The CHOLESTEROL Myth & What Causes HEART DISEASE

This comes directly from my frustration of explaining to dozens of people every week, coming to me for consultancy or personal training, the facts about cholesterol, fats, sugars and heart disease. I thought it was better to write an article about it to help them understand better.

Every time a person comes to me who is suffering from obesity in a bid to lose weight I observe these common phenomenon :

9 out of 10 times his lipid profile (LDL, HDL, Triglycerides) is out of whack ,
9 out of 10 times he has low energy levels & lethargy,
6 out of 10 times he has high or borderline high blood pressure,
10 out of 10 times he is having a diet HIGH in carbohydrates or sugar,
10 out of 10 time he is trying to eat a diet super LOW in dietary fat.

My immediate actions steps for them :

Introducing weight training
Getting the carbs lower and increasing dietary FAT intake

However, before I complete my second recommendation, I am faced with a flabbergasted reasction of “But fat intake gets you fat” or “Fat intake (special mention to egg yolk) causes cholesterol which causes heart attack” !!!

“My dear friend, you have already been eating a diet low in fat !!! Then why is your cholesterol high ? Why is your LDL up and HDL low? Why are your triglycerides up & why are you still fat ?

Buddy, you’re at a much GREATER RISK of having a HEART ATTACK now than you will be when you will LOWER YOUR CARBOHYDRATES and INCREASE YOUR DIETARY FAT intake !!!”

Let’s break this down….

First of all, I want you to understand that CHOLESTEROL is a good thing. Cholesterol is a versatile compound produced by the body that is vital to the function of the human body. Cholesterol serves extremely important functions like:

1. Cholesterol is used by the body to manufacture important hormones like testosterone, estrogen and cortisone. That is why men who have low cholesterol often suffer from low testosterone. And introducing saturated fat in the diet helps them at that point to increase total cholesterol and hence testosterone production.

2. Cholesterol helps the liver produce bile acids. These acids are essential for digestion of fats and ridding the body of waste.

3. Cholesterol acts to interlock “lipid molecules,” which stabilize cell membranes. Therefore, cholesterol is a vital building block for all bodily tissues. Lowering such a vital molecule is absurd. To illustrate, imagine that your house represents your body and the nails holding it together, cholesterol. Now start pulling just a few nails out of the house. What happens? The house turns to a pile of rubble. The same is true for the human body.

4. Most notably, cholesterol is an essential part of the myelin sheath. The myelin sheath, similar to the coating on copper wire, ensures that the brain functions properly by aiding the passage of electrical impulses. Without the myelin sheath, it is difficult to focus and we can lose memory.

5. And finally, cholesterol has beneficial effects on the immune system. Men with high cholesterol have stronger immune systems than those with low cholesterol.

From the above list, it is evident that Cholesterol is a good thing, infact advantageous and important for the body, lowering such a vital compound is absurd. The total cholesterol in itself is not so much of a worry if the TOTAL CHOLESTEROL:HDL ratio is good. Having a diet high in saturated fat has been found to increase total cholesterol but there’s nothing to worry about when the HDL is maintained high (which happens by intake of essential fats like OMEGA-3) so that the TOTAL CHOLESTEROL-HDL ratio maintained. Normally an HDL value of between 40 to 60 is considered good for heart as HDL takes away the cholesterol deposits from the walls of arteries (discussed later). Points to remember before you start the panic on the mention of having more fats in the diet (and I normally include saturated fats as well as unsaturated fats like omega-3) for my clients. J

Please have a look at the REAL CASE STUDY of my client Dildeep Singh, who was put on a ketogenic diet and was having all kinds of saturated fats like ghee, butter, cheese and egg yolks in his diet. The BEFORE & AFTER lipid profile reports show a marked difference in all parameters like total cholesterol, total cholesterol to HDL, LDL & triglycerides values.

So now the question is, that if cholesterol is not bad then what causes a heart disease ?

The primary cause of coronary heart disease (which causes a heart attack) is INFLAMMATION of the coronary arteries (the arteries which carry oxygenated blood to your heart). Before I move on to explain what is inflammation, let’s see what is atherosclerosis.

