Real Food (37 page)

31. Talk by Peter Langsjoen, "CoQ
₁₀
Depletion: The Achilles" Heel of the Statin Crusade: A Review of Published Animal and Human Trials Showing Statin-Induced
Coenzyme Q
₁₀
Depletion Resulting in Muscle Wasting and Heart Failure," Weston A. Price Foundation, annual conference, May 4, 2003, attended
by the author. Langsjoen confirmed to the author that this was still his practice with heart patients in a talk on November
13, 2005 titled "The Clinical Implications of Statin-Induced Coenzyme Q10 Depletion" at the Weston A. Price Foundation Conference
in Chantilly, Virginia. See also Peter Langsjoen, "Overview of the Use of CoQ
₁₀
in Cardiovascular Disease,"
Biofactors
9, nos. 2-3 (1999): 273-84.

32. Correspondence with the author, June 18, 2004. For more information from Barry Groves, see www.second-opinions.co.uk.

33. On June 21, 2004, Uffe Ravnskov provided the author with an English translation of a chapter titled "The Benefits of High
Cholesterol" in the second German edition (2004) of
The Cholesterol Myths.
See also H. M. Krumholz, T. E. Seeman, S. S. Merrill, C. F. Mendes de Leon, V. Vaccarino, D. I. Silverman, R. Tsukahara, A.
M. Ostfeld, and L. F. Berkman, "Lack of Association Between Cholesterol and Coronary Heart Disease Mortality and Morbidity
and All-Cause Mortality in Persons Older than 70 Years,"
Journal of the American Medical Association
272, no. 17 (1994): 1335-40.

34. I. J. Schatz, K. Masaki, K. Yano, R. Chen, B. L. Rodriguez, and J. D. Curb, "Cholesterol and All-Cause Mortality in Elderly
People from the Honolulu Heart Program: A Cohort Study,"
Lancet
358, no. 9279 (2001): 351-55.

35. O. Gatchev, L. Rastam, G. Lindberg, B. Gullberg, G. A. Eklund, and S. O. Isacsson, "Subarachnoid Hemorrhage, Cerebral
Hemorrhage, and Serum Cholesterol Concentration in Men and Women,"
Annals of Epidemiology
3, no. 4 (1993): 403-9. See also D. R. Jacobs, "The Relationship Between Cholesterol and Stroke,"
Health Rep 6,
no. 1 (1994): 87-93; and H. Iso, D. R. Jacobs Jr. D. Wentworth, J. D. Neaton, and J. D. Cohen, "Serum Cholesterol Levels and
Six-Year Mortality from Stroke in 350,977 Men Screened for the Multiple Risk Factor Intervention Trial,"
New England Journal of Medicine
320, no. 14 (1989): 904-10.

36.
New England Journal of Medicine
342 (2000): 836-43.

37. Scott Deron reports on the 2002 study in
C-Reactive Protein.
The 2005 study appeared in the
Journal of the American Medical Association
294, no. 3 (2005).

38. David J. A. Jenkins et al., "Direct Comparison of Dietary Portfolio of Cholesterol Lowering Foods with a Statin in Hypercholesterolemic
Participants,"
American
Journal of Clinical Nutrition
81, no. 2 (2005): 380-87.

39. Two of McCully's professors at Harvard were pioneers in the field of cholesterol metabolism. Louis K. Fieser was the Sheldon
Emery Professor of Organic Chemistry at Harvard. He published the classic method for purification of cholesterol. He and several
students and colleagues first fed oxidized cholesterol to rabbits to produce atherosclerotic plaques. Konrad E. Bloch was
professor of chemistry at Harvard and winner of the Nobel Prize in Physiology or Medicine in 1964. He and Fyodor Lynen won
the Nobel Prize for working out the biosynthesis of cholesterol.

40. Interview with the author, May 20, 2004, New York City.

41. P. Reaven, S. Parthasarathy, B. J. Grasse, E. Miller, F. Almazan, F. H. Mattson, J. C. Khoo, D. Steinberg, and J. L. Witztum,
"Feasibility of Using an Oleate-Rich Diet to Reduce the Susceptibility of Low-Density Lipoprotein to Oxidative Modification
in Humans,"
American Journal of Clinical Nutrition
54, no. 4 (1991): 701-6.

