Dilemma of Cholesterol-by Dr harold Gunatillake

Is cholesterol a risk factor for heart disease?

Transcript: Doctor, I have a disease. What is that disease? Too much cholesterol in my blood. This you hear from many people in Sri Lanka when you visit the country on a holiday and stay with friends. A beneficial important steroid that is found in every cell life in the body required for body functions and wellbeing, formed in your liver, brain tissue, bloodstream and nerve tissue has been demonized over the ages.

Cholesterol is indeed manufactured in your body mainly in your liver serves beneficial events such as making hormones and vitamin D and supporting digestion, but it is possible that the large amounts of dietary saturated fats stored in the adipose cells as triglycerides, and excess dietary carbs converted to sugar being stored in the same adipose tissues as triglycerides through insulin intervention, maybe a factor in the metabolic process that can lead to heart disease, whilst providing energy to the body. They give rise to high cholesterol and triglyceride levels in your blood and may participate in the plaque buildup causing blockage of arteries.

Your liver generates enough cholesterol to handle the above tasks, but the problems arise when you eat foods such as meat, dairy and poultry among others that creates a problem, giving a bad rapport for cholesterol formed in your liver.

There is the good cholesterol called high-density lipoproteins (HDL) and low-density lipoprotein (LDL) becoming the bad one through oxidation in the bloodstream.

So, cholesterol is such a beneficial steroid that could be deadly to the body when you overdose through your diet. Through excess eating of carbs, dietary fats, including junk fast food, I emphasize.

Furthermore, high levels of cholesterol are not the only cause of coronary heart disease, and many people who have heart disease do not have high blood cholesterol levels.

Also, high levels of blood cholesterol, which is easy to measure, may not be the only cause of atherosclerosis- that is hardening of arteries and plaque formation. Now it is believed that it is more an inflammatory disease than cholesterol, causing the problem.

Heart disease is a metabolic issue and is only a symptom due to other factors, such as being overweight, having diabetes, having high triglyceride levels in your blood, and most of due to sedentary lifestyles, without much daily exercise and unhealthy lifestyles with added smoking.

Without saying cholesterol causes heart disease, it is more likely that inflammatory processes in the body cause heart disease. This inflammatory process is brought about due to genetic predisposition, bad lifestyles, and environmental factors like pollution that ultimately brings about heart disease.

Nevertheless, it is also true that dietary cholesterol may accumulate on plaques to block the arterial blood flow.

The plaque is a buildup of cholesterol, white blood cells, calcium, and other substances in the walls of arteries. Over time these plaques narrow the arteries, and the artery hardens. Plaques reduce blood flow to the heart muscle, which can cause angina symptoms.

Another factor that results in the hardening and thickening of your arteries, narrowing the channel through which blood flows is due to uncontrolled high blood pressure.

Now let us talk about eggs and cholesterol.

People have been deprived of eating eggs for many decades, because of the high cholesterol levels in them. The eggs were nicknamed ‘cholesterol balls’

Then they found that cholesterol in eggs and seafood such as prawns, and crabs do not influence the blood cholesterol levels, but it is the cholesterol from saturated fats that cause the problem.

So, in the dietary guidelines, dietary cholesterol was eliminated as a cause of heart disease, and it was declared that it is ‘no longer a nutrient of concern”

Most doctors prescribe statins to bring down the level of blood cholesterol when the heart disease could be due to other inflammatory processes brewing up in your body. In such situations high blood cholesterol could be an incidental finding and lowering the cholesterol levels through statins makes no difference to the disease.

On the same token, statins are proved to have anti-inflammatory properties against atherogenesis, meaning that in studies on animal models, it has been found that statins exert beneficial cardiovascular effects by suppressing vascular and myocardial inflammation.

Your liver makes most of the cholesterol and is made by most cells in your body for your body’s needs. They are carried in your bloodstream as spherical particles called lipoproteins.

The quality of these lipoproteins matters for heart disease.

Dietary cholesterol from fatty foods and carbs forms about 20 per cent in the bloodstream. It could get worse; depends on how much junk fast food you eat. It is these dietary fats that increase blood cholesterol that could give a bad reputation and contribute to the clogging of arteries with plaques and may lead to heart attacks.

Cholesterol is needed to make vitamin D, hormones-including testosterone and estrogen and fat-dissolving bile acids. This means the body needs cholesterol to create these hormones.

Cholesterol is a crucial building block and keeps the cell membranes soft for nutrients to enter them.

Dr Zach Bush explains that cholesterol keeps your double-walled cell membranes soft and flexible, increase the permeability of nutrients, and reduces the amount of cholesterol in the blood with statins will make this double-wall rigid. And in years the blood vessels will become rigid and will continue to have heart attacks.

We disagree with Dr Zach Bush. By taking statins you reduce the high level of cholesterol in your blood to the normal range. By doing that there is sufficient cholesterol in your blood to keep the double cell wall permeability intact. So, statins have a place in the management of heart disease.

For those who eat a well-balanced diet, meaning a plant-based diet with less meat, dairy, and have no metabolic disorders, excess dietary carbs are converted by the liver into complex chains of glucose called glycogen.

On the other hand, excess carbs intake places a metabolic load on the body is stored in fat cells, or adipocytes with fat as triglycerides, leading to weight gain, poor metabolic health, and an increased risk of heart disease.

When dietary fat is digested, they are broken down into fatty acids, passes through the lymph system and then throughout the body via your bloodstream to be used or stored for energy, cell repair and growth.

Eating more fatty food in your diet, the excess is stored in fat cells with excess sugar as triglycerides.

The liver is the major site for converting excess carbs and proteins into fatty acids and triglycerides which are stored in adipose tissue, meaning fat cells.

In addition to high cholesterol and high triglyceride levels in your blood, there are other risk factors for heart disease.

High blood pressure, diabetes, obesity and overweight, smoking, physical inactivity, gender where men are at a higher risk, Heredity, age.

Contributing factors are Stress, birth control pills, alcohol-Studies have shown that the risk of heart disease in people who drink moderate amounts of alcohol is lower than in

nondrinkers. Experts say that moderate intake is an average of one to two drinks per day for men and one drink per day for women. One drink is defined as 1½ fluid ounces (fl oz) of 80- proof spirits, 1 fl oz of 100-proof spirits, 4 fl oz of wine, or 12 fl oz of beer. But drinking more than a moderate amount of alcohol can cause heart-related problems such as high blood pressure, stroke, irregular heartbeats, and cardiomyopathy (disease of the heart muscle).

Let me now give brief footage about the misinformation of Statins,

Stephen Kopecky, MD from Mayo Clinic has to say about statins and heart disease.

These productions are educational to our people, but you should always discuss them with your family doctor if you have any doubts.

Stay safe. Goodbye for now.

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