March 20, 2023


Cholesterol Part V - What to do?


I hope that over the last four weeks I have sufficiently laid the case for heart disease as a complex disorder that is far from just a cholesterol/lipoprotein issue. It is vastly more complex than this especially with the new emerging data on the actions of high density lipoproteins, HDL, in reverse cholesterol and other molecule removal from circulation. In the next weeks newsletter, we will look at HDL.

Somewhere in the near future, I will synthesize further recent work linking CVD, immunobiology and obesity.

As I think about my late father's and my heart disease risk factors, I immediately think about my two minions and how I can prevent these issues from coming to life in them as they are genetically 50% of me.

Turning back to Dr. Mark Houston, I think that his approach makes the most sense for my family. He states, "micronutrients, macronutrients and optimal nutrition and nutritional supplements can prevent, control and treat hypertension through numerous mechanisms related to vascular biology. These treatments are complementary to drug therapy. Oxidative stress, inflammation and autoimmune dysfunction initiate and propagate hypertension and cardiovascular disease."

To reduce the risk of all heart based metabolic disease we need to focus on the core risk factors for the development of disease:

1) We have known for years that smoking and exposure to toxins are major drivers of CAD and other metabolic derangements in the body. Avoid all toxins in your family's environment, diet and water. See for information on toxin avoidance. I highly recommend water filtration systems on your drinking water. Use quality house filters on your HVAC and air out your house when possible. Try to avoid eating and drinking from plastic containers as they leach micro plastics into your body as well as into the environment during natural degradation. Remember that we are finding micro plastics in marine animal flesh and water sources at unnatural rates. The effect on us is not good. We all need to do our part here. There is so much to look at in the toxicity exposure space.

2) Clearly, we need to eliminate trans fats and reduce our over consumption of processed pro-oxidant vegetable oils known as omega 6 fats. The biggest culprits are heated corn, soy, canola oils. Omega 6 fatty acids are inherently safe in normal volumes as found in natural unprocessed foods. The processed and ultra processed foods are driving this inflammatory reality. Help your mitochondria and cell membranes stay alive and happy.

3) Dramatically reduce or eliminate altogether refined carbohydrates like flour and added sugars from your family's diet. This has multiple effects including balancing metabolic hormones, increasing insulin sensitivity, improving the gut flora composition, reducing small dense LDL cholesterol levels, decreasing fat cell proliferation, reducing triglycerides and reducing overall inflammation. This is likely the most important recommendation off this list.

4) Ensure adequate micronutrients for full cellular functioning throughout the vascular system. Magnesium, calcium, zinc, potassium are needed in higher volumes in most Americans. Limit sodium to allow the sodium to potassium ratio to rise. Obtain most micronutrients through food sources and supplement as needed based on testing and SNP knowledge.

5) Increase all natural brightly colored vegetable and fruit ingested matter to load the system with polyphenol antioxidant chemicals that are direct protectors of mitochondrial activity system wide as well as inflammatory reducers.

6) Increase the consumption of fish and or Omega 3 fatty acid fish oils as they are a natural source of specialized pro resolving lipid mediators aimed at reducing systemic inflammation and balancing the omega 6 fatty acids. I am a big fan of fish oil because of its pleotrophic effects. Concussion mitigation and brain health promotion are two beneficial effects as well.

7) Increase the consumption of soluble and insoluble fiber to enhance gut flora growth, improve endothelial function and regulate bowel function. Aim for greater than 50 grams daily for the average teenager or adult. The primary sources are fruits, vegetables and legumes.

8) Brush and floss your child's teeth daily to prevent abnormal oral bacterial flora from proliferating and turning into a bacterial seed of heart disease. Reducing flour and sugar exposure also provides protection in the oral cavity. Oral hygiene is so important.

9) Exercise vigorously 3 or preferably 5 days a week to stimulate the production of nitric oxide, a chemical that dilates blood vessels. Try having your children vary the intensity to put stress on the system. Mix up cardio training with resistance training. This is a great thing for heart disease prevention.

10) Reduce stress through meditation, yoga and prayer. Visit the Long Distance Love Bombs website for a tour down happiness lane.

11) Sleep 7-8 hours per night for rejuvenation and stress reduction. More based on age. 8 to 14 hours for toddlers to teens.

12) Learn about your genetics. Over the coming years, we will have evolving information regarding gene environment interactions that can be acted upon to reduce the risk of all disease including CVD. APO E4 and Lp(a) are direct risk factors that should push a person to be more aggressive with self care.


The key to this discussion is the fact that we have the ability to delay, if not halt, most lifestyle diseases by modifying our and our children's choices. The above is really a primer for most diseases. Heart disease is just one of the more common and deadly issues that we face.

The cholesterol lipid hypothesis is still aggressively pursued by most adult physicians and statins as a class of medicine is here to stay for the foreseeable future until further studies change this dogma, if at all. I understand this based on the risk of not treating. My goal has been to show a preventative approach that can forestall this disease and an alternative hypothesis for why cholesterol is what it is and does what it does.

I still hold true to the belief that cholesterol is necessary and not bad unless it becomes unbalanced by epigenetic forces that are based on our lifestyle choices. Change these lifestyle factors, and you may be able to be medicine free and make your cardiologist very happy!....or your pediatrician that wants your child to be medicine free forever. If you need medicine despite an aggressive lifestyle approach, so be it. Although the medicine dosage will likely be substantially lower than expected.

The end.

Dr. M


Deep Nutrition, Catherine Shanahan, MD

Jury J of Immunology Article

Slauch Molecular Microbiology Article

Houston World J of Cardiology Article

Cheng Critical Care Medicine Article

Lanter mBio Article

Nosarev Front Cel Dev Biology