Glossary

alpha-linolenic acid (
ALA)
— A polyunsaturated omega-3 fat, one of the two essential fatty acids (the other is linoleic acid, or LA). ALA is required
for the formation of other omega-3 fats, EPA, DPA, and DHA, which are essential to brain, visual, and hormone function. It's
easier for the body to get EPA, DPA, and DHA from fish. Think of ALA as the land-based omega3 fat. For vegetarians, key sources
of ALA are flaxseed oil (60 percent), walnut oil (10 percent), and canola oil (10 to 15 percent).

alpha-lipoic
acid
— An antioxidant essential for metabolism found in grass-fed meat. Most antioxidants are either fat- or water-soluble, but
alpha-lipoic acid is both. It extends the life of other antioxidants, such as vitamins C and E, lowers blood sugar, and improves
sensitivity to insulin.

antioxidants
— Compounds that counter the effects of free radicals and prevent or delay undesirable oxidation, or damage by oxygen. Vitamin
C is a water-soluble antioxidant, vitamin E a fat-soluble one, and alpha-lipoic acid is both water- and fat-soluble. Coenzyme
Q
₁₀
, which is depleted by statins, is an antioxidant found in organ meats (especially heart), red meat, and fish. Sesame and
olive oil are rich in antioxidants. Plants contain dozens of antioxidant compounds, including carotenoids. Antioxidants last
mere hours in the body; that's why it's sensible to eat fresh, brightly colored fruit, berries, and vegetables every day.

arrhythmia
— Irregular heartbeat. Sometimes follows a myocardial infarction, or heart attack. Omega-3 fats reduce the rate of fatal
arrhythmia by 30 percent.

arteriosclerosis
— A common condition in which the smooth, elastic walls of the artery (never veins) become stiff, possibly as a protective
measure to keep the high arterial blood pressure from straining the walls. Increases with age.

atherogenesis
— The formation of plaques, or atheromas, in the arterial wall.

atheroma (
plaque)
— Raised swollen areas in the arterial wall. Atheromas may burst, resulting in a blood clot and a heart attack (in a coronary
artery) or stroke (in an artery leading to the brain). Atheromas contain fats, cholesterol, white blood cells, and calcium.

atherosclerosis
— Multiple atheromas. Atherosclerosis is more pronounced in people with high blood pressure and worsens with age. When an
artery is obstructed, heart disease can result. However, many people who die of heart disease do not have atherosclerosis;
something else blocks the blood flow.

betaine
— A vitaminlike nutrient found in eggs, liver, and beets. Betaine reduces homocysteine and thus helps prevent heart disease.

bile
acid
— Manufactured in the liver from cholesterol and stored in the gallbladder, bile acid is essential for the emulsification
and digestion of fats.

canola
oil
— The mostly monounsaturated oil from rapeseed, a plant in the genus
Brassica,
which includes broccoli and cabbage. Originally rapeseed was high in erucic acid, a toxic monounsaturated fat, but modern
hybrids developed in Canada are low in erucic acid. Canola oil is frequently refined and partially hydrogenated in processed
foods.

cardiovascular
diseases
— Diseases of the heart and vascular system, including heart disease, high blood pressure, congestive heart failure, stroke,
and others.

carotenoids
— Antioxidant plant pigments that are mainly fat-soluble. Examples: beta-carotene (sweet potato, carrot, kale, mango), lutein
(melon, guava, spinach, collards), lycopene (tomatoes), and zeaxanthin (corn, nectarines, oranges, papaya). Eating carotenoids
helps prevent cardiovascular diseases and cancer. Lutein and zeaxanthin, also found in egg yolks, may prevent the eye disease
macular degeneration.

cholesterol
— A molecule, chemically a sterol, made chiefly in the liver. It forms all cell membranes and makes up most of brain and
nervous tissue. Cholesterol is required for production of bile acids, vitamin D, and the sex hormones (estrogens and androgens).
It's a repair agent, rushing to the scene when arterial walls are damaged. Cholesterol is carried in the blood by the lipoproteins
HDL and LDL. Cholesterol is found only in animal foods.

choline
— A B-vitamin-like nutrient that is part of lecithin, which is found in egg yolks and butter. Choline is essential in the
metabolism of fat and to the developing brain of the fetus. It reduces homocysteine and thus helps prevent heart disease.

