Read The Great Cholesterol Myth Online
Authors: Jonny Bowden
The Great Cholesterol Myth (31 page)
Glad you asked. Here’s what Dr. Sinatra has to say:
Some years ago, I was asked to submit to a fasting serum cholesterol test for an insurance evaluation. Because I was performing three cardiac catheterizations that day, I asked that blood be drawn prior to 7:30 in the morning.
At that time, my blood cholesterol was 180 mg/dL, a number my doctors and I were utterly delighted with. After performing two of the three cardiac catheterizations, both of which went smoothly, I tackled the third case, which was anything but routine. This was an individual with complex congenital heart disease. The cardiac catheterization itself was further complicated by the fact that during the procedure, the patient suffered cardiac arrest. The patient actually stopped breathing, though, luckily, he was successfully resuscitated. The procedure took a grueling five hours, and it required multiple catheters and multiple pharmacological interventions.
Man, I really sweated during that case, even though, thankfully, it all ended well.
When the procedure was over, it was approximately three in the afternoon, and I hadn’t eaten all day. As I was walking to the cafeteria, I passed the blood lab where I had blood drawn earlier that morning. Because I had a strong belief in the effect of psychological stress on the body, I was curious to see whether the day’s activities had produced any changes in my own blood. So I asked my colleagues to perform a second blood test.
My blood cholesterol had risen to 240 mg/dL, a number that would cause virtually any conventional practitioner to put me on a statin drug immediately.
I had been fasting for nearly 20 hours at this point, and there was absolutely no dietary variable that could have caused this jump of 33 percent in my cholesterol. Obviously, my body reacted to the stressful events of the day by producing an excessive amount of cholesterol.
The connection between stress and elevated cholesterol is well documented. In 2005, researchers conducted a study of about 200 middle-aged government workers in London.
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First the workers gave blood samples and “rated” their levels of stress. Then they were given two paper and pencil tests, both designed to be somewhat stressful. In the first test, they were shown mismatched words and colors. For example, the word “red” would be written in blue letters. The participants had to name the color in which the words appeared (in this case “blue”). It’s a confusing and annoying test and makes people uneasy. In the second test, the participants were told to trace the outline of a star in a mirror, under a deadline. (Try it sometime—it’ll make you crazy.) Afterward, the participants gave blood again, had their cholesterol checked, and rated their stress levels.
Three years later everyone had their cholesterol levels measured again.
The first finding was interesting on its own: Cholesterol rose for everyone after doing the stress-inducing paper and pencil tests. But it rose for some people a lot more than it did for others. Let’s call them the “high reactors.”
Now check this out: Three years later, the high reactors had the highest cholesterol levels.
The researchers created three “thresholds” for cholesterol: low, medium, and high. After the three years, those who hit the “high cholesterol” threshold included 16 percent of those who had initially shown little cholesterol reaction to the stress tests and 22 percent of those who had initially shown a “moderate” cholesterol reaction to the stress tests.
But a whopping 56 percent of those who initially had the biggest change in their cholesterol after the stress tests were now in the “high cholesterol” group! And this was even after making adjustments for weight, smoking, hormone therapy, and alcohol use.
The short stress tests were excellent predictors of how people—and their cholesterol levels—responded to stress. “The cholesterol responses we measured in the lab probably reflect the way people react to challenges in everyday life,” said lead researcher Andrew Steptoe, D.Sc. “The larger cholesterol responders to stress tasks will be large responders to emotional situations in their lives,” he added. “It is these responses in everyday life that accumulate to lead to an increase in fasting cholesterol . . . three years later. It appears that a person’s reaction to stress is one mechanism through which higher [cholesterol] levels may develop.”
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Stress is certainly a trigger for depression, and the relationship between depression and heart disease is well established. Individuals who suffer from mood disorders are twice as likely to have a heart attack when compared to people who are not depressed.
One researcher who has spent much of his career investigating the relationship between depression and heart disease is Alexander Glassman, M.D., a professor of psychiatry at Columbia University and chief of clinical psychopharmacology at New York State Psychiatric Institute. In a number of published studies, he has shown that medically healthy but clinically depressed patients are at increased risk of both cardiovascular disease and cardiac death. Depression following a heart attack especially increases the risk of death.
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“It is now apparent that depression aggravates the course of multiple cardiovascular conditions,” he wrote.
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If we look at those suffering a bereavement, sudden death is two to ten times higher than in the general population. It’s even worse if a man loses his wife than if a woman loses her husband. In general, women adapt better than men do. Women express feelings more often. They find joy in sharing those feelings, especially with other women. They form networks and nurture each other. Men, on the other hand, build walls. They hold feelings in. They keep secrets and sometimes have a really hard time communicating.
Dr. Sinatra:
As trite as it sounds, love heals.
