Cardiovascular disease, cholesterol, and your health
Cholesterol has many uses within the body, and we get it either
through dietary sources or by our own
body’s production. In fact, human body manufactures 60 - 75% of its
total cholesterol for its own use. The body uses cholesterol as a
sort of “glue” to keep cell membranes from falling apart, and is one
of the building blocks for many of the body’s hormones such as
estrogen, testosterone
and cortisone. In the intestines, the cholesterol is a large
constituent in bile which emulsifies fats and allows them to be
absorbed into the body. Recent studies have suggested that
cholesterol may have a role in cell signaling and even antioxidant
properties.
High blood cholesterol levels seem to lead to the development of artery and heart diseases, but low cholesterol levels can be destructive to the body, with some recent studies suggesting a correlation between cancer risk and low cholesterol. The important aspect here is having a good, healthy balance with respect to cholesterol.
Cholesterol and arteries
In the lining of the larger arteries, excess cholesterol is deposited in pockets called “plaques” which will often become replaced with calcium over time. This process decreases the lumen size of the vessel and prevents the arteries from expanding and contracting normally, forcing the heart to work harder to pump blood through the body. Consequently, blood does not flow efficiently, limiting the nutrition and oxygen available to tissues and can lead to stroke, heart attack, high blood pressure and circulation problems in the legs and arms. Many studies have found that lowering high cholesterol levels can actually reduce the size and number of plaques and lower the risk of heart attack and stroke. With diligence in changing dietary patterns, this process can be halted and even reversed.
When testing cholesterol levels, the doctor will take a blood sample and order a “lipid profile” which lists the proportions of a number of different fats in the blood. LDL’s and VLDL’s are “bad guys” - proteins which carry cholesterol through the body and deposit excess in the arteries. HDL is the “good guy” – and have been found to carry cholesterol from other sites in the body (including arteries) to the liver where they are made into bile or broken down and used by the body in other areas. The number that the doctor will most often give you is all the types added together - total cholesterol. The doctor also measures the triglycerides in the body, but high levels seem to correlate even more highly with an increased risk of diabetes, than heart disease. These levels are best lowered by removing sugar and other refined carbohydrates from the diet.
There is some disagreement among various sources about the levels of the LDL’s VDL’s and HDL’s that are considered optimal for health. Based on present research, we prefer total cholesterol to be between 150 & 190mg/dl HDL’s should be 1/3 to 1/2 the total cholesterol. Because 60-75% of the body’s cholesterol is produced by the body, even with a cholesterol-free diet one could still be in the cardiovascular danger zone. In most cases however, a few changes in diet will significantly lower the blood cholesterol levels. There are other factors that can affect cardiovascular risk, such as homocysteine, and C-reactive protein, and studies have been suggesting that these and other cardiovascular risk factors are even more accurate in determining the risk for a cardiovascular event.
What can I do about my cholesterol level?
What about fats?
The body builds cholesterol most quickly from saturated fats and
decreasing these will reduce levels as
well. Saturated fats are the solid-at-room temperature ones such as
animal fats, plant oils that have been hydrogenated to make them
solid (margarine & shortening) and coconut and palm oils. Saturated
fats raise cholesterol twice as much as polyunsaturated fats
(oil-at-room-temperature fats). Unsaturated fats should be retained
in the diet. Olive oil is known to raise beneficial HDL levels while
saturated fats lower it. Fatty acid oil components are needed for
hormone synthesis, skin function, cell wall synthesis, and other
cellular processes. The best kinds of oils are cold-pressed soy,
sunflower, safflower, nut and flax seed oils.
What else can I do?
Besides reducing intake, another way to lower cholesterol levels is to increase its elimination from the body. This means more fiber in your diet. Cholesterol containing bile is secreted by the liver and carries fat to the side of the intestines where the fat is absorbed. The bile is then reabsorbed just before the small intestines empty into the large intestines. If the re-absorption of bile is reduced, it gets excreted in the feces along with the cholesterol it contains. The liver will then use stored cholesterol to make new bile. Oat bran and apples are especially good absorbing agents, but evidence suggests that increasing fiber of any kind in the diet will decrease cholesterol levels. We define fiber as the undigestible cell walls of the plants that travel through the gut unchanged, so that any whole, unrefined plant will work - vegetables, grains and beans. The process of refining grains removes most of the fiber. Use whole grains and be liberal with consumption of beans. Half-a-cup serving of cooked pinto or navy beans daily can lower LDL cholesterol levels by 20%. One tablespoon of ground flax seeds mixed in yogurt or dilute fruit juice in the morning can also be beneficial.
Cardiovascular Risk Factors and Micronutrients
During the 1960s and '70s, research scientists examined the
relationship between micronutrient deficiencies and heart disease,
but it wasn't until recently (the past 10 years), when research
steadily
accumulated with results so compelling, many clinicians now
include nutritional intervention in their treatment and prevention
of this disease. This exciting research confirms what earlier
scientists suspected: vitamin deficiencies contribute to the
processes leading to the development of cardiovascular disease.
These include B6, B12, and folate which are required for proper
homocysteine metabolism. Intracellular deficiencies of these
specific B-vitamins are responsible for 70% of the cases for
hyperhomocysteinemia. Other micronutrients include calcium and
magnesium for their role in maintaining the normal function of the
heart muscle; antioxidants for their role in scavenging free
radicals which have been shown to cause cellular damage contributing
to heart disease, and a number of other micronutrients.
Homocysteine, Lipids and Proteins
In addition to well-known risk factors, other proatherogenic factors have been identified which contribute to the development of atherosclerosis:
- Elevated homocysteine status
- Elevated LDL cholesterol (the "bad" cholesterol)
- Elevated lipoprotein(a) status
- Elevated c-reactive protein status
- Elevated apolipoprotein B status
- Low apolipoprotein A-1
- Low apolipoprotein B
- Low HDL cholesterol (the "good" cholesterol)
For more detail about what these factors are, click here.
Medical findings support the health benefit of laboratory testing to improve the assessment of risk, particularly in persons with a personal or family history of cardiovascular disease. Coronary heart disease is the number 1 cause of fatality in the U.S.; stroke is number 3, and the leading cause of serious, long-term disability. But early detection and treatment can make a big difference in reducing cardiovascular risk and thus, improving one's health.
Studies have associated moderate elevations in homocysteine with coronary heart disease, MI, cerebrovascular disease, carotid intima-media thickness, lower extremity arterial disease, and isolated systolic hypertension. Since homocysteine metabolism depends on B vitamins as cofactors, the relationship between B vitamin status, homocysteine levels, and atheroclerosis has been the focus of many investigations. Early detection of deficiencies is a critical step in disease prevention. At DC Canyon, we have a cardiovascular profile which includes homocysteine, and can detect functional deficiencies of vitamins B6, B12, folic acid, calcium, and magnesium, as well as total antioxidant function.
At DC Canyon Health and Wellness Center, we can perform these important tests and others to determine a very accurate cardiovascular assessment, and in turn, a very comprehensive treatment plan. Please call us if you have questions at 623-215-4107.