre-prepared in a ‘ready to use’ liquid form that you buy at the supermarket, that have plenty of time to oxidise before they get to you. These ‘ready to go’ egg mixtures are often used in cafes and hotels to make scrambled eggs and should be avoided. So when eating out, try to order boiled or poached eggs, as they are made from fresh eggs in the shell.

A word of warning. Many packaged foods are made with dried egg powder. These dried egg products are over-exposed to oxygen, and contain oxidised cholesterol and other fats that you should avoid.

Finally it’s important to remember that chickens are heavily dosed with antibiotics and growth hormones, so try to buy eggs that are free of hormones and antibiotics.

Milk

Healthy in moderation

A lot has been said about milk, regarding its benefits or otherwise. To most people, milk means pasteurised cow’s milk that has been heated to 72 degrees C to kill any microbes, and then homogenised**.

** Homogenization was introduced in 1932 and is the process that breaks down milk fat into small globules to keep the fat from separating and floating to the top. Homogenization occurs by passing milk under very high pressure through very tiny holes. The milk manufacturers like it because it extends the shelf life of milk.

Milk that you buy in the shop is not the same as the fresh milk that you get on a farm, because pasteurization destroys the natural enzymes. It should therefore be consumed in moderation. Many people, particularly as they get older, show some intolerance to milk and you would have heard of people who are ‘lactose intolerant’. This intolerance often occurs in the digestive tract causing bloating or inflammation.

There are cases of people with inflammatory diseases like rheumatoid arthritis or eczema who have reduced or eliminated this condition, by removing milk from their diet. Needless to say, there are many books written on food allergies and milk is high on the list of culprits.

The concern is that any food which is known to cause inflammation in the human body should be consumed in moderation. For most people however, adding milk to tea and coffee should be no problem.

Most children seem to tolerate pasteurised milk fairly well, and it’s a better food then many of the sugary drinks available. Milk provides a number of valuable nutrients like calcium and vitamins, which are very useful for growing children. So children should be allowed to drink milk freely, unless they are milk intolerant.

The big question of course, is whether you should drink low-fat or full cream milk? I have spoken to a number of researchers on this, and received a variety of different responses, without any consensus.

Just for your information, many years ago we had raw milk, but it is rarely seen these days. It is a completely natural food that digests easily, has no inflammatory effect on the human body, and is full of nutrients. But raw milk is difficult to get unless you live on a farm, because government regulations prohibits raw milk from being sold publicly, due to the risk of contamination.

It’s great to see that most supermarkets now sell organic milk and its not much more expensive.

Cheese

98Healthy in moderation

Cheese has been a staple food for thousands of years. It’s a very simple food made from milk, culture, rennin and salt.

Cheese is also a high fat food and therefore its association with heart disease has been extensively debated.

The French love their cheese and eat about 18 KG (40 pounds) per year which is roughly twice the amount consumed in countries like USA, UK or Australia. So let’s have a more detailed look at cheese:

Unpasteurised cheese – This is how cheese has been made for centuries and the people in France consume large amounts of this type of cheese. These are naturally fermented cheeses made from raw unpasteurised milk. These cheeses are a complete food and you can eat as much as you like. It’s worth noting that raw milk may contain pathogenic bacteria (i.e. nasty bacteria) at the start of the cheese making process, but they do not survive the cheese ripening process of three (3) months or more. Hence unpasteurised hard cheeses are safe to eat. However you need to be careful with semi-hard cheeses like Brie made from raw milk, as bacteria like Listeria can survive within these softer cheeses.

Pasteurised cheese - In Australia, cheese makers are required by law to use pasteurised milk to make natural fermented cheese. This is justified in a warm country like Australia where food can spoil very quickly. Cheese makers add ‘living’ starter cultures to pasteurised milk at the start of the cheese making process, and effectively they are putting ‘life’ back into the cheese. Pasteurised cheeses are a healthy food as far as your arteries are concerned. I personally like the aged parmesan cheeses imported from Italy, because of their flavour.

Low-Cholesterol Cheese - These cheeses are made with vegetable oils, in an attempt by cheese producers to make ‘low cholesterol’ cheese. These cheeses are usually made from processed vegetable oils, and are likely to contain trans fats. These cheeses should be avoided at all costs. Cheese should be made from real milk from cows, sheep, or goats, and no vegetable oils should be added.

Processed Cheese – Lastly, we have the processed cheeses, which would send a shiver up any Frenchman’s spine. Processed cheeses are, as the words imply, highly processed and one wonders whether they should be allowed to be called cheese at all. They are the fast foods of the cheese industry.

In summary, cheese is a very simple food made from just milk, culture, rennin, salt. Look on the label and if there are any other ingredients listed on the packet such as preservatives or food chemicals, then don’t buy them. The French consume large amounts of cheese, but it’s the real thing!

Margarine

Do not eat

Margarine is made from liquid vegetable oils through a ‘hydrogenation process’ that involves high heat, or via a process called interesterification.

Contrary to all the marketing hype, margarine has little nutritional value. Margarine is totally void of vitamins, which is why governments have made it mandatory for manufacturers to add Vitamins A and D, in an attempt to give it some of the nutritional qualities found in butter.

Margarine manufacturers have been on a downward slide over recent years because of concerns about cancer. So they have countered the decline in margarine consumption with new gimmicks like adding plant sterols, or mixing in olive oil, or some other healthy component, that the marketeers can link with good health. But there is no ‘getting away from the fact’ that margarines are a highly processed product, and offer little nutrient value.

Someone once described margarine as: “Manufactured grease concocted in large machines from various oils and chemicals, then coloured, and moulded to pose as butter. Its stiffness comes from being loaded with trans fats or other strange additives. And then they manage to produce a product that they try to pass off as butter”.

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Needless to say, the French are not big on margarine, and prefer to eat butter in the Northern provinces of France, olive oil in the Southern provinces nearing the Mediterranean, and duck/goose fat in the Eastern provinces along the Atlantic Ocean.

Butter

Healthy in moderation

Some people are concerned about eating butter, because it contains saturated fats. The French on the other hand eat plenty of butter.

The reality is that butter is a healthy food that has been eaten for centuries, and in recent years many people have gone back to eating butter because of concerns about hydrogenated fats and margarines.

Most western countries derive butter from cow’s milk, although for many centuries butter was derived from sheep and goats, and this still the case in some countries. Butter is ideal for use as a table spread, general cooking, and for pastries and baked goods.

Many people think that butter is 100% saturated fat, but that is not correct. Butter is around 80% fat, and the balance is water and milk solids.

The fat in butter is 50% saturated fat (long chain), 14% short/medium chain** saturated fatty acids with properties like oil, 32% monounsaturated oil, 4% is polyunsaturated oil, and traces of Vitamins A and D.

**The short/medium chain saturated fats have confused many people simply because of the word ‘saturated’. Many short/medium chain fats can be liquid at room temperature just like oils, and some are even liquid at freezing 0ºC (32ºF). They are also metabolised more efficiently then saturated fats (long chain) and via a different metabolic pathway.

When you consider that butter is 80% fat, and half of that is saturated fat (long-chain), then you can calculate that butter is really only 40% saturated fat (long-chain).

For anyone who suffers ‘saturated fat’ phobias, remember that the human body has a preference for saturated fats. This is confirmed by the fact that when you eat excess carbohydrates, the body converts and stores that excess carbohydrates, as saturated fat. Mothers breast milk is 50% saturated.

My own view on foods like butter, is to be generous when it comes to active young people who are burning calories. For them, a big dollop of butter on a slice of crusty whole grain bread is tasty and nourishing. And as we get older and our energy requirements reduce, then you might use less.

The best butter comes from pasture-fed cows, and this is standard in Australia and New Zealand. My only concern with butter is residues of farm chemicals, and therefore I buy organic.

Meat & Animal Fats

Healthy in moderation

The French cuisine includes ample animal meats like beef, chicken, pork, and game meats including hare, rabbit, and deer. And, if you are a regular consumer of meat, then you will be pleased to know that the latest research indicates that there is no association with meat and CHD. But there are a few provisos.

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Firstly, don’t burn meat. The French know how to cook their meat very carefully; cooked slowly or sautéed, without excess heat that may damage the delicate structure of meat.

I asked Dr James Khong, MD at the Wellness Clinic in Melbourne, whether he thought beef was better or worse than chicken. James was trained in both Chinese and Western medicine, and has a very holistic view of a persons health. His view was:

“Frank, it doesn’t matter whether chicken or beef is better. What’s important to know, is that different foods have different nutrients, and our objective should be to get the broadest range of nutrients as part of a varied diet. Therefore, I would prefer you eat a varied diet each week, that includes chicken, beef, pork, lamb, fish, turkey. It’s all about variety in your food to ensure you will get all the essential nutrients that you need. That’s what’s important”

And James is quite right; most people tend to eat a very narrow range of foods. So we need to be aware of our tendency to be ‘creatures of habit’ and eating the same thing week in and week out. Aim for variety in your diet.

One key issue with beef is whether it is grain-fed or corn-fed. Cows are natural grazing animals with stomachs designed for eating and digesting grass which is high in Omega 3. When the Omega 3 oils are uplifted into the cow, the result is meat that is higher in Omega 3. You can see the difference, because the fat from a grass-fed animal is softer. The fat from grain or corn-fed animals is much harder.

In some countries like the USA, farm animals are grain or corn-fed because it fattens the animal more quickly. It produces a larger bulkier animal. The problem is that this feed causes severe digestive problems to these grazing animals, and results in their poor health, and an inferior meat. A cow is a grazing animal that is meant to eat grass, and has great difficulty digesting grain and corn.

Australians and New Zealanders are lucky because their farm animals are generally grass-fed. That’s because it’s cheaper to have the animals ‘roam the paddock’ and eat fresh grass. Grain feed is only used in special situations, such as during severe droughts where there is a shortage of grass.

One concern with beef is the use of growth hormones, which are used to fatten up cattle. Growth hormones in farm animals are associated with cancer in humans. So try to buy organic grass-fed meats that have been raised without growth hormones.

Fish

Highly Recommended

Fish has been consumed as part of a regular diet for thousands of years. Whilst Omega 3 has received much of the credit for the reason to eat fish, the fact is that fish is high in many nutrients including proteins, minerals and vitamins.

But what is the best way to prepare fish, because it’s easy to overcook?

In a perfect world we would all eat raw fish like sushi, but not everyone enjoys that.

Your second best option is poaching fish in water, which is a gentle form of cooking.

Your third option is baking the fish in the oven on medium temperatures. Alternatively sautéing the fish with some oil and water in a frypan, as the water stops the fish from being overheated.

Frying fish or BBQing should be your last choice, because it’s easy to damage the delicate Omega 3 oils in fish when cooking at high temperatures.

A huge problem with fish is the contamination from mercury, PCBs and pesticides that are poisoning our oceans. For this reason pregnant women should limit fish consumption to a maximum of one serve per week.

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Research suggests that there is a compelling reason for the majority of people to eat fish regularly, possibly twice a week. However, some fish are safer to eat than others, and you can learn more by visiting www.oceansalive.org

Nuts

Highly Recommended

Nuts and seeds are embryos of life and for that reason they are rich in nutrients including essential oils, minerals and vitamins.

Yet for many years, nuts were a restricted food for anyone concerned about CHD, because they contained oil. However extensive research has now shown nuts to be very healthy. In fact, they may well help protect against heart disease.

One interesting study was the 10-year Nurses Study, where nurses who regularly ate 450 grams (around one pound) of nuts per week, were associated with a 40% reduction in heart attacks. Because it was a study and not a trial, it’s not certain whether it was the nuts alone that reduced the rate of heart attacks. It may well be that nurses who eat nuts have a different lifestyle from nurses who don’t eat nuts.

However it does give us some reassurance that nuts are a healthy food and we should consume them without hesitation. What’s interesting to know is that nuts have the highest amounts of minerals of all the food groups. They are an excellent source of pure virgin Omega 6 and Omega 3 oils. And contain lots of Vitamin E. It’s possible that nurses eating a classic American ‘processed foods’ diet would have been low in these essential nutrients, and the consumption of a pound of nuts per week, would have ensured that they received adequate amounts of essential nutrients.

Another large-scale study published in the Archives of Internal Medicine in the USA examined the consumption of nuts by more than 21,000 male doctors. The study found that those who had eaten at least a handful of nuts twice a week had a 47% lower risk of heart attack and 30% lower risk of coronary heart disease. The results appeared linear, meaning the more they ate, the better the results.

You should be aware, that nuts are very high in minerals because they come from trees which have deep roots that go down several metres (i.e. 6-12 feet). In fact weight for weight, no other plant food is as potent in minerals.

Studies show that nuts have maintained their mineral qualities over the past fifty years. Vegetables on the other hand have lost 40% of their minerals in the past fifty years, because vegetables are surface plants, and intensive farming techniques have depleted the topsoil.

