Lifestyle Nutrition

Eat Well & Thrive

Continuing Education

Cholesterol

Posted on April 15, 2018 at 1:55 PM


This information is solely provided to assist you in a conversation with your physician. Consult your physician regarding the applicability of any information provided to your symptoms or medical condition. Only your physician is qualified to determine what is right for you and your specific health concerns


Let’s begin with “What is cholesterol?”

Cholesterol itself is a waxy, fat-like substance that is primarily made by the liver, although some comes from the diet. It is an essential component of cell membranes and is used by the body to produce hormones and vitamin D. Cholesterol is carried through the bloodstream attached to two different categories of lipoproteins: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL is commonly known as the “bad or Lousy cholesterol” because it transports cholesterol from the liver throughout the body, and potentially allows it to hang out in your artery walls. HDL, known as the “good cholesterol or Healthy” picks up cholesterol from the blood and delivers it to cells that use it, or takes it back to the liver to be recycled or eliminated from the body – now the latter is what a well-behaved body is supposed to do!

How much cholesterol do we need?

Most of the 1,000 milligrams of cholesterol that your body needs to function each day, according to the American Heart Association, is manufactured in the liver of a well-functioning body- About 75%. Only around 25 percent comes from the cholesterol you eat. If you eat a well composed diet, your liver manufactures just as much cholesterol to supply your cells with what they need. But if your liver makes too much cholesterol, which can be an inherited problem and/ or if you take in too many calories, especially in the form of certain fats and sugar, your cholesterol levels rise as your liver converts extra sugar to fat. This new research syncs with decades of data on how sugar causes insulin resistance, high triglycerides, lower HDL (good) cholesterol and dangerous small LDL (bad) cholesterol. It also triggers the inflammation we now know is at the root of heart disease.

Conflicting information- What’s the truth?

We still have some differing views, so controversy over whether high cholesterol is in itself a cause of heart disease (the lipid hypothesis), or a symptom of an inflammatory condition that is the true cause of heart disease (the inflammation hypothesis) continues to be debated. According to the latter theory, chronically high levels of inflammation creates small lesions (like a scrape) on arterial walls; the body sends LDL to heal those lesions (like a bandage) but it ultimately accumulates and oxidizes, causing blockages. From this perspective, the best lifestyle approach to lower cardiovascular disease risk is to lower inflammation in the body rather than simply LDL levels.

Recent evidence indicates that your sugar load is probably a greater contributor to heart disease than is consumption of saturated fat. While high fat/high sodium may contribute to inflammation; poorly managed sugar loads appear to be the alpha culprit. This suggests that the inflammatory hypothesis may in fact have more validity than the conventional lipid hypothesis. Researchers have identified cholesterol's partner in crime as inflammation; which is simply the flood of white blood cells and chemicals that our immune system unleashes to ward off damage or infection. Cholesterol wouldn't be nearly as dangerous without this process, which is thought to play an essential role in atherosclerosis, the hardening that occurs when low-density lipoprotein (LDL) layers on “too many bandages” in the arteries. When high levels of cholesterol occur in the bloodstream, excess LDL begins to seep into the inner wall of the artery. This triggers an inflammatory response, which actually speeds up the accumulation of cholesterol in the artery wall. This in turn produces more inflammation and now that’s where those flagged labs come from. Eventually the deposited cholesterol hardens into a plaque, which can rupture and lead to the blood clots that cause heart attacks and strokes. Some experts now believe that inflammation is the link between the many diseases and conditions that affect the heart and brain. Just focusing on “sweets” is a flawed mindset. Some food choices may have a high sugar conversion but aren’t thought of as a sugary choice. Here’s how sugar works: Most carbohydrates must break down into glucose before you can absorb them. If you convert more sugar than your body needs, the excess amount is stored in your liver in the form of triglycerides, a type of fat that can cling to artery walls as it travels through the bloodstream. High triglyceride levels contribute to atherosclerosis, the formation of plaque in blood vessels. It also appears to contribute to lowering your high-density lipoprotein, the "good" cholesterol, according to an Emory University study published in the April 2010 issue of "JAMA." People in the study who ate the highest sugar producing foods had the lowest HDL and the highest blood triglyceride levels. People who ate the lowest had the highest HDL and the lowest triglyceride levels. If LDL cholesterol and/or triglycerides are an area of concern, ask about your HDL cholesterol since low HDL cholesterol is also a major risk factor for heart disease;

I was interested in who is practicing from the inflammation point of view

And I found that many “super doctor” endocrinologists were on board. The American College of Endocrinology and The Metabolic Institute of America are fertile ground for comprehensive and unique multiple interventional approaches to the cardio-metabolic high risk patient, preventing and managing obesity, diabetes and cardiovascular disease with a focus on inflammation factors. “Inflammation is the common denominator in nearly all of the diseases we deal with "Heart disease, diabetes, dementia all seem to have links to inappropriate, low-grade, chronic inflammation." Inflammation appears to be aggravated by poor and/or unbalanced diets. Research shows that high-calorie, high-fat meals cause a sudden spike in inflammatory markers because they flood the body with blood glucose and triglycerides. “While we have been told to swap eggs for Cheerios, my research says this is dead wrong. Learn more about “Super Doctors” • http/www.superdoctors

Warrior or Victim?

So yes it may be true that as we age we are more likely to see higher LDL cholesterol scores and yes some families seem to have more incidents of certain diseases. But before we give up, let’s explore if it is possible to reduce bad cholesterol levels and improve the good one? Past research has shown a strong association between obesity and high blood pressure and poor lipid profiles. So if you are overweight, start by losing a little fat. If you are not overweight don’t assume that your pro-active options are inconsequential. It was once assumed that obesity was automatically tied to high LDL cholesterol and triglycerides. However, in a recent subgroup analysis, researchers studied subjects with higher GI impact models that had a BMI in an acceptable range and still have concerns with high triglycerides and LDL cholesterol. So while many patients with these maladies may be overweight or obese; this should not be the overlying suspect for high LDL/low HDL cholesterol and/or high triglycerides. Whether you are overweight or not; consider these natural helpmates as well: Being in charge of what you consume at least        80-90% of the time is a smart strategy. Give due diligence to the nutrition fact of the foods you consume and remember that sugar isn’t just from “sweets”. And while we are focusing on pro-active things: don’t forget that high fats and sodium can also impact inflammation which may impact your cholesterol and triglyceride scores. Think integrative and toss in some consistent exercise/activity to ensure you are doing everything you can to support your health goals.

These are the resources that provided the information that I used in this article and shaped my opinion: Emory University study published in the April 2010 issue of "JAMA •Dr. Yehuda Handelsman •American College of Endocrinology’s• Metabolic Institute of America


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