Dr Robert Buist Re-Examining Cholesterol Interview

Dr Robert Buist Re-Examining Cholesterol Interview

Simplistic advice on cholesterol could be placing Australians at greater risk of health problems, according to nutrition expert, Dr Robert Buist, PhD (Medicinal Chemistry).

Author of 'The Cholesterol Myth", Dr Buist says the terms 'good HDL and bad LDL" cholesterol are far too simplistic and are encouraging people to avoid all fats and eat dangerous levels of sugary carbohydrates which are hidden in many processed foods.

'Cholesterol has been blamed for clogging up blood vessels, but is it the villain? It is vital for our body and plays a role in many essential processes including the brain function and hormone production," Dr Buist said.

'Avoiding fats in favour of a low-fat, high carbohydrate diet may actually be deleterious.

We are finding out that it is not saturated fat or dietary cholesterol that increases the amount of the dangerous small, dense LDL cholesterol we have in our blood. It's refined carbohydrates and especially sugars."

Dr Buist explains that it is the size and number of the cholesterol carrying packages, called lipoproteins, that puts us at risk of health problems.

'The so-called bad LDL cholesterol has two types – small, dense LDL is much more likely to cause damage and lead to health problems than the larger fluffy variety of LDL.

'We all know that ball-bearings are much more damaging than balloons. It is the same with cholesterol. Large LDLs are like balloons and gently move through the circulatory system without damaging the arteries. The small -ball-bearing' cholesterol can easily oxidise and damage the wall of an artery. The more of them you have the greater is the risk.

Dr Buist says, 'In the near future pathology labs will look at both the size and number of the cholesterol carriers to give us a better idea of which type of cholesterol is dangerous"

The Integrative Cardiac Wellness Program

Specific nutrients are currently under clinical trial at the Integrative Cardiac Wellness Program at the Alfred Hospital, Melbourne. The trial involves using metabolic therapy, where patients are given a nutrition pack of fish oils, magnesium orotate and the antioxidants coenzyme Q10, alpha-lipoic acid and selenium. Additionally, exercise and stress reduction techniques such as massage are employed to improve outcomes for cardiac patients.

The results to date have been positive, demonstrating up to 50% reduction in complications and a shorter hospital stay.

Dr Buist's Diet Tips To Help Protect The Heart

Dr Buist advises a seasonal wholefoods balanced diet with a few extra dietary supplements to assist the natural processes in protecting the heart.

Anti-Oxidants - We can take simple means to prevent heart damage by protecting ourselves with plant-based antioxidants including ubiquinol, alpha-lipoic acid, natural vitamin E (tocotrienols), carotenoids, flavonoids,vitamins C and A. Studies have shown that the body uses these nutrients as protection.

Lean Meat - Meat consumption has traditionally been associated with higher cholesterol levels but studies now show that 45% of what is known as 'saturated" fat is actually oleic acid, the main beneficial component found in olive oil.

Olive Oil – Studies show olive oil is a winner for heart patients. It is most resistant to oxidation and most importantly does not lower the beneficial HDL cholesterol.

Fish Oil - Omega-3 fatty acids have the effects of dampening down inflammation and thinning the blood. They may also increase the ability of red blood cells to change their shape and squeeze through narrow capillaries, thereby supplying oxygen to the various tissues. This is crucial to people suffering from diabetes as these fatty acids improve oxygen supply to the extremities.

Vegetable Oils – All polyunsaturated oils are unstable and have a greater requirement for food-based antioxidants to prevent their oxidation. Hence the importance for eating plenty of fruit and vegetables.

Ginkgo Biloba & Ginger – Ginkgo Biloba is important in dilating blood vessels to the brain and ginger helps control platelet stickiness.

Magnesium orotate – Studies show magnesium orotate might have a protective role in heart health. A preliminary clinical study in people with heart failure found it improved heart failure symptoms in about 40% of patients.

Always speak to your healthcare practitioner when considering supplementation. When taking supplements, make sure to always read the label and use only as directed. If symptoms persist, see your healthcare practitioner. Supplements should not replace a balanced diet.

Interview with Dr Robert Buist

Robert has an honours degree in Biochemistry and a PhD in Medicinal Chemistry and Pharmacology.

After eight years in asthma and cardiovascular drug research at Macquarie University and later as a Postdoctoral Research Fellow at New York State Health Department, he switched his research focus to the newly emerging field of nutritional biochemistry and complementary medicine and is presently acknowledged as one of the founders of Nutritional Medicine in Australia.

He is presently on the BioCeuticals Scientific Advisory board and is a formulator of nutrition products and functional foods.

Question: What inspired you to look into cholesterol?

Dr Robert Buist: I was editing a nutritional abstracting journal for 22 years and there was no clear evidence linking high cholesterol with heart disease. It seemed that some groups were doing better with high cholesterol but this was not coming out in the general media. There was obviously a lot more to this story.


Question: What are your main concerns regarding cholesterol?

Dr Robert Buist: Well I do have quite a few, but just for starters:
A. Cholesterol has been blamed for clogging up blood vessels, but it is vital for every cell in our body because it constitutes 20-30% of our cell membranes and plays an important role in many essential processes including the brain function, the production of bile salts, vitamin D, sex and stress hormones, and the correct functioning of our nervous system.

