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Cholesterol Clarity: What The HDL Is Wrong With My Numbers? Hardcover – August 27, 2013
"Rebound" by Kwame Alexander
Don't miss best-selling author Kwame Alexander's "Rebound," a new companion novel to his Newbery Award-winner, "The Crossover,"" illustrated with striking graphic novel panels. Pre-order today
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"I call Jimmy Moore 'A Great Connector.' He is one of those people who has the exquisite ability to connect with many people and experts, ask them pointed and sometimes difficult questions, consider each carefully, then reach a logical conclusion. In Cholesterol Clarity, he provides an incredibly rich and deep consideration of this 'cholesterol is bad' message we hear repeated so often. I predict that readers will emerge from reading this book enlightened, empowered, and with a renewed appreciation for just how much we can achieve when we ask the right questions. Jimmy Moore has not written a book; he has created a milestone."—William Davis, MD, author of the New York Times best-selling book Wheat Belly
About the Author
Jimmy Moore catapulted onto the health scene in 2004 after a phenomenal 180-pound weight loss success enabled him to come off of prescription drugs for high cholesterol, high blood pressure, and respiratory problems. He is the energetic personality behind the uber-popular Livin' La Vida Low-Carb blog and host of one of the top-ranked iTunes health podcasts, The Livin' La Vida Low-Carb Show. He has interviewed well over 700 of the world's top health experts and dedicated his life to helping people get the best information possible so they can make the right decisions about their health. He lives with his wife, Christine, in Spartanburg, South Carolina, where they can often be found playing Frisbee golf in their front yard. Learn more about Jimmy and his work at: http://www.livinlavidalowcarb.com.
Eric C. Westman, MD, MHS is an Associate Professor of Medicine at Duke Health Enterprise and Director of the Duke Lifestyle Medicine Clinic in Durham, North Carolina. He is an internist who combines clinical research and clinical care regarding lifestyle treatments for obesity, diabetes, and tobacco dependence. He is currently President-Elect of the American Society of Bariatric Physicians and a Fellow of the Obesity Society and the Society of General Internal Medicine. He is coeditor of Obesity: Evaluation and Treatment Essentials and coauthor of The New Atkins for a New You. When he is not working in the clinic, he enjoys taking ballroom dancing classes.
Author interviews, book reviews, editors picks, and more. Read it now
Top customer reviews
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Jimmy Moore has missed a golden opportunity to truly help educate people on the controversies and the current consensus on the significance (or lack thereof) of the various biomarkers and measures for assessing cardiovascular risk. This is evident in that one of the most controversial and important topics of the day in lipidology -- LDL particle number vs. LDL particle size -- is all but avoided in the one chapter devoted to the topic. This is such a disservice to those who might recognize the names of Dr. Thomas Dayspring and Dr. Ronald Krauss and purchase this book in hopes of learning more from them. Save your money.
Instead of engaging Krauss and Dayspring (and a few other true experts interviewed for the book) in a genuine dialog, Jimmy Moore has reduced this important and complex topic to a series of sound bite-style quotations (called Moments of Clarity), cobbled together with his highly biased commentary, and finished off with often banal Doctor's Notes from co-author Dr. Eric Westman. What value there is, in some of the sound bites, is diluted with quotes from "experts" with absolutely no qualifications or knowledge to be designated as such. Most are merely known within the low carb internet community and have perhaps been a guest on one of the author's podcasts.
Let's say there is a major capital improvement initiative under consideration in your town. The stakes are high and the outcome, one way or the other, will impact you personally for decades to come. Would you want to base your decision on the 30 second commercials put forth by political interest groups? Worse yet, on only those commercials a biased media outlet chose to carry? Of course not. You would attend the town hall meeting. Jimmy Moore could have brought you this town hall meeting. Instead he is the biased media outlet bringing you sound bites.
If you have troublesome cholesterol levels and want a book to convince you there's absolutely nothing to worry about, this is the book for you. If you want unbiased information to assist you to work *with* your doctor, this is not the book for you.
