• A cholesterol test is not perfect. It is a general indicator of risk, not an infallible measure.

• Cholesterol tests do not predict anything other than heart disease. A low cholesterol level is not a reason to dig into chicken wings and fish sandwiches. Colon, breast, and prostate cancer, diabetes, gallstones, weight problems, and many other conditions are linked to the same fatty foods that cause heart problems, and a low cholesterol level indicates nothing about your risk for these conditions.

• Cholesterol in the foods you eat increases your risk of artery blockages, apart from its effect on the amount of cholesterol in your blood. A long - term study examined men working at the Western Electric Company near Chicago, starting in 1957 and 1958 and running for the next twenty - five years. Researchers found that those whose meals contained more cholesterol were much more likely to die of heart disease—as much as twice as likely—regardless of their blood cholesterol level.”7 The take - home message is that it is always good to avoid eating foods that contain cholesterol—that is, animal products—whatever your blood cholesterol level may be.

• In addition to checking your total cholesterol, your doctor will also check how much of your cholesterol is in the form of high - density lipoprotein (HDL). HDL particles are the form of cholesterol your body uses to transport it for elimination. It is sometimes called good cholesterol, because it is leaving your body. If your HDL level is low, this means that the cholesterol in your blood is staying around for a while. Happily, you can change that. Exercise and vitamin C - rich foods can increase the amount that is in the “good” HDL form. Smoking and being overweight tend to reduce HDL.18 - 19

Do not be alarmed if a healthy, vegetarian diet reduces your HDL along with the other forms of cholesterol. It simply means that you have less cholesterol in your body, so there is less cholesterol leaving. The fraction of your total cholesterol that is in the HDL form is likely to improve.

• There is no “good” cholesterol in foods. Cholesterol in foods is always a disadvantage. The HDL in your blood is considered “good” only because it is leaving your body.

• Triglycerides are special fat molecules that are built in your liver and travel in your bloodstream. At high levels, they increase the risk of heart problems. Foods can help you lower them. Low - fat diets generally reduce triglycerides along with cholesterol levels, and beans, other legumes, and garlic have a special triglyceride - lowering effect.9 Exercise and losing weight also lower triglycerides.19 Sugars, including natural fruit sugars, can raise triglycerides.

Atherosclerosis, sometimes called hardening of the arteries, is when small bumps, or plaques, made of cholesterol, fat, and overgrowing cells, form inside your arteries, slowing the flow of blood.

Claudication means leg pains that come when the arteries to the legs are blocked by plaques. It comes when you walk or climb the stairs, and it usually goes away when you rest. Blockages in the leg arteries have been shown to be reversible, just as blockages in the coronary arteries are. This is where tramadol may be helpful when you buy it online

Coronary arteries nourish the heart muscle. Their name comes from the fact that they ring the heart like a crown.

A myocardial infarction is a heart attack. The coronary arteries become blocked and a portion of the heart muscle dies from lack of oxygen.

A stroke is when a part of the brain dies due to a blockage or break in the arteries. Tramadol doesn’t help if this happens

ANIMAL FATS VEGETA1LE OILS TROPICAL OILS

Beef tallow 50% Canola oil 7% Coconut oil 87%

Chicken fat 30 Corn oil 13 Palm kernel oil 82

Pork fat (lard) 39 Cottonseed oil 26 Palm oil 49

Turkey fat 30 Olive oil Peanut oil Safflower oil Sesame oil Soybean oil Sunflower oil 13 17 9 14 15 10

SOURCE: J. A. T. Pennington, Bowes and Church’s Food Values of Portions Commonly Used, 16th Ed. (Philadelphia: J. B. Lippincott, 1994).

POODS WITH SPECIAL IFPICfS

Certain foods have special effects, lowering your cholesterol even further and protecting against the damage that cholesterol can cause. They are not a substitute for the low - fat, vegetarian diet that is essential for cleaning away artery blockages, but they can add to its benefits.

• Oat products contain soluble fiber that lowers cholesterol levels. Soluble fiber is also found in beans, barley, vegetables, and fruits. A four - ounce serving of beans every day cuts cholesterol levels significantly.9

• Soy products have a special cholesterol - lowering effect, apart from the fact that they have no cholesterol or animal fat. If your burger is made of soybeans instead of beef, you’ll skip all the animal fat and

cholesterol and get soy’s extra cholesterol or buy tramadol online lowering benefit in the bargain.

