This week, on A Different Perspective, Dr. Jason Nobles fills in for Dr. Flynn and makes the connection between statin drugs and type 2 diabetes. Statins are generally prescribed to lower cholesterol, which is then supposed to lower your risk for heart disease. However, statin drugs increase your risk for developing type 2 diabetes… which ultimately increases your risk for heart disease. Dr. Jason shares a different perspective on both cholesterol and heart disease.
Doctors prescribe statin drugs for dealing with high cholesterol. They are the “gold standard treatment” for high cholesterol. The American Heart Association explains,
What is Cholesterol? To summarize,
Cholesterol is a waxy substance that comes from two sources: your body and food. Your body, especially your liver, makes all the cholesterol you need and circulates it through the blood. But cholesterol is also found in foods from animal sources, such as meat, poultry, and full-fat dairy products. Your liver produces more cholesterol when you eat a diet high in saturated and trans fats.
Does the body make more cholesterol when we eat more of these foods, or does our dietary intake of cholesterol increase it in the body? There’s been a lot of research dating back 70+ years around this subject. Yes, dietary intake can increase our cholesterol, but why is that?
The question that’s never really asked when it comes to this topic is “why is the body making more cholesterol?”
What is cholesterol for? Healing, repair… lots of different things. We’re going to cover all of them in this ADP. But why are we here in the first place?
A Brief History of Statins
Statins were first prescribed back in 1987 for heart disease:
On September 1, 1987, lovastatin became the first statin to be approved in the United States by the Food and Drug Administration (FDA). This agent is responsible for revolutionizing the treatment of hypercholesterolemia, initially achieving peak annual sales of more than $1 billion USD.
That’s a lot of money. But then, if you look at the top causes of death in 1987, nearly three-fourths were caused by the first four leading causes of death –heart disease, cancer, stroke, and unintentional injuries (accidents).
So, what was the #1 of death? Heart disease. So, in 1987, heart disease was the #1 killer. Cholesterol medications –statins—were prescribed to treat and prevent heart disease and heart attacks. How are we doing? Well, let’s look at the statistics.
If we look at the website from Bellin Health here in Green Bay, here’s what it says:
Heart disease continues to be the number one killer of both men and women – a shameful statistic because when found early heart disease can be treated and oftentimes reversed.
So, heart disease is still #1 while statins are being sold and making billions and billions of dollars.
Heart Disease: No Gender Discrimination
In both men and women, heart disease is still the #1 killer. So, how is it that we have been addressing heart disease with statins for over 35 years and the outcomes are still the same?
We continue to prescribe more and more statins. Why is it that this miracle cure, although used for years and years, didn’t change anything?
Dr. Jason then shares what got him interested in this topic. When he was growing up, he appeared to be fit and healthy. But after years of consuming fast food and other junk foods, he was eventually diagnosed with type 2 diabetes. He was still in his twenties.
What does this have to do with heart disease? That’s what he’ll cover next.
The Study That Changed Everything
So, what’s the connection between type 2 diabetes and statins? Here’s where it all started. This study changed everything for people in the United States: Quantitative effects of dietary fat on serum cholesterol in man, published in the American Journal of Clinical Nutrition in 1965.
Here’s a summary of the study:
Researchers -who used fats and oils supplied by Proctor & Gamble and milk and ice cream supplied by the Hood Milk Company- developed something that would come to be known as the Hegsted equation, which predicts the relationship between fats in the diet and serum cholesterol. They tested these fats and oils by incorporating them into “waffles, muffins, cakes, cookies, pie crust, biscuits, salad dressings, and spreads for bread”; their focus of concern was fats in the diet and serum cholesterol. [The rationale behind their experiment was to contradict the conclusion stated by Ancel Keys a decade earlier, that dietary cholesterol does not have an effect on serum cholesterol.]
So, they essentially put butter on bread, and when cholesterol went up, they blamed the butter, not the bread.
Why is that important? Bread is very high in carbohydrates. So are waffles, cakes, and pie crusts. The body processes carbohydrates into sugars. After eating all these muffins, cookies, and cakes, cholesterol went up.
But from the conclusions of this study published by Dr. Hegsted and a couple of others, they came up with this equation to show how much these fats increase cholesterol and heart disease.
But what was the real culprit here? It was the sugar.
So, they blamed the fats and not the sugar. Interestingly, the people who did the study received money from the Sugar Research Foundation.
Following this study, they came up with this beauty: The Food Pyramid.
Diabetes, The Old-Fashioned Way
The Food Pyramid was taken by the government and forced on public schools. For public schools to get funding, they must feed the kids this way. This is how we got diabetes “the old-fashioned way.”