Remember, it’s the raw and dry roasted nuts that we should consume. The nuts cooked in processed vegetables oils should be avoided.

A word of caution about peanuts. They are not really a nut - but actually a legume - and they do not have the same health qualities as nuts. Also they can contain certain toxins that affect some people, who may be allergic to peanuts. If you are not allergic to peanuts, then they are fine to eat, and best from the shell.

There are a wide range of nuts to choose from including cashews, macadamia, almonds, walnuts and hazelnuts. My personal favourite is the macadamia nut, because you can buy them raw without any processing, and they store really well.

One of the great things about nuts is they make a convenient snack food at the office. Keep them in a container at your desk, and have a handful whenever you feel hungry. At home, transfer them into a sealable plastic container and keep them in the fridge to preserve freshness.

Just to repeat, weight for weight, nuts are the most potent food group available. Consider them a natural mineral supplement.

102Fibre

Highly Recommended

Animals and humans have consumed high levels of fibre for thousands of years by eating fruits, vegetables and nuts. So we can assume that fibre is a very important component for the healthy functioning of the human body. At a minimum, fibre has a key role in shifting the body’s waste products out of the body.

You should think of your digestive track as a flowing river. A free flowing river is healthy, and a river that does not flow will stagnate and become unhealthy and toxic. If you don’t eat enough fibre, then your digestive track will stagnate, and become unhealthy. The very best source of fibre for a healthy digestive tract, is fruits and vegetables, because they are gentle and won’t inflame the gut.

The box cereal manufacturers recommend that wheat, oat and rice bran are valuable sources of fibre, but Nutritionists may disagree. These products contain non-soluble fibre which is harsh on the gut and causes inflammation of the digestive tract in many people, and are high in toxic residues.

To illustrate this latter point, we had a fire up in Northern Australia in 2007 in one of the large grain storage silos. What followed was all the towns 1500 residents were urgently evacuated for three days, because the toxic Phosphine gas had to be released from the silos, so that the firemen could enter the silos to put out the fire.

Phosphine is a common gas fumigant used worldwide in bulk grain silos to kill insects and animals. The Phosphine reference manual states “high acute mammalian toxicity, good penetration abilities, highly flammable, residues in treated seeds are generally negligible”. What this means in plain English, is that Phosphine is very toxic, and people exposed to Phosphine can die in hours.

The problem is that most of the toxic residues of Phosphine gas (or the surface sprayed alternative insecticides used in silos) are absorbed into the outer husk of the grain that is called the bran. Since these large grain silos are used to store wheat, oats, rice etc, you can see that the bran of these cereals is the worst part to eat. Some might even argue that eating refined white bread is safer than eating whole grains and the following study is a case in point:

A study consisting of 617 cases of prostate cancer and 636 disease-free individuals from Ontario, Quebec, and British Columbia, found that among the grains, refined-grain bread intake (ie white bread) was associated with a lowering in prostate risk by 35%. However, whole-grain breakfast cereals that included the outer bran were associated with a higher risk for prostate cancer. (Ref: Nutrition and Cancer – An International Journal 1999 Vol 34, Iss 2, pp 173-184). It means that the health-conscious chap eating whole grain cereals and breads with higher residues of pesticides in the bran is actually far worse off. If you are one of these people, then you deserve to be mad for having been sold a dud. My suggestion is to always purchase organic bran, cereals, and flour that do not see the inside of a grain silo.

The recommended daily intake of fibre is around 40 grams for men and 30 grams for women. Most people would be lucky if they consumed half that amount. If you don’t eat enough fibre in your normal diet, then your ‘fallback position’ is to take fibre as supplement to make up the difference.

What are your best options for fibre supplements? Psyllium husks are a source of fibre, and are usually available in the health section of your supermarket. Or you can buy a product called Metamucil, which is finely powdered psyllium, and available at most pharmacists. However, psyllium may be a bit harsh on its own for some people.

A better alternative would be some of the ‘blended’ organic fibre supplements that are available. These combine soluble and insoluble fibre, seed meals, together with slippery elm to sooth the digestive tract. Look for a quality supplement that contains several fibres, such as oat bran (soluble fibre), flaxseed meal, rice bran, psyllium husks, LSA, slippery elm.

Vitamin E Supplements

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Recommended, but choose supplements carefully

Vitamin E is important to your cardiovascular system because of it has anti-inflammatory properties that keep your blood vessels healthy. It is a powerful antioxidant against free radicals that can damage the artery walls. It has strong anti-clotting properties to keep the blood thin, and to reduce the likelihood of a clot blocking an artery. It is also an essential nutrient required by every cell in the body to form the outer casing (ie cell wall). So it’s really important that you get an adequate amount of Vitamin E in your diet. Vitamin E is contained in all raw nuts and all unprocessed oils. For example, the cold-pressed oils used by the French in their cuisine contains ample amounts of Vitamin E. On the other hand, the refined cooking oils used in the USA, Australia and many other countries, have no Vitamin E, as it was removed during the sterilisation process. So for these people supplementation may be necessary.

But you should be aware that ‘the jury is still out’ on the benefits of Vitamin E as a supplement. Some study trials have shown Vitamin E supplements to be beneficial, and others have shown them to be a complete waste of money. The problem is that there are many different forms of Vitamin E, and the inconsistency of their analysis in study trials has resulted in confusion in the marketplace. .To cut a long story short, let’s clarify which Vitamin E supplements you should be buying:

Type of Vitamin E Source Nutritive Rating Value

alpha tocopherols beta tocopherols delta tocopherols gamma tocopherols

These are the natural Vitamin E’s found in the unprocessed oils of seeds and nuts. The best sources are seeds, nuts, and virgin cold-pressed oils.

Found in superior supplements, and are the best supplemental form to take. Five stars.

*****d-alpha tocopherols This is natural alpha tocopherol,

changed to the d-alpha form to make it suitable for packaging into capsules.

Less absorbable, but still shown worthwhile in some study trials.

***dl-alpha tocopherols This dl form is a totally synthetic

type of Vitamin E that is made in a chemical factory

Very poor results in all study trials, not worth buying.

*

The recommended dosage is 400mg for adults. But remember your best sources of Vitamin E are unprocessed nuts, seeds and oils.

Magnesium

Highly Recommended

Magnesium is one supplement, which in my opinion, stands high above the rest. That’s because most people are deficient in this essential mineral, due to the over-processing of foods.

The health benefits of magnesium have been studied for many years, and a deficiency is clearly associated with a host of muscle related conditions including heart disease, high blood pressure, arrhythmias, leg muscle cramps, eye twitching etc.

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Magnesium plays a key role in relaxing the muscles. These include the heart muscle, the nerves that initiate the heart beat, and the muscles inside the arteries. This ‘muscle relaxing’ capability may be the reason why magnesium helps to prevent arrhythmias. A magnesium deficiency can thus lead to cardiovascular abnormalities including arrhythmias, heart attack and stroke. A most insightful book on this subject is called The Magnesium Factor by Mildred S Seelig, MD, that would be a valuable read for any healthcare professional.

So how should you get magnesium? The best solution is to eat foods rich in magnesium like whole grains, nuts, beans, seeds, fish, avocados, and leafy green vegetables and other whole foods. You should be aware that with wheat and rice, most of the magnesium is in the bran and germ, which are removed in the milling process. So white flour and white rice are poor sources of magnesium, and has helped create chronic deficiencies in the population.

The French diet is adequate in magnesium. That’s because they eat lots of vegetables, fruits, dairy etc which contain a lot of minerals such as magnesium.

Magnesium is an interesting element, because the human body contains only about 19 grams of magnesium, which is just 4 teaspoons. That’s not a lot. But for some reason the body seems to churn through it pretty quickly, so you need to keep topping it up. If your diet is mediocre, your best option is to take a high quality magnesium supplement that will contribute 300mg of magnesium to your daily intake.

Trace Minerals - Selenium, Zinc, Chromium etc

Highly Recommended

You would have read reports that people low in trace minerals are associated with higher risks of CHD. Yet these trace minerals make up only a small proportion of the human body. To put it in perspective, if you analyse the composition of a 70-kg person you would find that 69-kg are made up of the following:

Oxygen 43kg Carbon 16kg Hydrogen 7kg Nitrogen & Calcium 3kg

Total 69kg

The remaining 1 kg consists of trace minerals like selenium, chromium, zinc and some 50 others. Many of these minerals do have an important role in the human body. For example, people that are low in selenium are shown to have higher rates of CHD. On the other hand, selenium is highly toxic and you only need a very tiny amount for good health. So what should you do?

Some people take mineral supplements. However, a lot of research suggests that the minerals in a tablet are not readily uplifted to the billions of cells where they are needed. You should also be aware of the risks of taking mineral supplements. Since some minerals are highly toxic, if you take them in excess, you could be worse off. Therefore you should only use supplements from reputable manufacturers with strict manufacturing controls.

I did learn that some soils are depleted, and for example the entire Pacific Northwest in the USA has soil that is deficient in Selenium because of the ice age. This would have been a problem for residents living area many years ago, when the entire food chain was derived from local produce. However with modern food distribution, most people would be eating foods that are brought in from other regions, often other countries. So if you eat well, it’s unlikely that you will get a single mineral deficiency in today’s world.

Clearly, your safest source for all trace minerals is foods. And the best sources are nuts, beans, seeds, fish, dairy products, leafy green vegetables, fruits, and whole grains. But there are some other good sources:

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Mineral Water is a good source of minerals. The French and Europeans have consumed mineral water from natural springs for centuries, because of the dodgy water supply in many communities. Mineral water is an excellent source of minerals when consumed with a meal. Many people today have water filters to remove impurities as well as chlorine and fluorine, but these filters also remove any useful minerals in the water like magnesium and calcium. So the idea of drinking bottled mineral water with meals does make sense.

Beef & Chicken Stock is another source of valuable trace minerals. The French have had the tradition of making stock for many years to flavour their foods. Stock is made by cooking meat bones for many hours at simmering heat, which extracts large quantities of minerals and proteins from the bones and marrow. Bones as you know are alkaline, and vinegar which is acidic is added to the liquid stock to help release the minerals and other nutrients from the bones. The result after some 12-24 hours of simmering, is a liquid stock that is rich in minerals that can be used to flavour soups, stews and sauces. Minerals contained in stock are highly absorbable, because the minerals bind with the protein in the stock, and make it easy to uplift to the cells. The medico terms would be bioavailability.

In summary it’s far wiser to get all you trace minerals from natural foods like fresh fruits and vegetables foods, mineral water and broths/stocks.

Exercise

Highly Recommended

We all know that regular exercise is part of a healthy and active lifestyle. It’s common knowledge that people who exercise regularly, do strengthen their arteries, their heart, and most other aspects of their body. Just as muscles respond to physical training, arteries respond to cardiovascular exercise.

However, exercise by itself won’t stop you from getting CHD if you have inflammation in your arteries. There have been many people over the years who were enthusiastic about keeping fit, and who genuinely believed that exercise alone was the key to optimum health, yet they died of heart disease in the prime of their life.

Regular exercise is important to avert CHD, but what you eat is even more important.

The French appear to get about the same amount of exercise as most other countries, so clearly exercise in itself has no association with the French Paradox. But regular exercise is very important for overall fitness and health.

Stress

Best avoided

There is a lot of evidence to suggest that continuous stress can be very inflammatory to your arteries, and also elevate your blood pressure.

Stress is a common condition, a response to a physical threat or psychological distress, which generates a host of chemical and hormonal reactions in the body.

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In essence, the body prepares to fight or flee, pumping more blood to the heart and the muscles, and shutting down all non-essential functions. As a temporary state, this reaction serves the body well to defend itself, but if prolonged, the chemicals swirling around your arteries, can be inflammatory.

Many people work in environments that are high stress, and some manage it better than others.

The French people intuitively seem to handle stress quite well, and this was something I noticed years ago.

In France it’s quite normal for business people to have a leisurely 1 ½ hour lunch with a glass wine every day. However that would be quite unusual in English speaking western countries except for important business lunches.

So the question of stress management varies between individuals, and countries. Naturally everyone’s lifestyle is different and it’s impossible to be prescriptive, but certainly anyone under stress needs to manage it, for the health of their arteries.

Ageing & Longevity

In business we often hear people say “so what is the end game” and this applies to longevity and ageing. Most people would like to live a long healthy life, where they are mobile and active, and able to look after themselves and without pain. The idea of being chronically ill, or completely reliant on medical drugs and medical services is not what people want as they get older.

The big question to ask yourself, is whether to adopt a generally healthy lifestyle that can slow down the onset of conditions like CHD, Arthritis, and Diabetes. Or do you continue to eat processed and packaged foods until these diseases hit, and then try to alleviate the symptoms with a long-list of pharmaceutical drugs. It’s really all about making choices.

