Vol. 4, Issue 11 November 2014
Brand new research turns everything you thought you knew about cholesterol on its head
"Bad" cholesterol isn't always bad--and 5 more cholesterol facts you need to know

It never ceases to amaze (and distress) me that my patients still get concerned about cholesterol. Why does this upset me so much? Because, for years, I've been pleading with everyone on the planet--my patients included--not to worry about their total cholesterol score. In fact, that number doesn't actually tell you anything about your risk for a cardiac event...whether it be a heart attack or stroke.

But, as I have been telling my patients for years--just because total cholesterol isn't a big deal, that doesn't mean you should ignore it entirely.

So, forget about that one number and let's take a more in-depth look at your complete cholesterol profile.

Redefining "good" and "bad"

Most people are aware of the traditional cholesterol roles: HDL is the good guy and LDL is the bad guy. But, as a new study shows, there's a whole lot more to it than that.

In fact, this study questioned whether oxidized LDL (you know, the supposed "worst of the worst" in terms of cholesterol) is, in fact, harmful after all.

The widespread belief has been that oxidized LDL moves rapidly into arterial walls and engorges them with cholesterol, which ultimately converts into plaque. That plaque then blocks the arteries. Or, in a worst-case scenario, ruptures and sends clots into the bloodstream, causing heart attacks and/or strokes.

Guess again.

The new research appears to indicate that oxidized LDL might, in fact, be a good guy in the process. Instead of increasing the amount of cholesterol uptake and accumulation, mildly oxidized LDL actually prevents increases in cholesterol.1 This theory is encouraging for those of us who believe the cholesterol hoopla is a myth. One based solely on selling billions upon billions of dangerous medications known as statins.

I lambast statins on a regular basis in my Reality Health Check e-letter, so I'll skip that part of the cholesterol discussion (at least for now). Instead, I'm going to give you a detailed rundown of all the important blood fats (lipids) you should be keeping tabs on. And I'll also tell you how you can make a positive impact on these markers at the cellular--and, ultimately the genetic--level.

Yes, you can change how your genes affect your health: This is fun, life-altering 21st century medicine, folks. But it's not stuff the mainstream medical community will ever bother to tell you about (often because they simply don't know).

The devil in the details

Let's start with LDL. As I mentioned above, classifying LDL cholesterol as "bad" is a bit of an oversimplification. You see, LDL is made up of particles. These particles come in both large and small sizes. And as it turns out, large LDL particles are quite normal--even healthy. Small, dense LDL particles (very-low-density LDL, or VLDL), on the other hand, can be problematic.

It sounds a bit counterintuitive, I know. But studies show that people whose LDL cholesterol is predominantly small and dense have a threefold greater risk of coronary heart disease.2 And other studies suggest that determining the number of small, dense particles in the blood predicts the risk of heart disease more accurately than simply measuring total LDL cholesterol.

Your overall VLDL level should be below 40 mg/dL. But there are actually three subclasses of VLDL particles--VLDL1, VLDL2, and VLDL3. VLDL3 is the smallest, most dangerous type. Your level of VLDL3 should be below 10 mg/dL.

The same holds true for HDL--it comes in both large- and small-size particles. Large HDL particles are called HDL2, and the small variety are called HDL3. HDL2 is the most protective form. So the more of them you have, the lower your risk for cardiac events. You want your levels above 10 mg/dL.

But even these details are only a fraction of your overall lipid profile. As I mentioned above (and as I've said many times before), there's more to it than just cholesterol.

Two blood lipids more important than cholesterol

In my opinion, triglycerides are even more important than cholesterol. Triglycerides are a type of blood fat (lipid) that occurs when you take in more calories than you can burn. Your body converts these excess calories into triglycerides. And if your liver isn't operating at the top of its game (which is frequently the case these days, thanks to the Standard American Diet), it can't process those triglycerides. Which means they build up--and wreak havoc in your body. You want your triglyceride level at or below 100 mg/dl.