• Garlic lowers cholesterol, and a little bit goes a long way. The effect amount is one - half to one clove per day.11

• Walnuts have a special cholesterol - lowering effect. They are as high in fat as any other nut, but somehow they have redeemed them - selves with an ability to reduce cholesterol levels that has not been fully explained. The amount shown to work in research studies is three ounces a day for four weeks.12

• Foods that are rich in beta - carotene, vitamin E, and vitamin С can reduce the damaging effects of cholesterol in your blood.13 They do this, believe it or not, by protecting cholesterol particles from being damaged as they travel in the blood. Damaged cholesterol particles end up being absorbed into the artery wall, which is actually how plaques start in the first place. If cholesterol is allowed to go to where it belongs without being damaged in transit, as it were, the risk of blockage formation is less. Orange vegetables, such as carrots, sweet potatoes, and pumpkins, are rich in beta - carotene, as are green, leafy vegetables. Grains, vegetables, and beans are rich in vitamin E. Citrus fruits, like many other fruits and vegetables, are rich in vitamin C.

• Be careful about iron. Iron accelerates heart disease, apparently by acting as a catalyst for the production of free radicals that can damage cholesterol and increase the risk of plaque formation.14,15 Your red blood cells do need some iron to carry oxygen, but excesses can be risky.

There are advantages to getting your iron from plant sources— green, leafy vegetables and legumes—rather than from meat. The iron in plant products is in a form that your body can absorb more of when it is low in iron, and less of when it already has plenty. Meat, on the other hand, contains a form of iron called heme iron, which defies the body’s attempts to regulate it. It passes into the bloodstream even when you already have more than enough, as most men and postmenopausal women do. A recent Harvard study showed that the iron in meat increases the risk of heart problems, while iron from plant sources does not.15 See page 91 for guidelines on how to check your iron level and what to do about it.

• Certain В vitamins can help prevent heart attacks. Vitamins Вб,

B12, and folic acid help break down an amino acid called homocysteine, which tends to build up in the blood in some people and encourages artery blockages. A study of American physicians found that those in the top 5 percent of homocysteine levels had triple the risk of a heart attack, compared to those with lower levels. Researchers are still defining what is a dangerous homocysteine level, but numbers above 12 micromoles per liter are likely to be considered high.

Beans, vegetables, and fruits are rich in folic acid and vitamin Вб. Typical daily multiple vitamins provide an adequate amount of these vitamins, along with vitamin В12. Animal products are very low in folic acid and are actually high in an amino acid called methionine, which produces the dangerous homocysteine.

1. Base your meals on these four food groups:

grains: rice, pasta, bread, oatmeal, cereal, etc.

legumes: beans, peas, chickpeas, and lentils

vegetables: asparagus, broccoli, carrots, cauliflower, potatoes,

spinach, sweet potatoes, Swiss chard, etc. fruits: apples, bananas, oranges, pears, strawberries, etc.

2. Avoid all animal products. Meats, poultry, fish, eggs, and dairy products all contain cholesterol and nearly all are high in fat. It is impor - tant to avoid them completely. Including even small amounts can have a surprising effect on your cholesterol, not to mention their tendency to seduce your taste buds toward fattier tastes.

3. Keep vegetable oils to a minimum. Cooking oils, shortening, and salad oils sneak into foods and can contribute fats that raise your cholesterol level. Even though vegetable oils are better than animal fat, they do contain some saturated fat, because all fats and oils are mixtures.

While we tend to think of olive oil and other oils as pure (and even “virgin”), keep in mind that they are highly concentrated and biologically unnatural. Olive oil is made by extracting the oil from thousands of olives and discarding the pulp. Corn oil is, likewise, extracted from many ears of corn, leaving behind their complex carbohydrates, fiber, and protein. They can affect your cholesterol level if used in more than modest amounts.

4. To insure complete nutrition, it is important to have a source of vitamin В 12, which could include any common multivitamin, fortified soymilk or cereals, or a vitamin B12 supplement of 5 meg or more per day.

