Killer Fat / Ray D. Strand, M.D.

Central weight gain is a hallmark sign of insulin resistance. Even though not everyone who develops insulin resistance will also have central weight gain, approximately 85 to 90% Her will gain a significant amount of weight around their middle. This is why physicians are beginning to take out their tape measure during an annual physical exam, instead of just weighing their patients. Central weight gain is associated with elevated blood pressure, elevated triglyceride levels, low HDL or good cholesterol, high total and LDL or bad cholesterol, along with an increase risk of developing clots (increased fibrinogen levels).

Another hallmark sign of central weight gain is a tremendous increase in the amount of inflammation you have in your arteries. Central fat releases a tremendous amount of inflammatory products. Your highly sensitive C - reactive protein (hsCRP), which measures inflammation in your arteries and is a very good indicator of having a higher risk of a heart attack, can rise significantly. You can see why I am so concerned when a patient who comes into my office for their annual physical and is showing signs of an expanding waist size. All you have to do is take out a tape measure and measure 1 inch below your belly button and over the top of your hips. This is the best measurement for central abdominal fat. Women should become concerned when this gets above 32 to 33 inches and men should become concerned when it gets above 36 to 37 inches.

RAY D. STRAND, M.D.
Specialist in Nutritional Medicine

Should I be Taking a Statin Drug to Lower my Cholesterol? / Ray D. Strand, M.D.

About 2 years ago, a panel of 11 cardiologists met (as reported in USA Today) to lower the recommended level of LDL cholesterol from 130 to 100. Obviously, the pharmaceutical industry was ecstatic with these new recommendations. However, it should not have come as a surprise to them, since 10 of the 11 cardiologists were on the payroll of one of the pharmaceutical companies. The problem with this recommendation is that nearly 98% of the population in the US and Canada has an LDL cholesterol level greater than 100. These recommendations would mean that nearly the entire population should take statin drugs. The New York Times reported that maybe statin drugs should be placed in our drinking water.

Several clinical trials show that individuals who are at risk of developing heart disease can decrease this risk by taking statin drugs. The problem is that researchers are not really sure if it is the lowering of cholesterol that lowers the risk or if it is the anti-inflammatory properties of the statin drugs. I believe that it is probably a combination of both of these effects. If you lower LDL cholesterol, there is just less that is available to become oxidized. Just like aspirin has been shown to decrease the risk of cardiovascular disease due to its anti-inflammatory qualities (it all starts to make sense doesn't it), the statin drugs do the same. However, I have always believed that we should use drugs as a last resort and not a first choice. Statin drugs are truly over prescribed.

RAY D. STRAND, M.D.
Specialist in Nutritional Medicine

Oxidized or Modified LDL Cholesterol / Ray D. Strand, M.D.

Native or natural LDL cholesterol is not a concern when it comes to heart disease. It acts as a transport vehicle of cholesterol. However, when this LDL cholesterol becomes modified or oxidized by excessive free radicals, it causes a tremendous amount of inflammation of our arteries. Fat soluble antioxidants like vitamin E, beta carotene, and alpha lipoic acid have the ability to incorporate themselves within the wall of the LDL cholesterol and offer protection against this oxidative process. The medical literature shows that the higher the level of antioxidants within the wall of the LDL cholesterol, the more it is able to resist this damage by excessive free radicals.

Dr. Daniel Steinberg reported in the New England Journal of Medicine in 1989 that if enough antioxidants were on board, LDL cholesterol levels would not be a concern.

The problem is that physicians are not able to measure "Oxidized" LDL cholesterol levels in the lab. This is primarily research done in clinical trials. Physicians just measure total LDL cholesterol. This is why I believe it is so important to supplement all of these antioxidants and their supporting nutrients at optimal levels (cellular nutrition) to best protect your LDL cholesterol and decrease inflammation of your arteries.

RAY D. STRAND, M.D.
Specialist in Nutritional Medicine