B. The categories 'good" and 'bad" cholesterol are simplistic and we have moved beyond these definitions.

C. Avoiding fats in favour of a low fat, high carbohydrate diet may actually be harmful. New evidence reveals that saturated fat and dietary cholesterol may not be the risk factors previously thought. Rather, it is the refined carbohydrates and especially sugars that are the problem, because they change the structure of the cholesterol carriers in the blood stream which ultimately lead to deposits of plaque on the artery walls.


Question: Can you briefly explain the difference between good and bad cholesterol?

Dr Robert Buist: There are two types of cholesterol: LDL and HDL. Both have important roles but very different effects on our health.

LDL is known as 'bad" cholesterol, but the reality is more complex. The LDL packages come in different sizes, densities and numbers. It is the small dense variety of LDL that's the problem because they become either rancid (oxidised) and or sugar-coated (glycated) and are likely to cause a build-up of cholesterol in arteries, which we call plaque.

HDL is considered 'good" cholesterol because it carries cholesterol away from your blood vessels and delivers it back to the liver for recycling.

We should be aiming to lower our small dense LDL levels and increase our HDL levels to maintain a healthy balance. If your small dense LDL levels are high and your HDL is low, the healthy flow of cholesterol is compromised and this is where health problems may occur.

So we need to determine which fractions of the LDL are present and determine ways to correct any unfavourable balance, rather than trying to lower cholesterol per se. In the USA, Europe and presently in Australia, some pathology labs are measuring these different lipoprotein fractions and within the next few years these tests will become more mainstream.

I believe that we all have a different 'set point" for cholesterol production by the body and this will vary amongst individuals depending upon metabolic need. We need to get tested to see what our lipoprotein fractions are but, as said previously, the new LDL fractionation tests and oxidised LDL testing is only now being introduced and may take some time to hit the mainstream.


Question: Is it important to re-examine our diet in light of this new information?

Dr Robert Buist: A diet aimed at producing healthy heart and blood vessels will move from one that focuses on removing saturated fat and cholesterol to one which drastically cuts back on seed oils, sugar and refined carbohydrates while maximising good fats from seeds, nuts and grains and emphasises olive oil, fish oil, avocado and antioxidant rich fruit, vegetables, herbs and spices. The good news is that this type of diet is undergoing extensive research that suggests great scope for prevention and even reversal of cardiovascular deterioration.

Question: Are there any supplements that we could we include in our diet to ensure we've got the right balance of cholesterol?

Dr Robert Buist: Firstly, I should point out that the recent Catalyst shows on the ABC really put the cat amongst the pigeons. People should not act too hastily in discarding their cholesterol lowering drugs. This is because while statins definitely have adverse side effects, they are also lowering cholesterol around 20%, and some of this is likely to include the dangerous small dense LDL variety which we are trying to lower. So they may be having some positive effect. Some statins also appear to have some beneficial antioxidant activity. These factors must be considered and professional advice should be sought to get some good information on any alternative approaches. Anyone who says that more natural alternatives are unscientific, however, is not keeping up with the latest medical literature.

There are supplements that can move the lipoprotein balance (both LDL and HDL) in the right direction and also have a positive antioxidant action. These include bergamot, niacin, ubiquinol and a new form of vitamin E which includes the entire eight members of the vitamin E family (these are four tocopherols and four tocotrienols). There are also many benefits associated with food supplements that concentrate phytonutrients and include carotenoids, flavonoids and polyphenolics. Omega-3 oils and various magnesium supplements can also be very helpful. However, any cholesterol management plan, whether with pharmaceutical or complementary medicines, or a combination of the two, should be undertaken with the supervision of a healthcare professional.


Question: Can you talk about the results of the clinical trial at the Integrative Cardiac Wellness Program at the Alfred Hospital, Melbourne?

Dr Robert Buist: Specific nutrients are currently under clinical trial at the Integrative Cardiac Wellness Program at the Alfred Hospital, Melbourne. The trial involves using metabolic therapy, where patients are given a nutrition pack of fish oils, magnesium orotate and the antioxidants coenzyme Q10, alpha-lipoic acid and selenium.

Additionally, exercise and stress reduction techniques such as massage are employed to improve outcomes for cardiac patients.

The results to date have been positive, demonstrating up to 50% reduction in complications and a shorter hospital stay.


Question: How does stress play a role in cholesterol?

Dr Robert Buist: When you are stressed, chemical messengers are released in your body to produce the fight or flight response. These changes within your body may increase cholesterol levels to a point. If you are not stressed regularly, this may not be such an issue. However, if you are stressed on a regular basis it is important to check with your healthcare professional. Taking time out during a stressful day to relax and clear your mind may be beneficial for your correct cholesterol levels.


For more health articles, go to www.bioceuticals.com.au/education/articles

 

Speak to your healthcare practitioner for more information about taking supplements. Make sure to always read the label and use only as directed. If symptoms persist, see your healthcare practitioner.

 

Interview by Brooke Hunter