Cardiovascular disease is the leading cause of death for both men and women in the United States. Arterial plaque formation and blockages result in one million heart attacks a year. Cholesterol levels are considered a key modifiable risk factor in the fight against cardiovascular disease.

   So many ideas that we have about cholesterol come from the 1950’s diet-heart hypothesis. These beliefs have actually contributed to the chronic disease epidemic happening right now in this country. We know this because science says so.

   Cholesterol is a lipid, which is another name for a fat that is an essential component for the healthy functioning  of plants and animals. Cholesterol is an essential lipid for our bodies. It is used in cell membranes and maintenance. Cholesterol is so important that our bodies do not rely on cholesterol from food sources alone. We actually manufacture about two-thirds of the cholesterol that we use. Saturated fat stimulates cholesterol production and overproduction.

   Low Density Lipoprotein (LDL) plays a major role in atherosclerosis, which is the process by which our arteries age and become occluded. LDL is not inherently dangerous. It tansports about 75 percent of the cholesterol to the body’s cells. Cholesterol is an important building block for our hormones and cell membranes. If LDL becomes oxidized, it can produce inflammation in the lining of our arteries, which results in atherosclerosis.

   Factors that can cause an increase in oxidation and subsequent inflammation include excessively high cholesterol and LDL cholesterol levels, stress, poisons (tobabbo), allergies (including food sensitivities) and infections and metabolic abnormalities like diabetes and insulin resistance leading to excess insulin production.

   If the diet-heart hypothesis was accurate, we should see a lower risk of heart disease once cholesterol is lowered. We see the opposite in the literature. Small, dense LDL particles are like little darts that tear holes in the lining of blood vessels, but large buoyant  LDL particles are like large fluffy balls.

   There are actually biomarkers that predict heart attack and stroke. They include: Low HDL “good” cholesterol; high triglycerides, which can reflect a diet high in sugar and refined carbohydrates; and high levels of small dense LDL. So, cholesterol is involved, just not at all in the way most people think.

   ApoB-containing lipoproteins is the most reliable blood marker of lipid burden and cardiovascular risk. In a recent study, ApoB levels were the most predictive of a heart attack when compared to other lipid metrics.

   What most doctors and drug company commercials don’t talk about are the studies that show most people who have heart attacks actually have normal cholesterol levels. Because of statins and other drugs that lower cholesterol, the belief is that these drugs are preventing heart attacks. What we need to focus on is what we can do to reduce our risk of heart attacks.

   Statins are pushed because of a multi-billion dollar drug industry. However, these drugs can introduce a whole host of problems including muscle damage, memory issues, Parkinson’s-like symptoms and muscle aches and pains. Statins can increase risk of diabetes by about 50 percent. The drawbacks outweigh the potential benefits for most people.

   The functional approach to dealing with this issue is very different from the conventional approach. In functional medicine, we view high cholesterol not as a disease but as a symptom. There are six key underlying processes that can lead to hypercholesterolemia: Metabolic dysfunction, chronic infections, gut dysbiosis permeability, poor thyroid function, environmental toxins and genetics. The functional approach is where you try to address the roots of the problem. Try these strategies to optimize lipid levels and your overall health.

   You should remove inflammatory fats and replace them with heart-healthy fats. Bad fats include hydrogenated and partially hydrogenated oils, trans fats and polyunsaturated industrial seed oils such as corn, vegetables, soy and canola oil. Sources of good fats essential to hormone production, cancer prevention, brain function, weight loss and heart disease prevention come from coconut oil, avocados, local farmed eggs, kefir, ghee, organic butter, grass-fed raw milk and raw nuts and seeds.

   Not all meat is bad, What separates good meat from bad meat is quality. Studies have linked commercial meat to heart disease. Grass-fed beef and organic chicken helps you avoid many problems.

   What we’ve done as a society to our grain supply is contributing to the deaths of millions. The genetic modifications, refining, hybridization for more starch and sugar content, and the all-around defilling of most grains with pesticides and desiccants, makes it difficult to get a good source of this once healthy food. Organic quinoa and wild rice are great alternatives.

   Then there is sugar, which offers insignificant amounts of vitamins and minerals, but simultaneously robs your body of nutrient stores. This can lead to chronic diseases.

   When getting a cholesterol test, get the right one. The tests to get are either NMR Lipid Panel from LabCorp or the Cario IQ Test from Quest Diagnostics. You want to see results that show lots of safe, light, fluffy, bit cholesterol particles. You do not want to see small, dense, artery-damaging cholesterol particles.

   Besides healthy fats, focus on a high-fiber, plant-based diet with lots of phytonutrients and omega 3 fats. That includes lots of non-starchy vegetables. Consume plenty of good-quality protein found in beans, seeds, nuts and high-quality, sustainably raised or grass-fed animal protein.

   Studies show consistent, regular exercise can optimize cholesterol levels. Focus on quality sleep as well. Taking the right supplements can help too, including a multivitamin, fish oil or EPA/DHA, vitamin D3, glucomannan or PGX and low-dose statins. Only take low-dose statins if you’ve had a heart attack, heart disease or if you have multiple other risk factors.

   There are other supplements you can take that will also help with cholesterol: Artichoke leaf extract, garlic, curcumin, fiber, ginger, green tea, gugulipid, niacin, pantethine, plant sterols and red rice yeast.