So how long do people live for, and what are the differences between affluent countries? The World Health Organization (WHO) publishes a report called Facts and Figures and I extracted the life expectancy at birth in 2005 comparing five countries. I thought you might find the data interesting:

Country Women Years Men Years

Japan 85 78

France 84 76

Australia 83 78

UK 81 76

USA 80 75

You can see that France rates very well, considering that their diet is rich in saturated fats, foods high in cholesterol, and often washed down with a little red wine.

In Summary:

� Margarine is a heavily processed food that should be avoided. � Grass-fed meat is superior to grain-fed. � Fish can be eaten twice a week, except for pregnant mothers. � Eggs are an excellent healthy food if organic. � Traditional fermented cheese made from only milk, rennin, culture is an excellent food. � Nuts and seeds are excellent foods and can be consumed as often as you like. � Adequate fibre intake is essential for moving toxins out of the body. � Magnesium supplementation is proving helpful to many people.

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� Real beef or chicken stock/broth is an excellent source of minerals.

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CHAPTER 23 THE FRENCH PARADOX UNRAVELLED

In this book we have been on a journey to investigate the French Paradox. We looked at why the people of France are able to eat generous amounts of saturated fats and cholesterol, and yet enjoy low levels of CHD. The French cuisine therefore ‘flies in the face’ of what we have been told, which is that fats and cholesterol are bad for us.

We looked at the fact that males in France between 46-64 years of age, had average cholesterol levels between 5.1 and 7.1 with an overall average of 6.1 mmol/L (235 mg/dl).

Yet in Australia and the USA, anyone with this cholesterol level will be told by their doctor that they are ‘at risk’ of heart disease, and prescribed cholesterol-lowering medications. Patients are rarely told about the many side effects of cholesterol-lowering drugs, because the doctors have not being told about them either. And the medical system rarely bothers to investigate patients’ arteries via High Speed CT Scan, EBT, or other ‘non-invasive’ medical tools to determine whether the patient actually has a problem to worry about.

So we are talking about mass ‘blanket’ drug prescriptions for a significant part of the population, to reduce cholesterol, which at best has a relationship with heart disease that is ‘questionable’.

The French Paradox is significant because it substantiates the findings by countless researchers that normal intakes of cholesterol and saturated fats do not cause heart disease.

So in our journey in this book, we investigated the French approach to food, which has changed little over the last century. Our look at this cuisine has served to remind us, that we have abandoned our traditional foods and replaced them with pseudo foods like margarine, egg beaters, packet cereals and other junk foods.

We embarked on a journey to understand the causes of Coronary Heart Disease (CHD), and if it is not due to cholesterol and saturated fats, then must be due to something else.

We then investigated the findings of a number of medical doctors and researchers, and looked at how the arteries are damaged by a number of factors, particularly free radicals (oxidation), processed vegetable oils, and vitamin/mineral deficiencies. Each of these has the ability to cause inflammation to our arteries and cause CHD.

We discussed how the human body responds to inflammation of the arteries, by ‘laying down’ plaque in or on the walls of the artery, to protect the inflamed area, and this results in the narrowing of the arteries.

Heart Disease Factors

So let’s now summarise the causes of damage to our arteries, what we can learn from the French Paradox, and what we can do to protect ourselves in future:

Vitamin Deficiencies - We looked at the period between 1920 – 1968 when all sorts of diseases were running rampant including CHD, and the problems caused by vitamin and mineral deficiencies. And we discussed the mandate by governments to fortify white flour, margarine and other processed foods by forcing food manufacturers to add iron, B1, B2, B3 back in to certain foods. This caused many diseases to disappear altogether, and others like heart disease to fall. All these health problems could have been avoided if the population had continued to eat fresh meats, vegetables, fruits, dairy, nuts and avoided packaged, canned and dehydrated foods.

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Elevated Homocysteine was another risk factor for CHD that we discussed earlier, that inflames the arteries, and is caused by a simple deficiency in Vitamin B6 and Folate. Elevated Lipoprotein(a) was another risk factor for CHD that we discussed earlier that is generally caused by a deficiency in Vitamin C and bioflavonoids. We

learned that the best way to get these vitamins and nutrients – without sounding too laborious – was to eat fresh fruits, vegetables, meat, cheese, eggs. That’s what the French eat.

Free Radicals/Oxidised LDL - We also looked at how oxidised LDL (that contains oxidised cholesterol and lipids) damages the artery wall, and why high levels of antioxidants in the bloodstream offer protection. We looked at the role of the phytonutrients found in fruits and vegetables, which are powerful antioxidants able to neutralise oxidised LDL and thereby inactivate their damaging effects. And we learned that the more colour in the fruit or vegetables that we eat, the greater the antioxidants to neutralise the free radicals. Consequently people like the French who eat foods rich in phytonutrients, have less risk of free radical damage to the delicate inner lining of the arteries.

Wine - The French Paradox centered on the subject of red wine. So we investigated wine which is very high in phytonutrients. And how just 1-2 glasses of red wine per day, offered a substantial boost to our phytonutrient and antioxidant levels to neutralise the free radicals in our arteries.

Trans Fats - We spoke about the processing of vegetable oils and dangerous hydrogenated trans fats – which are now being restricted in some countries due to major health concerns. Just 2 teaspoons of trans fats (i.e. 10 grams) per day greatly increases your chances of CHD. These pseudo fats are used extensively in cookies, biscuits, cakes, donuts, pastries and processd foods, and damage both small and large blood vessels. We also investigated a new chemical process called interesterification to replace trans fats, that results in oils and fats that are just as chemically modified as trans fats. We looked at why the French use very stable fats that don’t oxidise easily, such as butter, duck & chicken fat, and lard.

Polyunsaturated Omega 6 Oils - We looked at ‘factory processed’ Omega 6 oils like sunflower and safflower which oxidise readily when they are removed from their seeds, and why they need to be sanitised. Recommended by experts for decades, these highly processed vegetable oils with their vitamins and lecithin completely removed, and residues of toxic hexane left behind, are now implicated with breast cancer, prostrate cancer, and CHD. The French do not use these highly processed and sanitised vegetable oils.

And that explains “The French Paradox” and why the French enjoy low levels CHD.

Some people may think that this is all a bit too simple, and that averting CHD couldn’t be that easy? On the surface, it may look simple, but its not. Our dietary habits are learned behaviours that are curiously ingrained in the mind. It took years to develop and it can take several years to make the quantum shift described in this book. For some it will be impossible.

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To help assess where you are today, you will find a Self-Assessment on the next page. It will help you understand how your current eating habit rate against others. Have a try.

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Self-Assessment Form

Put yourself to the test and see how closely your dietary habits are to the French. Circle each questions below and add up. Yes =10 points Sometimes = 5 No = 0

Circle the one that you believe is closest to you:

Question 10-Points 5-Points 0-PointsI consume 5 daily serves of colourful

fruits and vegetables? Yes Sometimes No

I drink red wine at least 3 times per week?

Yes Sometimes No

I eat nuts several times week? Yes Sometimes No

I eat butter instead of margarine? Yes Sometimes No

I use virgin olive oil, not vegetable oils? Yes Sometimes No

I try to buy organic food, and hormone antibiotic free?

Yes Sometimes No

I eat cheese butter and eggs? Yes Sometimes No

I get adequate exercise twice a week? Yes Sometimes No

I avoid deep-fried foods? Yes Sometimes No

I do not eat ‘factory made’ cakes and cookies?

Yes Sometimes No

Total Your Points:

90 or more points - you must be French!

75 – 89 points - you are doing very well.

50 and 74 points – there is room to improve.

CHAPTER 24 ACTION PLAN - YOU AND YOUR PHYSICIAN

I hope you have enjoyed reading this book. I wanted to introduce you to researchers whose views on cholesterol were different from what you might have heard. The aim of this book was therefore to provide you with a balanced view of a topic that receives very little debate.

From the outset, I had planned to write a book to explain what cholesterol is, why it clogs our arteries, and how we should protect ourselves from its dangers. But what I found was countless doctors who did not believe that cholesterol caused CHD. These doctors had done significant research into CHD and some have spent their entire lifetime studying the causes of CHD.

These doctors are in fact quite distraught by the misinformation published on cholesterol. Like David versus Goliath, they are prepared to stand up for what they believe is correct, even if they are a small minority. These dedicated professionals, with no vested interests, are prepared to ‘take on’ the big pharmaceutical corporations, the food processing industry, and even the medical associations, who they see as profiteering from the cholesterol myth.

I must confess when I first discovered that there was nothing wrong with cholesterol, I was perplexed. I had spent years trying to reduce my cholesterol level of 10 mmol/L because I was told that it was necessary. But after studying all the available information, I also learned that there was nothing wrong with having elevated cholesterol. And so I stopped worrying about my cholesterol, and started to concern myself with the real causes of CHD that we discussed in this book.

The reason cholesterol is different from most other medical matters that you and your doctor will discuss, is that cholesterol is not a disease. A lot of people believe it’s a disease, but it’s not a disease at all.

Dr George Mann, MD

The myth about cholesterol is not new. Dr George Mann, eminent American physician and scientist, author of Coronary Heart Disease: The Dietary Sense and Nonsense is acknowledged for being the first to uncover the cholesterol myth. In the New England Journal of Medicine in 1977 Dr Mann presented his arguments against the diet-heart idea, and the lack of relationship between diet and blood cholesterol and heart disease. He went on record as saying:

“The diet-heart hypothesis (the notion that saturated fats and cholesterol cause heart disease) has been repeatedly shown to be wrong, and yet, for complicated reasons of pride, profit and prejudice, the hypothesis continues to be exploited by scientists, fund-raising enterprises, food companies and even governmental agencies. The public is being deceived by the greatest health scam of the century.”

At the time, Dr George Mann was Professor of Medicine and Biochemistry at Vanderbilt University, Tennessee. Importantly, he was Co-Director of the Framingham Heart Study, which was one of the largest medical studies on the effects of diet on heart disease.

It’s unfortunate that most practicing doctors in our community do not have the time to do in-depth research into subjects like cholesterol. They are simply too busy handling patients, and in any event, they can only be expected to practice medicine using the guidelines determined by the higher echelons of the medical pyramid.

So what can you do for yourself to reduce the risks of CHD? Let’s look at some practical things that you can do with the help of your physician.

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Action Plan & Recordkeeping

If you are already diagnosed with heart disease, or any other medical condition, then it’s important to continue under the care of a qualified physician.

On the other hand, if you don’t have any health problems, but are concerned about how CHD may affect you in the future, then there are some positive things you can do. Your physician will be your key resource, but you need to be an active participant in the process since it’s your life.

I use the word physician in the general sense, because around the world there are different kinds of physicians. They include doctors, doctor nurses, osteopaths, naturopathic physicians, homeopaths, traditional Chinese medicine and others.

Your Physician – Hopefully you have a very good physician, and if not, then ask some of your friends who they recommend. Most importantly you need a physician who is able to listen to you, rather then be too prescriptive.

Medical Log – You need to create a personal Medical Log to keep at home either in a book or on the computer. You require some base data that you can refer to later to see how you are going. You need to initially record your basic data like weight, blood pressure, and heart-rate, and the results from blood tests and others pathology tests that you will get done initially or later. If you are already using a software package to record your medical history, that’s great.

Blood Pressure Testing - Buy a blood pressure kit, and become familiar with your blood pressure reading, and record it from time to time. This will help you to build some confidence in understanding blood pressure, and remember to record your blood pressure in your Log Book. If your blood pressure is 120/80 or less, and your pulse is 64 beats per minute or less, then you should be pleased. If not, re-read the chapter marked “Blood Pressure” and purchase the books recommended.

Laboratory Blood Tests – You need to speak to your physician about getting some basic blood tests done. You may already have a record of these, but if not, these are the ones you need, to get a basic health profile:

� Full Blood Count � Liver Function Test � Electrolytes, Urea, Creatinine - Serum � Lipid Studies (Cholesterol/Triglycerides) – Serum � Thyroid Function Test � Glucose – Fasting Test

When you receive the results for these tests, get a copy, and keep them in your Medical Log. If there are any unusual scores with the above, then your physician will discuss these with you, and advise what actions may be necessary.

Cardio Indicators - To help determine your risk for CHD, you need to get three additional tests done. The tests were explained in the Chapter 11 headed “Clinical Tests for your Heart” and you should discuss the reasons for these tests with your physician. You may wish to loan him/her a copy of this book. The tests are:

� Homocysteine � Lipoprotein(a) � C-Reactive Protein

If your Homocysteine levels are elevated, then commence taking the B vitamins as recommended which are Vitamin B6 (20mg), Folate (400mcg) and B12 (100mcg). Some companies make a specific B6/B12/Folate supplement which would be ideal.

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If your Lipoprotein(a) results are elevated, then immediately increase your consumption of citrus fruits and berries which are high in Vitamin C, and take 500mg or more of Vitamin C / Bioflavonoids daily.

