Here’s a cholesterol crystal shooting out the top of a test tube, and when you look at the tips of the crystals under a microscope, they are sharp jagged needles. They placed a thin membrane over the top of the test tube to see if the cholesterol needles would poke through, and indeed, the sharp tips of the cholesterol needles cut through the membrane. So, they showed that as cholesterol crystallized the peak volume then increases rapidly and then sharp-tipped crystals can cut through and tear membranes, suggesting that the crystallization of supersaturated cholesterol in atherosclerotic plaques can induce those final ruptures.
And that’s what you see on autopsy. All patients who died of acute heart attacks had these perforating cholesterol crystals like this, sticking out of their plaques, but no crystals were found perforating the arteries of people who had severe atherosclerosis but first died of other, non-cardiac causes. This can explain why dramatically lowering cholesterol levels with diet and drugs if necessary can reduce the risk of fatal heart attack, by pulling cholesterol out of the artery walls, decreasing the risk of crystallizing these cholesterol needles that can then pop the plaques in our arteries.
High cholesterol can also cause what’s called fatty liver disease, our next global chronic disease epidemic. Fatty deposits in our liver can trigger inflammation, and result in liver cancer, failure, and death. And again, it may be these crystals, cholesterol crystals, triggering the progression of fatty liver into serious hepatitis. We’re talking dietary cholesterol, the cholesterol people eat in eggs and other animal products. A strong association between cholesterol intake and hospitalization and death from cirrhosis and liver cancer. And beyond just the crystals, dietary cholesterol may oxidize and directly cause toxic and carcinogenic effects.
It was not appreciated until recently that the average cholesterol level in the United States, the so-called “normal” levels were actually abnormal, accelerating the blockages in our arteries and putting a large fraction of the normal population at risk. Having a normal cholesterol in a society where it’s normal to drop dead of a heart attack, not necessarily a good thing. Normal cholesterol levels may be fatal cholesterol levels.
In cholesterol lowering, moderation kills. Even if all Americans kept their total cholesterol below the recommended 200, millions would develop coronary artery disease. Strong evidence shows we need to keep our total cholesterol under at least 150 to stem the epidemic. What kind of evidence? Well, in many cultures, coronary disease is practically unheard of when total serum cholesterol is under 150. And here in the U.S., in the famous Framingham Heart Study, few under 150 developed heart disease, and none died from it.
We cannot continue to have these public and private organizations on the forefront of health leadership recommending to the public a dietary plan that guarantees that millions will perish of the very disease the guidelines are supposed to prevent. The reason given by health authorities to not tell people the truth, for not advocating what the science shows is best, was that it might frustrate the public, who may have difficulty getting their cholesterol levels that low. But the public’s greatest frustration might come from not being informed of the optimal diet for health. Heart disease can be reversed with a plant-based diet. The evidence justifies igniting a social movement, let the people lead, and eventually the government will follow.
Some criticize plant-based diets as being extreme. You want extreme, though? Check out the consequences of our present diet. Having a breastbone sawed in half for bypass surgery or having a stroke that renders one mute, or having a breast, prostate, colon, or rectum removed for cancer, now that’s extreme. Eating a bean burrito is easy.
Instead of just bypassing the problem, literally, you can treat the cause, arrest and reverse heart disease, our #1 killer, with a whole food, plant-based diet.
Next on the list is arthritis, such as rheumatoid arthritis, a chronic inflammatory systemic disorder causing progressive destruction of the joints. As many as 80% become disabled, can cut 18 years off one’s lifespan. There are drugs, but unfortunately they’re often associated with severe side effects, blood loss, bone loss, immune suppression, and toxicity to the liver and eyes. There’s got to be a better way.
Well, populations that eat more meat do seem to have more rheumatoid arthritis, and there have been some dramatic case reports of rheumatoid arthritis attacks being triggered by consumption of animal products, starting six to ten hours after ingestion of animal protein and lasting a few days, but they stopped when patients stopped consuming animal products. The researchers suggest that immune complexes formed by the body attacking animal proteins may promote autoimmune reactions inside the joints themselves. And indeed, those with rheumatoid arthritis have striking elevations in antibodies to foods like fish, pork, egg whites, dairy proteins, and even some cereals. But it could also be a pro-inflammatory effects of meat fats or free radicals from the iron accumulating in the joints or other mechanisms, but case reports and country-by-country analyses can only raise questions. To prove cause-and-effect, you need an interventional study to put it to the test.
And here we go: a 13-month-long randomized controlled trial of plant-based diets for rheumatoid arthritis. Patients were put on a vegan diet for three and a half months and then switched to an egg-free vegetarian diet for the remainder. Compared to the control group, that didn’t change their diet, the plant-based group had a significant improvement in morning stiffness within the first month, cutting the number of hours they suffered from joint stiffness in half, a drop in pain, a drop in disability. They reported subjectively feeling better, significant improvement in their grip strength, fewer tender joints, fewer tenderness per joint, and less swelling. They also had dramatic drops in inflammatory markers in the blood, sed rate, C-reactive protein, and white count; highly significant and clinically relevant findings.
What about osteoarthritis? Most frequent cause of physical disability among older adults, affecting about 20 million Americans, affecting maybe 20% of Americans in the coming decades, and becoming more and more widespread among younger people.
Osteoarthritis is characterized by loss of cartilage within the joint. We used to think there’s just kind of wear and tear, but it is now generally accepted as an active joint disease with an inflammatory component. So if the loss of cartilage is caused by inflammation, maybe if we put people on an anti-inflammatory diet, it could help; like with rheumatoid arthritis. Using optimal nutrition and exercise as the first-line intervention could well be the best medical practice.
So where’s the best science on what optimal nutrition might look like? The China Study is a prime example, showing the serious health consequences of high consumption of pro-inflammatory foods — meat, dairy, fat, and junk — and low consumption of anti-inflammatory plant foods: whole grains, vegetables, fruits, beans, split peas, chickpeas, and lentils. The unnatural Western diet contributes to low-grade systemic inflammation, oxidative stress, tissue damage, and irritation, placing the immune system in this kind of overactive state, a common denominator for these conditions like arthritis.