coenzyme Q
₁₀
(
CoQ
₁₀
)
— An antioxidant found in organ meats (especially heart), red meat, and fish. Statin drugs deplete CoQ
₁₀
, which is essential for heart function. Low CoQ
₁₀
is a risk factor for heart disease.

conjugated linoleic acid (
CLA)
— An omega-6 fat found in the fat of ruminant (grass-eating) animals. Grass-fed beef fat and butter are all but unique sources
of CLA, an anticancer agent that also aids weight loss and builds lean muscle tissue. CLA is an unusual omega-6 fat in that
it behaves like an omega-3 fat.

coronary heart disease (
CHD)
— See heart disease
C-reactive protein (
CRP)
— A protein made by the liver during acute inflammation. High CRP is a risk factor for heart disease.

docosahexaenoic acid (
DHA)
— An omega-3 fat essential to cell membranes, especially brain, eye, and sperm cells. Half the fat in the brain is DHA. Found
chiefly in fish, DHA is used to form EPA. DHA can be manufactured in the body from alpha-linolenic acid (ALA), an essential
fatty acid, but fish is the best source.

diabetes
— A metabolic disease in which insulin does not work properly and sugar accumulates in the blood. In type 1 diabetes, the
pancreas does not produce insulin. In type 2 diabetes (90 percent of cases), muscle cells are deaf to insulin, or "insulin-resistant."
Obesity, sugar, excess of polyunsaturated vegetable oils, and a lack of omega-3 fats cause type 2. Prediabetes is called metabolic
syndrome. Diabetes is a risk factor for heart disease.

eicosanoid
— Several kinds of hormonelike agents, including prostaglandins, derived from the essential fatty acids. Omega3 fats produce
anti-inflammatory and calming eicosanoids, and omega-6 fats make inflammatory and reactive eicosanoids. The body needs both,
but the industrial diet contains an excess of omega-6 fats and too few omega-3 fats, which leads to inflammation, diabetes,
obesity, and heart disease.

emulsifier
— An agent able to mix water and fat because it contains both water- and fat-soluble elements. The lecithin in egg yolks
emulsifies mayonnaise. Bile acids emulsify fats in digestion.

eicosapentaenoic acid (
EPA)
— An omega-3 fat found chiefly in fish. EPA is required for the formation of eicosanoids, powerful hormonelike agents that
control all cellular activity. EPA can be manufactured in the body from alpha-linolenic acid (ALA), an essential fatty acid.

epidemiology
— The study of population and disease. Researchers look for risk factors and causes of disease.

essential fatty acids (
EFA)
— The omega-3 and omega-6 fats. They cannot be made by the body; hence they are "essential" and must be obtained through
diet. From EFA, the body forms hormonelike agents called eicosanoids. EFA are essential to growth and brain and vision. If
you don't eat enough EFA, the body will plunder its own stores. EFA deficiency is progressive and cumulative over generations.
Pregnant and nursing women need large amounts of omega-3 fats to feed the baby's brain and prevent post-natal depression.

fat
— A collection of triglycerides that are usually solid or semisolid at room temperature.

fatty
acid
— An organic molecule made up of a chain of carbon atoms. Classified by the number of carbons (short-, medium,long-, and
very-long-chain fatty acids) and by whether the carbon atoms are saturated with hydrogen atoms (saturated or unsaturated).
Fatty acids include oleic acid (in lard and olive oil), stearic acid (beef and chocolate), and lauric acid (coconut oil and
breast milk).

flavonoids
— Antioxidant compounds found in plants, especially brightly colored ones, such as sweet potatoes, cherries, and chocolate.
Flavonoids fight cardiovascular diseases and cancer.

folic
acid
— An essential nutrient found in liver, eggs, green leafy vegetables, oysters, salmon, and beef. Prenatal deficiency of folic
acid causes spina bifida in babies. Lack of folic acid elevates homocysteine, which causes heart disease.

free
radicals—
By-products of cell metabolism formed when oxygen is metabolized or burned. They damage cells and contribute to aging, cardiovascular
diseases, and cancer. Antioxidants counter the effects of free radicals.

