The Doctor Speaks 1

36By Philip Incao, M.D.
Issue: Summer 2004, Biography Emerges as a Tool For Therapy - Issue #36

Q: I am taking medication for high blood pressure and high cholesterol and am concerned about the overall effects on my well-being. How can I offset any potential negative impact of these strong drugs?

A: It is pretty much common knowledge that heart attacks and other symptoms of heart disease are often related to clogging of the heart’s own arteries with a fatty cholesterol-rich substance that tends to become calcified. But the scientific theory that dietary cholesterol and saturated fat are the cause of hardening of the arteries (arteriosclerosis) and heart attacks, which has held sway since the 1950’s, is now beginning to unravel. And few know about that.

Even though evidence to back the dietary intake/arteriosclerosis theory has always been weak or non-existent, the cholesterol theory of heart disease has been accepted as fact by both the medical establishment and popular opinion for the past fifty years.

A leading researcher, George Mann, MD, formerly of Vanderbilt University author of Coronary Heart Disease: The Dietary Sense and Nonsense, stated, “The diet-heart hypothesis 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.”

This, if true, is shocking news. If the public has been deceived, so also have practicing doctors, who rarely evaluate the research for themselves but who instead put their trust in the guidelines issued by professional and governmental bodies who are supposed to be serving the public. When so much of our trust and our work have been invested in a theory, we physicians tend to cling to it even after the evidence has shown it to be wrong.

The public relations, advertising and commercial investment in support of the cholesterol theory are still very strong, so we will continue to hear a lot in the coming years about cholesterol as a cause of heart disease, and the supposed benefits of reducing that cholesterol with statin drugs. There are huge clinical trials among many thousands of patients showing some degree of heart attack prevention with statins*. While some challenge these benefits altogether, others suggest that the sources of the benefit lies outside cholesterol lowering, perhaps through reductions in inflammation—which in recent years has been identified as an important culprit in causing heart attacks.

As healthcare consumers, the more proactive we are in asking questions and in informing ourselves, the better our health will be. For more insight I highly recommend checking out Uffe Ravnskov, MD, PhD’s The Cholesterol Myths, (New Trends Publishing, Washington, D.C.), first published in the U.S. in 2000. In addition, emeritus professor of chemistry Joel M. Kauffman, Ph.D. has recently written Statin Drugs-A Critical Review of the Risk/Benefit Clinical Research, which is on the internet at http://www.nccn.net/~wwithin/cholesterol.htm. He points to clear evidence of a lack of connection between intake of cholesterol and cholesterol levels in the blood.

You may also check out The Weston A. Price Foundation’s valuable site (www.westonaprice.org).

High blood pressure is a common condition that is caused by what is at first a reversible contraction-constriction of the arteries—ensuing from our reaction to stress. If this is not corrected by stress reduction and lifestyle and diet changes, it may progress to a hardening of the arteries (arteriosclerosis) and increased risk of heart disease and stroke. Dean Ornish, MD, and others have shown how arteriosclerosis can be improved with a dedicated commitment by the proactive person to a natural healing program. Several books on the subject are available, but it is best to work with a practitioner who is experienced in natural and complementary healing.

In published clinical trials, Dr. Ornish showed that his program of rigorous stress reduction (including meditation), exercise, diet, weight loss and smoking cessation results in less chest pain and a slight widening of the coronary arteries. Dr. Ornish put his patients on a strict low-fat, low cholesterol diet. If, as some researchers are now saying, saturated fats and cholesterol are not to blame, what explains the success of Ornish’s patients and methods?

In the past fifty years Americans have been eating less cholesterol and saturated fat, and more refined carbohydrates, sugars, margarine and other hydrogenated vegetable oils containing trans fatty acids. While heart attacks in the U.S. have decreased slightly, over the same time period the number of Americans with Metabolic Syndrome, also called Syndrome X, a combination of overweight, high blood pressure and insulin resistance (a pre-diabetic condition) has very much increased. How can we understand this also?

Rudolf Steiner observed in 1920 that conditions like high blood pressure and arteriosclerosis are caused ultimately by too strong an attachment to the physical world and to one’s physical body. Tibetan medicine holds similar views. When we expand our horizons, broaden our thinking, educate our habits, strive for inner peace and equanimity and develop an interest in spiritual things and in deeper questions of life and death, this helps us to be less attached to all things material, and is very likely to improve our health as well!

There is deep truth in all the legends, myths and metaphors that describe the heart as the bearer of the human spirit. Whenever we rouse our spirit and take ourselves in hand and make purposeful choices in our life rather than just following our habitual likes and dislikes, we strengthen our spirit and influence our heart’s health in a concrete and beneficial way. Any healthy and meaningful discipline that we willingly undertake is good for us, and especially good for our heart.

Dr. Ornish’s results demonstrate that, taken together, the disciplines of diet, exercise, smoking cessation and stress reduction can result in concrete improvements in the heart and blood vessels. In my opinion, if Dr. Ornish had used a diet low in sugar, white flour and processed trans-fats, rather than one low in cholesterol and saturated fats, his results would have been just as good or even better. My medical experience has taught me that no one diet is right for everyone, but that a wholesome diet based on an interest in good health and on an inner knowledge of one’s own bodily needs and not merely on one’s likes and dislikes is good for anyone.

*For example, in the Scandinavian Simvastatin Survival Study among nearly 4500 individuals with elevated cholesterol and either angina pectoris (chest pain) or prior heart attack, those receiving a statin had significantly reduced relative risk of death, coronary death, or major coronary events.

Philip Incao, M.D. maintains a medical practice in Denver, Colorado. Do you have a question for The Doctor Speaks column? Please email editor@lilipoh.com or write LILIPOH/ PO Box 628, Phoenixville, PA 19460.