This came out between 1978 and 1980. In 1980, there were zero new cases of type 2 diabetes in adolescents. Back then, they called it adult-onset diabetes. By 2010, on the other hand, there were 57,638 new cases of type 2 diabetes in adolescents.
What changed? It’s how we’re teaching people to eat.
Sugar is addictive. Studies have shown it’s just as addictive as cocaine. It lights up the brain in the exact same way, triggering dopamine receptors and everything else to make you want sugar.
Obesity Trends: 1985 to 2010
Dr. Jason then shows a color-coded, interactive map of the United States with obesity trends – right from the Centers of Disease Control (CDC) website. It shows trends starting in 1985 among U.S. adults. They use 30 pounds overweight for a 5’ 4” person, which puts the BMI (Body Mass Index) at equal to or greater than 30. BMI is just height versus weight.
Over 5 years, from 1985 to 1990, you can see a massive increase in obesity across the U.S. In 1990, they changed the name from adult-onset diabetes to type 2 diabetes. Now, instead of just affecting adults, it’s also affecting kids.
In the 1990s, they only kept track of states with less than 10% obesity (30+ BMI) and 10% to 14% obesity. By 1991, there was a color designated for 15% to 19% obesity. By 1997, they added equal to or greater than 20% obesity. By 2001, equal to or greater than 25% obesity, and by 2005, they added equal to or greater than 30% obesity.
Now, ever since 2010, all the states have at least 20% obesity. We have a national obesity and diabetes epidemic. What happened? Did everyone suddenly genetically change, so we are now programmed to be obese? No. It’s a result of how we have been instructing people to eat. How did we develop all that obesity and diabetes? Insulin resistance.
Insulin Resistance, The Old-Fashioned Way
This is how we got insulin resistance back in the day:
- We would eat food… which would be high in sugar (they would add sugar to the food to make up for the lack of flavor due to lack of fat)
- Make insulin – to get sugar into the cells
- Cells resist insulin – because you’re making too much insulin from excess processed sugar
- Sugar stores as fat – which makes your body shove all that sugar into liver and fat stores, decreasing sugar rapidly.
- Tired and hungry – because of the drop in blood sugar.
- Eat more (high sugar) food – to raise blood sugar and feel better.
It becomes a vicious cycle of going through this process over and over again.
Ultimately, this insulin resistance triggers diabetes, obesity, and numerous other chronic diseases, including cardiovascular disease, cancer, Alzheimer’s disease, PCOS, et cetera.
These are some of the leading causes of death in the United States. Coming across this information inspired Dr. Jason to start digging into the research and reading articles,
Time for Some Research!
All this research is published on PubMed.gov, the website of The National Institutes of Health. It’s not Wikipedia. Here are some studies to check out:
Statins and their increased risk of inducing diabetes
Statin therapy and new-onset diabetes: molecular mechanisms and clinical relevance
Diabetogenic Action of Statins: Mechanisms
Statin induced diabetes and its clinical implications
The connection has been established in the scientific literature. It’s just a matter of doing some research.
What Exactly is a Statin?
So, what are statins? According to the Statins page on Drugs.com:
Statins (also called HMG-CoA reductase inhibitors) block an enzyme called HMG-CoA reductase (3-hydroxy-3-methylglutaryl coenzyme A reductase) that is involved in the synthesis of mevalonate, a naturally occurring substance that is then used by the body to make sterols, including cholesterol.
By inhibiting this enzyme, cholesterol and LDL-cholesterol production is decreased. Statins also increase the number of LDL receptors on liver cells, which enhances the uptake and breakdown of LDL-cholesterol. Most of the effects of statins, including the blocking of the HMG-CoA reductase enzyme) occur in the liver.
This is a big deal because what does the liver do? About 15,000 different things that your body needs to survive.
What is the “Primary” Function of a Statin?
Statins prevent the body’s natural production of cholesterol. There are lots of different kinds of statins, as Dr. Jason mentions, but they are almost identical in structure, and they all more or less do the same thing in blocking natural cholesterol production.
Blocking cholesterol is the primary function of statin drugs. However, they have other functions, which are labeled as “side effects.” Statins affect more than just the HMG-CoA reductase function.
If we look at statins and glucose (sugar) balance, statins affect several things relating to your body’s ability to handle sugars:
- Liver – Free fatty acid accumulation, leading to fatty liver. Increased gluconeogenesis = making more sugar.
- Fat cells – Decreased GLUT-4, needed to transport sugars. A decreased ability to move insulin and out of cells. Decreased adiponectin hormone, needed to maintain insulin sensitivity and decrease inflammation.
- Muscle cells – Decreased GLUT-4, needed to transport sugars.