There's also lipoprotein (a), or Lp(a), to consider. Lp(a) is a substance that builds on the inner lining of arteries, promoting inflammation and damaging artery walls. Lp(a) also contains a blood clotting component, which compounds the risk for heart disease and stroke even further.

This is one of the strongest indicators of heart disease risk. So you should have it checked every year. You want your level to be below 10 mg/dL. Though keep in mind, if you have a family history of heart disease, you're genetically predisposed to have an elevated Lp(a) level. The good news is, this is yet another instance where you can "outsmart" your genes. And all it takes is two simple supplements. More on those in just a minute. But first, there's one more blood lipid I want to tell you about.

The most dangerous kind of cholesterol (and chances are, you've never heard of it)

The last risk factor you should be keeping tabs on is one you've probably never heard of. It's called intermediate-density lipoprotein (or IDL) cholesterol. IDL is the "sticky" kind of cholesterol that clogs up blood vessels and arteries. So, really, it's the most important cholesterol number of all.

Keeping IDL low (at or below 20 mg/dL) greatly reduces your risk for cardiovascular events. Like Lp(a), IDL has a genetic component to it, especially if you have a family history of diabetes.
Luckily, you can keep track of all of these lipids with one simple test, called the Vertical Auto Profile, or VAP test. Chances are, your doctor won't order it for you unless you specifically request it. But it costs about the same as a regular, routine lipid profile. And it's covered by Medicare and most insurance carriers.

Once you have your results, you can work with your doctor on a specific action plan for getting your scores where you want them. And despite what Big Pharma would like you to believe, chances are, you can do that without resorting to a single drug.

Your foolproof plan for a perfect lipid profile--NATURALLY

Of course, the first step towards reining in these lipids is to focus on your nutrition. A diet that's low in processed, refined carbs and high in fruits, vegetables, lean protein and healthy fats will put you on the fast track towards a better lipid profile. But there are also a few supplements that can help you perfect your scores.

Niacin and L-cysteine. These two nutrients help keep Lp(a) in check. Start with 500 mg of niacin per day and work up to 3,000 mg per day. It may take a while, but it's worth it. (And, if you can tolerate it, it's best to opt for regular niacin here instead of the flush-free varieties. In my experience, the flush-free versions just aren't very effective.) As for L-cysteine, I typically recommend 1,000 mg twice per day.

Pantethine (not pantothenic acid) is very good at lowering IDL. I recommend 300 mg, twice per day, for my patients. Omega-3 fish oils also help in this situation, keeping the blood from getting "sticky." As you know by now, I recommend taking a quality fish oil supplement that contains 1,500 mg of DHA and EPA twice per day. And there's one more supplement in particular that offers "one stop shopping" in terms of your lipid profile. It's a citrus bioflavonoid called bergamot from a specific tree grown in Calabria, Italy (where my family is from). I mentioned it briefly back in the December 2012 and May 2014 issues.*

Studies have shown that bergamot can lower total and LDL cholesterol, triglycerides and blood glucose, all while raising HDL (basically, everything you wish to accomplish). It actually works in a similar matter to statins. But without the side effects.

Because of its bioflavonoid properties, bergamot is also an antioxidant and an anti-inflammatory, both of which have very beneficial effects on endothelial cell lining function, inhibiting clot formation.

Obviously, keeping your heart functioning at peak performance is a big topic--and I could go on and on about it. I covered it in even more detail in my special report The World's Easiest Heart Disease Cure (which is available at www.drpescatore.com if you don't already have a copy). But when it comes to cholesterol, the bottom line is this: If you really want to stay healthy, you need to break the numbers down and look at the bigger picture, so you can attack the real problems--and plan your nutritional supplement regimen accordingly.

Pinpointing plaque build up

There's another new test worth asking your doctor about at your next appointment. It's called the LPAC-2, and it gives an overall assessment as to whether a plaque build-up exists somewhere in your body.

