INTRODUCTION

If you want to maintain a healthy heart there are things you need to know about. It’s not just about cholesterol or triglycerides — it’s a combination of things. The kind of diet you eat, whether you are overweight, how active you are, whether you smoke, (if you do, you should quit) whether you have high blood pressure, whether you have high blood sugar. You can make a really good impact on your health by eating in ways that support your body.

Cholesterol level alone is not a problem. Damaged cholesterol and inflammation are the things that need to be avoided. In this book, I will explain how it all works and show you how to use diet to decrease your heart risk.

You’ve probably heard a lot about cholesterol and why you should lower your total cholesterol, or maybe you’ve heard completely the opposite and that cholesterol isn’t the problem anyway and you should eat all the fat and cholesterol you want.

It used to be that in the medical literature we just heard about the ‘good HDL kind’ the ‘bad LDL kind’. But now we hear about different kinds of LDL cholesterol too. We have the ‘the good’ large fluffy LDL kind –and’ the bad ‘small dense LDL kind. And I wouldn’t be surprised if you were confused about all of the different information that you hear.

I hope that this information will clear some things up and help you understand what you can do to protect yourself from blocked arteries and potential heart attacks.

CHOLESTEROL

What is Cholesterol?

Cholesterol is a molecule that is carried in the blood to the cells that need it. The molecule has 3 areas to it. One end can dissolve in watery type substances, the other end can dissolve in fat-like substances and the middle is made up of steroid type of substance and its used to make several hormones in our body. Even though it can dissolve in a watery type of substances, it can’t do this very easily and so it has to be taken through the blood on carriers called lipoproteins.

Here is a useless but interesting fact for you.

Cholesterol is not HDL or LDL. It’s the lipoproteins that are HDL or LDL. It stands for high-density lipoprotein and low-density lipoprotein. Cholesterol gets carried on HDL or LDL

LDL and HDL Cholesterol

Here’s a useful fact for you:

Most of the cholesterol in your body is made by your liver, and some are made by your brain. If you don’t eat it, you will make it because you need it. What you don’t need is lots of oxidized cholesterol floating about or stuck in your arteries combined with lots of underlying inflammation that you aren’t even aware about.

Why we need to have cholesterol

Cholesterol helps to keep your body together. Each cell in our body is covered by a membrane. The membrane is coated in cholesterol which helps keep cells rigid enough to stay in shape. This is called ‘cell integrity’. Without it, your body would dissolve into a watery mess.

To make many hormones the body needs. Cholesterol forms the hormones testosterone, estrogen and vitamin D. (Vitamin D is a hormone-like vitamin)

To allow your body to absorb fat-soluble vitamins. Cholesterol helps make bile. Bile allows fats to be absorbed into the bloodstream and carry fat-soluble nutrients like vitamin A D E K.

To allow you to think and learn and keep your mind as you age. Your brain is about 2% of your body weight but contains about 20% of your cholesterol. The brain synthesizes cholesterol for its use. Cholesterol is needed for your brain to form synapses that allow your neurons to fire.

Important types of cholesterol:

LDL cholesterol that is small and dense (called bad cholesterol)

LDL cholesterol that is large and buoyant (sometimes called the good — bad cholesterol)

HDL Cholesterol: The smallest of cholesterol molecules (called good cholesterol)

Why you need to take care of your cholesterol

Taking care of your cholesterol means preventing it from becoming oxidized or damaged. Cholesterol that is not damaged will not cause heart problems even if it’s the small dense LDL On the other hand, even HDL can create bad conditions for the heart if it’s oxidized, and certainly, the large fluffy LDLs can cause heart damage if they become oxidized.

LDL and HDL: What oxidation does

LDL cholesterol circulates in the bloodstream to be used by the cells that need it — keeping your cells firm, building hormones, making bile, helping your neurons fire.

