Let’s talk about cholesterol.  A diet high in saturated fat was implicated as the main factor in heart disease, by causing hardening of the arteries or atherosclerosis. Much of this came from the findings of Ancel Keys in the late 1950s, who took only the information that supported his hypothesis.  Foods that are high in saturated fat are typically also high in cholesterol, and foods high in cholesterol became foods that should be limited.  Ancel Keys was so influential that an era of low fat was to follow, and to replace the fat, but keep the taste, high sugar content was added.  Was saturated fat really the problem? Below, we talk about the types of cholesterol, what cholesterol does in the body, the link between cholesterol, saturated fat and heart disease, and implications of interventions and medications used to treat high cholesterol.

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What is cholesterol?

Cholesterol is the precursor of the five major classes of steroid hormones, powerful signaling molecules within the body that regulate many functions within the body (11). Cholesterol is synthesized by our bodies, and is in every cell of the body. Cholesterol synthesizes Vitamin D from the sun, and Vitamin D deficiency has been linked to cancer, chronic disease, and just about every health issue you can imagine. Cholesterol plays an important role, but when it builds up in arteries it creates a problem.  Contrary to what most people think, only about 20% of the cholesterol in the body comes from what we eat (4).  The rest is synthesized by the liver, thus the connection between a diet high in cholesterol and cardiovascular risk has been disputed with only a few exceptions (5).  Interestingly enough, many people who suffer a heart attack have normal cholesterol levels, which is why heart disease is called the “silent killer.”

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Types of Cholesterol

HDL
HDL or high density lipoprotein is known as the “good” cholesterol because it takes excess cholesterol from the tissues and throughout the body and transports it to the liver for excretion. The APOE gene can determine whether or not you are able to influence HDL levels for the better through exercise (8).  The Genetic Direction Slim Test can provide this information. Use code LILRUNNER for $20 off.

LDL
LDL or low density lipoprotein is known as the “bad” cholesterol since it moves cholesterol from the liver and into the body, including into arteries where it can contribute to build up and plaques that can lead to clogged arteries, stroke, and heart attack (2).   Within low density lipoproteins, there are large, fluffy LDL particles and small, dense LDL particles. The small and dense particles are linked with a higher risk of heart disease.  A lipoprotein (a) test can determine whether or not LDL is oxidized, which is linked with a higher risk of heart disease (3).

WHAT ABOUT SATURATED FAT?

As noted above, Ancel Keys called out saturated fat as the main reason for heart disease and the culprit for clogging arteries causing heart attacks. Eating foods high in saturated fat was thought to raise blood cholesterol levels, and the result was heart disease.  This theory has been proven wrong on multiple accounts and studies on the basis that inflammation and lifestyle are to blame (13, 14).  Some of the foods that are known for being high in saturated fat and cholesterol such as eggs have been recommended to be eaten in limited amounts, but actually, eggs are known to be one of the healthiest foods to eat (6).  If foods that contain modest amounts of saturated fat and cholesterol are not the issue, what factors do cause a higher risk of heart disease? Lifestyle factors such as maintaining a healthy weight, exercising, not smoking, and eating a diet rich in vegetables and fruits and low in refined carbohydrates, sugar and alcohol are helpful lifestyle changes.  Additionally, eating fiber rich foods especially soluble fiber, drinking green tea, eating nuts and heart healthy avocados are great for your heart. Foods that are rich in Vitamin K2 help to move calcium in arterial plaques out into bones and teeth, so foods such as grass fed beef, liver, eggs, chicken thighs, and natto are good choices. Because coronary calcium has been shown to be a factor in heart disease risk, Vitamin K2 supplementation has been shown to reduce the risk of heart disease (9).  Arterial plaques are made up of fat, cholesterol and calcium, thus keeping a healthy body weight, healthy cholesterol level and consuming foods rich in K2 can help reduce arterial plaques.

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RISK FACTORS FOR HEART DISEASE
  • sedentary life style
  • high blood pressure
  • obesity
  • poor diet
  • smoking
  • diabetes
  • insulin resistance
  • stress
  • inflammation

All of these things have been noted as the risk factors for heart disease, rather than spotlighting cholesterol and saturated fat. Leading a healthy lifestyle is key.

treating high cholesterol with STATINS

Those with high cholesterol will often be treated with a drug called a statin.  Statins work by reducing the production of cholesterol from the liver by blocking the enzyme HMG CoA reductase(12).  Cholesterol has many important roles within the body making blocking the production of cholesterol questionable.  Taking statins can result in side effects such as muscle pains, Type II Diabetes, and brain fog, among other symptoms.  Could statins even be contributing to heart disease by inhibiting CoQ10, which has been shown to have a significant cardiovascular protective effect (10), and reducing K2, which protects the arteries from clogging? This study believes so (7).  Since high cholesterol is not the main factor in cardiovascular disease, taking a statin is not recommended, but rather lifestyle changes should be the first step to lower cholesterol levels and the risk of heart disease.

REDUCE YOUR RISK OF HEART DISEASE
  • Exercise
  • Maintain a healthy weight
  • Eat a healthy diet including antioxidant rich foods, fiber and phytonutrients
  • Limit refined carbohydrates, alcohol and sugar
  • Do not smoke
  • Eat foods high in K2 or supplement with this vitamin
  • Supplement with CoQ10 as directed by your healthcare practitioner
  • Aim for 8 hours of sleep each night
  • Keep stress at bay

In summary, studies have found that lifestyle changes can lower cholesterol to healthy levels, and lifestyle changes also reduce your risk of heart disease. LDL cholesterol is the red flag on your bloodwork if high, and measures can be taken to reduce LDL. Saturated fat, while found to be the culprit in heart disease for many years, has been

Sources

(1) https://www.ncbi.nlm.nih.gov/pubmed/19401122

(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586287/

(3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586287/

(4) https://www.ncbi.nlm.nih.gov/pubmed/22037012

(5) https://www.ncbi.nlm.nih.gov/pubmed/26109578

(6) https://www.ncbi.nlm.nih.gov/pubmed/16340654

(7) https://www.ncbi.nlm.nih.gov/pubmed/25655639

(8) https://www.ahajournals.org/doi/full/10.1161/hq0102.101819

(9) https://www.ncbi.nlm.nih.gov/pubmed/18367736

(10) https://www.longdom.org/open-access/coenzyme-q-for-cardiovascular-prevention-2329-6607.1000e125.pdf

(11) https://www.ncbi.nlm.nih.gov/books/NBK22339/

(12) https://www.ncbi.nlm.nih.gov/pubmed/12067471

(13) https://bjsm.bmj.com/content/51/15/1111

(14) https://www.ncbi.nlm.nih.gov/pubmed/26068959

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