- Beta cells of the pancreas – Decreased insulin secretion and decreased calcium channel blockers. Decreased GLUT-2, needed to transport sugars.
- MiR modulation – Modulation of micro-RNA, which also increases your risk of developing type 2 diabetes.
Overall, it increases your blood sugar while decreasing your insulin. What do you call that? Diabetes.
So, based on these peer-reviewed research articles, statins are causing type 2 diabetes, a risk factor for heart disease. Yet, statins are still the gold standard medication for preventing heart disease.
Why are we causing heart disease (with statins) while working to prevent heart disease (with statins)?
Statin Actions in Tissues
Dr. Jason then goes into the actions of statin drugs in each of these tissues: beta cells, muscle cells, fat cells, and the liver. Watch the video for a more detailed explanation of how statins impact these tissues.
You’ll hear from doctors that “the benefit outweighs the risk.” The benefit of taking the statin to prevent heart disease outweighs the risk of developing type 2 diabetes… which causes heart disease? What?
Medications will always do what they are designed to do: Statins will block cholesterol production. However, they will also do these other things – “side effects.” The study concludes with these conclusions/admissions:
- Although a number of questions remain unanswered, the available evidence supports that statins do increase the chances of T2DM…
- …it is important to emphasize that there is still a favorable risk–benefit ratio for statin therapy, due to the large reduction in cardiovascular risk
- Several mechanisms through which statin treatment causes β-cell dysfunction and insulin resistance in peripheral tissues have been identified.
- In addition, miRs are glucose homeostasis regulators through the specific modulation of insulin signaling components. Growing evidence indicates that statin modulation of miRs expression may also be another mechanism through which statins increase the risk of T2DM.
Micro RNAs (miRs) also regulate blood sugar. Statins also increase your risk of diabetes by impacting these miRs.
So, you have five different ways that statins may unintentionally cause type 2 diabetes.
Is cholesterol the problem? No. Is the testing incomplete? Yep. What’s the major testing panel doctors typically look at? The lipid panel. It has your total cholesterol number, your HDL (“good” cholesterol), your LDL (“bad” cholesterol), and your triglycerides.
The only increased number that’s clinically relevant in Dr. Jason’s opinion, is triglycerides. You want your triglycerides to stay under 100. Here’s where the testing is incomplete. It doesn’t give you the particle size.
You have particles of cholesterol. LDL stands for Low-Density Lipoprotein. Yes, “bad” cholesterol is protein. LDL takes cholesterol to where the body needs it.
Every cell wall of the body has cholesterol in it and needs cholesterol to heal and repair. If you have low cholesterol, watch how quickly your skin and everything else starts to age.
Then you have HDL (“good” cholesterol), which brings the cholesterol back to the liver for processing. Overall cholesterol numbers are pretty irrelevant.
Let’s say you have a heart attack. You’ll see an exorbitant amount of LDL and cholesterol at the place of damage. They will then blame the cholesterol or LDL for the heart attack. It’s like blaming the policemen for bank robberies or the fire department for fires. They are there to do their job. The body is trying to heal.
If we get in the way (by inhibiting cholesterol), we decrease the body’s ability to heal.
Importance of Cholesterol
Here’s another fascinating study: High total cholesterol levels in late life associated with a reduced risk of dementia. Why is that?
Well, let’s look at the brain’s composition. (What is your brain made of?) Only 4% is carbohydrates (sugar). Protein makes up 35%. The remaining 61% of the brain is FAT. About 25% of that is cholesterol.
Importance of Cholesterol in The Elderly
So, what happens when we reduce cholesterol in the brain? The brain doesn’t function as well as it’s supposed to. We end up with brain fog and decreased cognition… which increases dementia. Diagnoses of dementia have skyrocketed in the last few decades.
According to the Washington University School of Medicine in St. Louis, The brain represents only about 2 percent of your body weight, but has about 20 percent of your body’s cholesterol.
We find cholesterol in large amounts in brain tissue, where it supports brain function. According to the above study, cholesterol is vital to the health of older people whose memory may be declining.
So, as we age, cholesterol should actually increase. What should your cholesterol numbers be as you get older? Add 200 to your age to get your ideal total cholesterol. You want your triglycerides to be low and your HDL and LDL to be high.
Importance of Cholesterol in Babies
What about babies? Babies need plenty of cholesterol for proper brain development. Hence, we find large amounts of cholesterol in human breast milk. Infant formulas usually contain little to no cholesterol because of the widespread lack of understanding about cholesterol.