Remember, you don't necessarily need to worry about the plaque itself. Plaque is there to protect us by indicating that something isn't right in your body and that you're experiencing oxidative stress. But knowing it's there means you can take action to eliminate this stress. And the easiest way to do that is to eat healthfully (lean, organic proteins and plenty of vegetables and healthy monounsaturated fats).

Healthy lipids, by the numbers
60 mg/dL or higher
LDL 110 mg/dL or lower
HDL2 10 mg/dL or higher
40 mg/dL or lower
VLDL3 10 mg/dL or lower
Triglycerides 100 mg/dL or lower
Lipoprotein(a) 10 mg/dL or lower
IDL 20 mg/dL

1Minimally oxidized LDL inhibits macrophage selective cholesteryl ester uptake and native LDL-induced foam cell formation." The Journal of Lipid Research 2014; 55(8): 1,648
2 "Small, dense low-density lipoprotein particles as a predictor of the risk of ischemic heart disease in men. Prospective results from the Quebec Cardiovascular Study." Circulation 1997; 95(1): 69-75

Prediabetes increases cancer risk

Three simple ways to spot this deadly trend--and how to stop it in its tracks

November is Diabetes Awareness Month, so I'm taking yet another chance to talk about this potentially deadly--yet completely preventable--disease.

But today I want to back up a bit and focus on the dangers of being prediabetic. I've warned you many times before that it doesn't take a full-blown diabetes diagnosis to increase your risk of some pretty terrifying things. And now some news has come out that confirmed what I've already said...

Prediabetes increases your cancer risk.

According to a new study, prediabetes increases cancer risk by 15 percent.[1] And that's just on its own. When combined with a high body mass index (BMI)--which, in itself, increases your cancer risk--it ups the total risk to 22 percent.

And this finding wasn't from some small-scale clinical trial. Researchers looked at 16 prospective studies that included over 890,000 participants, all with elevated blood glucose (from 5.6 mmol/L to 6.9 mmol/L), for three or more years of follow-up.

The most common types of cancers that appeared in the test patients were stomach/colorectal, liver, pancreas, breast, and endometrium.

I was particularly struck by what the study's lead author, Dr. Yuli Huang, noted: "Cancer should be considered as a potential complication of diabetes. The risk of cancer is increased even in intermediate stage blood glucose [elevations].... So periodic screening of abnormal blood glucose is important, not only for prevention of cardiovascular disease, but also for prevention of cancer."

Dr. Huang also recommended some stuff you've heard from me before:

"Lifestyle intervention (weight control, stop smoking and healthy diet, etc.) should be suggested earlier and recommended as the mainstay of treatment for prediabetes in the general population."

I should note here that Dr. Huang is not U.S.-based; he practices at the First People's Hospital in Shunde, China. A lot of us in the U.S. (yes, sometimes justifiably) poo-poo food supply, air quality, and nutrition/health in China... And yes, some of the criticism is justified. But not too many U.S. doctors tout the importance of nutrition in a diabetes-related study, as Dr. Huang did.

China may be controversial when it comes to a lot of things. But a statement like this indicates they're not as intimidated by Big Pharma drug giants as we are here in the U.S. of A.

But I digress...

Let's back up for a moment, so I can give you a refresher on prediabetes.

Three warning signs your body is sending you

This condition develops very gradually over the course of years (sometimes many years). The medical community would like you to think it's not obvious until a doctor tests your blood sugar and it's high enough to constitute diabetes.

But you have more control over it than that. You don't have to simply wait to get diagnosed with diabetes (which is when the medical establishment will finally be more than happy to get involved, with all kinds of harmful, and unnecessary, stuff for you to take).

Despite the fact that plenty of "experts" will tell you that there are no signs and symptoms of prediabetes...there are. And there are ways to slow, and even prevent, this course. It's not an inevitable downward trajectory.

The first warning sign is extremely evident, and spotting it simply entails doing one thing: looking in the mirror. Being overweight or obese goes hand in hand with having prediabetes. Sure you can get on a scale and calculate your BMI. But, let's be honest here, you can tell if you're overweight simply by taking a look at your own reflection.

