Most of us have been told that your cholesterol levels predict your risk of heart disease. Often it’s our own doctors than take a look at lab tests and scare us into reducing our cholesterol as much as possible. However, as “The Nutrition Myth Buster” Dr. Jonny Bowden tells us, this is all a big myth. In the first episode in a series with Jonny, he and the Amens dish the details on all things cholesterol, such as the importance of HDL and LDL, and why too little cholesterol can also be a bad thing.
For more info on Dr. Jonny Bowden, visit https://jonnybowden.com/
Daniel Amen, MD:
Welcome to the Brain Warrior’s Way podcast. I’m Dr. Daniel Amen.
Tana Amen, BSN RN:
And I’m Tana Amen. In our podcast, we provide you with the tools you need to become a warrior for the health of your brain and body.
Daniel Amen, MD:
The Brain Warrior’s Way podcast is brought to you by Amen Clinics, where we have been transforming lives for 30 years using tools like brain SPECT imaging to personalize treatment to your brain. For more information, visit amenclinics.com.
Tana Amen, BSN RN:
The Brain Warrior’s Way podcast is also brought to you by BrainMD, where we produce the highest quality nutraceuticals to support the health of your brain and body. To learn more, go to brainmd.com.
Daniel Amen, MD:
Welcome, everyone. We have a very special cholesterol week for you. We have one of our friends and favorite guests, Jonny Bowden, with us who wrote really a seminal book on cholesterol called The Great Cholesterol Myth.
Tana Amen, BSN RN:
One of my favorites.
Daniel Amen, MD:
I use it clinically. I talk to my patients about it. I’ve probably sold thousands [crosstalk [00:01:15].
Jonny Bowden, PhD CNS:
Thank you.
Daniel Amen, MD:
Dr. Bowden, also known as the Nutrition Myth Buster, nationally known, board certified nutritionist and an expert on diet and weight loss. He’s appeared on Dr. Oz, Fox News, CNN, MSNBC, ABC, all the letters, New York Times, Forbes, Daily Beast. But what he’s really great at is taking complex concepts in health and make them easy to understand.
Heart disease is the number one killer. However, traditional heart disease protocols, with their emphasis on lowering cholesterol, have it all wrong according to The Great Cholesterol Myth. Emerging science is showing that cholesterol levels are a poor predictor of heart disease, and that standard prescriptions for lowering it, such as ineffective low fat, high carb diets, and serious side effect causing statin drugs, obscure the real causes.
We are going to talk about that today. His new book, The Great Cholesterol Myth, now includes a hundred recipes for preventing and reversing heart disease. What you and I often say is, whatever’s good for your heart is good for your brain, because your brain uses 20% of the blood flow in your body, which is also good for your genitals. So if you want to keep [crosstalk [00:02:57]
Jonny Bowden, PhD CNS:
I quote you on that all the time. Everybody, my friend Daniel said that, and it’s got to be true. But it is so true. It is so true. People don’t make that connection enough, do they?
Daniel Amen, MD:
Welcome, Jonny. We’re so [crosstalk [00:03:10]
Tana Amen, BSN RN:
We’re so happy to have you. [crosstalk [00:03:11] I just want to tell you, Jonny, it’s an honor, because that book really did change so much for me. I had several people that I consider huge mentors in my nutritional journey.
Jonny Bowden, PhD CNS:
Wow.
Tana Amen, BSN RN:
I didn’t set out to write my books to help other people initially. I set out doing the research to save myself. You were one of those people. When I read that book, it was so eye opening and so life changing. It made sense. So I really appreciate it.
Jonny Bowden, PhD CNS:
Thank you so much. That is such an honor to hear that from you. I appreciate it very much.
Daniel Amen, MD:
What’s new [crosstalk [00:03:46]
Jonny Bowden, PhD CNS:
I’m glad you asked.
Daniel Amen, MD:
What’s new?
Jonny Bowden, PhD CNS:
The premise of the old book, which is still true today, is that the way that we test for cholesterol, HDL, LDL is obsolete and does not give us valuable information. That’s even more true today, because we now have tests that actually do predict.
I want to clear up the notion that … Sometimes when people take a contrarian position, like we did in The Great Cholesterol Myth, that statins are overused and all that, the soundbite comes out, “Oh, they don’t believe cholesterol has anything to tell us, and they think statin drugs are evil.” Neither of those is really what we said.