If your C-Reactive Protein is elevated then it suggests inflammation, and you should speak to your physician about the cause. It may be due to an acute (temporary) infection somewhere in the body, in which case it should resolve itself, but if it stays elevated for more than a few weeks, then it may suggest inflammation in the arteries.

Vitamin Supplements – If the results of some of these tests concern you, then you should take action by seriously improving your diet and lifestyle. The quickest starting action – if you are not already doing so - is to commence with vitamin supplementation as a prelude to getting your diet into shape. These vitamin supplements should be used to top up depleted reserves of nutrients, minerals and vitamins. Take as per the daily directions found on the product label, and if you are on medication or under medical treatment then check with your physician about any contra-indications being starting:

� Multi-vitamin (premium formulated product) – to help metabolic processes, take in morning. � Magnesium, 300mg - to reduce blood pressure, and to assist metabolic processes. � Omega 3 Fish Oils, 5 capsules – as an anti-inflammatory, and to reduce blood viscosity. � L-Arginine Amino Acid, 2 grams - to reduce blood pressure, and as an antioxidant, take in morning. � Wheat Grass or Spirulina, 1 teaspoon powder or 8 tablets – to improve energy levels, take in morning. � Fibre Supplement, 2 Tablespoons - to eliminate toxins from the body.

CT Scan – If the test results for your cardio-indicators were disappointing, then it would make sense to look inside your arteries, and get some idea of potential blockages and plaque build-up. Explain to your physician that you would like to get a CT Scan or EBT Electron Beam Tomography scan done. These are non-invasive and will give you an insight into the condition of your arteries. If your arteries are clean, then you are doing something right, and you can relax a little. Most people aged 40+ will show some plaque build-up, so don’t be too alarmed. The continuous pumping action of the heart would have caused some hydraulic ‘wear and tear’ to your arteries over the years, and it’s likely that some build-up will show up in your results. If the results are discouraging, then you know it’s time for more aggressive actions as follows:

Diet - Start to eat quality fresh foods like fruits, vegetables, meats, nuts, and the other nutrient rich foods mentioned in this book. Avoid all processed vegetable oils. Reduce your consumption of processed and packaged foods wherever you can. When eating out, aim for quality fresh foods. And remember that it took years to get to your current situation, so don’t expect a dramatic turnaround too quickly. There are some excellent books that you can buy to help you this area, and something like The South Beach Diet which emphasises healthy foods, would be very helpful.

Improving your eating habits is going to be very important. However, it’s difficult to change eating habits, and most of us fall back to our old ways very quickly. You may need to involve your spouse in changing your diet. As a suggestion, there are likely some wonderful cooking classes in your community, covering French, Italian and Chinese cooking, and you should consider enrolling. These classes can be a lot of fun and often include regional wines as well, and can be effective in helping you change your eating habits.

Testing 3 Months Later – If your first blood tests were disappointing, then three months later have your blood tests done again. Hopefully you will see improvements in your scores, as your lifestyle changes start to come good. You might need to have these blood tests done several times during the first year, to monitor improvements in your scores.

Cholesterol-lowering medication – You may be advised by your physician to take cholesterol-lowering drugs to reduce your cholesterol. That means a life-long commitment to medications with the risk of severe side effects. Advise your physician that you would like to get a better understanding of your options, and that you want a referral to another physician or specialist to get a second opinion. This will allow you to do a bit more research and make a considered decision about whether to take pharmaceutical drugs for the rest of your life.

Specialist – Clearly if you are worried about CHD then it makes sense to visit a specialist like a Cardiologist trained in heart disease. Make sure you bring along the results of your Lab Blood Tests, your blood pressure log book, and also the CT Scan results. That will give your Cardiologist a lot of data to help him/her assess your situation. It’s likely that your Cardiologist will want you to do a Treadmill Stress Test to see how your arteries actually perform under exercise.

If ultimately you and your Cardiologist decide to reduce your cholesterol, then the question is whether to take pharmaceuticals drugs or the natural cholesterol-lowering agents mentioned in Chapter 7. Having read this book you are now aware that you have some options. I personally don’t take any medication and that’s my choice, but if I was concerned about it, I would start with a natural cholesterol-lowering supplement. Everyone is different.

Remember also that chelation therapy is a very effective treatment that has done wonders for a number of patients with cardiovascular problems as discussed in Chapter 15.

And if you need to take cholesterol-lowering medication, then read the book called What You Must Know About Statin Drugs by Dr Jay Cohen that explains the correct dosing of statins drugs. This will be important if you want to avoid the nasty side effects. And with statins, also take 100-200mg of Q10 as mentioned in this book.

Hopefully these suggestions will help you but they are not meant to be prescriptive. The key is working with good physicians as a team, with yourself as a proactive participant.

To help you with the changes to your eating patterns you will find a ‘Reminder Checklist’ on the next page that you can paste on your fridge.

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Reminder Checklist

REMINDER CHECKLIST

� Fruits and Vegetables - Consume 5 or 6 colourful serves each day � Red Wine - Enjoy a daily glass of red wine � Trans Fats - Avoid cookies and cakes made from trans or interesterfied fats � Proteins – Eat high quality proteins from fish, meat, poultry, or game meats � Nuts & Seeds - Eat nuts or seeds like walnuts, almonds, cashews, sunflower � Dairy Foods – Eat natural foods like butter, cheese and eggs, preferably organic � Animal Foods – Buy hormone and antibiotic free � High Temperature Cooking - Avoid all deep fried foods � Insulin Response– Avoid all ‘high insulin’ foods like sugar and white flour � Omega 3 Oil – Consume some fish each week, or take fish oil supplements � Cooking Oil – Replaced polyunsaturated oils with monounsaturated � Food Additives – Avoid foods with chemical additives or preservatives � Exercise – Aim for 2-3 sessions a week � Stress Management – Do Yoga, or some other stress management program � Cooking Skills – Should I consider a French or Italian cooking course � Bad Food Days - Take supplements Vitamin C, B6/B12/Folate, 300mg Magnesium

Excerpted from the book Cholesterol & The French Paradox

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CHAPTER 25 READER COMMENTS

I would like to share with you the feedback that I received from readers, and hopefully this will encourage you to work with your physician in a collaborative manner.

Hi Frank I thought you might like to know I gave a copy of your book to my Doctor. I had an appointment recently with her to get a flu shot and she said reading the book had been "mind changing" and that she was seriously questioning the "cholesterol paradigm". All the best, David, Perth, Australia

Good Evening Frank We have just finished reading your book for the second time - so much fabulous information - thank you. Four weeks ago my doctor prescribed Lipitor because my cholesterol was 7.9. I refused to take the script and read your book instead (which my wife bought for me) and we have now purchased 6 more copies to give to family, friends and a friendly pharmacist.

I am 54, fit and well and have no reason to suspect my arteries are full of plaque yet, however EDTA seems to have so many side benefits that I may undergo the treatment as a preventative measure. We already eat mostly good food including the vegetables and fruit and I have never spurned meat and diary much to the concern of my doctor and friends who think I should be very fat.

I now add a little French red wine - whilst I like Australian reds I find I never feel well later - is this because of different ingredients such as preservatives? David, Gold Coast, Australia

Hi Frank Well done. I appreciated the book; it has supported and greatly expanded upon some issues raised in another recently published book by Dr Sandra Cabot. I thought you may be interested in yet more examples of Lipitor’s side effects. I was prescribed a daily dose of 20mg Lipitor 18 months ago (cholesterol read at that time 7.1). Over the last couple of months I noticed short term memory problems and some cognitive impairment, which of course I put down to age (54) and too many beers at the local on Friday nights.

When a recent blood test showed a 0.57 level of Lipoprotein A (versus a safe level of 0.3), and the doctor told me it was a genetic marker and I could do nothing about it, I decided in fact, to do something about it. Your book was perfect timing to confirm my suspicions. I have stopped taking Lipitor, and am following what I hope will prove to be a successful diet and vitamin regime.

My colleague was also recently given a 40mg daily dose of Lipitor for a cholesterol read of 6.1 (aged 50). He is a keen sportsman and runner. After 6 weeks of this dosage, he was suffering so much muscular pain that he stopped taking the drug (and stopped running!). Since then he has been suffering with back disc/muscular problems which may be associated with that heavy dosage. I note your book says the drug companies encourage doctors to prescribe a heavy initial dose for fast results, no matter, it would seem, of the consequences.

It is a tragedy that there must presumably be many Lipitor patients out there with an acceptable cholesterol read, providing them an illusory defence against CHD, whilst their lifestyle supports continued oxidization and plaque formation in the arteries. It must be even more of a tragedy that GP’s can continue to practice under such a veil of ignorance (or unethical coercion). Thanks again for a great book. Lee, Brisbane, Australia

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Good Evening Frank

Thank you for leading me to review my medication; I am now much more able to deal with the daily trials and tribulations being free of ‘Cholesterol drugs’. As you would expect, my health has improved and motivation and ability to think and react quickly is much improved after being ‘drug free’ for some time. My Doctor is not convinced but then he is ‘old school’ and heavily overworked, but is ready to admit that my general health is better as I continue to loose weight while eating more protein and [as far as possible] no synthetics such as margarine. Kind Regards, Herbert, Country NSW, Australia

Before We Finish

One of the disappointments in writing this book is that the findings have proved somewhat dark on the pharmaceutical industry. This is perplexing as some of my family and friends work in the pharmaceutical industry. However, my role in writing this book has been as an author and researcher to investigate the views of medical experts, and to present it as I found it.

This book represents the experiences and views of many acclaimed medical doctors and scientists, whose combined experience in the area of heart disease represents thousands of man-years of research and clinical experience. Their views are all on the public record and available for anyone to read.

If you have been worried about cholesterol, then I hope this book has eased some of your concerns. I also hope that it has provided you with information that you can use in your daily life.

I would encourage you to work closely with your physician or qualified healthcare professional so that the ideas gained from this book are adapted to your specific requirements. Most healthcare professional are receptive to patients who are well-informed, and I would encourage you therefore, to share any aspect of this book with them as some of the information may be new to them. Or you can give them a copy of this book in PDF format, which you can freely download from my website.

If anything, this book would have shown you that there are many steps involved in improving ones health, and the biggest challenge is changing our behaviours.

Thank you for taking the time to share my journey with the French Paradox. I hope you will agree that the French are a good benchmark for changing some of our dietary behaviours based on their achievements:

� France has the lowest levels of heart disease of all western countries. � The French healthcare system is rated #1 by the World Health Organisation. � The French live long healthy lives.

So this book about the French Paradox has given us a point of reference for living healthy lives. As you know, vested interest groups have given us confused messages about the benefits of drugs and foods, yet chronic diseases continue to climb. Hopefully this book has put things in a better perspective to help you navigate forwards for a healthy life. My suggestion is that you look to fresh and natural foods as Mother Nature intended, to achieve good health.

Best Wishes and Bon Appetit!

Frank Cooper, Naturopathic Nutritionist Australia www.frankcooper.com.au

PS - The Appendices of this book includes additional information that you will find useful.

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Important Notice - This book is intended for informational purposes only and is protected under Freedom of Speech. It is not intended as medical advice nor should it be construed as such. Nothing in this book is intended to diagnose or treat any disease. It is not a substitute for any treatment that may have been prescribed by your doctor or qualified health professional. If you suspect that you have a medical problem, seek professional medical help. Always work with a qualified health professional before making any changes to your diet, prescription drug use, exercise activities, or other lifestyle changes.

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The information in this book is not supported by conventional medicine or medical doctors. The information contained in this book is provided as-is and the reader assumes all risk from the use, non-use or misuse of this information.

APPENDIX 1 MY LIFE JOURNEY WITH CHOLESTEROL

I thought you might find it interesting, if I shared my life journey with cholesterol. I first became aware of heart disease when I was a teenager living in Canada when I was 15. My mother explained to me that one of her brothers had just died of a heart attack at age fifty and he had suffered from something called angina. At the time I thought that it was just a case of bad luck.

My own real life experience with CHD occurred when I was 27, and working for a large multinational company. I was based in Sydney Australia and doing a lot of overseas travel, so I thought it might be sensible to have a medical check-up to see if I was in good physical condition.

I remember my Doctor did a comprehensive check-up, which included various blood tests, and he told me I was in good shape. Only one little problem - I had a cholesterol level of 13.2 (That’s 504 in USA) which meant a referral to a cardiologist.

Not surprisingly, the cardiologist said my cholesterol was far too high and we had to get it down pronto. Medication was required. So he prescribed me a drug called Clofibrate and I think his idea was that I would take this medicine permanently. I must say I was not too keen on the idea, as I thought medicines were for old people. But I felt I should have an open mind and give it a try.

Well I certainly wasn’t a long-term subscriber to this drug, because after a month of not feeling myself, I thought I would be better off with the high cholesterol.