Gamma-linolenic acid
( GLA)— A polyunsaturated omega-6 fatty acid found in the oils of borage, black currant seed, evening primrose, and Siberian
pine nuts. The body can also make GLA from the EFA linoleic acid (LA). GLA is an unusual omega-6 fat in that it tends to behave
like an omega-3 fat. Eicosanoids derived from GLA reduce inflammation, dilate blood vessels, and reduce clotting. GLA also
aids fat metabolism and treats premenstrual symptoms.

heart
disease
— The first stage of heart disease, angina, is restriction of blood to the heart. When the blood flow is stopped for a long
time or stops totally, a heart attack (myocardial infarc­tion) results. Together, angina and heart attack are heart disease.
Heart disease is one of several cardiovascular diseases.

high-density lipoprotein (
HDL)
— Carries cholesterol from the bloodstream to the liver.

homocysteine
— An amino acid that causes atherosclerosis. Lack of folic acid and vitamins B6 and B12 elevates homocysteine.

hydrogenation
— A chemical process that adds hydrogen to unsaturated double bonds in fats. Hydrogenation turns unsaturated, liquid oils
into saturated, solid fats (such as corn oil into margarine) and creates unhealthy trans fats. Many processed foods contain
hydrogenated and partially hydrogenated vegetable oils, which cause heart disease.

hypercholesterolemia
— A rare genetic condition affecting about 1 percent of the population. The main symptom is high LDL. Hypercholesterolemics
do not respond to changes in dietary cholesterol or saturated fats and often get atherosclerosis and heart disease early in
life.

inflammation
— The body's normal chemical response to injury or danger. White blood cells, platelets, and other healing agents rush to
the injury, causing redness, swelling, warmth, and pain. Chronic inflammation (due to genetics, diet, infection, or some other
cause) contributes to heart disease. Omega-6 fats in polyunsaturated vegetable oils lead to inflammation, while omega-3 fats
prevent it. Inflammatory diseases resulting from lack of omega-3 fats include Crohn's, lupus, rheumatoid arthritis, and asthma.
Fat cells promote inflammation, which may explain why being fat is a risk factor for heart disease.

insulin
— A hormone produced by the pancreas and released when blood sugar rises after eating. Insulin directs the muscles to take
sugar from the blood to muscles for use as immediate or short-term energy. When the muscles are deaf to insulin—" insulin
resistant"— normal metabolism fails, and sugar (toxic in excess) accumulates in the blood. Excess sugar is stored as fat.
Diabetes is a disease of insulin resistance.

isoflavones
— Phytoestrogens, found in plants, which act like estrogens in the body. Isoflavones in soy foods may contribute to estrogen-dependent
breast cancers.

lauric
acid
— A medium-chain saturated fat found in tropical oils such as coconut and palm and breast milk. Butter contains minor amounts
(about 3 percent). A potent antimicrobial agent, it also stimulates metabolism and aids weight loss. Because lauric acid is
stable (not easily damaged) at high temperatures, coconut oil is ideal for baking.

lecithin
— An emulsifier in egg yolks and butter. Necessary for the proper digestion of cholesterol and fats.

linoleic acid (
LA)
— A polyunsaturated omega-6 fat in walnuts and flaxseed and one of the two essential fatty acids (the other is alpha-linolenic
acid or ALA). LA is required for the formation of eicosanoids, hormonelike agents. Seed oils such as safflower (78 percent),
sunflower (68 percent), and corn oil (57 percent) are rich in LA. The typical American diet contains far too much LA, which
leads to obesity, diabetes, heart disease, cancer, and depression.

lipids
— Fatty molecules including fats and oils. Lipids include fatty acids (such as oleic acid in lard and olive oil) and phospho-lipids
(such as lecithin).

lipoprotein
— A molecule that's part protein, part fat. It circulates in the blood, carrying cholesterol, homocysteine, and triglycerides.

lipoprotein (a) (Lp (
a))
— A unique lipoprotein that causes atherosclerosis and promotes clots. Trans fats raise Lp (a), and saturated fats lower
it.

low-density lipoprotein (
LDL)
— Carries cholesterol from the liver to the blood. Oxidized LDL causes atherosclerosis.

metabolic
syndrome
— Also insulin resistance. Refers to several conditions involving chronically elevated insulin, including: belly fat, high
blood pressure, low HDL, high LDL, and high triglycerides. Another sign of metabolic syndrome is normal cholesterol and high
CRP— a sign of inflammation. First identified in 1989, metabolic syndrome is an early stage of diabetes, which is a predictor
of kidney failure, stroke, and heart disease.