The test that we’re using … If I had one mission with this book, is that never, ever, ever again would a prescription drug be given on the basis of this test. This test is as useless as a horoscope from Cosmopolitan Magazine. Sometimes they get it right. It’s not always wrong. You go, “Oh, I’m a Sagittarius. Yeah. That is me.”
Daniel Amen, MD:
[crosstalk [00:04:46] say that you mean total cholesterol with HDL, LDL.
Jonny Bowden, PhD CNS:
And LDL.
Tana Amen, BSN RN:
Yeah. I think he’s going to get to this fractionated thing in a minute.
Jonny Bowden, PhD CNS:
That’s exactly what I am saying. I think it’s important to understand that I don’t say that cholesterol tells us nothing. I think we’re measuring it incorrectly, and we’re emphasizing it where it shouldn’t be emphasized. So if I could clear a couple of those things up, I think people would actually have some usable information about this.
What’s important to understand, and this, I guess, is sort of new, is that cholesterol does not travel in the blood. It can’t. It would be like trying to, if I wanted to get some cooking oil across a lake, if I poured the oil into the lake, it’s not going to arrive on the other side so that you can now cook with it. It has to be in a container.
Cholesterol has to be in a container, and that container is called a lipoprotein. If you look at HDR, LDL, what do they stand for? A high density lipoprotein and a low density lipoprotein. But the lipoprotein is the ship, the boat. Cholesterol is the cargo.
Tana Amen, BSN RN:
Oh, I like that analogy.
Jonny Bowden, PhD CNS:
In the last 10 years, the evidence has stacked up that what’s important here is the number of boats in the water, not the cargo, not the cholesterol. Cholesterol doesn’t even do any damage to anybody until the boat breaks. Then it gets out into the water, and then all kinds of different things happen. [crosstalk [00:00:06]:14].
But in looking at the cargo, instead of saying, “Why is this boat being damaged, and by the way, how many of them are there?” When I talked about the particle test in the old book, and I still do in this one, and there’s even more modern stuff that people are using now even beyond the particle test, we’re talking about counting the number of boats in the water.
Here’s why. Any time you have more people in a nightclub, there’s more likelihood of a fight. Any time you have overcrowded conditions, people are going to bump up against each other. Any time there’s tons and tons of boats in any water, there’s more likelihood of a crash.
The action in measuring cholesterol has nothing to do with LDL and HDL. It has to do with the particles, the lipoproteins, because that’s what gets damaged. We use cholesterol as a shorthand, but it’s the boats. Those boats don’t just carry cholesterol. They carry triglycerides, they carry protein. Some of them are high density. Some are low.
The part that makes my head explode about this is that they figured out about HDL and LDL in 1963. Using this test, when we have the equivalent of … It is like using one of those old cell phones that you used to have to carry [inaudible [00:07:23]. Right? Then we had the flip phones. That was a slight improvement. That’s like the HDL, LDL. Now we have the iPhone 12 Pro and we have the Samsung … Why are we using this crazy old, outdated test?
There are 13 different subfractions of cholesterol. They don’t all behave the same. Some are more likely to become inflamed in [inaudible [00:07:46]. Some are less likely to become that. They have patterns of distribution that we can actually see. Those patterns tell us something. They predict insulin resistance. They predict heart disease a lot better than whether you have HDL and LDL. Yet we are still using this flip phone equivalent, when we’ve got such more sophisticated tools available.
When we wrote the old book, people hadn’t even heard of the particle test. Now it’s given everywhere. LabCorp has it. Quest labs has it. There are even surrogates for it that every doctor already knows, and it’s not a big, heavy lift. ApoB, it’s as good as a particle test, and under regulation, it costs four bucks. Why are they still using LDL/HDL?
Tana Amen, BSN RN:
My question is why are doctors so resistant to giving you a fractionated test? Why are they so reluctant? Because I hear all the time from our patients, from my own doctor, “No. We’re not going to do that. No. I’m not going to order it. No. You don’t need it.”
Jonny Bowden, PhD CNS:
Yeah, yeah.
Tana Amen, BSN RN:
[crosstalk [00:08:49] I’m pretty pushy, but most [crosstalk [00:08:52]
Jonny Bowden, PhD CNS:
I get it.
Daniel Amen, MD:
[crosstalk [00:08:53] for the pushiness.
Jonny Bowden, PhD CNS:
No, no, no. I mean, I get that you’re an informed patient. You don’t just take it like, “Oh, my doctor says he won’t order …” Why? I want to know why.
