"The Great Cholesterol Myth" is a New York Times best-seller which goes against what many in the medical community have been preaching for years. The authors are Dr. Steven Sinatra, a board-certified cardiologist, and Jonny Bowden, a Ph.D. Action News spoke with Bowden about this theory and if high cholesterol doesn't cause heart disease, what does?
61-year-old Marsha Dougherty has to take dozens of medications including one to lower her cholesterol.
Heart disease runs in her family. She lost both her father and sister to heart attack.
They were both only 52 when they died.
"I was devastated and to be honest with you, I will never get over it. It was just so sudden," Marsha said.
Marsha believes high cholesterol like the kind she has caused their deaths.
But now the new book, "The Great Cholesterol Myth," goes against what we've always been told.
The authors say "cholesterol does not cause heart disease."
I spoke with Jonny Bowden via satelite.
"Trying to lower heart disease by lowering cholesterol is like trying to lower the calories you're eating by taking the lettuce off your whopper, fries and shake," Bowden said.
He believes the attention to cholesterol is, "taking our eyes off the ball on what really causes heart disease - things we can really do something about."
And as for medications like statins, Bowden said, "We are prescribing very strong medicines with many, many side effects to thousands and thousands of people who should not be on them, for whom no real benefit has been shown and who may suffer a lot of side effects," Bowden said.
We brought a copy of the book to preventative cardiologist Dr. Daniel Rader at Penn.
He says the title is a great way to sell books, but he doesn't agree with the main theme.
"There is more data to suggest cholesterol as a causal risk factor for heart disease than just about anything else that exists," Rader said.
And as for statins and other cholesterol-lowering medications, Rader said, "These drugs work, they are safe and they do reduce risk, but they don't reduce risk in everybody."
Dr. Rader says one good thing about this book is that it shines the spotlight on other factors that contribute to heart disease.
The authors write inflammation is the true cause of heart disease.
They're not talking about the kind of reaction that happens when you stub your toe, but chronic inflammation.
"This is the little micro-injuries and tears that occur in the vascular wall. When that happens, debris gets caught in those inflamed pockets," Bowden said.
Bowden says this can be triggered by a number of things including eating too much sugar.
He says the best way to combat heart disease is by lowering inflammation in our diet and in our lifestyle.
"What you're looking for is anti-inflammatory foods," Bowden said.
Anti-inflammatory foods such as fruits and vegetables, omega-3 and flax seed.
"That's going to have the biggest effect on lowering heart disease, not lowering cholesterol and if you lower stress, you will knock out another big percentage of it," Bowden said.Bowden says the premise of "the Cholesterol Myth" isn't new. He says that from the time cholesterol was first tagged as a cause of heart disease,"There's been a vocal minority who's questioned the research on which this was based, who looked at some of the studies, and said - you know, the data's not really there."
But again the views in this book are not the same as many in the medical community. Dr. Rader says there are many factors that contribute to heart disease including cholesterol. Dr. Sinatra and his co-author Bowden say there is one type of cholesterol - the small molecule in the LDL - that plays a role in the development of heart disease. But it is not measured in the standand blood test.
Studies show that LDL, the so-called 'bad' cholesterol, has two types of particules: large buoyant ones, and smaller more dense ones. The smaller particles appear to do more damage, by penetrating the walls of arteries. The number of small particles can be measured indirectly, by counting the overall number of LDL particles. The higher the number, the more small particles.
Several large medical institutions, such as the Mayo Clinic, have recognized the presence of the particles, but don't advocate abandoning the conventional thinking on cholesterol's importance in heart disease.
Bottom line, besides the medication debate, the advice from Jonny Bowden and his co-author echoes a familiar strain: eat fruits and vegetables, don't smoke, exercise regularly, and maintain a healthy weight.