You will get far more information from two interviews Krauss did with meandmydiabetes: LDL Cholesterol - Ron Krauss MD and Ron Krauss - Saturated Fat? Red Meat? It Depends. Thomas Dayspring has a nice PDF on his views entitled Understanding The Entire Lipid Profile. The other experts? If you want to get the "full skinny" from Chris Masterjohn PhD, you are better off listening to his three part podcast (or read the transcripts) with Chris Kresser. Forget Gary Taubes and Mark Sisson, neither of whom has ANY special training or demonstrated knowledge of the topic. Instead, you might be interested in the free, informative, two part guest post on Sisson's Mark's Daily Apple blog by Taubes' NuSI partner, Dr. Peter Attia: The Straight Dope on Cholesterol: 10 Things You Need to Know.
Jimmy Moore has assembled an ... eclectic ... group of "experts" with a clear bias among the vast majority, and the opinions of the minority are either absent or even misrepresented by selective quotations. Most appear so blinded by their views on statins that they seem incapable of separating the issues of lipid profiles from statin treatment. Perhaps statins aren't the answer, but adopting a diet that sends your LDL through the roof may still be ill-advised.
So I purchased a copy of this book and am writing this review so that potential customers will have at least one critical pair of eyes on it. The eyes of someone who did not receive a promotional free copy or who might benefit in some ancillary way from leaving a gushing review for Jimmy Moore.
This is not the sort of book to take with you to the doctor and expect to have any sort of constructive conversation to ensue about YOUR health. Most of the MDs have no special training or experience with lipidology and are simply making up their own theories on cholesterol. Before taking any of the sound bites to heart, potential readers would do well to search on The Livin La Vida Low Carb Show and the expert's name to find where Jimmy has published the full interviews behind this book. You can listen to all of them for free.
One major theme of this book is that your doctor has outdated misinformation and is relying on your total cholesterol to put you on deadly statins to make a quick buck for their friends in Big Pharma (the unspoken accusation is that the docs themselves profit from prescribing these drugs). And yet one of these very same "experts" -- The Hamptons Diet author Dr. Pescatore -- is selling a cholesterol lowering supplement on his website! What's in it? Red rice yeast. A statin. Wikipedia has the scoop.
So while many of the MDs and others chime in on how stupid and uninformed your doctor is, they proceed to provide you with unsubstantiated wisdom like (paraphrasing) 'a low carb diet is the best to get your cholesterol where it needs to be' (Pescatore again). But "While he does test for cholesterol levels in patients who request them, 'I never do anything about it. You need to see the whole picture and not focus too much on any one marker,' Dr. Pescatore explained." Odd that he sells a statin-containing cholesterol lowering supplement then.
A second major theme is that fat and saturated fat have no impact on weight or cholesterol levels and carbohydrates do. And yet the aforementioned Pescatore says: "I don't think medical science has any idea why LDL-P would rise above 2,000 or even 3,000 in some people who eat a low-carb [aka a high fat] diet." Yet there are multiple studies showing that saturated fats in the diet DO increase LDL in many people, and "medical science" has a pretty good idea why (search on saturated fats and LDL receptors for the answer).
The author only partially discloses his history of obesity and its relevance to his cholesterol history which is also incomplete. By telling the readers that his cholesterol has always been high he is misleading, because in fact it is higher now than when he weighed 410 lbs. More importantly it was close to normal by mainstream standards after about 10 months of maintenance of his initial 180 lbs weight loss on Atkins. He has been adding a ton of fat to already fatty meals for years now while his weight fluctuated and he hit 300 lbs in 2012. Since May of 2012, Jimmy Moore has been consuming an 80% fat "nutritional ketosis" diet to lose roughly 80 lbs at the one year mark. Aside from other health issues that may be diet related, potential readers should know that he is extremely biased by his attempts to wish his worsening metabolic profile away. If you search on 6 Month Lipid Panel for Jimmy Moore you should find his latest update before this book.
In comments, Thomas Dayspring wrote... "Dr Lipid analysis: Using all the knowledge we possess today, all of the numbers that you are thrilled about have no meaning in the face of a 99th percentile LDL-P. You also should not say an LDL-C of 285 has no meaning. The cholesterol concentrations that often have no meaning are low levels (where an LDL-P is needed to evaluate risk). No one with an LDL-C of 285 with the exception of a Type III dyslipoproteinemia patient have a low apoB or LDL-P. If you have an LDL-C that high, particle testing is not needed. You need to significantly reduce the saturated fat in your diet and see what happens: repeat the NMR in 3 weeks and you will know if your nightmare LDL-P is sat fat related. I'll bet your LDL-P drops. If it does not, you need serious lipid-modulating medication. We have seen this paradoxical horrific rise in LDL-P in some people who are on ketotic diets."
Yet here is the quote Jimmy chose for Dayspring in his chapter on LDL particles (Chapter 9):
"The least accurate way of estimating your atherogenic risk on a standard cholesterol panel would be to look at total cholesterol or LDL cholesterol."
Does this seem like an accurate reflection of Dayspring's full positions on the topic? This chapter should have contained liberal quoting from Dayspring, yet Jimmy Moore claimed on his blog that "I let him make his case in my book."
Even Dr. Krauss has had this to say about particle number: "But most people certainly in the field of cholesterol and heart disease understand that the number of particles matter more than just how much cholesterol they carry overall. In terms of health, the first order of business is to make sure the total number of particles in a person's blood is maintained in the healthy range, because that's what dictates heart disease risk."
Instead of this information, you get quotes like "If most of your LDL particles are the large, fluffy kind, then you don't have a problem and you have nothing to worry about." This advice comes from Cassie Bjork, who is not even a medical doctor, and has no special training in lipidology. Nevermind that people with familial hypercholesterolemia (a genetic condition characterized by both very high LDL and atherosclerosis) are known for having just that fluffy sort of LDL. And nevermind that both Dayspring would take serious issue with Bjork's advice were he actually given his say ... as it appears would Krauss.
Dr. William Davis (author of Wheat Belly) writes:
"Isn't it funny that people are turning to people like Jimmy Moore for answers to their health problems rather than their own doctors because the doctors have no damn idea what's going on?"
No, it's not funny. It is utterly irresponsible.
If anyone is interested, I have a review post on my blog for this book that shall be updated regularly with new information, including links to reliable sources of information that you CAN share with your doctor: Jimmy Moore's Cholesterol Clarity ~ Ongoing Review and Information on The Carb-Sane Asylum.
Rather than getting information from so-called experts who tell you your doctor is stupid, arm yourself with credible information from credible sources. And if your doctor won't listen, find another one. Internet doctors, and others like Jimmy Moore, will be quick to point out that they bear NO liability for the not-really-medical-advice they dole out. That's just my two cents.
People reading this may have seen my comments left on other reviews. I care deeply that people get accurate information, especially when acting on that information can impact their health. Therefore, I think it is important that folks know:
1. That many of the 5-star reviews were written by people who were provided free advance copies of the book and failed to disclose this per Amazon policy.
2. That many of Jimmy Moore's "world leading experts" are not experts at all.
3. That those experts of value in the book are either under-represented or outright misrepresented in this book.
I gave this 2 stars, only because there might be a few folks who discover the names of helpful experts through this book, and might seek further information from them. Otherwise it is a 1 star.
Mark Sisson, another contributor, said, "Cholesterol is one of the most important molecules in the human body: we would die very quickly without it. It's an integral part of cell membranes. It's involved in the creation of vitamin D and in the formation of many important sex hormones, it is necessary for the production of bile, which is critical to our ability to emulsify and digest fats." Jimmy Moore points out another of its many health benefits, "Cholesterol is a major line of defense when your immune system comes under attack. So lowering cholesterol levels artificially with drugs could make you more susceptible to germs or bacteria, wreaking havoc on your health." Cholesterol is also essential for proper brain function, as the brain contains more cholesterol than any organ in the body. Both estrogen and testosterone are made out of cholesterol (is it a coincidence that the same companies that sell statins sell Viagra and Cialis?).
