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The Mythological Dangers of High Cholesterol and High Fat
by Gabriel Cousens, MD

The following is a excerpt from There is a Cure for Diabetes, Revised Edition.

Clarity is needed on the question of risk/benefit ratio of low cholesterol, especially because 56 percent of Americans have a fear of fat and cholesterol. On my diet for treatment and prevention of diabetes, which is plant-based, cholesterol is not a particular concern, as 159 is high enough to be safe. The main reason I am dissecting the “high- cholesterol danger myth” is that it has resulted in dangerous low-fat dietary practices. In specific to the Dr. Cousens’s Diabetes Recovery Program—A Holistic Approach and in a larger holistic context, the increase in healthy fats supports the macronutrient calorie shift away from carbohydrates. This is additionally important since the research of the last 30 years shows that a serum cholesterol below 159 is unsafe, whereas serum cholesterol as high as 260–270 not only is perfectly safe but actually decreases cardiovascular mortality and increases longevity in women. What exactly is that 56 percent worried about, and are their worries justified or is it just a fearful, unscientific response to mythological hype?

As I have made it clear, all forms of carbohydrates in excess, including grains, fruits, and all sugars and sugar substitutes (except stevia and birch-tree-based xylitol), often result in an increased insulin resistance, obesity, increased triglycerides and increased levels of pathogenic small LDL particles. Empowered by the scientifically disproven idea that the “best way to protect your heart is a low cholesterol diet,” we can look at the whole cholesterol issue from a science-based perspective. Some of the more recent research that significantly nullifies the earlier speculative research gives us a new perspective of not only why I feel that a 25–45 percent fat diet, depending on constitution, is a safe way of reversing the degenerative process of Type-2 diabetes, but also why I feel (based on my clinical experience and more recent epidemiological scientific studies) that normal cholesterols as well as healthy levels of omega-3s are essential for long- term healthy function. The first thing I would like to point out is that in a 1992 editorial published in the Archives of Internal Medicine, Dr. William Pastelli, the former director of the Farmington Heart study, made an amazing statement: “In Farmington, Massachusetts, the more saturated fat one ate, the more cholesterol one ate and calories one ate, the lower the person’s serum cholesterol was.” It is easier to appreciate Dr. William Pastelli’s observation when one understands that the body makes 75 percent of its own cholesterol. The key in helping us understand this process is that the body of research shows that the liver produces three-to-four times more cholesterol than one eats and is always adjusting for the amount of cholesterol taken in orally. A low-cholesterol diet will increase production, and endogenous production decreases with large cholesterol dietary input. There’s a homeostasis going on. In addition, when one has a healthy insulin level, one tends to have a healthy cholesterol level because a healthy cholesterol is mediated by a healthy insulin level. This is a remarkable and important statement that is very much validated by the book The Cholesterol Myths by Uffe Ravnskov, MD, PhD, which offers many scientific arguments invalidating the idea that saturated-fat and cholesterol intake cause heart disease. His data and the data in general are overwhelming on this point.

Health Dangers of Low Cholesterol

My biggest concern in this discussion is the significant and pathological dangers with not only statins, as previously explained, but with cholesterol levels under 159. As a psychiatrist, I have been quite aware, for more than 40 years, of the serious mental illness dangers associated with low cholesterol. Recent research has shown that there is a much higher association of depression, suicidability, and anxiety with cholesterols less than 159. Several cohort studies on nondepressed subjects have assessed the relationship between plasma cholesterol and depression. Optimal membrane fat ratios positively affect the quality of neuro- transmission and neurotransmitter production. Low cholesterol is also associated with decreased serotonin receptors in the neurons (brain cells). In another study in relationship to cholesterol, called “Low Serum Cholesterol Concentration and Risk of Suicide,” adjusting for age and sex, they found that those with the lowest serum cholesterol concentrations had more than six times the risk of committing suicide. Another study found that if the cholesterol levels were equal to or below the twenty-fifth percentile, the risk of a suicide attempt doubled. Obviously from a holistic and psychiatric perspective, this is highly significant.