However I was worried about my high cholesterol and researched Clofibrate (brand Atromid-S) to see how it worked and whether maybe I should continue taking it. But I was horrified to learn that whilst this drug certainly reduced cholesterol, the World Health Organisation (WHO) had done a study and found that people who took this drug died a lot earlier than those who didn’t. They just died of other causes than heart disease.

The bottom line was that Clofibrate was a nasty drug that could damage vital bodily organs, and if I had taken it as a long-term therapy then I would likely be dead today, or have some serious liver damage to make my life pretty miserable. The bottom line was that this drug was not something you prescribed to a healthy 27-year old whose only problem was that he had high cholesterol.

But this experience gave me a real insight into the medical world, and the need for me to make some of my own decisions about my health. It was the first time in my life that I did not do what the doctor ordered, and it turned out to be a good decision.

However, from this whole exercise I did learn that high cholesterol was something that I had inherited from my mother’s side of the family. She had high cholesterol, as did my older brother and my daughter.

So I did a lot of further research into CHD and Cholesterol. This meant reading many books and sifting through as many articles as I could find on the topic. What I found was that there was really no single roadmap for someone with high cholesterol to avoid CHD, but there were many different opinions.

I remember speaking to a number of medical practitioners and came to the conclusion that the medical field was similar to the business world, in that opinion can vary.

Back in those days, diet and nutrition were not understood, and in hindsight my diet of hamburgers, milk shakes, meat pies, and pizza might have had some bearing on my elevated cholesterol levels.

One person who was a pioneer in understanding CHD at that time was Nathan Pritikin. Nathan had spent much of his life working for companies like GE and Honeywell and used his spare time to study CHD. Nathan’s contribution to understanding heart disease was extraordinary and he changed the conventional thinking on how to avoid CHD.

After reading Pritikin's books I decided to follow the Pritikin diet in the hope that it might reduce my cholesterol levels. His diet meant eating better, with more vegetables, fruits, breads, legumes and removing animal fats and high cholesterol foods like eggs and cheese from the diet. It certainly helped because my Cholesterol went down from 13 down to 10 and has stayed there ever since. It’s my natural level.

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One of the things I found in researching cholesterol and CHD was that a lot of the material I read was contradictory. Some experts said eggs were bad, and some said they were fine. Some experts said

polyunsaturated oils were good and some said they were bad. Avocadoes were bad for a number of years, and now they are good. This confusion caused a number of people to give up trying to understand CHD and simply opting for a cholesterol-lowering pill.

Another thing that didn’t make sense was that whilst my cholesterol averaged around 10 for most of my life, it did manage to go down to 7.8 when I was transferred to New Zealand. This is a country where the dairy industry had a strong hold at that time, and I found myself eating butter and creamy milk, because products like margarine and skim milk were not readily available. I seemed to be eating more saturated animal fats, yet my cholesterol went down. The question was why?

Thereafter I returned to Australia with my employer, and my cholesterol level was back to 10.

I then had the opportunity of attending a new initiative at one of the major hospitals, which had started a Lipids Clinic focusing on the study of heart disease. This was very interesting and I attended every two weeks. We started with various dietary changes to see whether that might reduce my cholesterol. But my cholesterol was stubborn and stayed at 10. So the Lipids Clinic was unhappy with my 10, and wanted to try drug therapy.

One of the first drugs prescribed was Nicotinic acid. I was quite enthusiastic to try it because it is really Vitamin B3 (Niacin). As a vitamin supplement you might normally take 25mg per day, but my prescription called for 30X that at 750mg day.

How does Nicotinic Acid work? Well the liver makes the body’s own cholesterol; separate from the cholesterol we get in our diet from foods like meat and eggs. Nicotinic acid stresses the liver and thereby reduces the livers ability to make cholesterol. The liver is not happy about this stress, which is why you need to get a liver test every few months to see whether there is any liver damage.

But Nicotinic Acid has side effects. One was that I felt tired during the day, probably because my liver was ‘under the weather’ from trying to get rid of all the Nicotinic Acid. Another side effect was my face turned red as a beet each time I took it, which was embarrassing. Later we changed to ‘slow release’ Nicotinic Acid which releases the contents slowly over two or three hours and reduces the redness.

In my case, Nicotinic acid did lower my cholesterol down to 8 for the first three months but after six months I was back at 10. When I asked the clinic doctor why I was back to 10, he said it was because my body seemed set on having that cholesterol level, so my liver was working overtime to attain that level.

Rather than allow the liver to win, we decided to apply a little more pressure, and doubled the Nicotinic Acid to 1500mg per day. My cholesterol did go down for a three months, but after six month we were back to 10 again. At that point I said to the doctor that if my cholesterol was going to be at 10 with or without the Nicotinic Acid, then I might just as well go without.

It seemed irresponsible for me to take a drug that was not delivering quantifiable benefits, and having my liver tested every few months to see whether the drug was impairing my liver. The noted side effects that I found for Nicotinic Acid were:

� Liver problems (hepatoxicity), especially with the sustained-release form.

� High blood sugar (hyperglycaemia).

� Too much uric acid in the blood (hyperuricemia).

� Gastrointestinal problems such as peptic ulcer, nausea, vomiting, and diarrhoea.

� Dizziness, light-headedness, fast or slow heartbeat.

Just for the record, at that time some of the more enthusiastic subscribers of Nicotinic Acid were taking between 2000mg and 8000mg per day. However today you will find very few people on such extreme doses.

Nicotinic acid was an interesting experiment and it did make me wonder whether there might be more natural ways of reducing the liver’s cholesterol production capabilities. Later I was to learn that red wine, which is so popular with the French and Italians, has a positive effect on lowering cholesterol production. That is because the body breaks down alcohol in the liver, thereby keeping the liver pretty busy, and so reducing its ability to produce cholesterol.

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The next drug I tried was Cholestyramine, which is a powder you mix with water or juice. This powder cements itself to the cholesterol travelling through the gut, and in doing so, it stops the cholesterol from being absorbed

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into the bloodstream. However it made me very constipated (as cement would) so after a while I stopped taking it.

But it did make me consider whether there might be natural ways of binding cholesterol in the gut so as to reduce it’s absorption into the bloodstream, and I later learned that water-soluble vegetable fibres could do that. Therefore a diet high in fresh fruit and vegetables to get adequate fibre has proved to be important.

But it also made me consider the impact of our low fibre diet and the consequence of having a slow digestive tract where food moves slowly, rather than quickly. Think for a moment about a fast flowing river versus a slow moving or stagnate river. A very fast moving digestive system means that a higher proportion of cholesterol is sent downstream if you know what I mean, so less is absorbed into the body and bloodstream. Hence a good dose of daily fibre are important and hence the fruits and vegetables.

With all these different therapies I was exposed to, I was never sure whether I was the patient or the researcher.

I remember sitting on a beach in Hawaii at the age of 33 with a fellow windsurfer who was an American cardiologist, and spending much of the day talking heart disease. At that point I realised I knew a lot about heart disease, but during the next twenty years I was to learn a lot more.

Clearly all the drug treatments and therapies that I participated in, didn’t seem to reduce my cholesterol. I also felt frustrated because during this time no doctor ever told me that I had any build-up of plaque in my arteries (atherosclerosis), just that I had high cholesterol.

And deep down I felt confident that my healthy diet offered me some reasonable protection against the build-up of plaque in my arteries, and without the side effects of drugs.

A few years passed and in the late 80’s there was a new range of drugs that could reduce cholesterol called the statins, and they worked by reducing the amount of cholesterol manufactured in the body.

I had an open mind and decided to give these new statin drugs a go. I remember I tried Simvastatin, Pravastatin, Lovastatin each for about six to nine months, but ultimately I was not prepared to put up with the side effects and the well-documented risks that these drugs carried.

In the end, I stopped taking cholesterol-lowering drugs in 1997. That was the year my older brother, who is 5 years my senior, had a triple bypass. My older brother is a well-educated Ph.D. space research scientist working at JPL in the USA, who had spent 20 years doing everything possible to manage his cholesterol. He had been diagnosed with high cholesterol very early in life compared to most people, and received treatment very early. This early detection and treatment should have put him ‘well in front’ of others to avoid CHD.

My brother was very dedicated in his battle with cholesterol. He tried each new drug and therapy that was recommended to reduce his cholesterol. He kept meticulous records of the drugs taken, his cholesterol levels, blood pressure etc. He exercised, and was running 5 to 8 km several times a week.

I should add that my brother and I are very similar in terms of physical stature, cholesterol levels etc which we inherited from my mothers side of the family. So if my older brother did everything possible to prevent high cholesterol and CHD, then my luck was probably running out fast. Equally, I concluded that if the cholesterol-lowering drugs had not protected him, they were not going to protect me either; in which case, there was no point in taking them.

However it did encourage me to start my research. I kept thinking that since CHD was a new disease of this century, and also that some countries seemed to enjoy low levels of CHD, that we were clearly missing something. I had to find out, for example, why CHD was much lower in the Mediterranean countries, lower in France, lower in Mexico?

In my research I investigated CHD with professionals in different healthcare sectors including doctors in Traditional Chinese Medicine, Naturopaths, Homeopaths, Nutritionists, and practitioners in the health and fitness industry. I found they all had some valuable ideas that started to fit together like pieces to the puzzle.

I must say I was fortunate over the years because I have had my cholesterol condition monitored by an excellent Australian cardiologist. He was always fully ‘up to speed’ on the latest developments in CHD including dietary, drug therapy, and testing. There are two useful tests that he had me take, to check how likely I was to get CHD.

The first was the Thallium Scan that assesses the blood supply to the heart. I did some treadmill exercises to get my blood flowing and was given an injection containing a small amount of radioactive material. They then take pictures of your heart using a special camera. This takes about 15 minutes.

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Later there was the CT Scan that we spoke in earlier chapters. At age 52 I had a CT Scan score of forty seven, which is not too bad for someone with FH. It confirmed that my arteries were in good shape, and that my diet had somehow protected me.

What I have learned over many years of study is that a lot can be done to reduce the risk of heart disease. I have also learned that cholesterol in itself is not such a bad thing, and if yours is elevated like mine, that there are many things you can do.

APPENDIX 2 CHOLESTEROL: HOW IT BECAME A DISEASE

How did cholesterol become such a dangerous substance? Why would something so vital to human life, that makes up 8% of the dry weight of the human brain, be dangerous to our arteries? How can cholesterol, which is found inside every one of the trillions of cells in your body, be dangerous? Did Mother Nature get it wrong?

One of the best books to explain how cholesterol became a disease is called Heart Failure written by American medical journalist Thomas J Moore and published by Random House Inc (1989). The book is out-of-print, but you may still be able to get a copy from Amazon. His website is www.thomasjmoore.com

Let me explain the history of cholesterol, and how it became a scapegoat for the cause of heart disease, and how it became the ultimate financial windfall for the drug industry:

In the 1940’s there was an epidemic of heart attacks in the USA. The US health sector was at a complete loss as to why it was happening, and it was becoming an embarrassment to the US Health Department.

The cholesterol story actually begins in 1953 when US Army and Marine doctors published a discovery that shocked the world. It occurred during the Korean War, as autopsies were performed on young American soldiers who had died in battle. The doctors were shocked that many of these young soldiers had streaks of fatty plaque in their arteries, which were signs of coronary heart disease normally found in only older men. These streaks were made from a mixture of calcium, fats, cholesterol, white blood cells, fibrin, blood platelets, and collagen.

The US Government was under considerable pressure to find answers, as doctors everywhere grappled helplessly with the heart attack epidemic. Doctors themselves were dying at a young age from heart disease, and children lost their parents prematurely.

In the 1950’s, American Dr Ancel Keys theorised that saturated fats and cholesterol were the cause of heart disease. Keys had distinguished himself during World War II by developing a high-calorie food package (consisting of dried meat, dried biscuits etc) carried by paratroopers and it was named after him as the “K Ration”. Consequently, Keys had considerably notoriety and influence.

Keys had ‘put together’ some multi-country statistics that compared different diets, and he produced convincing charts and data that showed that saturated fats and cholesterol were the cause of heart disease. With the US health sector languishing for answers to the heart attack epidemic, Keys’ data was accepted by a willing audience with little debate. Those doctors and scientists who protested against Keys theories and lack of data, were considered obstructive.

There were a number of flaws in Keys theories, and one of the most fundamental flaws were trans fats. During Keys’ time, few researchers knew the difference between hydrogenated trans fats and saturated fats. So foods made with hydrogenated fats (the real killers) were recorded as saturated fats by study trail researchers. So the trials were flawed from the start, and this misunderstanding would continue for another forty years.

It would be many years before Keys data was re-examined, and found to be incomplete, and with incorrect conclusions. But by then it was too late, because the fear of saturated fat and cholesterol was thoroughly entrenched in the minds of the American public and other affluent western nations.

