January 4 | 2022 | Jeremiah Ridderbos
The plan is Over an extended period of time in this podcast, we will cover the individual cardiovascular risk factors. These risk factors are Age, family history, smoking, diabetes, dyslipidemia, sedentary lifestyle, obesity, hypertension
The CVD risk factor that we will cover today is dyslipidemia.
Dyslipidemia? – dyslipidemia is having an abnormal level of lipids within your blood. General recommendations suggest to Aim for having less than 200 mg/dl TC, and HDL above 60mg/dl or at least not below 40 mg/dl, with LDL below 130mg/dl. However, keep in mind that there is more than just the amount of cholesterol that accounts for CVD.
Cholesterol- Cholesterol is a nonpolar carbon compound with 4 hydrocarbon rings that has many functions in the human body such as cell membrane structure, hormone/steroid production (steroids such as testosterone, progesterone, aldosterone), Vitamin D production and it is also an essential component of bile acid. Cholesterol is picked up and transported around the body via lipoproteins since the nonpolar cholesterol cannot be transported in a polar, water-soluble environment by itself. Lipoproteins, are molecules that are made of lipids/fat and protein That transport triglycerides and cholesterol. There are several types of these lipoproteins that are commonly found in our bodies. While there are five of these lipoproteins, we will focus on only two, HDL and LDL.
HDL (high density lipoprotein) has a relatively high proportion of protein to fat compared with LDL. HDL transports cholesterol from within blood vessels to the liver and sort of cleans out the blood vessels. HDL is an antioxidant and is known to have anti-inflammatory effects. [i]HDL cholesterol is commonly thought of as “Good Cholesterol.”
On the other side we have LDL, low-density lipoprotein. LDL is a lipoprotein with relatively low proportion of fat to protein, making it less dense than HDL. LDL is formed from two other lipoproteins known as VLDL and IDL. LDL is not all bad, The function of LDL is to deliver triglycerides, cholesterol, phospholipids and other molecules to peripheral cells throughout the body. LDL also plays an important role in the immune system.
LDL receptors on cell membranes enable cells to take in cholesterol and other molecules delivered by LDL. While other lipoproteins (VLDL– very low-density lipoprotein/ IDL intermediate density lipoprotein) have receptors that are easily recognized by the liver (APOE &C) – allowing them to easily enter the hepatocytes (liver cells) via endocytosis – endocytosis is cellular uptake of large objects .LDL (ApoB) is less easily recognized by the liver and often times lingers in the bloodstream and can leads to higher blood lipid content. LDL is commonly seen as the “Bad cholesterol” since it is thought to be responsible for the buildup of plaque in the arteries.
LDL receptors are needed to uptake LDL from the blood to the liver cells. However, with certain genetic disorders, the hepatocytes don’t produce LDL receptors (or very few depending on whether the condition is heterozygous or homozygous) The lack of LDL receptors leads to a condition called hypercholesteremia. It is thought that high LDL can be lowered through diet and exercise. https://www.ncbi.nlm.nih.gov/books/NBK519561/
https://biology.stackexchange.com/questions/27543/why-doesnt-hdl-cause-diseases-like-ldl (atherosclerotic lesion) https://atpscience.com/cholesterol-facts/ https://atpscience.com/podcasts/episode-103-cholesterol-controversy-confusion-conspiracy-part-1/
As I mentioned before, dyslipidemia is having an abnormal level of lipids within your blood. General recommendations suggest to Aim for having less than 200 mg/dl TC, and HDL above 60mg/dl, with LDL below 130mg/dl. but, there is more to cholesterol than keeping LDL low and HDL high. Some will make the argument that cholesterol has an undeserved bad name.
It is common knowledge that the bad, LDL cholesterol is involved with plaque buildup in the blood vessels, but many people have a superficial understanding of how exactly plaque buildups start. To say that LDL causes plaque buildup in blood vessels would be an oversimplification.
A general overview of how plaque builds up starts with high blood triglyceride and glucose content as well as other damaging molecules which can cause many negative effects such as decreased endothelial function and inflammation. This inflammation, leading to oxidative stress, damages cholesterol (regardless of where it came from be it one’s diet or liver). https://biology.stackexchange.com/questions/27543/why-doesnt-hdl-cause-diseases-like-ldl
These LDL molecules, now modified by oxidation are detected by scavenger receptors on macrophages and brought into the macrophages via endocytosis. Macrophages will hunt down and engulf any debris that doesn’t indicate a healthy living substance. The LDL molecules are hydrolyzed or broken down by lysosomes (via lipases – enzymes that break down lipids) and the cholesterol then undergoes a process called re-esterification. It results in lipid droplets that have the appearance of foam. This contributes the formation of what are called foam cells. As foam cells increase cholesterol accumulation and inflammation, functional problems arise in the foam cells which lead to the apoptosis of the foam cell. When the foam cell ruptures, it spews in contents on the surrounding arterial wall, leading to the beginning of an atherosclerotic lesion. These lesions can be the beginning of plaque buildup in blood vessels. https://www.sciencedirect.com/topics/neuroscience/foam-cell
According to this explanation, the problem is not so much on the cholesterol as it is on the inflammation in our bodies which causes the oxidation of LDL in the first place. Some would argue that Cholesterol is not the problem, rather, it’s the oxidized cholesterol (caused by inflammation) that will cause plaque formation.
Regardless of one’s view on cholesterol, A diet that is suitable for decreasing inflammation and oxidation should be low in processed food such as pasta, cereal soda, etc. these contain a high amount of sugar. Fried foods can also cause much inflammation. A diet high in sugar can cause gut dysbiosis and bacterial problems and free radical production (via glycosylated end products). With a diet high in sugar, blood triglyceride levels will be elevated since your body prefers to use sugar as fuel vs fat.
A suitable diet for protecting against atherosclerosis is high in antioxidants. Food high in antioxidants are • Omega-3 rich fish,
• Beans,
• Whole grains are great for protecting against heart disease.
• Tea (contains antioxidants anthocyanin and pro anthocyanin)
• Sweet potatoes and orange vegetables (often very high in vitamins A and C)
•Dark green vegetables (high in vitamin C,E,A and many essential minerals)
• Nuts – have a great omega-3 FA content while each variety offers a unique benefit
• Red Berries
• Coffee contains polyphenols and natural anti-inflammatory agents can protect against inflammation as well.
• Blueberries are great for reducing damage and lowering inflammation as well as strengthening ones immune system and protecting against heart disease and cancer.
•Dark colored grapes are another great option for reducing oxidation, protecting against heard disease, cancer and boosting your immune system,
• Olive oil is also a great substitute in the kitchen, its very high in antioxidants as well.
https://www.webmd.com/food-recipes/features/10-super-foods
That concludes this episode on the cardiovascular risk factor – dyslipidemia
Journal Review 