Hamburger(Photo by Vanessa Pike-Russell,  Creative Commons)It must have surprised many that a president as young and vigorous as Barack Obama could be experiencing rising cholesterol, as reported last week.

But even more surprising is the misinformation being doled out by the people around him about the likely causes. “Too many burgers,” came the ready explanation. More likely, Mr. Obama’s beef isn’t with the meat he eats or even the fat in it, but with the cushy bun surrounding his burger and his apparent weakness for White House pies.

In his most recent physical exam, Obama’s cholesterol had spiked. His total cholesterol was up to 209, compared to 173 previously. His HDL — or “good” cholesterol — had dropped slightly, to 62. But the LDL — or “bad” cholesterol — was up to 138. Borderline high cholesterol starts at 200, with LDL considered unsafe above 130.

Most cholesterol doesn’t come from what we eat, but rather is manufactured by the body. Genetics play a huge role in whether a person’s cholesterol level is high or low. However, the body’s cholesterol function can be influenced by the foods we consume and medical research is accumulating more and more evidence that the culprit behind high cholesterol isn’t what we’ve been led to believe — meat and fat — but all the cheap, refined carbohydrates in the modern American diet: french fries, cakes, cookies, chips, beer, sodas.

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The most famous case of a U.S. president dealing with fat and cholesterol was Dwight D. Eisenhower, who suffered a heart attack in 1955 at age 64. At the time, Eisenhower had quit smoking six years earlier, had no family history of heart disease, exercised regularly, and possessed perfectly normal blood pressure and cholesterol levels, although his blood pressure was occasionally elevated. Alarmed, Eisenhower began dieting, eliminating fat and dietary cholesterol wherever he could. When his weight nevertheless climbed, he switched from a frugal breakfast of oatmeal and skimmed milk to Melba toast and fruit. Eventually, he stopped eating breakfast altogether.

Eisenhower renounced butter, margarine, cream, and lard and still his cholesterol rose, from a healthy 165 to a dangerously high 259 on his last day in office. In 1960, his doctor noted: “He eats nothing for breakfast, nothing for lunch and therefore is irritable during the noon hour.”

By then, the doctor was lying to the president about his cholesterol — telling him it was only 209 — and the case became known as the “Eisenhower paradox.” Eisenhower died of heart disease in 1969 at age 78.

In an exhaustive book about fat and its supposed links to high cholesterol, obesity, and heart disease, Good Calories, Bad Calories, published in 2007, science writer Gary Taubes concluded that the claims made against fat were more hype than actual science and that solid research pointed to carbohydrate consumption and the insulin such foods trigger as the true cause of modern diseases such as diabetes and atherosclerosis. A potent hormone, insulin is responsible for storing fat in the body and is secreted whenever we eat foods containing carbohydrates — starchy foods such as grains or potatoes or sugar, for instance. Insulin has been shown to suppress HDL and elevate LDL, especially the small, dense LDL particles implicated in degenerative artery disease.

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Research with sonogram technology shows that carbohydrates, and especially refined carbohydrates, have an almost immediate effect on the body’s arteries — and not in a good way. Recent studies in Israel, for instance, revealed that high-glycemic carbs that cause a sudden spike in blood sugar can be responsible for heart attacks. Medical researcher Dr. Michael Shechter found that volunteers who consumed high-glycemic foods such as bread, french fries, corn flakes, and sweetened soda experienced arterial stress and dysfunction. Eating carbohydrates acts directly on brachial arteries, stretching them out for hours at a time until they become prone to heart disease or even sudden death.

“It’s very hard to predict heart disease,” said Shechter, a fellow of the American College of Cardiology and the American Heart Association. “But doctors know that high glycemic foods rapidly increase blood sugar. Those who binge on these foods have a greater chance of sudden death from heart attack.”

Even avowed lipo-phobes in the medical research community have come to recognize a cholesterol phenomenon as virtually axiomatic: lower a person’s carbohydrate consumption and “good” cholesterol, HDL, will increase.

But I don’t need studies to tell me there’s a link between eating carbohydrates and high cholesterol. I have dramatic personal experience. When I stopped eating starchy foods a year ago, I lost nearly 30 pounds, and my cholesterol count went from borderline to excellent.

In a matter of weeks, my HDL count rose 39 percent, from 41 to 57 (normal range: 40 to 59). My triglicerides — a measure of fat in the blood and a key marker for insulin resistance and potential heart disease — dropped 35 percent, from 103 to 66 (normal range: 0 to 149). My LDL also dropped 7 percent, from 149 to 138. (Anything under 100 is considered good. But it’s important to note that in a simple blood test, the LDL result is not an actual reading but a calculation based on other test components. A more complicated assay would need to be performed to determine the actual composition of my low-density lipoproteins, and whether they consist of small, dense and dangerous LDL particles, or big, fluffy, more benign LDL.)

In fact, Obama’s cholesterol results on close inspection don’t seem bad at all. Total cholesterol, although it is commonly used as a marker for well-being, is a fairly meaningless number. More important is the HDL count — the president’s, at 62, is excellent — and trigliceride level: Obama’s, at 46, is superb. Based on those results alone, I would say that if our president has any fear of heart trouble, it is more likely to come from the current battle over health care legislation than his burger-prone diet.

But if you really want to improve your cholesterol, Mr. President, my advice to you would be this: Keep eating those burgers. Just eliminate the buns. Replace the fries with a nice lettuce and tomato salad. Serve red wine at your next “beer summit.” And those famous White House pies? Not a good idea. Have a slice of cheese instead.

And stop smoking!

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