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May 28, 2023 18 mins

Cholesterol has been touted as the leading cause of heart disease, the leading killer in America, which would make it public enemy #1. But what if cholesterol is not the main culprit? Compelling data shows that may very well be the case. Listen on and find out!

 

Show Notes:

4:40 - Is atherosclerosis caused by high cholesterol? - https://academic.oup.com/qjmed/article/95/6/397/1559536

7:44 - Endothelial Dysfunction, Oxidative Stress and Inflammation in Atherosclerosis: Beneficial Effects of Statins - https://www.ingentaconnect.com/content/ben/cmc/2007/00000014/00000002/art00011

8:40 - Statin Therapy: Review of Safety and Potential Side Effects - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126440/

9:48 - Psychological stress, immune response, and atherosclerosis - https://www.researchgate.net/profile/Hongfeng-Gu/publication/221805408_Psychological_stress_immune_response_and_atherosclerosis/links/5d418723a6fdcc370a6fb5a4/Psychological-stress-immune-response-and-atherosclerosis.pdf

10:41 - Psychosocial stress and atherosclerosis: family and work stress accelerate progression of coronary disease in women. The Stockholm Female Coronary Angiography Study - https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2796.2006.01759.x

11:37 - Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women - https://academic.oup.com/ajcn/article/80/5/1175/4690419

12:00 - Gut Microbiota in Hypertension and Atherosclerosis: A Review - https://www.mdpi.com/2072-6643/12/10/2982

13:07 - Microbial trimethylamine-N-oxide as a disease marker: something fishy? - https://www.tandfonline.com/doi/full/10.1080/16512235.2017.1327309

13:51 - The Gut Microbiota and Its Implication in the Development of Atherosclerosis and Related Cardiovascular Diseases - https://www.mdpi.com/2072-6643/12/3/605

Mark as Played
Transcript

Episode Transcript

Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
welcome to Primedy where we find simple techniques to address modern problems for
our primitive bodies my name is Andrew Pafford and I'm a health and wellness professional with
over a decade of experience helping Olympic level athletes desk jockeys and seniors achieving their
goals and improving their quality of life today I wanted to talk a little bit about cholesterol
cholesterol has a bit of a stigma around it since it is closely tied to heart disease given that

(00:26):
heart disease is the leading killer of people in the U.S and one in five adults will die from
heart disease it seems fair to say that it is too important of a topic to pass up and not talk about
the good news is that number has been declining over the years so a fair bit of Headway has been
made however as cholesterol truly the evil it has been painted to be

(00:49):
what lifestyle choices cause our cholesterol to truly become elevated are there ramifications
from using drugs like statins for the sake of keeping one's cholesterol down and does
treating cholesterol levels with medication even reduce your chances of getting heart disease
before we get too far ahead of ourselves I want to reiterate I am not a doctor nor do I play one

(01:10):
on TV or the internet so please do not change any medication you might be on without consulting your
doctor first we are discussing lifestyle factors that are certainly within your purview to change
but we cannot take into account your allergies special considerations Etc so please consult with
the appropriate professional prior if you have any doubts now let's get down to Brass tax and

(01:34):
investigate first what is cholesterol cholesterol is a naturally occurring fatty waxy compound in
our bodies that serves many functions it is the critical backbone for hormone production
certain cells utilize it for cell construction our brains use it to communicate with our body
our nerves use it to transmit signals quickly basically without it we'd very likely be debt

(02:01):
but like most things that we need to survive too much of anything can kill us too much water can
kill us too much oxygen can be toxic as paracelsus is credited with saying the dose makes the poison
as with cholesterol too much could be a problem cholesterol is categorized into a couple different
groups based on its size high density lipoproteins hdls intermediate density IDL low density LDL and

(02:31):
very low density vldl and your more free form version or triglycerides denser the particles
the smaller it is so high density lipoproteins are actually the smallest and vldls are the largest
these categories are established as when blood is sampled the size indicates how the cholesterol is

(02:54):
currently being utilized by the body hdls for example serve the function of removing
cholesterol from the blood and transport it to the liver for processing and removal
ldls transport cholesterol from the liver to cells where it needs to be utilized for cell functioning

(03:15):
so on paper these seem like totally fine normal operating procedures with the checks
and balances system in place one to remove and one to add one system to utilize cholesterol
for functioning another to remove it if there is excess this is part of the reason why why
hdls are considered good and ldls are considered bad if high cholesterol equals heart disease then

(03:42):
having higher hdls which remove cholesterol would stand to reason that any excess cholesterol that
could be causing damage would be eliminated whereas having higher ldls would be adding
cholesterol to the body or being utilized potentially being laid down in arteries causing
atherosclerosis and heart disease after enough people started succumbing to heart disease and

(04:05):
autopsies revealed plaque buildup in the arteries atherosclerosis that led to Heart failures they
found that these plaques to have Fair amounts of cholesterol as their makeup thus if too
much cholesterol is leading to plaque generation anything that removes cholesterol from the body
and blood hdls must be good and anything that allows for cholesterol deposition in the body ldls

