In the last 15 years, knowledge about how to reduce heart disease has made major strides. This book is the best source I have seen about what has been learned, and how to apply it to help yourself and those you love. You will probably find it helpful to bring your copy along to see your physician because many primary care physicians will not be up-to-date with the latest findings in some areas, such as the use of supplements.

If you liked Mr. Kowalski's first program for controlling cholesterol, originally published in 1987, you will adore this book. When asking himself what had changed he noted, "Why, practically everything is new!" Mr. Kowalski reviews in detail the strengths and weaknesses of that program, describes the research that has been conducted on cardiovascular health since then, and shows you other risks in addition to cholesterol that must be addressed. He also debunks pseudo-science about cholesterol control.

What impressed me the most is that Mr. Kowalski's old and new programs have worked perfectly for him. Here is a man who had his first heart attack at age 35 and double bypass. He had a second heart attack at 41, followed by a quadruple bypass. In the foreword, cardiac surgeon Dr. Jack Sternlieb describes how the most rigorous tests of Mr. Kowalski's heart and arteries show that it has no blockages as of 1999. Without this program, Mr. Kowalski would probably have needed another bypass operation several years ago. His family record of heart disease is not a good one, and he probably has a genetic tendency to problems in this area. Mr. Kowalski is very physically active now, and has no limitations on his life style due to his cardiac history.

The new program has familiar elements in it, but is considerably less restrictive than the old one. You can eat a lot more foods, and a lot more fat (as long as it is the right kind of fat). The dietary guidelines are quite similar to the new ones brought out by the American Heart Association in 2000.

For most people, the diet features avoiding saturated fat and trans fatty acids, limiting overall fat to hold weight at a healthy level for your height, eating fish at least twice a week (especially fatty fish), lots of fruits and vegetables, whole-grain breads and cereals, consuming soluble fiber, lots of fluids, limiting sugars and empty carbohydrates, and eating slowly. Exercise is 15 miles of walking a week. A variety of supplements are encouraged (especially antioxidents, B vitamins, minerals, polysterols, and pantathine). Don't smoke. Limit alcohol consumption to moderate daily levels, but do not imbibe solely for the cardiovascular benefit. Take one aspirin a day if your stomach can handle it.

I liked the candor in the book quite a lot. For example, "I'm a little embarrassed when I look at the subtitle of the original book, which promises 'no deprivation.'"

In addition to the overall recommendations, each element is described in detail including the scientific studies that support why it works, who should not follow the recommendation, how to work with your doctor for the best results, side effects that can occur, and how these recommendations compare with the various prescription medications now available for lowering cholesterol. He also describes how these recommendations affect other factors for cardiovascular risk such as the amount of low-density lipoprotein (a negative component of overall cholesterol), high-density lipoprotein (a positive component of overall cholesterol), triglycerides, homocysteine, and C-reactive proteins. The section on niacin (B-3) was particularly interesting since it involves changing liver functions, and you are encouraged to work with your doctor in this area. I was not familiar with the "niacin flush" but was glad to learn that the newer versions usually avoid that problem. I especially found the discussions of the special issues that women, young people, and seniors have to be helpful.

Get this book today . . . follow its advice . . . and keep it with you!