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Cholesterol Down:
Ten Simple Steps to Lower Your Cholesterol in Four Weeks-Without Prescription Drugs

by Janet Bond Brill, Ph.D., R.D., LDN

What inspired you to write this book?

I am a professional nutritionist specializing in cardiovascular disease prevention. I was having limited success in helping my patients lower their cholesterol using the traditional low-fat, low-cholesterol type of diets that are very restrictive and tough to follow over the long haul. I started to notice that people were much more compliant when I took a more positive and prescriptive approach and focused on what foods individuals should be adding into their day for heart health rather than emphasizing what they should take away.

I also began to notice a pattern of anecdotal reports among my high-cholesterol patients. They had either tried a cholesterol-lowering statin medication and had intolerable side effects or else were averse to taking prescription medication to treat the problem. They began asking me if I had a “natural” lifestyle alternative to drugs for lowering their high cholesterol.

What really peaked my interest in “natural combination therapy,” however, is more of a personal story and quite serendipitous. At this point in time, I went for my annual physical exam and was shocked when my personal physician informed me that my own “bad” LDL cholesterol was dangerously high (I was shocked because I am a marathon runner and have eaten a healthy plant-based diet for decades). Naturally I was concerned because my own father had his first heart attack at age 45 (a major risk factor for me) and ended up dying from the disease several years later. Unwilling to begin taking a “lifetime” prescription medication without trying lifestyle change first, I decided to experiment on myself, formulating a cholesterol-lowering lifestyle plan based on the latest scientific research findings. After some time on the plan, I was thrilled to discover that my LDL cholesterol dropped almost 30% with no drugs and no side effects and nothing more dangerous or expensive than eating a bowl of oatmeal, a handful of almonds and an apple a day! I tested my plan on several patients and also had amazing results. So, I decided to write the book so that others could benefit from my plan and hopefully help people to prevent cardiovascular disease, the leading cause of death in men and women in this country and the Western world. Many people don’t know that most cardiovascular diseases (heart attacks and strokes) are almost entirely preventable with healthy lifestyle changes (diet and exercise).

Many individuals do not know the difference between LDL and HDL, is there an easy way to help people remember which is good and which is bad?

LDL, or “bad” cholesterol, stands for low-density lipoprotein cholesterol. A high level of LDL circulating in the bloodstream is dangerous and is the most significant risk factor for the development of cardiovascular disease (heart attacks and stroke). High LDL cholesterol in the blood promotes the process of atherosclerosis (plaque buildup). Furthermore, we have learned from the most recent large-scale statin studies that lowering “bad” LDL cholesterol saves lives.

Most otherwise healthy Americans should strive for a blood value of under 100 mg/dL and if you’re high risk, you should aim even lower, less than 70 mg/dL. An easy way to remember that LDL is “bad” is to think of the letter “L” as standing for either “lousy” or “lethal.” Remember, in the case of your LDL cholesterol number, “lower is better.”

HDL, or “good” cholesterol, stands for high-density lipoprotein cholesterol. To keep your heart and blood vessels in good shape, it is best to have a high level of HDL circulating in the bloodstream. HDL helps clear the cholesterol out of the artery walls, transporting it back to the liver (where it is disposed of) in a process called “reverse cholesterol transport.” An easy way to remember that HDL is “good” is to think of the letter “H” as standing for either “healthy” or “healing” and remember that with regard to your HDL cholesterol number, “higher is healthier.”

"Cholesterol Down" contains a list of 9 "Miracle foods" that can help lower LDL. Once an individual succeeds in lowering their cholesterol, do they need to continue to eat the 9 "Miracle Foods"?

Cholesterol-lowering statin drugs (such as Lipitor®) must be taken for a lifetime to achieve and maintain a low LDL value. My plan must also be followed for a lifetime to keep LDL cholesterol level low in the bloodstream.

Another reason that I wrote the book was because I wanted to write a cholesterol book in the form of a “diet book,” meaning results- oriented such that if people follow the plan for at least 4 weeks, they will have measurable results and will see a significant drop in their LDL cholesterol (pre- to post-testing). Positive results can be highly motivating and reward people for making difficult healthy lifestyle changes.

