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By Dr. Mercola
NMR Lipoprofile—the Most Important Test to Determine Heart Disease Risk
The incorrect idea that high cholesterol causes heart disease has led to
the demonization of entire categories of extremely healthful foods (like eggs
and saturated fats), and cholesterol has been falsely blamed for just about
every case of heart disease in the last 20 years.
Fat and cholesterol are commonly believed to be the worst foods you can
consume. Please understand that these myths are actually harming your health.
Not only is cholesterol most likely not going to destroy your health (as
you have been led to believe), but it is also not the cause of heart disease.
Chris Kresser, L.Ac., an acupuncturist and a licensed integrative
medicine clinician, has investigated risk factors for heart disease and
promotes the use of a relatively novel way of assessing your heart disease
risk based on your LDL particle number.
He’s currently writing a book about this topic for the Paleo ancestral
health community. His interest grew from losing his grandfather to heart
disease several years ago. His grandfather’s case was badly mismanaged,
which spurred Kresser to learn more about what really causes heart disease.
A few years later, while in graduate school studying integrative medicine,
he did a semester-long research project on the relationship between
cholesterol and heart disease.
Since then, he’s read about 750 peer-reviewed studies, consulted with
numerous experts in the field, and has challenged everything he thought he
knew about the role of cholesterol in heart disease.
Over the last several years, he’s been sharing that information on his
blog, in his podcast, and in educational seminars and programs.
The Problem with the Conventional Approach, in a Nutshell
For the past 50 years, you’ve been told that eating saturated fat and
high-cholesterol foods will raise cholesterol serum levels. However,
researchpublished over the past 10 or 15 years suggests that neither of
those statements are true.
Furthermore, the typical cholesterol tests your doctor prescribes, which
are supposed to measure your risk for heart disease, don’t actually do a very
good job of predicting your risk.
You can have low or normal LDL or total cholesterol and still be at high
risk from heart disease. Alternatively, you can have high or normal total or
LDL cholesterol yet be at low risk. Subsequently, many are not getting enough
treatment, and others are getting too much.
“We’ve learned a lot about what causes heart disease over the past 10
years,” Kresser says. “But unfortunately, that knowledge hasn’t really
trickled down into the mainstream yet. So, your average general care
physician, primary care nurse, or even science writer that’s writing for the
mainstream media is still operating on information from the old paradigm.
The other issue is that the current dietary guidelines that are
offered for how to reduce your risk for heart disease are based on this
information that’s still 30 to 50 years old. And they’re clearly not working.
Cardiovascular disease is still the number one killer. One out of every three
deaths is due to this cardiovascular disease, and it affects about 65 million
people in the U.S. alone.”
The INTERHEART study,
which looked at heart disease risk factors in over 50 countries around the
world, found that 90 percent of heart disease cases are completely preventable
by modifying diet and lifestyle factors. As Kresser points out, we clearly need
a new approach that’s based on more current evidence.
“The problem, of course, that we face is that the old paradigm is so
entrenched. The idea that cholesterol and saturated fat are bad for us is so
deeply engrained in our society that a lot of us don’t even question that
anymore.
One of the main problems there is the massive conflicts of interest
in the medical profession. We have a situation where two-thirds of medical
research is sponsored by pharmaceutical companies. Eight out of nine of the
doctors who are on the National Cholesterol Education program that write the
guidelines for cholesterol receive money from pharmaceutical companies,” he
says.
Conventional Tests Are Not Accurate Predictors of Heart Disease
If you’ve had your cholesterol levels checked, your doctor most likely
tested your total cholesterol, LDL cholesterol, HDL cholesterol, and
triglycerides. But we now know those are not accurate predictors for
cardiovascular disease risk. According to Kresser, a much more accurate
predictor is testing your LDL particle number. He explains:
“To use an analogy: if you imagine your bloodstream’s like a river,
the LDL particles are like the boats that carry the cholesterol and fats
around your body. The cholesterol and fats are like cargo in the boats. Right
now doctors are usually measuring the amount of cargo or cholesterol in the
LDL particles. But what we should be measuring is the number of LDL
particles, or the number of boats in the river, so to speak, because that’s a
much more accurate risk factor for heart disease.”
As mentioned, it’s possible to have normal total or LDL cholesterol yet
have a high number of LDL particles. This is completely missed using the
conventional testing. On the other hand, you may end up being prescribed a
statin drug to lower your cholesterol when in fact your LDL particle number
is normal, placing you in the low risk category for heart disease. (As a
general rule, regardless of your LDL particle number, chances are you do NOT
need a statin drug to address high cholesterol. The only people who may truly
benefit from a statin drug are those with the genetic defect called familial
hypercholesterolemia.)
How to Test Your LDL Particle Number
Some groups, such as the National Lipid Association, are now starting to
shift the focus toward LDL particle number instead of total and LDL
cholesterol, but it still has not hit mainstream. Fortunately, if you know
about it, you can take control of your health and either ask your doctor for
this test, or order it yourself.