Tana Amen, BSN RN:
Right.
Jonny Bowden, PhD CNS:
With ApoB … The reason that I’m moving towards recommending ApoB, which by the way, everybody should know … We want to know the number of boats in the water, and the best way to do that is with a particle test of fractionated … In other words, what are the fractions of cholesterol? Because that does tell us something. Particle size actually does predict bad events, I mean, particle number, unlike LDL and HDL.
We talk about this in the book. There are studies that have looked at hospital admissions for coronary artery disease and cardiovascular disease, mega analysis. They look at … They combined studies in 375,000 patients. They look at the admissions. Guess what. Depending on the study you read, between 50 and 70% of those people admitted to hospitals for cardiovascular disease have normal LDL. It doesn’t … It’s a terrible predictor. I don’t know why we still think that LDL …
We talk about this wonderful study that was done quite a while ago called the Lyon Diet Heart Study. It’s a very, very famous study. They took 605 people who were like the walking dead. They had every risk factor you can imagine. Sure, they had high cholesterol, but they were smokers. They ate a terrible diet. A lot of them were obese. They had had a heart attack. They were just insurance underwriters’ nightmare.
They divide them into two groups, and they give one what was called at the time the prudent diet, no more than 30% of your calories from fat, no more than 7% from saturated fat, high carbohydrates. It was the standard quote prudent diet. No eggs, because they have cholesterol, all that stuff. The other group got the Mediterranean diet, which is a 40% fat diet. The results were so dramatic that they stopped the study. They thought it was unethical. The results, it was over 70% reduction in not only actual end points like deaths, but all the risk factors.
Now here’s the interesting thing. Everybody knows that study, but they don’t know this. What do you think happened to the cholesterol levels, the LDL and HDL levels of the people who were now experiencing this enormous double digit reduction in risk? Nothing. The cholesterol was identical. They just stopped dying.
Cholesterol doesn’t predict what we think it predicts. We are concentrating on this molecule, this lab test, and we’ve got so much more sophisticated ways to assess risk, and we’re still sticking with this old thing. You asked why.
Daniel Amen, MD:
When we come back.
Jonny Bowden, PhD CNS:
Okay. When we come back, we’ll talk about why [crosstalk [00:11:40]
Daniel Amen, MD:
Talk about why [crosstalk [00:11:41]. But I also want to talk about how important cholesterol is …
Jonny Bowden, PhD CNS:
Yes.
Daniel Amen, MD:
… to your overall …
Tana Amen, BSN RN:
It’s critical.
Daniel Amen, MD:
… health and [crosstalk [00:11:51] hormones.
What did you learn during this podcast? Write it down, post it on any of your social media sites.
Tana Amen, BSN RN:
Tag us.
Daniel Amen, MD:
Also, we dearly love if you go to the brainwarriorswaypodcast.com. Leave us a comment, question or review. When we come back [inaudible [00:12:14] Dr. Jonny Bowden, we’re going to talk about why do you care about cholesterol? It is not the enemy. It is critical.
Tana Amen, BSN RN:
Title of the new book is The Great Cholesterol Myth Now, right?
Jonny Bowden, PhD CNS:
[crosstalk [00:12:28] It’s The Great Cholesterol Myth. It’s revised and expanded. That’s what we’re looking for, the revised and expanded. That’s the one that’s on Amazon.
Tana Amen, BSN RN:
What I like is your recipes are super easy.
Jonny Bowden, PhD CNS:
Actually, the recipes are in the old edition. They are not in the new edition. [crosstalk [00:12:42] so much new information that we just didn’t want to [crosstalk [00:12:45] … We wanted to get the new stuff in there, because it’s way … There’s many recipe books. So we dropped the recipes and stuck with [crosstalk [00:12:52].
Tana Amen, BSN RN:
… bunch of cookbooks.
Daniel Amen, MD:
[crosstalk [00:12:54] on audio, Jonny? Is it on audio?
Jonny Bowden, PhD CNS:
The old one was. I suspect this one will be. It isn’t yet. It just came out yesterday.
Tana Amen, BSN RN:
Oh [crosstalk [00:13:01]
Daniel Amen, MD:
Awesome. Congratulations. All right. Stay with us. We’ll be back. Dr. Jonny Bowden.
Tana Amen, BSN RN:
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Dr. Daniel Amen:
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