First, let's get one thing straight: Cholesterol is really our friend. It's necessary to form adrenal and sex hormones, Vitamin D and bile (a digestive fluid). It also gives cell membranes their proper shape, and helps carry fatty nutrients to every body tissue. If levels are too low, we sicken.

Half of all heart attacks occur in people with normal cholesterol levels. How, then, did we come to believe that high cholesterol levels cause heart disease?

Let's go back to the early 1900s, when coronary heart disease was relatively rare in America. What were people eating then? Prodigious amounts of rich organ meats, chicken and goose fat, butter, lard and tallows -- all highly saturated fat, all from free-range poultry and grass-fed animals. Saturated coconut or palm oil was used as shortening in most bakery items; French fries were cooked in palm oil. All farming was organic then, soils were rich and foods were nutrient-dense. As the 20th Century progressed, America's food lost more and more of its integrity.

THE CRISCO GENERATION
In 1911, Procter & Gamble added hydrogen to cottonseed oil, turning it into a semi-solid fat at room temperature. Thus was Crisco born. Hydrogenation results in what's called a "trans" fat, never before encountered by the human body. Gradually, other hydrogenated vegetable oils found their way into crackers, chips, cookies and a host of other snack and fast foods. Back then, we didn't understand the impact of these fake fats. Now we know they make blood platelets sticky, damage cholesterol itself, and inflame fat-containing structures like blood vessel walls, which, it's thought, initiates the cascade of events leading to heart disease. Trans fats also push the LDL:HDL (fat/protein complexes) ratios in an unhealthy direction. A robust HDL level is a sign of cardiovascular health, indicating that fats are absorbed into the tissues, where they belong.

By the '30s and early '40s, heart disease was on the rise. In 1948, the Framingham Heart Study aimed to determine risk factors associated with heart attacks. Though 240 risk factors were eventually identified, a high cholesterol level drew the most early interest. Soon, high cholesterol became synonymous with being a sitting duck for a heart attack.

There were several flaws in this thinking. First, though cholesterol may have been associated with heart attacks, it does not necessarily cause them. One big mistake was that early researchers failed to distinguish between saturated, monounsaturated and polyunsaturated fats. Neither did they differentiate between HDLs and LDLs; lumping them together, they searched for ways to lower the total sum. Their mistaken conclusion was that all fats were bad.

Maryann Napoli of the Center for Medical Consumers raises another question about the direction of research. She writes in the November 2003 HealthFacts newsletter, "Research focused on cholesterol because it is a modifiable risk factor (translation: drug industry opportunity)." Opportunity or not, the first-generation cholesterol-lowering drugs (Lopid, Cholestyramine) had extremely uncomfortable side effects and low compliance.

Nonetheless, Americans were advised to lower cholesterol by eating less saturated fat (eggs, red meat, butter, full-fat dairy), and began dutifully eating products like margarine, imitation cheese, egg-replacer and even "imitation ice milk" -- tasteless, fractured foods. Cholesterol, the experts said, could be lowered by using more polyunsaturated oils like corn and safflower oils. Just one problem: these oils are unstable and easily damaged (oxidized) by processing and cooking (to say nothing of hydrogenation). It's worth noting that the ancient Ayurvedic (East Indian) medical tradition viewed safflower oil as the most dangerous oil.

As fear of fat and cholesterol ran rampant, our fat profile radically changed. According to Sally Fallon and Mary Enig, PhD, authors of Nourishing Traditions, in the last 80 years, America's intake of vegetable oils (including margarine, shortening and refined oils) increased an astonishing 400%. The use of butter and other saturated fats plummeted. Complying with medical experts' advice and customer demand, manufacturers of baked and fried foods switched from healthier palm and coconut oils to hydrogenated soy, corn, canola and cottonseed oils.

Meanwhile, back at the ranch in the '50s, in a move that would prove to have serious consequences, the meat industry began moving animals from pasture to feedlots to fatten them on grains before their slaughter. Free-range hens, once enjoying a diet of both grains and their fill of weeds, insects and worms, were moved to factory farms and exclusively grain-fed. Fish farming got started, and the fish were being fattened with -- you guessed it -- grain-based feed.

Grain-fed fish and animals fatten quickly, improving industry's bottom line, but there is a down-side to these foods. The ratio of omega-3 to omega-6 fatty acids veers in the wrong direction, and our health suffers. While omega-3s reduce the risk of heart attack by calming inflammation, protecting blood vessels and decreasing high blood pressure and inappropriate clotting, omega-6s, on the other hand, are inflammatory and increase the tendency to blood clots and high blood pressure. Vegetable oils and grains are top-heavy in omega-6s.

