The 5CH Lifestyle: Lower Your Cholesterol Without Medication, Reduce Your Risk of Heart Attack and Achieve Long-term Wellness shows readers how to prevent—not just manage—heart disease through Dr. Stephen Fenton’s proven, natural, and prevention-focused approach built on decades of clinical cardiology experience. Author Dr. Stephen Fenton talks to Book Glow about the book.
What inspired you to write The 5CH Lifestyle?
During 40 years in clinical practice as a cardiologist I have come to increasingly realise that despite the amazing medical developments we now have to save lives of heart attack survivors, there is simply nothing that beats prevention. This seems obvious if we draw an analogy with horrific and fatal car or plane crashes. Despite an improvement in the rate of heart attacks over the last 50 years, it remains the leading cause of death right around the world. Overall, a third of heart attack victims will die many suddenly before they can get to hospital – about half if we consider those with a big heart attack. In the USA that’s a fatality every minute. Half of these people had absolutely no idea that they had an underlying cardiac issue. So early detection of heart disease is critical if we want things to improve and this is the first thing I teach in the book. The second thing is that through simple and effective lifestyle changes we can not only dramatically reduce this risk and prevent a myriad of other serious diseases but also feel so much better.
How has your decades of experience as a cardiologist shaped this preventive approach?
I have been very lucky in my career to witness amazing developments with the application of coronary artery bypass surgery; coronary stents; effective drugs that help manage cholesterol, blood pressure and diabetes; tiny pacemakers and miraculous implantable defibrillators. There have been incredible improvements to imaging with ultrasound, CT x-ray and MRI and major changes to the approach to heart valve management with percutaneous valve repairs and replacement as well as new ways treating of electrical heart abnormalities. But the tragedy of devastating heart attacks has not gone away. The 5CH book is my call to action to take the initiative with your heart health to have a meaningful and thorough heart check which includes plaque assessment, if indicated, and to start a holistic lifestyle change now including the 5CH diet together with exercise, stress reduction, good sleep, happy relationships, balance in life and so much more.
What do the “5 CH’s” stand for, and how do they lower heart attack risk?
The 5 CH’s are Chops, Cheese, Chips, Chicken skin and Chocolate. These are icons for food groups and by avoiding or reducing these we can achieve a very substantial reduction in our cholesterol level and improvement in general health by reducing our intake of saturated fats, trans-fats, simple sugars and processed foods. The 5CH Lifestyle book provides much more detail of these food icons and some additional tips to lower cholesterol and other damaging fats in our bodies.
How does your method differ from conventional medication-focused advice?
My approach starts with lifestyle. Current medical guideline algorithms provided to doctors to assist in heart risk management jump straight to drugs – especially at present to statins. Statins are fine if required as are other newer drugs for cholesterol management if indicated. But diet and lifestyle are vital and, although given lip service, I don’t believe they are discussed or utilized nearly effectively as they need to be. We jump to drugs often before and without a clear diagnosis of underlying plaque and in the vast majority of cases before a genuine trial of lifestyle changes.
Which lifestyle changes make the biggest impact on heart health?
This is a difficult question to answer as all the changes I talk about make a difference, and it can vary from individual to individual which makes the biggest impact but in general they are synergistic. I start with the 5CH dietary advice and encourage this and regular, preferably daily exercise to begin. I call this a scientific experiment and advise my patients it will start with a “miserable” month. But patients nearly always feel happier and so much better and recognise they have started on a new path in life. The ongoing elements of stress reduction, improved sleep, balance in life and so on start to follow. There is an immediate and measurable reduction in weight. Cholesterol levels fall and this is substantial and often up to or more than 25 -30%, and that is without drugs. By that stage most patients have had some simple plaque testing if indicated and we can then decide what their cholesterol targets need to be to achieve plaque stabilization and ideally plaque regression.
What’s the first step someone can take to adopt the 5CH Lifestyle?
In the 5CH book I introduce a personal risk-profile calculator. I have developed this by combining traditional and non-traditional risk factors. We know that the presence of traditional risk factors (smoking, high blood pressure, high cholesterol and diabetes) is certainly important, but these account for less than 50% of the causes of heart attacks. There are a great many other factors that are very important in many individuals. Many of these non-traditional factors are now recognised and positioned to be considered when considering drug prescriptions. These are discussed in detail in the 5CH book. I believe they should be considered not only with management decisions but importantly with respect to plaque diagnosis. I recommend this approach be utilized to decide when a CT coronary calcium scan will be helpful.
How can people stick with these lifestyle changes long-term?
The vast majority of my patients stick to these changes very well. Some are motivated by the results of plaque testing which may not be so good, and they understand it is time for a healthy change. In many cases they have been confused by dietary advice and simply don’t have the information they needed. In most cases when they do the “miserable month” trial they suddenly realise how easy it is to change and how much better they feel. They value and love their lives and don’t want to follow family members or friends who may have lost theirs at a young age to heart disease. Even those folks who are found to have no plaque are very motivated to stay this way. So, plaque testing is a win/win proposition and places diagnosis before management where it should be.
Can this approach complement existing medical treatments?
Absolutely! The concept is that a goal for your LDL (or “bad”) cholesterol level, is set and recommend by your doctors based on the results of your plaque testing and personal circumstances. The 5CH program can be initiated to see what you can achieve as your best or lowest LDL cholesterol level. Of course, any other identifiable risk factors will also be looked at. For patients at risk, such as those found to have significant coronary plaque, medication such as statins may be trialled and cholesterol levels repeated to assess progress. The good news is by partnering with the diet and lifestyle measures a much lower dose of medication may be sufficient. In many patients with no plaque medication at this time may not be required at all.
What motivates you to continue advocating for prevention?
It is immensely satisfying to see patients turn the corner from high risk to low risk and at the same time know that they feel so much better whilst improving their general health and reducing the risk of other diseases. To me this is what medicine is all about. The ancient wisdom of eastern medicine recognises prevention above all – and clearly for good reason.
Which heart-healthy habits do you follow yourself?
My diet is very largely pesco-vegeterian with an extremely low intake of the foods I encourage to be avoided. I exercise almost every day and enjoy tennis and golf. I have several hobbies including music and I love family time including two young granddaughters as well as our gorgeous golden retriever, George. I focus as much as possible on good sleep and regular breaks, include meditation daily where I can and strive for the admittedly ongoing challenge of work-life balance. Finally, I am mindful of the teachings of so many of the spiritual teachers, such as the Dalai Lama, who espouse loving kindness, compassion, gratitude for our blessings, looking at each day for meaning and purpose and being of service to others.
If readers remember one thing from your book, what should it be?
The one thing I will ask readers to remember is this: When the student is ready the teacher will appear. And I hope when it comes to your heart health, I can be your teacher. Some folks may read and apply this book enthusiastically from day one. Others may not be “ready” and might pick it up several months or years down the track. When it comes to improving our health and an effective approach to a better healthier life, it may be later than you think, but it’s never too late. Please remember, the longer we are exposed to the good things and the less we are exposed to the bad, the better off will be our health. Rome wasn’t built in a day. It takes time and the important thing is to start and then keep trying. I wish all your readers well and hope those who read The 5CH Lifestyle book will enjoy it, find true heart and other health benefits and never look back.
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