Cholesterol under control!

Cholesterol is essential for human life. It is not only a necessary component of cell membranes, but also an important starting material for the production of sex hormones in the adrenal grands, ovaries and testicles. In addition, vitamin D, which is so important for our metabolism, is formed from cholesterol under the skin. Most cholesterol is needed for the production of bile acid in the liver. Due to the many functions of cholesterol in the body, it is also able to produce cholesterol itself. This means that 90% of the daily amount of cholesterol needed is produced by the liver. In contrast, only 10% of total cholesterol is absorbed with food.

Cholesterol is a fat-like substance and, like triglycerides and long-chain fatty acids, is insoluble in water, i. e. it cannot circulate freely in the blood (blood consists of 70% water). Therefore, the fats are transferred to a water-soluble form, the so-called lipoproteins.

The exogenous metabolic pathway
Dietary fats absorbed through the intestine – cholesterol, triglycerides and long-chain fatty acids – are packed in lipoprotein shells in the intestinal wall and thus enter the vascular system via the lymph channels. From there they are distributed throughout the body. With the help of enzymes, triglycerides and individual fatty acids are broken down, which are needed for energy production and various metabolic processes. The remaining residual particles are absorbed by the liver.

The endogenous metabolic pathway
The liver produces various lipoproteins from the residual particles, among other things LDL cholesterol. The LDL is absorbed into the cells via special LDL receptors found on almost all cell types and thus removed from the bloodstream. Unfortunately, the absorption of LDL cholesterol into cells is not unlimited. If the supply of cholesterol from the blood exceeds the needs of the cells, the LDL receptors on the cell surface are reduced and the cells absorb less and less LDL cholesterol from the blood.
As a result, a large part of the LDL cholesterol present in the blood oxidizes and is absorbed by the immune system’s scavenger cells (macrophages). So-called “foam cells” are formed, which contain large amounts of cholesterol. Over time, these cells die off and release cholesterol crystals, which promote the deposition of plaques in damaged vessels – arteriosclerosis develops.

HDL cholesterol is formed in the intestine and liver as well as in the blood while metabolizing other lipoproteins. These can – and this distinguishes them from other lipoproteins present in the blood – absorb oxidized LDL cholesterol and transport it back to the liver, where it is then used to produce bile acids.

Primary and secondary lipometabolic disorders
Approximately 30 percent of diagnosed hypercholesterolaemia are primary or familial hypercholesterolaemia. Primary or familial hypercholesterol anaemia is attributed to a gene defect. This gene defect causes fewer LDL receptors to be formed on the cells and thus reduces the absorption of cholesterol into the cells – with the result that the LDL concentration in the blood rises rapidly. 
Often, however, an elevated cholesterol level is secondary. The reason for this may be, for example, a nutrition that is too rich in fats, which in particular contains too many saturated fatty acids and trans fatty acids. But a nutrition high in carbohydrates and low in fiber also contributes to this. Diseases such as hypothyroidism, diabetes or renal dysfunction can also cause elevated cholesterol levels. Furthermore, medication such as cortisone, antihypertensives or beta-blockers are suspected of having a negative effect on cholesterol levels.

What role does nutrition play?
Dietary and lifestyle changes are core elements of prevention and treatment of dyslipidemia.
In general, a nutrition that is simply low in cholesterol is not recommended. The cholesterol in food usually has only a small effect on blood levels. It is much more important to have a balanced nutrition in which, besides high-quality vegetable omega-3 oils, sea fish, lots of fresh vegetables, herbs, fruits, as well as high-fiber foods are on the menu.

Influence of carbohydrates on cholesterol levels
A low-carbohydrate nutrition has a positive effect on blood lipid levels and cholesterol. This was observed by scientists in a study of nearly 180 overweight middle-aged men. In the subjects who only met their energy requirements with carbohydrates for a quarter instead of a half, the harmful triglyceride levels and unhealthy LDL cholesterol in the blood already showed a decrease after three weeks. This effect was also observed if the participants did not lose weight.
The explanation for this is provided by the metabolic intermediate product acetyl-CoA. It is produced during the breakdown of carbohydrates, fats and proteins, is needed for energy production and at the same time is also the starting substance for the body’s own cholesterol synthesis. With a high consumption of carbohydrates, especially those with a high glycemic load, more acetyl-CoA molecules are formed, which then stimulate cholesterol formation when no energy is needed, for example in the form of exercise and activity.

Vegetables – cholesterol-lowering
Fiber-rich foods, which are mainly rich in soluble fiber, such as apples, pulses and oats, have a positive influence on LDL levels. Their direct effectiveness is mainly based on their ability to bind bile acids in the intestine and excrete them. The more bile acids are bound and disposed of in the intestine by the soluble fiber, the less cholesterol is reabsorbed into the bloodstream. As a result, the liver removes more cholesterol from the bloodstream for the production of bile acid – the level of LDL cholesterol in the blood drops.