(04:31):
must be bad as always however reductive reasoning seldom takes into account the bigger picture
take for example this compelling piece of literature called is atherosclerosis caused
by high cholesterol by you ravenskov in it a number of articles are cited and discussed
revealing that there is seldom a direct causality shown between LDL levels and atherosclerosis

(04:58):
in autopsies performed on individuals who had presented with aortic atherosclerosis
their LDL or total cholesterol levels had weak or inconsistent correlations
the degree of coronary atherosclerosis as seen on angiography which is typically used to
screen or C the amount of cholesterol buildup or plaque build up on someone

(05:22):
also had weak correlation with cholesterol levels and no correlation after excluding
patients who were already on statin drugs more later on why these may or may not be helping
what's more is the exposure response section of the literature said in 16 trials that sought an

(05:43):
angiographic response meaning that they could visually see the plaque changing in the body to
an exposure of LDL interventions including drugs exercise Etc out of the 16 trials only two found a
correlation of exposure response of which several explanations could be offered to explain why

(06:03):
the biggest mental shift that I'm looking to instill is cholesterol may not be the direct cause
of atherosclerosis however it could be a wonderful indicator of being at risk for atherosclerosis
for example having a bacterial infection can typically lead to a fever the bacteria is what

(06:25):
can kill you and the fever is how we can tell you are sick saying you're going to treat the Fever by
simply bringing the temperature down is not going to help stop the bacteria it is a sign a symptom
the fever is not causing the bacteria in this case there's a lot of evidence to question whether the
cholesterol levels are truly the cause of heart disease and could in fact simply be an indicator

(06:50):
or symptom another argument if hdls are removing cholesterol from the body and that's a good thing
however why is there so much cholesterol in the body that needs removal warranting these high
levels of HDL that would seem like an indicator that if someone has consistently high levels

(07:11):
of HDL and there seems to be a consistent environment where cholesterol is too high
that warns those hdls to always be needing to eliminate it in that sense that doesn't seem good
that the cholesterol is always needing to be purged and the scale has been tipped too far
to one side for too long now I want to double back and address a loose thread that we left

(07:35):
behind that we need to discuss and that is cholesterol controlling drugs or statins
statins are often prescribed to lower cholesterol levels however the data shows that they also have
pleiotropic properties or rather it actually has multiple effects of the body statins have
been observed to exhibit and I quote the article cited in the show notes Improvement of endothelial

(07:58):
function stability of atherosclerotic plaques decrease of oxidative stress and inflammation
and inhibition of thrombogenic response this means that there are a number of factors
that make statins uniquely equipped to handle atherosclerosis and not simply because it could
potentially lower cholesterol levels it could also be lowering the levels because it addresses all of

(08:23):
those other factors at the same time improving the environment thus needing or thus allowing
the lowering of total cholesterol however magic pills don't exist in statins are no exception
for starters they have their own fun little side effects like reports of giving people diabetes
or rhabdo Rhabdomyolysis is when your muscles basically Fall Apart then of course there's always

(08:48):
the cost of taking medication but what I want to double back and shine light on is the fact that
these pleiotropic properties included decreasing inflammation and oxidative stress and therein
lies some potential for us to capitalize on in terms of at-home strategies that we can employ
remember medication given for lifestyle factors doesn't change the lifestyle that could be

(09:12):
causing the problem in the first place as long as people are quote unquote taking the poison
they'll need to continue taking the antidote so without correcting the underlying cause
leading to elevated cholesterol then statins would invariably become a permanent fixture so what are
these lifestyle factors that we can change for starters we often say mind over matter but when

(09:36):
it comes to trying to explain this application in the real world it can come across as Hokum
however there is data that exists that can help bridge the gap and explain them
piece called psychological stress immune response and atherosclerosis discusses how stressors can
lead to an immune response which in turn leads to atherosclerosis try and briefly describe this

(10:01):
process a stress response to anything public speaking mean boss jerk drivers
Etc increases systemic levels of interleukins and other inflammatory markers and pathways
showing a direct link between mental stress and systemic inflammatory response in the article
they do a deep mechanism dive into the various other Pathways that stress triggers an immune

(10:26):
slash inflammatory response additionally they cite a couple of other studies done in monkeys
that the more unstable their condition AKA more stressful the greater their atherosclerosis
further they cite research showing that psychosocial factors including hostility type

(10:46):
a behavior personality depression and job stress may also be correlated with atherosclerosis in
humans ever hear stories about people Keeling over at work and saying how the stress finally got them
they're not lying stress literally creates a physical mechanistically observable chain reaction
that ends with it manifesting itself as plaque along your artery walls needless to say a Statin