Here are some sobering examples of what happened to our animal foods: Grass-fed animals have an omega-3:6 ratio of 1:2.5, whereas grain-fattened animals are 1:14. Free-range hens‚ eggs boast a 1:1 ratio, while commercial, grain-fed hens' eggs are a whopping 1:19! Even wild fish offer better omega-3:6 ratios than farm-raised fish. Grass-fed butter and cheese products likewise have completely different ratios than products from grain-fed cows' milk.

Given the strong link between animal feed and human health, why don't we hear more about this problem? Jo Robinson, author of Why Grassfed is Best! and co-author of The Omega Diet (with Dr. Artemis Simopoulos), describes part of the problem: "Much of our animal research is funded by commercial interests -- specifically the grain, chemical, pharmaceutical, farm equipment, and meat-packing companies. Together, these vertically integrated behemoths have a multi-billion dollar stake in perpetuating factory farming."

The low-fat craze continued well into the 1980s, Americans ate more omega-6 fats than ever (which also make people gain weight). At the same time, a sedentary lifestyle together with a sharp rise in the intake of sugar and refined carbohydrates added up to a glut of unused fuels. Obesity is not the only result of such a scenario: The liver transforms unused carbohydrates into a surfeit of triglycerides, which predispose people to heart disease. It seemed we had gotten nowhere in attempts to combat cardiovascular disease.  

A few voices in the wilderness insisted that when people with an inherited tendency to overproduce cholesterol were excluded, there was little evidence that high cholesterol is a causative factor in heart disease. Further, they claimed, faulty carbohydrate metabolism, obesity and diabetes are far more dangerous risk factors. An alternate theory emerged: The disease develops in response to blood vessel injury incurred by smoking, inflammation, high blood pressure, etc. Once the inside lining is damaged, cholesterol catches on the rough, damaged spots.

THE PROBLEM WITH INDISCRIMINATE SCREENING
In 1986, a new class of potent cholesterol-lowering drugs dubbed "statins" appeared on the medical scene. They were prescribed primarily for smokers, people with diabetes (which causes deranged fat and carbohydrate metabolism), people with existing heart disease, those who had had a heart attack, and those with total cholesterol above 350. People felt better on statins than on the earlier drugs, but there were silent and potentially dangerous side effects. These included transient amnesia (as yet not admitted by the drug companies) and a potentially fatal muscle disease. Liver enzymes were frequently elevated, a sign of a dysfunctional liver.

The following year, 1987, The National Cholesterol Education Program launched a public education effort called "Know Your Numbers." Routine cholesterol testing, once reserved for those who already had heart disease, was now promoted to everyone, regardless of age, symptoms or risk factors. Such indiscriminate screening often gets ahead of a true understanding of an illness, and can set people up for lifetime medication.

For decades, researchers had tried -- and failed -- to prove that lowering cholesterol saved lives. Then in 1995, a Scottish study on a statin drug (Pravachol) finally succeeded. This meant the drug could be prescribed preventively, and millions of people could take it, for the rest of their lives. (Ironically, the drug may save lives not because it lowers cholesterol, but because it's an anti-inflammatory.)

Then in 2001, the federal government lowered the threshold of the "normal" total cholesterol level from 300 to 200, resulting in millions more people being put on cholesterol-lowering drugs. Healthy people with high cholesterol might want to think twice. A 2001 review of all relevant statin trials concluded that these drugs harm as many people as they help. Statins block a liver enzyme necessary to make cholesterol, something that seems inherently unwise. The long-term consequences of suppressing cholesterol synthesis are unknown, as studies lasted but five years.

Worse, all patients on these drugs eventually deplete Coenzyme Q10, a heart-protective anti-oxidant. (If someone you love is on these drugs, make sure they take 200 mg/day of CoQ10. It‚s also possible to reduce the statin dosage by using other supplements.) Though conventional medical dogma stubbornly clings to the idea that cholesterol levels can predict future heart disease, there are two other tests that may be much more accurate. First, elevated C-Reactive Protein (CRP) levels indicate inflammation, but testing is most useful in high-risk people such as smokers, diabetics, etc. The other test is for homocysteine. When elevated, homocysteine is correlated with pathological buildup of plaque, and hardening and blockage of blood vessels. Health care professionals suggest supplements of Vitamins B6, B12 and Folic Acid to bring the levels down. This is one test to discuss with a progressive doctor.

EAT YOUR WAY TO HEART HEALTH
The case is strong for a dietary connection to cardiovascular disease, but the problem is not what the experts led us to believe. Remember two things: the quality of the fats you eat is much more important than the quantity; and excessive carbohydrates/sugars can set the stage for problems. There are many theories about how to structure your diet, but that discussion is beyond the scope of this article. Also, some people may not thrive on meat or dairy, so fine-tune all dietary and herbal choices with a health care practitioner to allow for constitutional differences.

Here are some health-enhancing tips to consider. As you make these changes, both your HDL:LDL and your omega-3:6 ratios will improve. Inflammation will decrease, and cholesterol levels will probably drop, which will make your doctor happy. If you are already on statins and would like to quit, arm yourself with all the research you can, then talk to your physician.

* Know what you're eating. If you buy anything in a can, jar or package, start reading the labels. You will make the unpleasant discovery that hydrogenated fats and undesirable vegetable oils (as well as sugar) are in most of these foods, even in some so-called health foods.

* Eat real fats. Beef, buffalo or other animals raised exclusively on pasture provide healthy fats. The popular deep-sea fish like halibut, tuna and salmon do, too. But because mercury concentration is a real concern with these large fish, allow the smaller herring and sardines to contribute to your omega-3 quota. If you have hardened your heart against them, try herring chunks (packed in wine sauce) with mixed baby greens, roasted red pepper, artichoke hearts (packed in water), sliced carrots, a handful of pumpkin seeds, olive oil and balsamic vinegar. Substitute sardines in your tuna salad. A yummy snack: Portuguese whole sardines, packed in olive oil (Bela brand, distributed by Blue Galleon), goat cheese, sliced radishes and lettuce on whole rye crackers.

Goat or sheep dairy products are preferable to those from grain-fed animals. Walnuts, hemp, flax and pumpkin seeds offer omega-3s, as do dark green leafy vegetables and seaweed. Avocado is among the healthy "monounsaturated" (omega-9) fats, along with pecans, almonds and some other nuts. Happily, a small piece of bittersweet chocolate (good fats and anti-oxidants) and a glass of red wine (anti-oxidants) each day contain compounds that support the cardiovascular system! A critical mineral for heart health is magnesium -- in short supply in the American diet. You'll find it in anything green -- chlorophyll-rich, leafy green vegetables, seaweed, green herb teas (nettle, raspberry, alfalfa, horsetail) -- as well as oatmeal, almonds, brazil nuts, pecans, walnuts, dried figs and dates.

* Choose the right oil for the job. The two best oils for raw use are flax and walnut oils (Spectrum is a reliable brand). Unsaturated oils must be refrigerated and never heated. In a foolish attempt to jump on the "healthy" bandwagon, many baked goods contain safflower oil or flax seeds, both badly damaged by heat. Throw out your corn, safflower, almond and canola oils. Canola can deplete Vitamin E (essential for hearts) and is susceptible to rancidity. What's more, when it's deodorized, the dreaded trans fats are created. Olive oil (another omega-9) can be used liberally, raw or cooked. Get unrefined, extra virgin. Ghee (clarified, organic butter) is good to cook with as well -- it won‚t burn as butter does. Use peanut and sesame oils only occasionally.

I predict health-enhancing, extra-virgin coconut oil (try the Garden of Life brand) will make a big comeback soon. It tastes and smells lovely, stores at room temperature for at least a year, does not promote weight gain, and enhances the immune system with potent anti-microbial properties. Use for high temperature cooking, in smoothies, and in baking. Buy Newman's Own cookies, now made with organic palm oil (another healthy tropical oil). Palm oil is widely used by savvy European food manufacturers as an alternative to partially hydrogenated oils.

* Herbs can help, too. Dandelion and burdock roots are bitter herbs that promote bile flow, emulsifying fats thoroughly for proper absorption. (You can eat nutty-flavored burdock root as a vegetable, too -- scrub well, slice thinly, and add to stir-fries.) Other herbs like green tea or Eleutherococcus (formerly known as Siberian Ginseng) can normalize cholesterol levels and regulate metabolic functions.

* Love. Finally, spirituality and connection nourish a healthy heart -- open to love and compassion for yourself and others. Relax, dance, walk and smile as much as you can. And may you enjoy eating your cholesterol from now on.

RESOURCES
* www.eatwild.com and www.realmilk.com: learn more about the benefits of eating grass-fed meat and dairy, and find out who's producing it in your community (note: Standard Market, listed as a source in Santa Fe, has closed.)
* HealthFacts, for Informed Decision Making, newsletter by the nonprofit consumer advocacy organization, Center for Medical Consumers, www.medicalconsumers.org, 212-674-7105.
* Nourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and the Diet Dictocrats, by Sally Fallon with Mary Enig, PhD
* The International Network of Cholesterol Skeptics, www.thincs.org
* Earth Medicine Gazette, free e-mail newsletter, subscribe: ctashel@cybermesa.com

Carole Tashel works with wild and cultivated plants as a clinical herbalist, teacher, gardener and author. 505-466-6153.