After decades of following the American Heart Association's recommendations, heart disease remains the number one killer in America. This approach is failing because it missed the cause of the epidemic. And, evidence is mounting that the recommendations themselves have caused other problems.

In fact, it is the medical establishment's worse nightmare come true. The preventative recommendations were based on assumptions that turned out to be false. And, following the recommendations actually caused new epidemics of other diseases.

The recommendations fall into three categories. Most Americans can recite them.

? We must eat less fat.
? We must increase “cardiovascular” exercise.
? And we must monitor and control blood cholesterol levels.

But since millions have been swearing off traditional foods, running on treadmills like never before and spending billions on prescription drugs to lower cholesterol, heart disease has stubbornly clung to its position as the biggest cause of both disease and death.

The reason these attempts have failed is that they are the wrong advice. In contrast to what we've been told:

? You can eat meat if you like. Dietary fat is not the problem.
? Long duration cardiovascular exercise is not what your heart needs. It is a waste of your time and causes additional problems.
? Cholesterol doesn't have to stay below 200 and cholesterol-lowering drugs are bad for your heart and your general health.

The truth is the epidemic of heart disease was more directly related to:

? Not fat in the diet, but starches.
? Not inactivity, but prolonged stress.
? Not cholesterol, but oxidation and inflammation in the arteries.

And the recommended preventions were the wrong tools. In some cases, they were like throwing gas on a fire because:

? Low-fat diets are higher in starches worsening the problem.
? Long duration cardio exercise mimics prolonged stress and breaks down vital cardiopulmonary reserve.
Cholesterol lowering drugs interfere with energy production in your heart and block your capacity to reduce oxidation in your heart and arteries.

Those three categories of interventions, nutrition, exercise and screening tools for early diagnosis are the bases of prevention - and heart disease is no exception. But the main focus of the nutritional change should be to lower starches not fat. Exercise programs should be directed at building cardiopulmonary reserve capacity not breaking it down. And the screening tools should be directed at measuring oxidation and inflammation of the arteries not cholesterol.

I have shown in my own patients that each of these three goals can be accomplished. What's more, doing it is easier. Americans have found following a low fat diet tough. This chronic denial of enjoyable food with its constant guilt is unnecessary. The only rule of my diet for heart health is that the food is part of our natural diet. When I tell patients they can eat any natural food that they enjoy, compliance is not a problem.

Likewise pounding away on a treadmill for an hour at a time is hard to stick too. Many patients have difficulty finding the time. And, when older people try this exercise, it makes them chronically tired. When we tell them to strengthen their heart, they shouldn't exercise for more than 20 minutes at a time and 6 minutes is enough to help, compliance is high.

Lastly, although most patients using them aren't aware that their cholesterol lowering drugs are causing them to feel feeble and ache, they are delighted when they discover the increased energy they feel when they switch to alternatives. And we have compelling evidence that the best predictor of heart disease risk is not cholesterol at all but homocysteine. It is not only a predictor but also an initiator of blood vessel disease. Lowering homocysteine is also much easier than lowering cholesterol. It doesn't make you feel bad and no toxic drugs are necessary.

In the next several Health Alerts, I will lay out my alternative program for each of theses three areas, real heart health testing, heart healthy eating and heart building exercise.

Al Sears MD