In my “Healing the Heart” workshops, we see profound cholesterol lowering when a patient experiences contact and connectedness in a supportive environment. In these four-to seven-day workshops, cholesterol levels have been lower in every one of our participants, with some losing as much as 100 mg/dL of cholesterol in just a few days!
The dramatic reduction in cholesterol supports the notion that emotional contact can positively affect our health.
Once, during a workshop, a physician from Greece was asked about the relative lack of heart disease in Crete and Greece. He immediately responded by speaking of the healing powers of nurturing relationships, particularly among the males. He described how men in Crete spend quality time with one another, talking over lunch about real feelings. The typical topics discussed when American men get together—sports, politics, and money—just aren’t central in their conversations. They talk about feelings. They talk about their families. They talk about their dreams and even their spiritual beliefs. And they rarely wear “social masks.” Instead, they argue, cry, support, and even hold each other. The Greek doctor felt that such camaraderie—occurring often over games of chess or during two-hour lunches—is a major factor in the reduction of coronary heart disease.
Maybe part of the “secret” of the Mediterranean diet isn’t the diet at all. Maybe it has something to do with how the people in the Mediterranean live.
When you support and nurture yourself, your positive self-esteem reflects itself in the healing of your body.
Although digging into your emotions and allowing yourself to be vulnerable can be difficult if you are unaccustomed to such soul-searching, we invite each of you to consider looking more deeply into your emotional self. Such introspection can initially be painful, but it is well worth the effort in the long run. When you support and nurture yourself, your positive self-esteem reflects itself in the healing of your body. Such nurturing and protective influences have been validated in studies time and time again.
If you’re an animal lover like we are, you might not want to read the next few paragraphs. We’re going to tell you about a horrible and sad study that nonetheless dramatically illustrates the role of psychological stress in heart disease and death. (Don’t say we didn’t warn you.)
Baboons are some of the most lovable creatures on earth. They sleep and travel in groups of about fifty individuals. They’re highly social and very connected. Adults sit in small groups grooming one another while the youngsters romp and play. They forage for about three hours in the morning, rest during the afternoon, and then forage again later on before returning to their sleeping places. Before bed, they spend more time grooming each other, which not only keeps them clean and free of external parasites, but also serves to strengthen their bonds. And they’re ambassadors for “family values”—they mate for life.
Early in the twentieth century, Soviet experimenters performed the following experiment. They reared eighteen baboon couples together, and then, after the bonds were strongly established, they removed the male from the cage and replaced him with a new male. The ex-mate was placed only a few feet away in another cage, fully able to observe his former partner and her new “mate.”
Within six months, every one of the eighteen “ex-husbands” died.
Technically, they died of strokes, hypertension, and heart attacks. Less technically, we could say they died of heartbreak. Either way, the acute psychological stress of being trapped, heartbroken, and, most important, helpless to do anything about it, overwhelmingly resulted in death.
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Dr. Jonny:
Warren Buffett is a particular hero of mine, but not because he’s the richest dude in America. Rather, I admire him because, by all accounts, he is remarkably down-to-earth, unpretentious, compassionate, and unafraid of expressing his feelings—not exactly a constellation of traits most of us associate with incredible wealth and power.
Much of this probably has to do with Susie.
Susie met Buffett in 1950, and they were married two years later. “She put me together,” he said.
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Susie was big on civil rights and fairness. She was involved in helping the cause of integration in Omaha back in the 1960s and influenced Buffet so much that he became active in overturning anti-Semitic membership rules at the fancy Omaha Club.
She humanized him.
Prior to meeting Susie there was little time in Buffet’s life for anything but moneymaking. Although they eventually separated, they shared a great love, and it was probably the most transformative relationship of Buffett’s life. Susie even introduced him to her friend Astrid, who, with Susie’s blessing, eventually became his mistress and, after Susie’s death, his second wife.
Seven years after Susie’s death, Buffett was the subject of a
Time
cover story by Rana Foroohar.
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When discussing Susie, he burst into tears. Foroohar reported that it took several moments for him to recover. She put her hand on his arm. “Eventually,” she said, “we moved on to an easier subject—his investments.”
Few men of Buffett’s station in life would allow themselves to feel vulnerable enough to break down and cry in front of a reporter when talking about the love of their life. In fact, few men of any station in life would feel free enough—and be in touch with their feelings enough—to do so.
Buffett eats a horrific diet of fast food, is reported to drink about 60 ounces (1.7 liters) of Coca-Cola a day, and has never been seen at a gym. Yet at eighty-one, he’s sharp, active, involved, and engaged.
He’s also healthy.
Could his dyed-in-the-wool optimism coupled with his ability to express his feelings easily and relate to people deeply be profoundly protective of his heart?
Food for thought.
CHAPTER 9
IN THIS CHAPTER,
we’re going to make specific suggestions about what you can do right now to prevent a first (or second) heart attack and keep your heart healthy for many decades.