Importance of Cholesterol for Nerve function
Cholesterol is vital for nerve function. Three-fourths of the myelin membrane is fat and of that, nearly one-fourth is cholesterol. Brain synapses (the vital connections between nerve cells in the brain) are made almost entirely from cholesterol.
Memory loss is one of the first signs of decreased cholesterol in the brain.
Importance of Cholesterol for The Gallbladder and Digestion
We need fats because cholesterol is made in the liver, converted into bile salts in the liver, and then dumped into bile. What is the gallbladder supposed to do? It breaks down and emulsifies fats for proper digestion.
The stomach produces acid to sterilize everything so when it gets into your digestive system, anything living in there (like bacteria or parasites) is dead. When the acid gets pushed into the small intestine, the gallbladder and pancreas secrete a bunch of enzymes and bile to neutralize all that so we can absorb it properly.
What’s the #1 surgery in America? Getting rid of the gallbladder. Now you can’t emulsify fats; you can’t absorb fats properly. Where do we need fats? The brain. Without good fat absorption, the brain can’t function properly.
Importance of Cholesterol for Hormone Production
Cholesterol is also needed for hormones. Sex hormones are made from cholesterol. These are stress-handling, energy-producing, and reproductive hormones. This is why serum cholesterol normally elevates with excessive or prolonged stress.
These hormones should increase with stress. You can take hormones and convert them from one form to the next to help the adrenals manage the stress. If you don’t (if the cholesterol is low and the stress is high), you will create massive hormone imbalances.
Guys are not affected as much because when guys are stressed, it doesn’t last long. It doesn’t play much of a role in their hormones because they have very low levels of progesterone and estrogens.
Ladies, on the other hand, should have nice sufficient levels of progesterone and estrogens. But with prolonged stress, if there’s not enough cholesterol, progesterone gets drained out to make more cortisol. Then we have an estrogen-dominance situation.
What’s one hormone group that’s especially related to breast cancer? Estrogens. The estrogen metabolites.
Estrogens are metabolized in the liver, which also produces cholesterol. If we’re on a statin drug, that increases the amount of fat in the liver, which disrupts hormone levels and hormone metabolism.
The Swiss Watch Principle and Cholesterol
Can we affect one thing in the body and not affect anything else? No. It’s impossible. It goes back to the Swiss Watch Principle. A stressor in one area of the body will affect the nervous system, which will affect another area of the body.
We have “specialists” for each organ system of the body. Can specialists hurt you? Yes. Back in 1984, they started teaching that an aspirin a day is good for your heart. Is that wrong? No, not exactly. An aspirin a day can help with blood pressure and take stress off the heart. But in the long run, it weakens blood vessels.
Back in 1984, strokes were not even in the top 10 killers. By 1987, it was up in the top four. What does aspirin do? It weakens the blood vessels. Where are the smallest blood vessels in your body? The brain.
If someone with weak blood vessels bumps into something, they bruise really easily. With all the smallest blood vessels in the brain, now we’re causing strokes.
If someone has a heart attack, what’s the “gold standard” of treatment? They are on a statin drug, they are on a blood pressure medication, and they are taking an aspirin daily. It’s the gold standard treatment for preventing another heart attack.
Will that person have another heart attack?
No. They’ll have a stroke.
Lifestyle is Key
Dr. Jason then shares a “no sugar” list. It has all different names for sugar. It goes on for three columns – a total of nearly 75 forms of sugar.
A lot of people have heard the term, “Familial hypercholesterolemia.” It means that high cholesterol runs in the family.
One of Dr. Jason’s patients was diagnosed with exactly that. Her doctor did the right thing and actually tested her LDL particle size. She was off the charts in small, dense LDL particles. The smaller the particle, the more damage they can cause. Her doctor advised her to eat more healthy proteins and fats. She did, and she cut out all these sugars from her diet.
Think of these particles like traffic. In her first test, she measured off the charts. It was over 3,000, so they stopped counting. You want to be at about 1000 or so particles. The less traffic in the bloodstream the better.
This patient changed her diet and lifestyle along with a little nutritional support. She did all the work. Her numbers came down.
It’s Time to Think Differently
The Wellness Way looks at these labs differently. We’re using their numbers and research, but we’re looking at them from a different perspective. The research gives answers in terms of taking an intervention to prevent one thing. But what else does it cause? In most cases, the benefit does not outweigh the risk.
To find out whether you should be taking a statin, the proof is in the organic, sugar-free pudding. The proof is in the testing, but in most cases, the testing is incomplete. Can they do the full, proper testing? Yes, absolutely. They can… but they don’t.
If you want the full, proper testing, find a Wellness Way doctor, who can help you find out what testing you need. Then they can help you find out why you are feeling the way you are and get your body back to health and balance.