Atherosclerosis is an inflammatory response initiated by damage to the innermost layer (known as the endothelium) of the arteries, which faces the bloodstream.

Atherosclerosis is a disease which causes narrowing of the walls of the arteries which is characterized by plaque build up. This plaque build up inside the arteries results in blockage of the blood flow or sometimes formation of blood clots. This plaque & blood clots can result in partial or complete blockage of blood flow. When all this happens inside the coronary arteries, it is called CORONARY HEART DISEASE which is the main danger as it can lead to a heart attack.

As we see here that the underlying cause of blockage is the plaque build up. Let us see how this plaque is built up:

Once damage occurs to the inner layer of the coronary artery, the body’s natural repair mechanism takes over. This mechanism begins with circulating levels of low- density lipoproteins (LDLs) into the damaged area. Let me stress that this occurs whether a person has high or low LDL-cholesterol !!!

Once LDLs move into the damaged area of the endothelium, there is an inflammation response initiated by the body (inflammation response is a protective response of the body). This attracts the immune cells to the damaged site. This, in turn, produces growth factors, which cause muscle cells to multiply and invade the damaged area of the blood vessel. Eventually, the conundrum of LDL, immune cells, muscle cells and debris from the initial damage form “plaque.”

So as we see above, the primary cause of plaque build up is inflammation of arteries, and this plaque formation can happen, whether a person has low or high LDL levels, we are getting closer to the point of understanding that it’s not the cholesterol, but inflammation that is the primary cause of the blockage, which causes heart attack.

Now the question is : WHAT CAUSES INFLAMMATION IN THE BODY?

Inflammation is not just restricted to the arteries, but every cell of the body, and the prime cause of this is SUGAR !!! SUGAR IS INFLAMMATORY. Imagine spilling sugar syrup on your keyboard and see what happens. Inside the body also, sugar does similar things. People with chronically high sugar levels (Type-2 diabetics or even pre-diabetics) are suffering from inflammatory stress in the body. That is why injuries or wounds in diabetics take longer time to heal and surgeries become critical !!!

And when I talk about sugar here, it is not only the refined sugar in the diet but also the excess intake of all carbohydrates in the body, which leads to chronically elevated blood sugar and insulin levels in the body.

So a person (specially a sedentary person) having predominantly excess carbohydrates and sugar in the body, even if taking a diet low in fats, is still at a greater risk of heart disease even though his saturated fat intake is low. That is why a Type-2 diabetic is at a greater risk of having a heart attack. This is due to inflammation of arteries. And since this inflammation is not only limited to arteries but every cell of the body, often these people suffer from lethargy and low and energy levels due to inflammation in the intestinal cells, which restricts proper absorption of vital nutrients like vitamins & minerals in the body and the hormones get affected leading to lethargy.

This inflammation or damage to arterial walls can be caused by a few other factors as well like :

High intake of Omega-6 fats (like vegetable oils, soybean oil etc)
High intake of alcohol
Smoking
High free radical damage
Increased cortisol (ie stress)
Lack of vitamin C and other anti-oxidants

BLOOD TESTS

If you really want to know the true health status of your cardio-vascular system that a mere LIPID PROFILE will not give you the true picture. A couple of blood tests that need to be added are :

HbA1c (Glycated Hemoglobin) : HbA1c test is an indicator of how well the sugar levels are controlled in the body in the span of 3 months. The excess sugar molecules bind with hemoglobin and the resultant molecule is called GLYCATED HAEMOGLOBIN. The life span of this molecule is 3 months. The normal value of HbA1c is 6. Anything more than that means the sugar levels are chronically elevated beyond normal in the last 3 months.
C-Reactive Protein : This test indicates the level of inflammation in the body. This substance is produced by the liver which increases in the presence of inflammation in the body.

In the next blog, I’ll write about the lifestyle factors for prevention or reversal of heart disease !!!!

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See you in the next blog.

Train Fierce !

Abhinav