The kind of LDL that is small and dense can easily cross out of the bloodstream into the cells that surround arteries. This bunch of cells is called the endothelial layer and it’s like a thick mat with tiny holes in it. The holes allow nutrients and oxygen to get to the arteries. Small dense LDL is tiny enough to pass into the endothelial layer.

Large fluffy LDL can cross into the endothelium too but it has a much harder time. That’s the reason that your doctor doesn’t want you to have too much LDL hanging around because this is the type that can hurt you but only if it’s oxidized.

The job of HDL cholesterol is to pick up LDL from the bloodstream and bring it back to the liver where it gets re-processed and used in bile. HDL also goes into the endothelial layer. It stops LDL from becoming oxidized, it removes LDL. HDL also helps to stop clots from forming.

What’s not so well known is that HDL can get oxidized too. So even though it’s the good kind, it can be harmful if damaged. And HDL can work against you if you have inflammatory conditions going on in your body. I know its bad news after everything we’ve been told, but nutrition science is always unfolding more information.

Apart from a diet that causes an inflammatory condition, some diseases promote inflammation too. Diabetes, Metabolic syndrome, Chronic Kidney Disease, Infections, Rheumatoid Arthritis all create inflammation in the body. But don’t despair because there’s a lot we can do about this with diet.

I hope that you are beginning to see why it’s important to do what you can to stop your cholesterol becoming oxidized and why you need to feed your body with lots of anti-inflammatory foods.

CHOLESTEROL LOWERING DRUGS

Cholesterol drugs, especially statins are very successful at lowering cholesterol levels. But there is no free ride with drugs. They are mainly metabolized in the liver and there is always a price to pay. Often people take one drug and wind up on another to offset side effects. Besides which it can set you back hundreds of dollars per month at times, especially if two people with a shared income need these drugs. It’s way better if you can avoid this by taking steps to keep your cholesterol and in good shape and your body free of inflammation.

Statins:

Statins are the most widely promoted drug to prevent heart disease and they are aimed at lowering your cholesterol. You will probably know these: Crestor, Zocor, Lipitor, Mevacor, Pravachol. By lowering your cholesterol, they also lower an important vitamin-like compound called CoQ10. CoQ10 is also a very powerful antioxidant.

Statins interrupt the process that makes cholesterol, so you will make less of it. In the process of interrupting this process, statins also block the pathway that makes CoQ10. Every cell in our body needs CoQ10. It’s involved in making cells work the way they need to so that you can have energy. It doesn’t give you energy, but the energy you have comes from the ability of your cells to create the molecule ATP, which IS energy. COQ10 helps do that.

CoQ10 is intimately involved in the process of creating ATP. It is involved in all kinds of activity to do with the way cells work, and coQ10 is found in large amounts in the heart. So….I think it’s safe to say, we want lots of it, and we don’t want to be NOT making it. The ability for us to make COQ10 gets less as we age, so add that on top of statins and you can see the problem.

Side effects of statins:

There are quite several side effects you might get with statins. These include nausea and vomiting, dizziness, drowsiness, cramping and pain in the stomach, diarrhea or constipation and sleeping problems. Muscle aches, memory problems, depression, being irritable, tingling and numbness in legs, vision problems, blood sugar changes, blood pressure problems, ringing in ears, breast enlargement, sexual dysfunction. There are more. If you have liver problems you shouldn’t take statins at all because of the damage that can occur. But I’m sure your doctor would check you out for that.

Here are a few incidental bits of information

If you do get muscle aches and pains: This can be a very serious side effect called rhabdomyolysis. This can affect major organs and you could die — so if it happens to get to your doctor immediately. Or it could be a lesser effect of not enough CoQ10. This is very common. You can buy supplements and I suggest you do it if you take statins.

If you are susceptible to headache or migraine: Statins can increase nitric oxide in certain cells along the sides of the head and behind the eyes. Nitric Oxide is implicated in triggering migraines.

If your sleep quality suffers: It can lead to weight gain and irritability. In tests where sleep quality and statins were studies, aggression scores increased.