The Importance of Omega-3s for Health

Adequate omega-3 levels contribute to a healthy brain in a variety of important ways. They are important for maintaining and improving memory, cognition, sleep, neuromuscular control, and slowing the mortality of neurodegenerative diseases. Omega-3s also support new manufacture of acetylcholine, which is an important neurotransmitter needed for memory. They stimulate release of gamma-aminobutyric acid (GABA; which protects against anxiety, depression, pain, and panic attacks). Omega-3s are major components of brain tissue. They also help with brain and eye development in babies. Long- chain omega-3 are essential for prevention and treatment of all depression, including bipolar disorder. Recent studies investigating the epidemic of military suicides in Iraq and Afghanistan found that those who committed suicide had the lowest omega-3 levels in the military population. In specific, low DHA was associated with a 60 percent increase in suicide, making a clear point that adequate brain DHA is necessary for healthy brain and mental health function.

Adequate omega-3s improve mood regulation and treat impulsivity, hostility, and aggression.They improve dysfunction of monoaminergic systems including 5-hydroxytryptamine and serotonin. They help prevent cortisol, epinephrine, and norepinephrine elevations in biological and emotional stress. They reduce the risk of Parkinson’s disease and help proper nerve signaling. Adequate omega-3s are antiatherosclerotic in that they prevent fatty deposits and fibrosis of the inner layer of the arteries from forming. Adequate omega-3s lower triglyceride concentrations and improve endothelial function.They are a major factor in promoting the growth of new blood vessels. They tend to prevent thrombosis (a blood clot within a blood vessel), and they decrease cardiovascular risk factors. People with atrial fibrillation with high omega-3 levels have 85 percent lower risk of dying from all causes. Adequate omega-3 lowers blood pressure.

Omega-3s also have some anticancer benefits: They protect skin cells from cancer-causing effects of the sun and help decrease prostate cancer risks. In premenopausal women, a high omega-3 to omega- 6 ratio resulted in a decreased rate of breast cancer by 50 percent. Omega-3s constitute 50 percent of our cell membranes and give our cells optimal stiffness, flexibility, integrity, and function. They improve liver health and protect the liver from toxins. They help build a strong immune system. They contribute to healthy lungs and also have an anti-inflammatory in counteracting inflammation (heat, pain, swelling, etc.). They protect organs and tissues from inflammation in general.

From an Ayurvedic perspective, deficient omega-3s, as well as inadequate cholesterol, create an imbalanced “vata” mental state with poorer cognition, memory, and functioning. This results in lower life-force, lower vitality, and generally a lower reserve of vital life-force and sexual energy. Along with this there may be depression, violence, anxiety, and even suicide. The Ayurvedic term for this is vital reserve is ojas, which means deep primordial vigor and reserve. Low ojas results in a generally weakened physical, emotional, mental, and spiritual condition. In this larger context, the overall effect of a low-fat diet has serious, global, negative ramifications for quality of life. To balance the vata Ayurvedic dosha, and specifically for calming a vata dosha imbalance (which, in essence, is the clinical description I have given of an omega- 3, long- and short-chain deficiency, as well as a cholesterol deficiency), I highly recommend adequate raw plant-source-only fat consumption in one’s diet to prevent Ayurvedically described “vata” physical and mental imbalances.

In summary, low-cholesterol and low-omega-3s have been shown through overwhelming scientific evidence to be a danger to the general health and longevity of the individual. The “extremely low cholesterol is good for your heart” and extreme low-fat mythology campaign is based on bad science and fear, which has, by 2011, been disproved. Saturated fat and omega-3 intake from plant-based fat is actually cardioprotective, brain- and mental-health protective, general-health protective, and life-force protective. This higher fat intake creates a macronutrient balance with the 25–45 percent carbohydrate direction, with its higher vegetable and nut and seed fat. A higher fat diet allows the potential for a lower protein in the diet, which is important when one understands about the glycemic impact of excess protein intake. Research more strongly suggests that high insulin is more linked to cardiovascular disease than the “cholesterol link.” There is a distinction between association and causal effect. Causal means a direct link and thus a stronger effect. There’s a causal link between high insulin and high leptin and heart disease and diabetes. There is neither an association nor a causal relationship between cholesterol and heart disease. The key to cardiovascular disease and diabetes is an imbalanced, dysfunctional insulin and leptin signaling secondary to excess carbohydrates, which of course is perhaps the key to all chronic diseases but particularly coronary disease.

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