There are several ways to test for your LDL particle number. Kresser
recommends using the NMR LipoProfile, offered by a lab called Liposcience.
The test uses FDA approved technology for testing LDL particle number, and
it’s the test used in most of the scientific studies on LDL particles.
“All the different lipoproteins have a unique magnetic signature, and
this test uses a nuclear magnetic resonance technique to pick up on that
signature. It can correctly identify the number of particles in each case,”
he explains.
It’s easy to get and all major labs offer it, including LabCorp and
Quest. Most insurance policies cover the test as well. Best of all, even if
your doctor were to refuse to order it, you can order it yourself via third-
party intermediaries like Direct Labs, or you can order the test online, and
get blood drawn locally.
In Europe and other parts of the world, LDL particle number is more
commonly measured using an indirect marker, apolipoprotein B (apoB). ApoB is
a protein required for the formation of the LDL particle. About 90-95% of
apoB particles are LDL particles, which makes apoB a fairly accurate measure
of LDL particle number. If you live in a country where the NMR profile is not
available, you can use the ApoB test to roughly determine your LDL particle
number, and then use triglycerides, HDL, fasting blood sugar, blood pressure
and waist-to-hip ratio to determine if you have insulin resistance.
The Devil Is in the Details...
How Medicine Got the Wrong Idea about Fats Saturated fat has long been
demonized as a heart attack waiting tohappen, and many doctors still cling
to this outdated view. Ironically,saturated fat is not only healthful fat, it’s one
of the most importantdietary factors to support health! There’s simply no way
to calculate theharm inflicted by the low-fat craze. We now know that if you
avoid saturatedfats, you’re asking for trouble. Not only is saturated fat the
optimal fuelfor your brain, it also:
Provides building blocks for cell membranes, hormones, and hormone-like
substances
Acts as carriers for important fat-soluble vitamins A, D, E and K
Is required for the conversion of carotene to vitamin A, and for mineral
absorption
Acts as antiviral agents (caprylic acid)
Helps lower cholesterol levels (palmitic and stearic acids)
Modulates genetic regulation and helps prevent cancer (butyric acid)
The US Department of Agriculture's dietary guidelines1 advises you to
consume less than 10 percent of calories from saturated fats. I and other
nutritional experts have warned that most people actually need upwards of
50-70 percent healthful fats, including saturated fat, in their diet for
optimal health. How did medicine get this so wrong?
A combination of factors is likely to blame. There were early studies
showing that saturated fat raised cholesterol levels in the blood, but they
were almost always short-term studies. Since then, much larger observational
studies, conducted for extended periods of time have been done, completely
refuting earlier short-term results. Later studies have shown absolutely NO
relationship between saturated fat intake and blood cholesterol levels.
“We’re talking about some really big, well-known studies that cover
tens of thousands of people,” Kresser says. “In fact, there was research
published in the American Journal of Clinical Nutrition that covered about
350,000 people in a follow-up period of five to 23 years. And there was no
relationship at all between saturated fat intake and heart disease. And then
a large Japanese study of about 58,000 people actually found an inverse
association between saturated fat intake and strokes. So, in other words, the
people who were eating the most saturated fat actually had the lowest levels
of stroke.”
Another problem is that early studies did not differentiate between
critically important omega-3 and less health-promoting omega-6 fats.
“There’s a study... that went back and looked at some data. Some of
the early data suggested that replacing saturated fat with industrial seed
oil or polyunsaturated fat would lower cholesterol and lower the risk of
heart disease. But what they didn’t realize back in the ‘60s when they were
doing those studies [was the difference between omega-3 and omega-6; they
thought all polyunsaturated fats were the same, so they would lump them
together in the studies.
Now we understand that omega-6 has very different effects from
omega-3. When you study them separately, you see that omega-6 actually
doesn’t reduce the risk of heart disease and may increase the risk of heart
disease when it’s studied independently of omega-3s.”
Today we have yet another complicating factor when it comes to omega-6
fats and that’s the fact that many of them now come from genetically
engineered corn and soy. When you add that into the mix, the health hazards
may be worse than we currently imagine.
Which Fats Are Healthy?
Sources of healthful fats (and in some cases cholesterol) include:
Olives and Olive oil
Coconuts and coconut oil
Butter made from raw grass-fed organic milk
Raw nuts, such as almonds or pecans
Organic pastured egg yolks
Avocados
Grass-fed meats
Unheated organic nut oil
Another healthful fat you want to be mindful of is animal-based omega-3.
Deficiency in this essential fat can cause or contribute to very serious
health problems, both mental and physical, and may be a significant
underlying factor of up to 96,000 premature deaths each year. For more
information about omega-3s and the best sources of this fat, please review
this previous article.
Continued
God Bless Everyone & God Bless The United States of America.
Larry Nelson
42 S. Sherwood Dr.
Belton, Tx. 76513
cancercurehere@gmail.com
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