In addition to soluble fiber, plant foods also offer a special group of bioactive substances, the so-called plant sterols (phytosterols). These are particularly useful in reducing the absorption of cholesterol from the intestines into the bloodstream.
Plant sterols compete on the micelles in the small intestine with the absorption of cholesterol, so that cholesterol in the presence of plant sterols is increasingly excreted in the stool. This also means that less cholesterol is absorbed into the body, whether it is food cholesterol or the cholesterol that enters the intestines with bile acid. Plant sterols are found naturally in vegetable oils, pumpkin seeds, sunflower seeds or pine nuts and other nuts.

In addition to abundant fiber and phytosterols, vegetable foods also provide a high proportion of other secondary plant substances (carotenoids, polyphenols, sulfides, etc. ), which may protect LDL cholesterol from oxidation. The free radicals that accumulate in the body during the metabolic process or also due to stress are absorbed by the antioxidants and thus prevent them from joining with the cholesterol-containing fat particles.

Avoid hidden fats
The quality of dietary fats also has a major influence on the concentration of lipoproteins. Neither cholesterol nor fats are “dangerous” substances, but essential to life. The problem is usually that too many fats with an unfavorable fatty acid composition are consumed. A scientific study shows that on average 70 % of the daily amount of fat is absorbed as hidden fat (e. g. in sausage, cheese, chocolate, sweet pastries, snacks etc. ). However, it is now known that the fatty acid pattern in nutrition influences the composition, size and oxidation tendency of LDL cholesterol.
Therefore, the focus should be on monounsaturated and polyunsaturated fatty acids. A wide variety of studies have shown that replacing saturated fatty acids and trans fatty acids with omega-3 fatty acids (sea fish, cold-pressed vegetable oils, walnuts, seedlings) helps to activate the LDL receptors on the cells to absorb more LDL cholesterol.

Conclusion:
With a balanced nutrition rich in vital substances, as well as by avoiding industrially processed foods and a healthy lifestyle, which means integrating exercise into everyday life and reducing stress, a secondary lipometabolic disorder can be kept in check. At the same time, other risk factors for cardiovascular diseases such as high blood pressure or blood sugar as well as obesity can be reduced.
In the Metabolic Balance metabolic program, analysis of blood values can determine whether the problem is primary or secondary hypercholesterolemia. Not only values such as total cholesterol, HDL or LDL cholesterol are decisive, but also glucose and triglyceride values must be taken into account in order to be able to make the appropriate nutrition recommendations. Simply avoiding foods high in fat and cholesterol can only reduce elevated cholesterol levels to a limited extent.

Sources:

  1. Scholz R: Medizinische Biochemie, Band 9/10 „Cholesterin, Lipoproteine und Steroidhormone“, Zuckschwerdt-Verlag
  2. Deutsche Gesellschaft für Ernährung e.V. Evidenzbasierte Leitlinie: Fettkonsum und Prävention ausgewählter ernährungsbedingter Krankheiten. Version 2015; http://www.dge.de
  3. Deutsche Gesellschaft für Ernährung e.V. Evidenzbasierte Leitlinie: Kohlenhydratzufuhr und Prävention ausgewählter ernährungsbedingter Krankheiten. Version 2011; http://www.dge.de
  4. Worm,N., Mehr Fett. Warum die etablierten Ernährungsempfehlungen nicht haltbar und potenziell gefährlich sind. Ernährung & Medizin 27 (2012)57-63
  5. Bantal, Ganapathi; George, Belinda (2012): Low density Lipoprotein cholesterol target. Changing goal posts. In: India journal of endocrinology and metabolism 16 (suppl 2), S233-5. DOI:10.4103/2230-8210.104047

Eggs

How many eggs are actually good for me? For a long time, opinions differed when it came to determining a recommended consumption level for eggs. Eggs were thought to have a negative effect on cholesterol levels. In fact, the recommended amount of eggs is not based on cholesterol at all, but on the inflammatory parameters in the blood. There is a lot of omega-6 fatty acid (arachidonic acid) in egg yolks, which is highly inflammatory. Healthy people with low inflammation levels could eat eggs daily without harming themselves. However, if the inflammatory parameters are elevated, you should really pay attention to the weekly amount of eggs. 

Your Metabolic Balance nutrition plan will tell you how many eggs are ideal for you.

Cholesterol – Facts and Myths

Many people cringe when “cholesterol” is mentioned as it is associated with unpleasant topics such as obesity and disease. But what actually is cholesterol and is it really as harmful as many fear? Who is affected by high cholesterol levels and is it enough to abstain from cholesterol-containing foods in order to protect oneself? You will find answers to all these questions in this short summary on cholesterol.

What is cholesterol and what does “LDL” and “HDL” mean?
Cholesterol is a fat-like substance and can be found in all animal foods. Like fat, it does not dissolve in water and must therefore bind to certain proteins (lipoprotein) in order to be transported in the body via the blood (90% of which consists of water) to the various organs.
The most important and best known lipoproteins in this context are HDL (high-density lipoprotein) and LDL (low-density lipoprotein).