There were anecdotal stories that emerged during this time that added to the saturated fat/cholesterol story. One was an experiment done with rabbits that were fed cholesterol, and their arteries clogged up after a month, which was widely reported in the press with great fanfare. Later it was realised that rabbits are total vegetarians and have no digestive capability for handling cholesterol. Eating lettuce and carrots is certainly normal, but a blob of cholesterol, certainly not. In addition, the rabbits had been fed stale cholesterol that was oxidised. (Feeding oxidised cholesterol to vegetarian rabbits, is like putting diesel fuel into a petrol engine, and a good way to clog the engine). So this rabbit story was - some years later - shown to be a good example of bad science.

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Some senior bureaucrats in the US Health Department latched on to the cholesterol/saturated fat story and supported the idea and gave it momentum. Officials within the government needed ‘to be seen’ to be doing something proactive, and the cholesterol/heart theory suited the purpose. My feeling is that they genuinely believe in the theory, but little research was done to verify the correctness of the data.

So in October 1987 the US Health authorities announced an unprecedented initiative for combating heart disease. They stated that based on research, that 25% of the US adult population had a dangerous condition called ‘elevated cholesterol’ which would require treatment for the specific purposes of reducing heart disease. People affected would go on to a strict cholesterol-lowering diet under the supervision of their doctors, and if the dieting was unsuccessful after 3 months, then cholesterol-lowering medications could be prescribed. What this meant, was that 25% of the adult population suddenly had a medical condition that required treatment by doctors.

Interestingly, 1987 was a notable year for others reasons. It was the year that the first statin cholesterol-lowering drugs were launched by the influential Merck Corporation. Coincidence?

The logic behind this move by US Institute of Heath in 1987 was concerning to many researchers, because heart attack rates had been declining steadily for the prior twenty years without any involvement from government or industry. Why not allow heart attack rates to continue to fall on their own.

The most amazing aspect of this huge initiative, was its low-key introduction. It was sponsored by a unit within the US National Institute of Health called the National Cholesterol Education Program, and was brought into existence as quietly as a stealth bomber. Considering that this was the biggest medical intervention in the history of the USA, it should have been properly presented and debated. But in reality, it was the ultimate snow-job according to independent medical researchers.

Let’s look at what medical journalist Thomas J Moore had to say in his book Heart Failure that was published two years later. On page 29 he writes:

“Before a government program of such importance moved into high gear one would expect it to have first survived extensive scrutiny. One would suppose that such a far-reaching intervention into the lives of millions of people would have been approved by the White House and scrutinized by the Congress. In fact, the Institute launched this project on its own authority, consulting mainly with special panels of hand-picked physicians.

One would suppose that before putting millions of people on a medically supervised diet it would have been tested in advance to demonstrate that it was safe and that it worked. No such tests were conducted.

One would suppose that the nation’s clinical laboratories could measure cholesterol accurately enough to identify those who needed treatment. In fact, laboratory performance was so poor that millions with average cholesterol or low cholesterol would be misled into believing their levels were dangerously high.

One would suppose that before launching a program that would involve billions of dollars in doctor’s bills, laboratory tests and medications, the costs and benefits would have been carefully weighed. In reality, officials would not even guess at the total costs and had no plan to measure the benefits.

And, one would suppose that it had been conclusively demonstrated that lowering blood cholesterol would save lives. No such evidence existed.”

So that’s how it happened. And with this level of support from the US National Institute of Health, the fear for cholesterol and saturated fats increased momentum. The food and drug companies provided the ammunition with a range of products and powerful marketing campaigns, and that set the ‘anti-cholesterol’ wheels in full motion. The American Heart Association became a fortunate benefactor to the cholesterol hysteria, by licensing its ‘healthy heart’ logo to food corporations for a royalty fee, and generating many millions of dollars. This is now a significant income source to the Heart Association.

Today there are so many beneficiaries to the anti-cholesterol campaign, that there is no motivation to bring it to an end. The food corporations, drug corporations, medical associations, pharmacies, doctors, laboratories etc derive huge revenues from the anti-cholesterol campaign. It is unfortunate that the media including TV and newspapers are so beholden to these organisations for their revenues, that they are not interested in publishing anything that might upset their clients.

Conflicts of Interest

Just before we close off, you should know that USA Today published a story on 16 October 2004 stating that 8 out of 9 doctors that make up the panel at the National Cholesterol Education Program mentioned earlier, had blatant conflicts of interest. This is what it wrote:

Cholesterol guidelines become a morality play (Via Associated Press)

“They led influential medical groups, starred at prestigious meetings, published in top journals and were undisputed giants in their field. But when these famous doctors advised the government recently on new cholesterol guidelines for the public, something else they had in common wasn't revealed. Eight of the nine were making money from the very companies whose cholesterol-lowering drugs they were urging upon millions more Americans. Two own stock in them. Two others went to work for drug companies shortly after working on the guidelines. Another was a senior government scientist who moonlights for 10 companies and even serves on one of their boards.

Consumer groups and others now are questioning not only the advice these doctors gave but also their fundamental ability to act in the public's best interest. It comes as some of these companies lobby the government to let drugs at the center of this controversy — statins such as Lipitor and Zocor — be sold over the counter.”

The article is quite revealing, and has some strong critiques in terms of conflicts of interest and lack of transparency.

Study Trial Inaccuracies

Let’s now talk about Study Trials. Most people would have thought that the Study Trials conducted for cholesterol over the past few decades would provide the black and white information that we need to determine whether there is any risk with cholesterol. The reality is that there are no conclusive results to prove a link between cholesterol and heart disease.

Generally speaking, study trials are very difficult to conduct, and their conclusions must be viewed with a degree of caution. The trials and studies that I have looked at were mostly for cholesterol, and some of these took place over many years and included thousand of participants. These sorts of large trials are very difficult to administer.

There are many papers and books written by highly-qualified medical doctors and medical writers, which highlight the inaccuracies of medical studies and trials. So let me provide a synopsis of why study trials are so inaccurate, and open to interpretation.

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This first problem that you have, is that the conveners of these trials are focused on a specific outcome for their drugs, to prove their effectiveness. As you know, a new drug needs a formal trial to validate its usefulness, and because these trials are expensive, they are only done if there are guaranteed $$ dollars at the end of the

whole exercise. Naturally, the sub-contractors who run these trials on behalf of the larger pharmaceutical companies, understand that a favourable outcome is what everyone wants. So we have a biased group of people overseeing these trials.

A study trial is unregulated, so if the trial results do not produce what the sponsor wants, then the trial data can be thrown in the bin, and another study trial commenced. If the trial results do support what the sponsor wants, the trials results are released with fanfare.

Why are study trials as inaccurate as the throw of a dice? Let’s walk through the complexities involved in running study trials, and understand why the final results are unpredictable and not representative of the facts.

For starters, how do you assemble the huge number of participants needed, who are prepared to spend the next 5-10 years participating in the trial. I mean would you do it? Generally the only participants that are motivated to join a trial, are those with real cholesterol or heart disease or health problems, which means a subgroup of people with known adverse medical problems, and these people do not represent the community at large. So this subgroup is not representative of the broader range of people who will take these drugs.

The next challenge you have, is how do you manage this group of volunteers, because what happens in reality is that many volunteers lose interest or find it difficult to keep reporting, whilst others move away or cannot be tracked etc, so records are incomplete. I don’t know about you, but many people struggle to keep proper records at home on their bills and other bits of paperwork, leastwise something with a low priority like a drug trial. So you can just imagine what sort of inaccuracies that these trials have.

And mortality records are another area of inaccuracy, because of inconsistencies in diagnosis between doctors. For example, if someone receiving cancer treatment dies of a heart attack, do they die of cancer or heart attack? What goes on to the Death Certificate? These sorts of complications are common in medicine and skew the data.

Also these trials are largely conducted in the USA, and the dietary and lifestyle habits for Americans are very different to Australians, and this has another skewing effect on the relevance to Australians.

And then you have the blood tests that are used to measure cholesterol levels, which are inaccurate by around 10-20%. They vary between pathology labs because blood cholesterol is difficult to measure accurately. That’s because cholesterol is not a freeform molecule, but sits inside a lipoprotein as a component of blood, and lipoproteins vary a lot between between individuals.

And then you have those subjective variables that really affect the results. In some studies - if you look carefully - you will find these innocent words written by the trial organisers, which give them a carte blanche to publish whatever results they want. Just look for these sorts of words “The results were adjusted for age, education, smoking, alcohol intake, mood, weight and past history”. I mean, what does that really mean?

And so the complexities and variables for conducting these study trials are huge, and each variable skews the data a bit more, so that the final results are not reliable.

And lastly you have the fact that the Final Conclusions of a trial are usually expressed in terms of Relative Risk instead of Absolute Risk, which overstates the findings. So a 1% increase in Absolute Risk is expressed as a 50% increased in Relative Risk. Let’s look at that:

What’s the difference between Absolute Risk and Relative Risk?

It is really important to understand the difference so let me paint a scenario. It’s a fictitious example to make the point. Imagine two groups containing 100 men each, let’s call them Group A and B.

Group A has 100 men with high cholesterol that are monitored for ten years, and during that time 3 men have a heart attack, and the remaining 97 men are fine.

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Group B has 100 men with high cholesterol that are monitored for ten years but these men take a new cholesterol-lowering drug, and only 2 men will have a heart attack, and the remaining 98 are fine.

The facts we can draw from these two groups are as follows:

In Group A, 3 people will have a heart attack, 97 will be OK. In Group B, 2 people will have a heart attack, 98 will be OK

So the question is, what is the increased risk of a heart attack for those in Group A where 3 people had a heart attack, over Group B where only 2 people had a heart attack? Try to pick the correct answer below, before you keep reading:

Absolute Risk is increased by 1% Absolute Risk is increased by 3% Absolute Risk is increased by 10% Absolute Risk is increased by 50%

Not sure? The answer is that the Absolute Risk is increased by only 1%, because only 1 additional man in a 100 will have a heart attack in Group A over the ten years of the study.

The problem is that 1% is not a number that will convince doctors to prescribe this new drug. So the marketing people have a simple solution, which is to publish the trail results using Relative Risk.

The Relative Risk is calculated by comparing 2 heart attacks to 3 heart attacks, and when 2 increases to 3, that’s a 50% increase. That is a pretty big percentage. So the announcement for the new drug will say:

“Men with high cholesterol have a 50% higher risk of a heart attack"

Relative Risk is deceptive because it over-inflates the benefit. Physicians need to be able to weigh up the absolute benefit of a drug to the absolute risks, so that they can advise their patients properly.

At the end of the day, it needs to be clearly understood that drugs taken for the sole purpose of avoiding a medical event that may not occur, have more to do with mathematical probabilities and calculated risk, then healthcare. Many people are attuned to taking calculated risks when they are given accurate data. Unfortunately, the medical community continues to use Relative Risk to inflate the benefits of pharmaceuticals to patients, whilst at the same time ignoring the risks. Consequently patients are unable to assess the true risk for themselves when taking these drugs and many end up worse off as we saw earlier.

Whenever you read any claims of how one drug is 30% or 50% better then another, or reduces a stroke by 40% or some other claim, then you will be wise to be very sceptical. The buyer beware adage should always apply.

The final ‘nail in the coffin’ affecting the accuracy of cholesterol study trials, is the limited information given to doctors and patients. The old sales and marketing adage of ‘emphasising your strengths and downplaying your weaknesses’ certainly applies to the pharmaceutical business, and the weaknesses are usually hidden within a lengthy document that few physicians have time to read.

As a case in point, one of the more recent statin drug trials highlighted with great fanfare in a press release that the statins had reduced the chance of heart attacks by over 30%. At face value, anyone would be impressed. However, what was not revealed in the press release was that haemorrhage strokes to the brain (a life threatening event) increased significantly for those taking the statins.

So the overall mortality was the about same for those that took statins and those who did not. In other words, the chance of dying had not changed at all. But the press releases and company information only highlighted the favourable statistics, whereas the negative statistics were not presented to either the medical profession or the consumer. Let the buyer beware!

So in summary, when you realise how unreliable drug trials are, you can understand why we chose to investigate the French Paradox to gain a more accurate insight into the relationship between cholesterol and heart disease. Epidemiology studies (i.e. studies of large populations) provide a much more reliable framework for deriving conclusions. As the French enjoy greater longevity and less heart attacks, they represent an excellent group to use as a benchmark for understanding why cholesterol, saturated fats and heart disease, are not linked.

APPENDIX 3 THE HISTORY OF FATS & OILS (1900 TO 2000)

Oils and fats are so important to your good health that you really need to take some time to understand them. This Appendix looks at the evolution of fats and oils during the past century.

Going back one hundred years ago, most of the oils that were consumed, were part of the foods that people ate. They were contained in the seeds and nuts that people consumed.

The solid fats that people consumed were typically butter, cream, lard (pig fat), dripping (beef fat), and fat from poultry. These fats were more stable then oils, as they did not did not oxidise readily, and were used for frying, baking cakes and biscuits, and general cooking.

At that time commercial shortening was mainly used by the food processing companies, and shortening was a mixture of liquid vegetable oils, and solid fats like beef tallow or pig lard.

Around 1910, food chemists discovered that if you took vegetable oils, and you added hydrogen via a high temperature process, you could convert liquid oil into a solid fat. This meant they could make commercial shortening without the need for tallow or lard. This was a major breakthrough, as commercial shortening could be made from 100% vegetable oil, it was cheaper, and importantly, it had an indefinite shelf life.

Also by controlling the hydrogenation process, they could produce a range of fat products, from mayonnaise-like consistency, to butter soft consistency, to a very hard fat.

Over time, these hydrogenated ‘solidified’ vegetable oils were increasingly used by commercial food manufacturers in a wide range of foods and they became the predominate fats used in many western countries.

Crisco was one of the very early brands and the website had this to say:

“Procter & Gamble introduced Crisco in 1911, to provide an economical alternative to animal fats and butter. To emphasise the purity of the product within, the Crisco can came inside an additional, removable over-wrap of white paper. Crisco, the first solidified shortening product made entirely of vegetable oil, was the result of hydrogenation, a new process that produced shortening that would stay in solid form year-round, regardless of temperature. Crisco, the all-vegetable shortening, introduced an entirely new way of cooking. Crisco provided an alternative to animal fats, and it was more economical than butter. The earliest cans came with cookbooks, and in 1913, a team of home economists began Crisco cooking demonstrations across the United States.”

This new Crisco product looked very attractive, and quickly gained market share. Of course there were other similar products, and from 1920-1940 there was exponential use of hydrogenated vegetable oils in processed foods. This was unbeknown to most consumers, because there wasn’t any labelling of ingredients on packet foods.

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Around 1950, the vegetable oil industry decided to capitalise on its ability to turn cheap vegetable oils into fats, and launched products such as margarine onto the consumer market. In those days, consumers trusted the

large companies for their innovative products, and a product that looked like butter which was made from healthy vegetable oil, had good consumer appeal.

I remember quite clearly that my mother started buying this ‘healthy’ margarine because it was vegetable oil.

Unfortunately at that time, no one in the health/medical sector bothered to study the molecular structure of these hydrogenated oils. Because if they had, they would have determined that the human body is not designed to handle this synthetic type of fat.

Naturally the Dairy Industry reacted very negatively to this new ‘margarine’ that aimed to displace butter. To pacify the Dairy Industry, the FDA legislated that margarine could not be coloured to look like butter, as it might confuse the consumer.

So the margarine we bought looked like white grease and was not very attractive. It came supplied in a sealed plastic bag, with a little orange colouring capsule. You would squeeze the colouring capsule and massage orange dye through the margarine, and presto it looked like butter. I remember how awful this white grease looked, and mixing in a yellow dye to make the white grease look like butter, seemed disgusting. Something inside of me said ‘this is not natural’.

A few years later, the margarine manufacturers got approval to add colouring into margarine at the point of manufacture. This is just as well, because the current generation would find the idea of mixing yellow dye into white grease called margarine, quite despicable. This was followed by clever marketing campaigns focused on the supposed health benefits of margarines made from vegetable oils.

In the 1970’s, the health benefits of polyunsaturated oils became the rhetoric of the day, supported by authorities like the US FDA, the American Heart Association, and other medical associations. Thereafter vegetable margarine became the preferred choice for many consumers in the USA and Australia, due to perceived health benefits.

In the 1980’s, research started to appear that raised serious questions about these ‘hydrogenated vegetable oils’ and studies showed them to have convincing correlations with heart disease in males and cancer in females.

One person at that time, who had made it her life passion to understand the chemistry of oils and fats, was Mary Enig. She had done her PhD on fats & oils, and made it her mission to understand their structure and their impact on humans.

Mary’s story is fascinating. She did her early research at the University of Maryland near Washington, DC. It’s a terrific university, and I remember touring the university campus some years ago after my brother completed his PhD there. Mary Enig’s research at Maryland, focused on the chemical structures of oils and fats, and how they affected consumers. She particularly looked at the synthetic man-modified fats - the hydrogenated fats - and a by-product called trans fats.

What Mary discovered from her research, was the damage that these hydrogenated trans fats did to people, and how they caused heart disease and cancer. She discovered that each cell in the human body consisted of a large amount of fat and cholesterol, which were essential materials to build their outer walls, and act as a sealant to keep out viruses and other bugs. She discovered that these hydrogenated trans fats, were displacing saturated fats in the cells of the body, and thereby damaging the cells structure. This has a ‘domino effect’ of cell damage, leading to cardiovascular damage, cancers and other diseases.

Naturally she felt compelled to tell consumers about the risks of these fats. So she went on to warn the general public, and became a regular TV and radio personality on fat & oil nutrition.

However, it did not take long before Mary came under attack from the big food companies. One was Proctor & Gamble, who owned the Crisco brand of vegetable oils in the USA. P&G applied a lot of pressure on her, to keep quiet. However it only made her more determined to educated housewives on the dangers of these products.

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So big business retaliated further, by threatening to cut-off research grants to Maryland University where Mary was based. Most universities rely on funding from industry & commerce for their PhD research. Most PhD researchers don’t have a lot of money to fund their own research, and rely on university grants.

Mary must have had some financial means or some backing, because she took her small research team out of the university, and continued her research into fats and oils independently. She played a key role in educating consumers on the dangers of hydrogenated fats.

Consumers should ‘take their hat off’ to people like Mary, who have the determination to battle it out with such powerful corporations, and suffer the considerable emotional stresses that would send some people ‘over the cliff’.

Interestingly, Proctor & Gamble sold its famous Crisco Division in 2002. It was done very quietly, and with minimal fanfare. The stated reason was that the company was moving away from that business. However some analysts questioned why a company would want to dump such a strong and successful brand. Some even suggested that P&G wanted to get as far away from Crisco as they could, because of the risks.

There were comments from a few sources suggesting that companies like Proctor & Gamble could find themselves up against huge Class-Action Lawsuits, because of the damage done to humans by hydrogenated oils.

It’s encouraging to see that common sense is emerging on hydrogenated trans fats. In Europe, hydrogenated trans fats are restricted in some countries, and Denmark was the first country to pass legislation in 2003 restricting hydrogenated trans fats because of the link to heart disease.

Also encouraging, is the fact that the US Food and Drug Administration (FDA) responded to universal pressure, and dictated in 2006 that hydrogenated trans fats must be listed on food labels. The FDA has taken the position that the “intake of trans fats should be as low as possible”.

Australia lagged well behind on these initiatives. A packet of biscuits or cookies in the supermarket rarely mentions trans fats, and simply states “vegetable oil” under the ingredients list. However in nearly every case the product will be made with hydrogenated trans fats or interesterfied vegetable oils.

Interesterfied vegetable oils

Because the problem with trans fats has been known for some years, the food chemists have been busily perfecting a replacement. The solution is in a process called interesterification. It is a process for making a butter-like product from vegetable oils. Interesterification can be used to make margarines, shortenings, baked goods, and confectionary etc that requires the texture, mouth feel, and smoothness similar to saturated fats.

So what is Interesterification? It uses enzymes to change the molecular structure of a vegetable oil, to give it the properties of a fat.

Let’s look at the process of interesterification. The interesterification process involves a batch of vegetable oil, to which we add an enzyme that acts as a catalyst. The catalyst causes the separation of a triglyceride into a glycerol and 3 fatty acids.

After breaking the Triglycerides apart, chemists can then re-configure the fatty acid molecules – combining Omega 3, Omega 6, Omega 9, or a fully saturated molecule, in whatever combination they like.

Depending on how you proportion them, ie the percentage of lighter Omega 3 or 6 oils, versus the heavier Omega 9 and Saturated oils, will determine what the factory makes. They can produce heavy oils suitable for deep-frying, semi-solid margarines that spread easily on bread, or liquid oils in a bottle for the unsuspecting consumer. The end result will be a product that has an indefinite shelf life.

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One question that you might ask is “If vegetable oils are liquid, how can interesterification make them solid?” “Where are the saturated fatty acids coming from to solidify the oils?” Well this is achieved by hardening some of the vegetable oil - by bombarding the liquid oils with hydrogen in a process called hydrogenation. In other words the hydrogenation process will still be a key part of the interesterification process. Certainly there won’t be any trans fats in these new vegetable oil/fats made via interesterification, but they will have a molecular structure that the human body has never seen before.

One thing to remember is that the interesterification processes mentioned above, takes place after the purification process that we discussed in an earlier chapter. Let’s remind ourselves of that purification process:

“The seeds are firstly ground by a grinding machine, and then steam cooked, and thereafter mixed with solvents to dissolve out the oils. The most popular solvents are Hexane or Trichlorethylene and both are very carcinogenic. The oils and solvents are then separated, and manufacturers say that only traces of Hexane remain in the oil. The oil is then refined with the addition of sodium hydroxide and temperatures are increased to over 200ºC / 400ºF. Thereafter the oil is treated with carbon that removes all the Vitamin A, E, F, Lecithin, Chlorophyll, and other nutrients. Preservatives and/or anti-oxidant additives like BHA/BHT are then added.”

In summary, these vegetable oils first go through the purification as described above, followed by the hydrogenation process, and then interesterification. Can you see why natural fats like butter, duck fat, lard might be better? No one knows the consequences of eating the newer interesterfied oils because no long term trials have been done. In any event, cancers take years to develop. Some preliminary testing is suggesting that interesterfied oils have the same risks as trans fats.

Currently there is no legislation covering interesterification, and you may not see it on any food labels. So if a margarine, cakes, biscuits etc states ‘vegetable oil’ then you can be absolutely certain that it contains either interesterfied fats, or trans fats. There is simply no other commercially viable way to produce a fat from seed oils that are suitable for baked goods.

In other words, if you see ‘No Trans Fats’ on a packet of cake or biscuits made from vegetable oils, then you can be certain that its contains highly processed interesterfied, or fully hydrogenated vegetable oils.

In Summary:

From research done in the last twenty years we’ve learned that processed vegetable oils are a serious threat to our health people for the following reasons:

1 - The big problem with processed vegetable oils is at the cell level. Since these fats don't occur in nature, our bodies don't know how to deal with them. The body tries to use them, thinking they are normal fats, and they wind up in cell membranes and other places where they behave strangely. These man-made fats weaken the cell membrane, particularly their protective structure and function.

2 – The big threat to males is coronary heart disease. In males, processed vegetable oils appear to activate the body’s immune responses when they enter the artery walls, because these fats do not resemble anything that the body recognises, so the body attacks it. This directly leads to an inflammatory response in the arteries which leads to the formation of dangerous plaque build-up.

2 - In the case of women it’s a bit different. These processed vegetable oils manage to somehow bypass the immune response at the artery wall. However they move further along into the body, and are deposited into the fatty tissues such as in the breasts, where they directly contribute to cancer.

Another 'side-effect' of processed vegetable oils is the residue of toxic metals, usually nickel and aluminium, left behind in the finished product. These metals are used as catalysts in the reaction, and they accumulate in our nervous system where they can lead to neurological conditions. These heavy metals also poison enzyme systems and alter cellular functions, and cause a wide variety of health problems. These toxic metals are difficult to eliminate, and our 'toxic load' increases steadily with small exposures over time.

Learning About Fats and Oils

A good place to start is the Book called ’Know Your Fats: The complete primer for understanding the nutrition of fats, oils, and cholesterol’ written by Dr Mary Enig. Also visit the Weston A Price Foundations website at www.westonaprice.org and check out the area called “Traditional Fats”. Dr Enig has written some interesting articles that you will find on this website.