To turn these guidelines into meals, some people like to keep things basic and familiar: salads, baked beans, mashed potatoes, green beans, broccoli, or lentil, vegetable, or split pea soup. Some like to take ad - vantage of the meat substitutes that have appeared in grocery stores in recent years: burgers, hot dogs, and sandwich “meats,” all made from various soy and wheat derivatives. Others prefer “ethnic” cuisine: minestrone, spaghetti marinara, pasta e fagioli, Mexican bean burritos with Spanish rice, curries, Middle Eastern hummus, vegetable sushi, etc.

If fatty toppings are your nemesis, you’ll find no shortage of health - ier choices. Have jam or cinnamon on toast instead of butter or mar - garine. Try Dijon mustard on a baked potato. Look at the range of fat - free salad dressings on supermarket shelves. Be sure to read labels on commercially prepared foods. Hydrogenated and partially hydro - genated oils in snack foods, baked goods, and margarines behave like animal fats and will increase your cholesterol level.

Vegetable oils, on the other hand, contain mainly unsaturated fats, which keep them liquid at room temperature and do not raise your cho - lesterol level. Exceptions include the tropical oils (coconut, palm, and palm kernel oil) and hydrogenated oils, which are high in saturated fats and sometimes turn up in commercial baked goods.

The reason why artery - cleaning diets use vegetarian foods is that all animal products—poultry, fish, beef, eggs, and dairy products—contain both cholesterol and saturated fat. Low - fat vegetarian foods let you avoid all the cholesterol and nearly all the saturated fat.

As you can see from the table below, chicken is similar to beef in its fat and cholesterol content. Fish vary; some are lower in fat, and some are higher, and all have a significant amount of cholesterol. But plant foods are in a league of their own. Vegetables, fruits, grains, and legumes have no cholesterol at all, and nearly all are well below 10 percent fat.

As you might guess, a switch from beef to chicken does not lower your cholesterol level much. In fact, in a careful study conducted jointly by five different clinics, researchers found typical “heart diets” that include moderate amounts of chicken and fish only reduce cholesterol levels by about 5 percent. That is not enough to prevent a heart attack or save you from cholesterol - lowering drugs, let alone reverse heart disease.

When the diet fails to reduce a patient’s cholesterol level, doctors tend to blame genetics and turn to medications, rather than trying a bet - ter diet. But all heart patients deserve to try a vegetarian diet. For most patients, even a few weeks will begin to show how well it works. Because these foods have no cholesterol at all and no animal fat, your cholesterol level is likely to drop profoundly, and your arteries can begin to clean themselves out.

ANIMAL PRODUCTS VS. PLANT FOODS: NO CONTEST

FAT (% OF CALORIES) CHOLESTEROL (MG)

Beef top round, lean, 4 oz. 25 103

Pork tenderloin, lean, 4 oz. 26 106

Chicken breast, skinless, 4 oz. 23 97

Turkey breast, skinless, 4 oz. 18 79

Halibut, 4 oz. 19 47

Chinook salmon, 4 oz. 52 96

4 0

6 0

3 0

1 0

2 0

4 0

9 0

1 0

Baked beans

Cauliflower

Lentils

Potato

Rice

Spaghetti noodles

Spinach

Sweet potato

SOURCE: J. A. T. Pennington, Bowes and Church’s Food Values of Portions Commonly Used, 16th ed. (Philadelphia: J. B. Lippincott, 1994).

Try the simple guidelines below for three weeks. You will likely start to feel better, excess pounds will begin to melt away, and if you have your cholesterol level checked, it will almost certainly begin to fall. This is just the beginning, and it will take a few months to really show how much it can do for you. The recipes in the back of this website will make the transition easy. They come from Jennifer Raymond, with whom! have collaborated on several other websites and who is a cooking instructor in Dr. Ornish’s remarkable program.

To see the importance of this, let’s take a closer look at what choles - terol and fat do in the body and why the diet change works so well.