But what if you're not overweight? Does that automatically mean you're in the clear? Not necessarily. But if you're normal weight, the signs you're looking for are much more subtle. They're not impossible to deduce, though.

Here are two signs to look for:
  1. Routinely feeling lethargic or tired after eating--even after smallish meals.

  2. Consistently craving carbs. I'm not talking about a once-in-a-blue-moon craving here. But feeling like you constantly "need" carbs for energy, or just because, is a bad sign.
There are even subtler signs, but being aware of these three things is all it takes for the vast majority of people to pick up on whether they're prediabetic. And if you are prediabetic, it's time to get serious about turning things around.

First thing's first

You can start by focusing on your liver. As I explained back in the April 2014 issue, recent research indicates your liver has just as much to do with your blood sugar health as your pancreas. In fact, it may be even MORE important.

Your liver keeps a stockpile of "stowaway sugar" stored away in case of emergency (i.e. you're stranded without food). But we rarely face dire situations like that. So all that excess stowaway sugar eventually turns into triglycerides, which form a layer of fat around your liver.

So if your liver isn't operating at peak performance, it simply can't clear the sugar out of your blood effectively.

I outlined my detailed protocol for combating fatty liver back in the April issue, so you should take a few minutes to go back and re-read that issue. But in the meantime, there are also a few simple steps you can take starting right now that will make a big difference.

You are what you eat--and drink

Obviously drinking too much alcohol isn't good for your liver. So go easy on the happy hour cocktails. But there's something else you can drink that's just as bad for your liver--if not worse. I'm talking about soda. And fruit juice too. Numerous studies have linked soda and sugary drink consumption--especially those sweetened with high fructose corn syrup-to fatty liver disease.

A team of scientists in Israel even found that just two sugary soft drinks a day (a number many people reach by early afternoon) can significantly increase your risk for fatty liver disease. In this study, fatty liver changes were reported in 80 percent of regular soda drinks, compared to 17 percent of non-soda-drinkers. Drink a liter a day? Your risk increases fivefold.

The big problem here is fructose. This type of sugar impacts insulin levels virulently, even more so than regular sugar (sucrose) does. Your body simply can't use any of it as energy, so it goes straight to your liver, where it sets off the chain of events I described above.

In addition to skipping the soda, it's critical to focus on what you're eating too. Starchy, sugar-filled foods that give you no energy and pile on the pounds. But steak, fish, cheese, veggies, and minimally processed whole grains don't just regulate blood sugar-they'll also keep you slim. (This is the premise of the New Hamptons Health Miracle.) Plus, they'll cut your risk of diabetes...and liver disease...and heart disease...and more.

Lastly, don't skip exercise. I'll never get tired of saying this: That evening walk is critical. Not only does it help clear your head and reduce stress, but, as studies constantly show, it will keep you vital and healthy

1 "Prediabetes and the risk of cancer: a meta-analysis," Diabetologia 2014; 57(11): 2,261-2,269

Tough to spell, smart to take: A natural way to
protect your brain--and much more

As you know, I love sharing revolutionary health information with you the moment I get it. And I just read a study that revealed some pretty exciting news about one of my favorite traditional Chinese remedies-Panax notoginseng.

I won't ask you to spell it, but I will ask you to take it. Especially after the results of this new study.

Researchers from the University of Michigan found that Panax notoginseng (also called Tienchi ginseng) has "antioxidant effects which may be neuroprotective in neurological disorders."

They tested Panax notoginseng's ability to protect brain cells from oxidative stress. And not only did it protect brain cells from harmful reactive oxygen species (ROS), but it actually led to a 23-percent reduction in brain cell death.1

This is major stuff.

We're talking protection from the damage caused by stroke, Alzheimer's disease and traumatic brain injury, not to mention just "everyday" damage caused by oxidative stress and the resulting ROS.