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Dengate, Sue, Website, www.fedupwithfoodadditives.info/

Dolamore, Anne, The Essential Olive Oil Companion, 1988, Macmillan

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Renaud, S, Wine, Alcohol, Platelets and the French Paradox for Coronary Heart Disease, 1992, The Lancet, June 1992, Vol 339

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IINNDDEEXX10 year Nurses Study, 40 Alcohol, 9, 55, 73, 74, 75, 80, 121, 134 American College for Advancement in Medicine,

66, 133 American Heart Association, 13, 17, 41, 53, 55, 65,

90, 125, 130, 133 American Medical Association, 44, 64, 65, 66 Angell, Marcia, Dr., 54 Angina, 51, 65, 67, 120 Angioplasty, 29, 64, 65 Antioxidants, 74, 75, 77, 78, 110 Arrhythmias, 68, 104, 105 Artificial sweeteners, 68 Aspartame, 68 Atkins, Robert, Dr., 71 Atorvastatin, 24, 133 Australia, 5, 12, 29, 34, 40, 59, 63, 68, 69, 71, 73,

79, 83, 85, 99, 107, 109, 120, 131 B12, 50, 51, 116 B6, 50, 51, 83, 109, 116 Baycol, 24, 25 Bayer, 24, 25 Beer, 74 Beriberi, 62, 63 Blood Pressure, 49, 50, 53, 54, 55, 58, 89, 113,

133 British Medical Journal, 12, 75, 133 Butter, 9, 18, 70, 91, 92, 93, 94, 96, 99, 100, 110,

116, 121, 129, 130 Calcium, 21, 56, 63, 67, 68, 69, 105, 133 Calcium Channel Blockers, 56 Canada, 62, 63, 66, 67, 70, 73, 120, 133 Cancer, 42, 45, 50, 51, 74, 79, 86, 93, 96, 99, 101,

110, 130, 132, 134, 140 Canola Oil, 91 Cerebral haemorrhage, 59 Cervistatin, 24 Cheese, 98, 99 Chelation, 65, 66, 67 Chlorophyll, 90, 91, 94, 132 Cholestene, 36 Cholesterol Levels, 19 Cholesterol test variability, 21 Cholestyramine, 121 Chromium, 105 Claudication, 65, 67 Clofibrate, 120 Coenzyme Q10, 28 Cognitive memory impairment, 26, 35 Cohen, Jay, Dr., 27 Copenhagen Heart Study, 74 Coronary artery bypass surgery, 64 Coronary Stent, 65 Crantons, Elmer, Dr., 67 C-Reactive Protein, 49, 50, 113, 114 Crestor, 33 Crisco, 129, 130, 131 CT Scan, 21, 22, 25, 109, 114, 123 Denmark, 26, 74, 93, 131 Depression, 26

DHA, 90, 116 Diabetes, 90, 93, 107 Diam cork, 81 Digoxin, 33 Di-Sodium EDTA, 67 dl-alpha tocopherol, 104 Dried egg powder, 98 Duck fat, 42, 91, 94, 100, 110 Eating Out, 87 EBT, 22, 23, 52, 64, 109, 114 EDTA Chelation Therapy, 65, 67 Eggs, 7, 18, 84, 85, 97, 98, 110, 116, 120, 121 Electron Beam Tomography, 22, 23, 114 Enig, Mary, Dr., 5, 96, 130, 132, 133 EPA, 90 Erasmus, Udo, Dr., 51 Exercise, 106, 116 Expert Panel for High Blood Cholesterol’, 39 Fallon, Sally, 85, 88 Familial Hypercholesterolemia, 42, 43, 139 FDA, 32, 33, 34, 36, 46, 94, 130, 131, 133, 134 FDA MedWatch, 32, 33, 34 Fibre, 60, 103, 107, 116, 122 First trimester of pregnancy, 46 Flame Retardant Chemicals, 79 Flavonoids, 75, 76, 77, 81 Flaxseed, 90 Fluvastatin, 24 Folate, 50, 51, 63, 83, 89, 109, 116 Food Chemicals, 69 Food preservatives, 68 Foods Associated With Chronic Diseases, 84 Foods That Heal, 83, 84 France, 15, 19, 22, 40, 51, 52, 70, 73, 74, 75, 81,

99, 100, 107, 109, 122, 134 Frankel, Edwin, Dr., 5, 74, 75, 76, 78, 133 French Paradox, 9 Gaist, D, Dr., 26 Gemfibrozil, 40 General Practitioners, 12 Glutamates, 71 Goitre, 62 Goose fat, 94, 100 Gordon, Garry, Dr., 67, 133 Grain-fed beef, 101, 107 Grass-fed beef, 101 Graveline, Duane, Dr., 5, 27 Gronbaek, Morten, Dr., 74, 133, 134 Growth hormones, 98, 101 Harvard University, 50, 96 Hay Diet, 86 Hay, William, Dr., 86, 88 HDL - High Density Lipoprotein, 14, 17, 75 Hexane, 90, 91, 94, 110, 132 High Density Lipoprotein. See HDL Histamines, 80 HMG-CoA, 24, 28 Homocysteine, 5, 6, 16, 49, 50, 51, 82, 83, 109,

113 Hydrogenated, 93, 94, 131

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Hydrogenation, 93 Inflammation, 6, 16, 25, 26, 28, 34, 36, 38, 50, 59,

60, 77, 82, 83, 85, 86, 88, 89, 92, 97, 98, 106, 109, 114

Irregular heartbeat, 68 Jezil, 40 Journal of the American Medical Association,, 44 Kassirer, Jerome, Dr., 55, 134 Kenton, Leslie, 87, 134 Keys, Ancel, Dr., 15, 16, 124 Khong, James, Dr., 5, 101 Kidney Damage, 25, 35 Kushi, Michio, 86, 134 L-Arginine, 57, 58, 114 LDL - Low Density Lipoprotein, 14, 15, 16, 17, 33,

49, 51, 74, 75, 82, 110, 133 Lecithin, 90, 91, 94, 132 Lescol, 24 Lightspeed CVCT, 22 Limb deformities, 46 Lipitor, 20, 24, 27, 29, 30, 31, 32, 33, 41, 44, 47,

126, 133, 134 Lipoprotein(a), 49, 51, 52, 109, 113, 114 Lopid, 40 Lovastatin, 24, 36, 38, 122 Low Density Lipoproteins. See LDL Macrobiotics, 83, 86 Macular Eye Disease, 90 Magnesium, 56, 58, 69, 104, 105, 107, 114, 116,

133 Male erectile dysfunction, 57 Mann, George, Dr., 112 Margarine, 92, 99, 100, 109, 111, 121, 129, 130 Marshall, Barry, Dr., 12 McCully, Kilmer, Dr., 5, 50 McGee, Charles, Dr., 5, 46 Mediterranean, 71, 73, 76, 83, 85, 91, 100, 122,

133 Memory loss, 30, 31, 57 Merck, 24, 36 Mevacor, 24, 25, 32, 36 Milk, 55, 84, 85, 92, 98, 99, 107, 120, 121 Mineral Water, 106 Mini-strokes, 60 Monascus Purpureus, 36 Monounsaturated, 89, 91 Monte Carlo, 71 Montignac, Michel, 76, 134 Montreal, 70, 71, 73 MSG, 71 Muenke, Maximilian, Dr., 46 Murad, Ferid, Dr., 57 Muscle Damage, 25 National Human Genome Research Institute, 46 National Institute of Health, 39, 40, 134 Nerve Damage, 26, 35 New England Journal of Medicine, 46, 50, 54, 112 New Zealand, 84, 121 Nicotinic Acid, 121 Nitric Oxide, 57, 58 Nitro Tablets, 51 Nitrous Oxide, 57 Nobel Prize, 12, 57 Norrie, Phillip, Dr., 76, 134

NutraSweet, 68 Nuts, 72, 84, 102, 107, 116 Oak, 79 Olive Oil, 91, 116, 133 Omega 3 Oils, 89 Omega 6, 89, 90, 96, 110 Pauling, Linus, Dr., 6, 51 Peanuts, 102 Pellagra, 62, 63 Personality changes, 26, 35 Pfizer, 24, 27, 32 Pharmaceutical Industry Doctors, 13 Phenolic compounds, 75, 76 Phytonutrients, 76, 77, 78 Policosanol, 35, 36, 38, 40 Polyneuropathy, 26, 35 Polyunsaturated, 89, 90, 110 Pravachol, 24, 25, 30, 31 Pravastatin, 24, 122 Pregnant Women, 46 Prehypertensive, 54, 55, 58 Pritikin, 86, 120 Prohibition, 73 Propionate, 68, 69 Rapeseed, 91 Rath, Matthias, Dr., 51, 83 Ravnskov, Uffe, Dr., 5, 16, 17, 44, 134, 140 Raw Energy Diet, 87 Recommended Cholesterol Guideline, 19, 39 Red wine, 9, 70 Red Yeast Rice, 36, 38 Renaud, Serge, Dr., 74, 76, 78, 134 Research Doctors, 11 Resting Heart Rate, 49 Resveratrol, 77 Rhabdomyolysis, 25, 26, 29, 30, 35 Rickets, 62 Ridker, Paul, Dr., 50 Rogers, Sherry, Dr., 67 Rosuvastatin, 33 Salicylates, 80 Scurvy, 82, 83 Selenium, 105 Sesame Oil, 92 Short-term memory problems, 29, 31 Sijbrands, Eric, Dr., 42 Simvastatin, 24, 122 Smoking, 45, 55, 59, 62, 64 Spirits, 74 Stage 1 Hypertension, 54 Stage 2 Hypertension, 54 Statin Overdose, 32 Statin Side Effects, 24 Statins, 24, 27, 28, 133 Steiner, Rudolf, 81 Stelvin Closure, 81 Stress, 53, 55, 81, 106, 107, 116, 121 Sublingual Vitamins, 51 Sulphites, 79, 81 Sulphur Dioxide, 79 Synthetic Statins, 24 The Lancet, 12, 74, 75, 134

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The Third Report of the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults, 39

Trans Fats, 89, 93, 110, 116 Transient Amnesia, 26, 35 Transient Ischemic Attacks, 60 Trichlorethylene, 90, 94, 132 U.S. Department of Health & Human Services, 39 US Food & Drug Administration, 32, 36 US National Institute of Health, 19, 20, 27, 125 Viagra, 57 Vitamin A, 62, 90, 91, 94, 132

Vitamin C, 50, 51, 82, 83, 109, 114, 116 Vitamin E, 102, 103, 104 Warren, Robin, Dr., 12 Weil, Andrew, Dr., 87, 134 Whitaker, Julian, Dr., 58, 135 Wine, 73, 74, 75, 76, 77, 78, 79, 80, 81, 83, 84, 85,

87, 107, 110, 111, 116, 121, 133 Women with Elevated Cholesterol Live Longer, 44 World Health Organization, 53, 107 Xerophthalmia, 62 Zocor, 24, 25, 27, 33, 41, 126

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ABOUT THE AUTHOR

Frank Cooper is a practicing Naturopathic Nutritionist with formal qualifications gained at the Australasian College of Natural Therapies, and advanced studies in Complementary Medicine at Charles Sturt University Australia. He is an accredited member of the Australian Traditional-Medicine Society (www.atms.com.au). He enjoys spending time in his vineyard called Monahan Estate that is located in the Hunter Valley near Sydney Australia see www.MonahanEstate.com.au

Frank was born with very high cholesterol (called Familial Hypercholesterolemia) and this condition is associated with the early onset of coronary heart disease. Diagnosed at age 25 with a cholesterol level of 13 mmol/L (500 mg/dl in USA terms) he appeared a likely candidate for a heart attack.

In this book Frank investigates the views of doctors, medical researchers, nutritionists, health experts, and pieces together the causes and risks of coronary heart disease. To his surprise, he finds many medical professionals around the world who could not find any notable association between cholesterol and a heart disease. This ‘flies in the face’ of popular thinking that cholesterol is bad, and sets the theme for this book.

Frank has consulted many doctors and medical researchers to ensure that everything in this book is current and factual. He shares his experience as a Nutritionist to provide a practical insight into a subject that concerns many people.

For further information visit Franks clinical website www.frankcooper.com.au

Cholesterol & The French Paradox– Back Cover

When Oscar-award winning filmmaker Michael Moore released his controversial movie SICKO in 2007 it brought tears to the eyes of many viewers. The USA - the world’s richest nation - was ranked only 38th in healthcare by the World Health Organisation (WHO). The American people thought they had the best healthcare system in the world, and learned that they had one of the worst.

What the movie showed was that the best healthcare system was found in France which was rated #1 by the World Health Organisation (WHO).

France also gave us The French Paradox, a term to describe how a nation of alcohol-drinking and fat/cholesterol-eating French people stay healthy and slim, whilst a disproportionate number of health-conscious Americans are obese or at cardiovascular risk.

Clearly the French have got it right, and the smart solutions for good eating habits, lowering heart disease, and improved health, can be found in France.

So if you are tired of conflicting theories, diets, worried about your cholesterol, heart disease, or just plain unsure about your best health options available - then this insightful book about the French and their food and lifestyle is a must read.

REVIEWS

“This book is a welcome contribution to the subject of cholesterol. It should appeal to busy business executives seeking a high-level view of the latest developments concerning cholesterol and heart disease. Dr Uffe Ravnskov, MD, Sweden, renowned expert on cholesterol and author of the book The Cholesterol Myths.

“You are doing a great service with the main themes of your book. I hope you disseminate it widely. It takes great courage to buck the well-funded dons of diet dogma, also called The Cholesterol Mafia. The essential nature of cholesterol — for cell membranesand brain function, the source of vitamin D in the body, and an important anti-anxiety, anti-inflammatory and anti-cancer agent — cannot be told too often." Dr Joel M Kaufmann, PhD, Professor for Chemistry Emeritus, University of the Sciences in Philadelphia, USA and author of the book Malignant Medical Myths.

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All author royalties from this book are donated to UNICEF - the United Nations Children Fund.