The Cholesterol Down Plan works in a similar fashion to combining two separate medications, each with different cholesterol-lowering mechanisms (such as the drug Vytorin that combines a statin medication—affecting the liver’s production of cholesterol and a cholesterol absorption blocker—that blocks the intestinal uptake of cholesterol). If you were to take just one drug, you would have less success than if you combine the two. The concept is the same with my 10 steps. Each step works in a slightly different fashion to lower LDL. Get in just 5 steps and you cut the cholesterol-lowering effect in half (I include a checklist in the appendix to help people get as many steps into their day as possible). So the bottom line is, it’s best to get in as many steps as possible every day.

How does Combination Therapy work?

Natural combination therapy is based on cutting edge scientific research demonstrating the “complementary” combined effects of an ensemble of several previously proven LDL-lowering dietary and lifestyle manipulations. Whereas a single food or exercise has been shown to significantly lower LDL cholesterol individually, it is the combination of several approaches all together in one single day that can lower LDL cholesterol as much as a statin medication (only without the side effects). Thus, combination is the magic word, as adding in all the foods and exercise together magnifies the LDL-lowering effect.

Considering that cardiovascular disease is our nation’s most important health concern, all Americans should practice a heart-healthy lifestyle to help prevent the leading cause of death in this country. With regard to those already taking cholesterol-lowering medication, the question is not a healthy lifestyle OR drugs but should always be a healthy lifestyle in addition to drugs for the best prevention of cardiovascular disease.

How did you decide which Heart-Healthy recipes to include in the book?

I based the 10-step Cholesterol Down Plan against a backdrop of a Mediterranean-style of eating. I believe the Mediterranean diet, rich in fruits, vegetables, whole grains, legumes, nuts, garlic, fish and olive oil and red wine in moderation. In my opinion, this diet is the easiest to stick to, tastiest and heart-healthiest pattern of eating, a style of eating without deprivation where you can still enjoy the good things in life.

Many of the recipes included in my book are Mediterranean-inspired dishes that I have been making for my family for years. Others were donated to me by my friends and relatives.

In figuring out which ones to include in the book, the recipes had to be:

  • healthy (either contain one or more of my “steps” and/or be a Mediterranean-style heart-healthy dish)
  • fairly simple to make—with 3 kids, a husband and a dog, who has hours to spend in the kitchen?
  • taste great (I love to eat)

Do you have plans to write a Heart-Healthy cookbook?

I am currently partnering up with a very talented South Florida chef (who has a background in my personal favorite… California-style healthy cooking). We are working on coming up with some delicious heart-healthy, cholesterol-lowering recipes. Perhaps this may just turn into my next publishing feat…a Cholesterol Down Cookbook!

Is high cholesterol only a problem for individuals who are overweight or obese?

Absolutely not! We have an epidemic of heart attacks and strokes in this country (the #1 killer of men and women) and we are all at risk. High LDL cholesterol is a hidden risk factor that can affect lean and obese individuals, young and old alike (albeit, overweight and obesity are conditions that do increase LDL cholesterol and obesity is a risk factor for heart disease).

The story of Jim Fixx is a striking example of how a visually healthy, lean and fit athlete can have high cholesterol, a major risk factor for heart disease. Jim Fixx was a marathon runner and the best-selling author of The Complete Book of Running (Random House, 1977). On July 20, 1984 , at the age of 52, he died of a heart attack during a run. At the time of death, he had several major risk factors for heart disease: his father had died of heart disease at a young age, Mr. Fixx was a male over the age of 45 and he had high cholesterol (his total cholesterol level was over 250 mg/dL—according to the American Heart Association, a total cholesterol level of less than 200 mg/dL is desirable for heart health).

I would like to reinforce the notion that heart attack and strokes are almost entirely preventable through healthy lifestyle changes. Take responsibility for your health, know your risk factors for heart disease, especially your LDL number, and if it’s too high, get your Cholesterol Down!

What are your current projects?

I am working as a health and fitness consultant, speaker and as an adjunct college professor (I teach a graduate course in nutrition at Florida International University ).

Do you have a book tour?

I have done a radio media tour for Cholesterol Down but have not done a “book tour” per se. However, I would love to do one if the opportunity arises!

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