Of course this antioxidant effect isn't limited to your brain. Panax notoginseng can also protect you against free radical damage that can lead to a variety of other illnesses.

And that's not the only benefit to taking Panax notoginseng. There are lots of others...

For instance, in one study, subjects who took 1,350 mg of Panax notoginseng per day for a month experienced improved endurance, enhanced aerobic capacity, and lower overall blood pressure.2

And a Chinese study published last year showed that Panax notoginseng significantly improves kidney function. This finding is particularly important because, as I told you back in the August 2012 issue, the rate of kidney disease in the U.S. is skyrocketing in recent years.*

Other benefits of Panax notoginseng include its natural blood thinning capabilities, as well as overall anti-inflammatory qualities.3,4

That last benefit is worth a second read-because it's really the most universally important. Why? Well, as I've said before, virtually every illness is the result of inflammation. Which is what makes Panax notoginseng such a powerful, protective tool. I recommend 100 mg per day.

1 "Antioxidative effects of Panax notoginseng saponins in brain cells," Phytomedicine 2014; 21(10): 1,189-1,195

2 "Panax notoginseng supplementation enhances physical performance during endurance exercise." J Strength Cond Res 2005;19(1):108-114

3 "Antiplatelet and anticoagulant effects of Panax notoginseng: comparison of raw and steamed Panax notoginseng with Panax ginseng and Panax quinquefolium." J Ethnopharmacol 2009; 125(3): 380-386

4 "Panax notoginseng attenuates the infarct volume in rat ischemic brain and the inflammatory response of microglia," J Pharmacol Sci 2009; 109(3): 368-379

Wipe out crippling leg pain with this step-by-step strategy

What do you recommend for peripheral artery disease?

Dr. Fred: I have to admit-peripheral artery disease (PAD) is a tough problem to solve.

Because at the moment, lifestyle changes are usually the best answer that even mainstream medicine has to offer.

Now on one level, this approach represents a refreshing change of pace. But PAD presents some unique challenges that make it difficult to make the changes that can provide the relief you so desperately need.

In a nutshell, PAD restricts the arteries leading to your limbs-blocking nutrient, oxygen, and blood flow. It's not quite the urgent health crisis that coronary artery disease is. (When blood flow is blocked to your heart, you have a heart attack and die.)

But as you already know, it can erode your quality of life just as quickly.

Leg pain and cramping-a phenomenon called "intermittent claudication"-is the most notorious hallmark of PAD. It can result from even a short stroll around the block. And it can be downright crippling.

So it can be pretty frustrating when you're told that you need to move more in order to improve your condition.

This is good advice, of course-I give to patients myself. But I also always offer some additional recommendations that can steer you toward recovery-and get you back on your feet, comfortably.

Of course, a healthy diet-like my New Hamptons Health Miracle, which includes lots of healthy fats and oils from sources like avocado and macadamia nut-is an essential first step.

But with PAD, there are additional factors you need to address too. Most importantly, you want to boost circulation. This means keeping your platelets slippery so they can make it through your blood vessels freely. And in order do that, I recommend a handful of key supplements:
  • Pycnogenol-200 mg per day
  • Fish oil-3 grams per day of EPA and DHA
  • Vitamin E-1,200 IU per day of a full-spectrum product that includes tocotrienols and tocopherols
  • Ginkgo biloba-120 mg per day
  • Turmeric-250 mg per day
  • Citrus bioflavonoids (250 mg of diosmin, 25 mg of hesperidin, and 50 mg of quercetin, in two or three divided doses over the course of the day)
  • Magnesium orotate (60 mg per day, depending on your individual needs)
Another solution you might want to try? Chocolate. Yes, really.

As part of a recent study, researchers recruited 20 men and women with PAD. These subjects gave blood samples and then participated in walking challenges over the course of two days.

First, the subjects walked as far as they could on a treadmill, while researchers recorded times and distances. Then the researchers gave the subjects a snack of roughly 1.5 ounces of dark chocolate.