Here is a eye-opening quote from Dr. Malcolm Kendrick: "There is absolutely no correlation between saturated fat intake, cholesterol levels, and heart disease. The most accurate research looking at this issue in different countries is the MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) study that started in the mid-1980s and is run by the World Health Organization. If you look at the figures, it's extremely clear that the countries whose populations have the highest saturated fat intake tend to have slightly higher cholesterol levels, but all have lower rates of heart disease. We're talking about a difference of 700 percent! The country whose people eat the highest level of saturated fat in Europe is France. Their average total cholesterol is 215 mg/dL, and yet their rate of heart disease is one seventh that of people in Ukraine, where people eat less than half the amount of saturated fat and their average cholesterol levels are slightly lower. So from this data we learn that the countries with the highest saturated fat consumption all have lower heart disease levels than the countries with the lowest saturated fat consumption...."
What's more, we are learning that LOW cholesterol may be really bad for us. One study of 120,000 men, published recently in the Scandinavian Journal of Health Care, shows that higher than the recommended level of cholesterol is associated with a reduced risk of death in subjects 50 and over. (Association of lipoprotein levels with mortality in subjects aged 50 + without previous diabetes or cardiovascular disease: A population-based register study. Scandinavian Journal of Primary Health Care 2013;31(3):172-180.)
Dr. Chris Masterjohn, a specialist on dietary fats and another contributor to the book, had this to say, "...We do know that people who have low cholesterol tend to have a higher risk of cancer and a higher propensity for violent suicidal tendencies." This suggests to me that low cholesterol might be a contributing factor to the rise in horrific mass-murder/suicides that have become an almost daily occurrence in the U.S. Investigators have been searching to find the commonality between the shooters, but no one seems to see what might be the link to all our current epidemics, including obesity, diabetes, heart disease, autism, depression, attention deficit hyperactive disorder (ADHD), Asperger's, Celiac's, Alzheimer's, and so on. They may all be the result of the dramatic change in the eating habits of Americans over the last 30 plus years.
This quote from Cholesterol Clarity sums up what has gone wrong since the government officially endorsed low-fat and low-cholesterol diets in the late 70s: "Statistics from the U.S. Department of Agriculture's Economic Research Service between 1977 and 1978 and 2005 and 2008 show that Americans dutifully cut their fat intake from 85.6 g to 75.2 g daily. Additionally, over the same periods, the percentage of total calories consumed from fat fell from 39.7 percent to 33.4 percent. And what has happened to the rates of obesity, diabetes, and heart disease since then? You already know the answer: Heart disease is now the number-one killer of both men and women, and nearly one million Americans have heart attacks annually. Obesity and diabetes have reached epidemic proportions. The financial burden of coronary artery disease alone totals close to $110 billion a year, and that trend is growing."
How could it be possible for the medical establishment to go down a dead- end road and become so hopelessly lost? Let me tell you a story. I posted an article on my blog in 2008 about a new drug called Vytorin. (carbwars.blogspot.com/search?q=vytorin) Dr. Michael Eades also wrote about it on the Protein Power blog (proteinpower.com/drmike/statins/vytorin-dis-enhance-d/)
Vytorin is a combination of Zocor (simvastatin), which reduces the production of cholesterol by the liver, and Zetia (ezetimibe), which inhibits the absorption of cholesterol from the digestive tract. Like all newly developed drugs, it is very expensive and gives Merck, the maker of Zocor, a way to continue making money from a drug whose patent has expired and is now available as a generic.
The combination drug must have sounded like a slam dunk for the pharmaceutical companies: If one drug could lower cholesterol, a combination of two that worked in two different ways should lower it even more. Both drugs had already been approved for sale separately, so Vytorin could be sold before it was tested. You undoubtedly remember the commercials for Vytorin: Cholesterol comes from two sources, from fettuccine Alfredo or your grandpa, Alfredo. From Barbecue ribs or your grandma Barbi. They showed goofy pictures of your pretend relatives dressed to look like high-fat foods. The remarkably effective, direct-to-the-consumer campaign convinced about five million people to take the drug. Here's an example from YouTube if you don't remember it: [...]
The ads reportedly cost at least 100 million dollars a year to run and two-page ads were featured in all the major newspapers and magazines as well. The first line in the ads asked, "Do you have high LDL cholesterol? It's important to talk to your doctor about ways to lower it." After a few sentences about how the drug works, they stated in bold type, "Vytorin has not been shown to reduce heart attacks or strokes more than Zocor alone." The second page lists the devastating side effects of the drug, but it fails to mention that Merck's own trial, called, ENHANCE, showed MORE heart attacks and an INCREASE in the thickness of artery plaque, known as atherosclerosis, in people taking the combined drug, even though it was 20% more effective at lowering cholesterol than Zocor alone. (The control group taking only Zocor also showed an increase in plaque.)
The obvious conclusion from the study by a rational person would be that lowering cholesterol did not prevent heart attacks and strokes. But a clever marketer can always find a way to spin a story--it might be better to take one statin than two. Too bad they didn't include a dietary change or even a placebo for comparison.
So why would a company spend huge amounts of money to advertise a drug that not only doesn't have any benefit, but actually makes the targeted problem worse? Just the fact that the ad is there gives the impression that this is a useful medication and may lead many people to pressure their doctors to prescribe it. Cholesterol is so firmly established in the minds of most of the population as the world's most dangerous substance that lowering it may be seen as a good thing in and of itself. Perhaps Merck and partner, Schering-Plough, hoped to cut their losses on a failed drug by continuing to have doctors put patients on it, in spite of the consequences. After all, they told us flat out that this drug didn't work, giving them a surefire defense against lawsuits.
When the results of the first study done on Vytorin were released, a story in the New York Times said, "A clinical trial of a widely used cholesterol drug has raised questions both about the medicine's effectiveness and about the behavior of the pharmaceutical companies that conducted the study." The article by Alex Berenson, goes on to quote Dr. Steven E. Nissen, the chairman of cardiology at the Cleveland Clinic, who said the results were "Shocking...This is as bad a result for the drug as anybody could have feared, Millions of patients may be taking a drug that does not benefit them, raising their risk of heart attacks and exposing them to potential side effects." (nytimes.com/2008/01/15/business/15drug.html?pagewanted=2&_r=1&sq=vytorin&scp=1) Other publications called it a PR debacle and predicted that the company would not survive the scandal.
The results were known to the company when the study was completed in April of 2006, but not released until January of 2008, and then only after a House of Representatives Committee began an inquiry into the delay. Schering-Plough's president was investigated for selling off $28 million worth of stock between the time the trials were completed and the results were released.
The study did not measure heart attacks or strokes, so the American College of Cardiology suggested that major clinical decisions not be made on the basis of this one study alone and the manufacturers promised follow-up studies to see what affect Vytorin had on those events. The first of the studies was due in 2012, but has now been extended to 2014. Meanwhile Vytorin continues to be heavily advertised and sold, giving Merck and Schering-Plough another year to rake in billions of dollars in profits. Multiply this sad story thousands of times and you may begin to understand how we got to where we are today.
The printed inserts that come with prescriptions for statins tell you to eat a low-fat, low-cholesterol diet when taking them. The tag lines for statin commercials say, "When diet and exercise aren't enough, ask your doctor if (fill-in-the-blank) is right for you!" Translation: "When the diet we tell you to eat and exercise don't help, ask your doctor to line our pockets!"
Americans spend more on health care than any country in the world, but a substantial part of our economy is based on our being unhealthy. It takes roughly a billion dollars to bring a new drug on the market. They literally bet the company on its success. If the best selling drugs were to go away, the repercussions would likely result in a financial melt-down bigger than the Wall Street scandal of 2007-2008. Big Pharma may now be considered too big to fail. If there is any hope of reversing the health crisis we face in this country, it is for brave people to speak out, people like Jimmy Moore and the top doctors, researchers, and experts who contributed to Cholesterol Clarity, including luminaries like Dr. Eric Westman, Dr. William Davis, Gary Taubes, Dr. Robert Lustig, Stephanie Seneff PhD, and many others.
A new nonprofit organization called the Nutrition and Science Initiative (NuSi), founded by Gary Taubes and Dr. Peter Atia, plans to carry out meticulous, unbiased experiments that will give us definitive answers to clear up the current confusion about diet and health, but those results won't be in for up to six years. In the meantime, we will have to take responsibility for our own well-being. Reading Cholesterol Clarity is a good place to start.
Disclaimer: I received an advance copy of this book as a pdf. It in no way affected my review.
P.S., the few trolls that are here giving poor reviews of this book are either: a) those looking for job security by keeping you SICK, or b) Big Pharm shills. Think about it.