(11:14):
drug does not remove those stresses from your life buying yourself time with medication might be a
good thing but as long as those stressors are still there so too will be the danger
what then about diet and cholesterol many are told to reduce fat which basically becomes cholesterol
in order to lower cholesterol levels there seems to be a lot of hair splitting over saturated

(11:40):
monounsaturated and polyunsaturated fats as to whether certain ones are better or worse for heart
disease and while saturated and trans fats are shown to definitely be bad news it seems even the
articles that try to focus on the different types of fat and the relationship to atherosclerosis
can't help but tie it back to inflammation and oxidative slash antioxidant stress

(12:06):
but more and more literature is also starting to focus on the relationship with gut microbiota and
atherosclerosis not only with the relationship to hypertension but also microbes process components
in food like carnitine and choline creating a compound that is finely oxidized by the
liver to create salt something called tmao trimethylamine and oxide whose levels are

(12:33):
independently linked to cardiovascular disease heart attack stroke and other forms of mortality
these components in food are typically found in animal products leading to the advice that
people at risk for heart disease should reduce red meat consumption this is not necessarily
due to the red meat itself but rather how our gut microbes or certain species of microbes

(12:54):
process the food and subsequently that the microbes metabolites are then absorbed by our
body and processed further money the waters not all microbes appear to be complicit in the process
another piece of data discusses how tmao levels might be similar to cholesterol and that they
are not the issue but rather an indicator or symptom of some other underlying cause

(13:21):
the example of how Seafood typically touted for its beneficial and heart protective properties
often have higher tmao levels than red meat and yet are not villainized like red meat products
the author's explanation dysbiotic gut microbiota or rather the wrong type of gut microbes taking

(13:43):
Roost in your gut that love to process red meat and make bad metabolites for us to process
additionally data shows that certain microbiota can release neurotransmitters to our central
nervous system that are in charge in charge of blood vessel muscle tone which dictates
our blood pressure coupled with the fact that certain strains are correlated with

(14:07):
low-grade systemic inflammation this can lead to blood vessel wall damage since blood clots
are stickier so to speak the appearance of blood clots on the cell walls for repairing cell wall
because of damage of hypertension makes it easier for plaques to form leading to what
are called atherosclerotic thrombocytic events AKA platforms on blood on blood clots that are

(14:33):
on the inside of your blood vessel walls the Common Thread tying all of this together is
inflammation or rather a case or multiple causes of chronic inflammation leading to damage of the
blood vessels and allowing for plaque to form this means dietary intervention dietary interventions
meaning to correct the gut microbiome population can have positive effects on blood pressure

(14:59):
and blood markers that have been associated with atherosclerosis eating fermented foods that are
known to be probiotic to help correct gut microbe populations would likely have beneficial effects
and fibrous foods and foods known to be Prebiotic to help maintain those healthy gut populations
stress management techniques that we've discussed in previous episodes have shown to have positive

(15:23):
effects on lowering blood pressure this can help correct the hypothalamic pituitary adrenal
axis so that is the major driver in hormone regulation and secretion throughout the body
if stress being able to be made manifest is a problem the Stress Management can in turn be the
solution that is to say our lifestyle choices and environments are likely the very things leading to

(15:48):
our ailments which means that they are also the very means to correct them expected to take a
pill in hopes that everything will be remedied might very likely be an exercise in futility
now we've covered a fair bit of info today so as always I like to recap and drive the finer
points home and give you some actionable steps to walk away with number one cholesterol is often

(16:12):
demonized for being a cause of atherosclerosis but many pieces of literature show that these
correlations to be weak changes in number two changes in cholesterol levels might actually be an
indicator rather than a cause of atherosclerosis three sentence might be working in other ways to
control underlying causes of cholesterol and not necessarily the cholesterol levels themselves

(16:36):
four many signs are showing chronic systemic inflammation is a strong cause of atherosclerosis
five stress has shown to have physical mechanisms via the HPA axis leading to inflammation and
psychological stress that can accelerate atherosclerosis six diet can contribute to

(17:01):
atherosclerosis not by the means that we think but because of poor gut microbiome that can contribute
to hypertension and inflammation and from other inflammatory causing Foods seven stress management
techniques can reduce hypertension and help balance the HPA axis eight eating fermented
at Prebiotic foods can improve gut micro diversity and subsequently be a step in improving conditions

(17:27):
that would otherwise lead to atherosclerosis and so meditation and healthy healing may sound
a bit reductive in terms of being able to solve all of your woes but here is clear data that is
beginning to emerge to prove just that our bodies are fascinating complex machines it can sometimes
fail in fascinatingly complex ways often we find that we are our own enemies and ultimately that is

(17:54):
the root of our own problems and it's up to us to correct it we thank you for taking the time
to listen to Primedy your interest in health and wellness means the world to us so we would greatly
appreciate it if you would send us your questions comments concerns and feedback to info primedy.org
you can also leave us reviews on YouTube and on your podcast platform of choice as always strength

(18:17):
comes in many forms from within and without so be strong to be useful until next time stay strong
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