Two hours later, the subjects hopped on the treadmill again. And results showed that they were able to walk for 17 seconds longer and nearly 40 feet farther than they did before.

The subjects also had fewer signs of inflammatory oxidative stress. As well as higher levels of nitric oxide (NO). And as you might recall, NO is essential for relaxing and widening arteries, which, in turn, increases circulation to every part of your body.

So it's no wonder that this "treatment" delivered measurable improvements in PAD patients. Though it's worth noting that the same regimen delivered zero improvements when researchers substituted milk chocolate for polyphenol-rich, 85-percent cocoa dark chocolate.

In other words, a Hershey bar isn't going to do the trick here. You need a high-quality cocoa product to replicate these results. (Or to get any of chocolate's best benefits, for that matter. And as I explained back in the August issue, there are a lot of them.)

In combination, all of these strategies should make a huge difference to peripheral circulation-and ultimately, to your comfort and ability to exercise.

And once you start adding regular physical activity into the mix-even if it's just a short 20 minute walk after dinner every evening-there's a good chance you'll be able to sideline PAD symptoms permanently.

But as they say, one step at a time.

"Dark chocolate acutely improves walking autonomy in patients with peripheral artery disease."J Am Heart Assoc. 2014 Jul 2;3(4). pii: e001072.

Natural steps for banishing gas and bloating

"HELP! I need a cure for bloating and flatulence. I love beans and sweet potatoes, and I know they're healthy foods. But the price I usually have to pay when I eat them is very bad gas, flatulence and bloating that is becoming too much to bear. I also have multiple uterine fibroids that are so large, they bulge when I lie down and when my bladder is full. I feel as if (and wonder if) the pressure from fibroids are blocking my intestines and blocking bowel movement. What remedies are there for me?"

Dr. Fred: First off, the fibroids definitely play a role in all of this. They're not going away, and they're sharing the same space with all of your organs. So when you eat and your body is digesting the foods, it just adds to the "too-many-things-and-not-enough-room" feeling-which is extremely uncomfortable. But, there are things you can do to work around this problem.

The first thing you can try is my top recommendation for fibroids: lipotropic factors. Lipotropic factors are substances that can help dissolve fatty deposits in the body. Sometimes I have seen fibroids shrink quite nicely after just a few months of using this approach. Choline is one of the most common lipotropic factors. I recommend 150 mg per day.

As for the bloating and the gas, in my experience, it's not usually high-fiber foods (like beans and sweet potatoes) that are the real culprits. Often, these symptoms are actually brought on by an underlying yeast or candida issue. And the primary culprit for yeast overgrowth is eating too many sweets or simple carbohydrates.

Obviously, the first step is to eliminate sugar and simple carbs from your diet. But you can help the process along by investing in a good, multi-strain probiotic supplement as well. To get rid of yeast overgrowth, I would recommend up to five capsules twice per day for two days, and then two capsules twice per day for three months. (After that, you can taper back to a maintenance dose.) Grapefruit seed extract can also help break down candida, so your body can eliminate it faster. I recommend 200 mg three times per day.

And finally, to help you process the food you eat more efficiently so there's less bloating and gas, I would recommend digestive enzymes. I've discussed the importance of these in the past (refer back to the August 2014 issue for a more detailed discussion of enzymes). But they can be crucial for people struggling with digestive disturbances, so it bears repeating. Here's a quick list of some of the key digestive enzymes you should be taking with every meal:
  • Papain-From papaya and helps digest proteins
  • Amylase-Aids the digestion of starches and carbohydrates
  • Lipase-Aids the digestion of fats
  • Cellulase-Helps break down fiber
  • Lactase-Helps break down milk sugars in dairy products
  • Bromelain-From pineapples and helps digest protein
The good news is, there are numerous products on the market that include most-if not all-of these enzymes in one formula. Start with a low dose and take it with every meal.

Until next time,

Dr. Fred

P.S. Visit my website, Drpescatore.com, to view my newest products and to check out our special offers. Online ordering is fast, convenient and secure.