Cholesterol Management
There are two types of cholesterol in the body, LDL cholesterol and HDL cholesterol. LDL is commonly referred to as the “bad” cholesterol and HDL is commonly referred to as the “good” cholesterol. Too much LDL is considered bad as it then becomes a major risk factor for cardiovascular disease. However, as you will see in the discussion below, it is a very important substance that is essential for life.
LDL cholesterol is required for several important bodily functions such as production of sex hormones (i.e., testosterone and estrogen), proper brain function and fat metabolism.
Most of the cholesterol produced in the body is synthesized in the liver and the brain. The nerve cells in the brain need cholesterol in the cell membrane to function properly. A shortage of cholesterol in these cells results in memory loss.
The cholesterol produced in the liver is required by the body to metabolize fats. When fat enters the body (i.e., butter), it is in the form known as a triglyceride, which is made of three fatty acid molecules attached to a glycerol backbone.
When the triglyceride molecule is broken down in the digestive tract, it is converted by the intestinal epithelial cells into a different molecule called a chylomicron which is then dumped into the lymphatic system and is carried through the lymphatic system into the portal vein and eventually deposited into the liver. The chylomicron is essentially a transport molecule that carries the fat to the liver for processing.
Once in the liver, the fat is processed (metabolized) and made ready for transport to the fat cells for storage or to the muscles to be burned for energy (muscles love to burn fat particularly in the resting state as well as during low intensity exercise).
To prepare the fat for shipment from the liver to the fat cells for storage or to the muscles for energy production, the fat is packaged by the hepatocytes (liver cells) into a new molecule called a Very Low-Density Lipoprotein (VLDL). The VLDL is comprised of some fat, some protein, and some cholesterol. The cholesterol is needed to make the VLDL molecule soluble in the bloodstream (so it will float in the blood and not settle out). The more fat you eat, the more cholesterol the liver will make to transport it out of the liver.
If cholesterol levels are inadequate or very low (usually due to cholesterol lowering drugs), the fat cannot be transported out of the liver and will accumulate in the hepatocytes, and the person will develop a life-threatening condition called Non-alcoholic Steatohepatitis (NASH) – also known as Fatty Liver Degeneration.
The VLDL is also a transport molecule. When things are working properly, the liver will dump the VLDL molecule into the bloodstream and the fat within the molecule will be transported to the fat cells for storage or to the muscles for energy production.
The most common cause of Fatty Liver Degeneration in developed nations is alcoholism (Alcoholic Steatohepatitis). However, the western diet with its high saturated fat and trans fat content is also a well documented cause as well as Diabetes mellitus, obesity, and severe gastrointestinal mal-absorption.
The major problem is that if there is too much saturated fat or trans fats in the body and the liver must produce much more LDL cholesterol in order to metabolize the fats. Of course, elevated levels of LDL cholesterol are a risk factor for the development of cardiovascular disease and is the reason why your doctor will prescribe cholesterol lowering medications (Statin drugs).
Research shows that 73% of people with elevated cholesterol do not actually require cholesterol lowering drugs. They can reduce their cholesterol to normal, safe levels with proper diet and lifestyle management.
The remaining 27% of people with high cholesterol do require these medications as they have been shown to have a genetic predisposition that cannot be corrected by diet and lifestyle.
Doctors typically will prescribe cholesterol medications universally to everyone with high LDL cholesterol because patients are generally unwilling to make the necessary diet and lifestyle changes required to correct the problem naturally. This leaves the doctor with no choice but to recommend the medications.
In order to manage cholesterol naturally, certain nutritional changes are necessary. Here is a starting point for those who are interested:
· Reduce saturated fat intake. This reduces the need for cholesterol and the liver will not have to produce as much. To reduce saturated fat, it means eating fewer red meats (lamb, pork & beef), less dairy products, less pastries, etc.
· Reduce trans fat intake. This reduces the need for cholesterol so the liver will not have to produce as much. Trans fats are man-made fats (chemical structure has been changed from the cis formation to the trans formation), and they are all very dangerous. Avoid completely, if possible.
· Reduce sugar intake as it can be converted into fat. It also contributes to increased inflammation in the body, which promotes cardiovascular disease.
· Increase intake of fresh fruit and vegetables. This provides soluble and insoluble fiber, which help remove cholesterol from the body via the fecal route and reduce your risk for developing colon cancer.
· Use ground flaxseed or psyllium husk fiber as a supplement to assist with elimination of cholesterol from the body.
· Participate in regular exercise. This increases HDL cholesterol production. HDL helps reduce LDL cholesterol deposits in your arteries by gobbling them up (like pacman) and carrying them back to the liver for processing and/or elimination. HDL cholesterol is part of nature’s plan to help keep LDL cholesterol levels within normal limits.
Patients requiring help creating a suitable cholesterol management program need only call our office for a complete evaluation.