There is new research coming out almost daily about the side effects of statins. Most recently, on the positive side Statins are shown to help delay the progression of Alzheimer’s. Why is this? Possibly because it’s preventing high levels of cholesterol in the brain. Lower levels of oxidized cholesterol in the brain then reduce plaque formation in the brain. Plaque in the brain is associated with Alzheimer’s.

Eating lots of fat-soluble antioxidants in the form of vitamin E will help keep brain cholesterol in good condition and pulling cholesterol out of your body will help to keep it lower. But here is something else to think about, another new finding is that taking a statin drug reduced — yes reduced the positive changes that exercise brings to your cardiovascular system.

Niacin

Niacin is considered a safe method of lowering cholesterol and apart from pharmaceutical drugs like Niaspan, Slo-Niacin there are a huge amount of niacin supplements you can buy over the counter to reduce cholesterol. One of the common problems with niacin is that it produces flushing of the skin but it is possible to buy no-flush niacin.

The question is, does it work? Well, maybe not. In February of 2012, a study of 25,673 people carried out by independent researchers at the University of Oxford reported that Niacin doesn’t reduce strokes or heart attacks. This was a trial drug that incorporated something to stop the flushing. The other problem is that the amount of niacin used for cholesterol reduction is monumentally higher than the RDA. And there are sometimes side effects. These side effects showed up in this study too. New-onset diabetes, diabetic complications increased and gastrointestinal problems increased. Significantly higher rates of bleeding and unexpected infection also occurred.

I have nothing against niacin, I’m just not sure of the safety of taking mega doses. The tolerable upper limit for Niacin is 35mg for adults. But the mega doses in supplements are way over the top: 2500% of the % daily value for example. Maybe this is what it takes to reduce cholesterol but there are side effects, and often niacin is combined with statins to reduce the amount of niacin and avoid the side effects. The most serious side effect is hepatitis. There are lesser ones, such as gout, decreased insulin sensitivity, eye problems, peptic ulcers. I can’t in all good conscience recommend taking such mega doses of vitamins. There are other ways to safely improve your heart health and reduce risk.

Bile-acid resins

These are fairly safe and are not usually used as stand-alone drugs. They are often combined with statins. All they do is trap bile in the gut and then you excrete it out. Normally bile gets recycled in the body but if you excrete it out then you have to make more of it. Since cholesterol is used to make bile, then cholesterol gets pulled from out of the bloodstream. You can do this very easily with fiber like psyllium and save yourself the cost of the drug.

Fibric acid derivatives

Tricor (fenofibrate) Lopid (Gemfibrozil). They are used to treat high triglycerides as well as to lower cholesterol. Unless you have a genetic problem triglycerides can be easily modified by what you eat and drink. The way they work is to reduce the carriers that transport triglycerides through the body. Cholesterol is carried on lipoproteins, and one that hasn’t been mentioned until now is VLDL or very-low-density lipoprotein. VLDLs and chylomicrons carry triglycerides. Fibric acid derivatives can irritate the liver, cause nausea, diarrhea, and gallstones; cause blurred vision, muscle pain, sore throat and stuffiness, numbness, sexual dysfunction and more. And again, it costs money. Unless you have a genetic problem, approaching this problem by making some simple changes in your diet is by far better.

Cholesterol absorption inhibitors

Wikipedia describes Cholesterol absorption inhibitors as a class of compounds that prevents the uptake of cholesterol from the small intestine into the circulatory system.

Zetia (ezetimibe). This class of drugs operates similarly to the bile acid resins. They are usually not used alone but are used with a statin and they stop the reabsorption of cholesterol from the gut via bile. Less cholesterol recycled means that more must be pulled from the bloodstream to be used where it is needed. Side effects are minor, except for rare cases of pancreatitis, muscle damage or hepatitis. You can use fiber in the same way you can you this drug with safer results.

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