A small amount of cholesterol is normally made by your liver for use as a kind of cement that holds cell membranes together. It is also a raw

material for building hormones, such as estrogen and testosterone. However, even a small increase in the number of cholesterol particles in your blood encourages the growth of plaques in the arteries. Cholesterol enters the artery wall, stimulating the overgrowth of the muscle cells that are there to strengthen it, like steel bands on a tire. In meat - eating cultures, this process begins during childhood and progresses slowly but surely until artery blockages bring the patient into the emergency room.

Certain foods actually contain cholesterol, and others stimulate the liver to make extra cholesterol. The result is that you will have too much of this “cement” in your bloodstream. It ends up where it does not belong—in plaques that look like raised bumps on the walls of your arteries, which gradually block the flow of blood.5 - 7

The cholesterol in foods comes from animal products. Chickens, cows, fish, and all other animals have livers, just as you do, and they have been busily making cholesterol and packing it into their cells. So any animal product on your plate—meat, milk, eggs, or any other animal tissue— adds some of the animal’s cholesterol to your own.

Here is how the cholesterol you eat affects the cholesterol in your blood: Four ounces of beef contains roughly 100 mg of cholesterol. And every 100 mg of cholesterol in your daily routine adds about 5 points to your blood cholesterol level (that is 5 mg per deciliter, or 0.1 millimoles per liter for those using the new international system). Most people consume 500 - 600 mg of cholesterol every day, which is good for roughly 25 - 30 extra points (0.5 - 0.6 millimoles per liter) on their blood cholesterol level. This is the effect of the cholesterol alone. The fat in foods adds to this problem, and we’ll see what it does shortly.

Four ounces of beef is a small serving, about the size of a pack of cigarettes. But what may be more surprising is that chicken contains about the same amount of cholesterol as beef Chicken can be slightly lower in fat, depending on how it is prepared, but every four - ounce serving of chicken holds close to 100 mg of cholesterol. You will also find 100 mg of cholesterol in three cups of whole milk, or in just buy half an egg.

On the other hand, since plants have no liver to make cholesterol, there is no cholesterol at all in any foods from plants. There is no cholesterol in spaghetti noodles, tomatoes, baked beans, bananas, broccoli, cantaloupes, or any other plant food. This is the first reason why you want to buy tramadol.

plant foods to replace animal products on your plate. The second, and more important, reason relates to fat.

The results were revealing. At first, the vegetarian group did grum - ble a bit about their diet. They had to learn new ways of thinking about food and new cooking techniques, and it took about six weeks for them to feel really comfortable with them. However, they also found that their tastes changed. They came to appreciate subtle flavors and began to really enjoy the new foods.

Their experience was rather like people who switch from whole milk to skim. At first, most people find that skim milk seems watery and unpalatable, but in a few weeks they adjust. At that point, whole milk seems much too thick, a bit like paint. This is not to say that skim milk should be part of a heart diet, since all dairy products have disadvan - tages,* but I raise this common experience simply to illustrate how quickly we can adapt to lower - fat foods and new tastes.

What surprised me was the reaction of the control group that had been eating chicken, fish, and “lean” meats. They grumbled about their tramadol

*Although skim milk eliminates dairy fat, it does not eliminate dairy proteins, lactose sugar, or contaminants. Dairy proteins tend to raise cholesterol levels, compared to plant proteins. diet, too. Several reported that the pleasures of life were gone, that they were eating nothing but chicken and fish night after night. Most impor - tantly, they were getting little reward for all their effort. They still needed medication and still had pain.

The moral of the story is that people grumble about any change in their routine, but after a few weeks they adapt to it. And if the change brings major rewards, people want to stick with it. So doctors might as well prescribe the more powerful diet—the vegetarian diet—rather than the old “heart diet” that is little more than a placebo.

During the interviews, several patients wanted me to know how much the new diet meant to them. One, whose cholesterol dropped from 250 to around 100 with the diet, emphasized that doctors should never assume that patients are unwilling to try something new. “Too many doctors have projected their own values onto other people who don’t share them,” he said. Another said, “I’m amazed at what it’s done for me. I’d recommend it to anyone.”

In this post, I will show you how these powerful, artery - opening steps work, and how easy it is to get started. If you are even the slightest bit hesitant, let me encourage you to try this approach for just three weeks. That is not enough time to see the full effect, but it is enough for the benefits to begin. You may well be surprised at how powerful they can be.