LDL supplies the organs and tissues with cholesterol. Excess LDL cholesterol can bind with white blood cells and deposit on the inner walls, usually the arteries, of blood vessels, leading to arteriosclerosis. If these deposits thicken over time, the blood vessels become increasingly inelastic and constrict. In the worst case, this results in complete vascular occlusion, which can trigger coronary heart disease, stroke or heart attack. This is why there is often talk of “bad” or “evil” cholesterol.

HDL cholesterol has the property of binding excess LDL cholesterol from the blood and transporting it back to the liver, which is why it is also called “good” cholesterol.

Myth 1 Cholesterol is fundamentally harmful

WRONG

Cholesterol is not fundamentally harmful, in fact, it is essential to life. Cholesterol is a very important component of the human body and performs a variety of tasks in the organism. It is involved . . .

  • . . . in the construction of cell walls and tissues
  • . . . in the formation of vitamin D
  • . . . in the formation of bile acids for fat digestion
  • . . . in the production of various hormones (cortisone, estrogen, testosterone)

Myth 2 Only very overweight people have high cholesterol levels

WRONG

A high cholesterol level is not visible from the outside and does not necessarily depend on body weight. Most sufferers have no symptoms and do not notice their high cholesterol levels, so the disease often goes undetected and untreated. Both obese and normal-weight people may be affected by an increased level of LDL cholesterol.
In addition to body weight, other risk factors such as an unhealthy lifestyle with increased tobacco and alcohol consumption, lack of exercise and poor nutrition, as well as diseases such as high blood pressure or diabetes play a major role.
In addition, there is also a genetically-related metabolic disease known as familial hypercholesterolemia, in which the affected people often have a strongly elevated LDL cholesterol level already at a young age, which greatly increases the risk of developing cardiovascular disease. So even young people can have a heart attack at a very early age.

Myth 3 Eggs and cholesterol-containing foods are bad for cholesterol levels

WRONG

About two-thirds of the body’s cholesterol is produced in the liver by the body itself. Only one third is ingested through food, of which only about half is actually absorbed by the body.
In healthy people, dietary cholesterol intake has little effect on cholesterol levels because the body can adjust its own production of cholesterol accordingly. Thus, if there is a higher supply of dietary cholesterol, the body’s own production is inhibited.
However, about 20-25% of the population are unable to do so, so that no adjustment of the body’s own cholesterol production takes place, resulting in elevated cholesterol levels in the blood.
This adaptation mechanism can also fail to occur in the case of highly unbalanced nutrition with a high proportion of cholesterol, a lot of saturated fats, few long-chain carbohydrates, such as those found in fruit and highly processed foods, and little fiber. Therefore, it is much more important to develop a healthy and balanced nutrition pattern than to avoid eggs or other cholesterol-containing foods in general. Dietary fats with poor fat quality are considered a major health risk – especially in terms of elevated cholesterol levels.
Saturated fatty acids, such as those found in butter, lard, cream, sausages, meat and cheese, increase cholesterol levels more than the cholesterol in food.Trans fatty acids, which are mainly found in industrially produced foods such as fried foods, pastries, confectionery and convenience foods, also have a negative effect on cholesterol levels, as they increase the “bad” LDL cholesterol and lower the “good” HDL cholesterol.

Nutrition tips:

In order to control cholesterol levels through nutrition, the most suitable diet is one that uses a lot of

  • fiber-rich foods such as oats, pulses, apples and vegetables and that inhibits cholesterol intake.
  • vegetable oils with high omega-3 fatty acid content such as linseed oil, walnut oil and hemp oil and thus supports the cardiovascular system. However, nuts and seeds are also an ideal supplement.
  • green tea. It is rich in cell-protecting antioxidants, but also saponins, which can bind cholesterol and inhibit fat absorption from food.

Conclusion:

With the Metabolic Balance nutrition concept and the individual selection of foods, the basis for a healthy cholesterol level is laid. In addition,   

  • exercise in everyday life
  • limiting alcohol and tobacco consumption and
  • reducing stress

can have a positive effect on cholesterol levels.

The Cholesterol Myth

The past few days our posts have highlighted how “eggcellent” eggs can be for your health! Inevitably when discussing this versatile food, the issue of cholesterol comes up.
Although eggs are rich in cholesterol, they do not – as it was long believed – increase cholesterol levels. However, studies that allegedly prove that the consumption of chicken eggs contributes to increased blood cholesterol levels or even poses a risk of heart attack have long been refuted. The Mayo Clinic notes that,

Although some studies have found a link between eating eggs and heart disease, there may be other reasons for these findings. The foods people typically eat with eggs, such as bacon, sausage and ham, may do more to boost heart disease risk than eggs do. Plus, the way eggs and other foods are cooked — especially if fried in oil or butter — may play more of a role in the increased risk of heart disease than eggs themselves do.

Many current studies have even shown the opposite: the lecithin in the egg yolk tends to lower cholesterol levels. The fact that pharmaceutical companies, doctors, and the margarine industry in general earn a lot of money by “bad mouthing” cholesterol is a possible explanation why the cholesterol myth continues to persist.

More information: