Unfortunately, most physicians today still consider a "normal cholesterol" level to be under 200 mg/dl. The average American's cholesterol is 210-220. However, Dr. John Mcdougall points out, "This level predicts a 50% chance of premature death from strokes or heart attacks due to atherosclerosis. A rise in cholesterol level from 200 mg/dl to 260 mg/dl increases the risk of death by 500%. People with levels below 180 mg/dl during their lifetime rarely have heart disease."
Dr. Mcdougall goes on to say that, "Worldwide and nationwide heart disease is very rare or non-existent in persons who have blood cholesterol levels below 150 mg/dl." Dr. McDougall's goal is to have all of his patients achieve a total cholesterol below 150 mg/dl and LDL cholesterol below 90 mg/dl with diet alone.
Dr. Caldwell Esselstyn, Jr. states: "Even if all Americans kept their total cholesterol below 200 mg/dL, as recommended by the American Heart Association, millions would develop coronary artery disease. Strong evidence from a wide variety of sources shows that total serum cholesterol levels must be kept below 150 mg/dL to stem America's epidemic of coronary artery disease."
What do Experts Say about Cholesterol Levels?
One of the studies Dr. Esselstyn highlights in his book is the Framingham Heart Study, a 50+ year study which began in 1948 involving over 5,000 participants in Framingham, Massachusetts. He notes that over the years, no one in the study suffered a heart attack that maintained their cholesterol level below 150.
Dr. Esselstyn also conducted his own 20 year comprehensive nutritional study consisting of patients with high cholesterol and advanced coronary heart disease. The dramatic results from this study revealed that plant-based nutrition can successfully prevent and stop the progression of heart disease, as well as reverse it.
Dr. Neal Barnard also agrees that ideally, total cholesterol levels should be kept below 150 mg since heart disease risk at this level is extremely low. According to Dr. Barnard, "For every 1 percent increase in the amount of cholesterol in the blood, the risk of a heart attack rises by about 2 percent. This association can be used clinically: lowering a patient's serum cholesterol level is rewarded by a two-for-one improvement in risk. If a patient lowers his or her cholesterol level by 20 percent, for example, by dropping from 200 mg/dl down to 160 mg/dl, the risk of a heart attack diminishes by roughly 40 percent."
Dr. Barnard explains in more detail, stating: "If the total cholesterol is above 150, you should check how much of the cholesterol is in the form of high density lipoprotein (HDL). This means that not enough of the cholesterol in the body is leaving. Ideally, the HDL level should be one-third or more of the total."
The total cholesterol level combines all forms of cholesterol in the blood.
|Above 240 mg/dl (6.2 mmol/L):||High risk**|
|205-240 mg/dl (5.3-6.2 mmol/L):||Above average risk|
|205 mg/dl (5.3 mmol/L):||Average for U.S. adults|
|150 mg/dl (3.9 mmol/L) or less:||Very low risk|
Equally important, Dr. Joel Fuhrman affirms and recommends that in order to be truly cardiac protective, we should strive to maintain a total cholesterol below 150 mg/dl and LDL cholesterol below 100 mg/dl. Lowering LDL cholesterol below 100 he says, "offers powerful protection against heart disease."
Why Some World Regions Don't Have Heart Attacks?
This corresponds to the most recent recommendation from most medical authorities like the American College of Cardiology and has been well documented for years in epidemiological studies. Dr. Fuhrman emphasizes that "People in countries who ate a more simple plant-based diet did not have heart attacks and those populations are always found to have much lower cholesterol levels than was thought to be acceptable in the past. For instance, the average total cholesterol in rural China was 127 and the average LDL was below 80. Heart attacks in rural China were exceedingly rare. The same thing was observed in multiple interventional and population studies, such as the Harvard Health Study; those with LDL's below 100 were not observed to have heart attacks. Medical authorities are now finally in agreement that much lower cholesterol levels are needed to be truly protective."
Furthermore, Dr. Fuhrman addresses how elevated cholesterol levels increase our risk of heart disease by saying: "More than 1.5 million people will have a heart attack this year, with about 1 million deaths as a direct consequence of heart attacks. That amounts to a death every 30 seconds. There is irrefutable scientific evidence that high cholesterol levels are associated with an increased risk of coronary heart disease." As dismal as this sounds, we can be reassured that by switching to a nutrient-dense, vegetable-based diet such as Dr. Fuhrman's, enables us to achieve remarkable goals which significantly reduce our risk of heart attack by 100%.
He concludes by adding "Today, the evidence is overwhelming that heart attacks, which kill half of all Americans, are preventable."
Additional Resources (videos):
1) "Heart Attacks and Cholesterol: Dying Under Normal Circumstances" by Dr. Michael Greger
Most heart attacks occur in patients whose cholesterol levels are between 150-200, which is considered by most physicians today to be "normal." However, heart disease is very rare in patients with cholesterol levels of 150 or lower.
2) "Heart Attacks and Cholesterol: Agribusiness Sees It Differently" by Dr. Michael Greger
"The average "bad" cholesterol (LDL) level in people having heart attacks is in the "near-optimal" range, suggesting that the current guidelines are too lax."
3) "Eliminating the #1 Cause of Death" by Dr. Michael Greger
The cause of atherosclerosis is elevated cholesterol
4) CBS News - "60 Minutes - Is Sugar Toxic?" - Sanjay Gupta reports that the consumption of sugar increases several risk factors (such as LDL cholesterol) which promotes heart disease.
Additional Resource (website):
1) "Cholesterol and Heart Disease" - Dr. T. Colin Campbell website