Metabolic Autophagy
Page 21
You can get cholesterol from eating animal foods like eggs, cheese, meat, and dairy but your body can also produce its own. An average 150 lb weighing male can synthesize 1000 mg of cholesterol a day. One single egg has 200 mg of cholesterol. The typical US dietary intake of cholesterol is about 307 mg[457]. In that case, about 75% of your body’s cholesterol gets produced by the body internally and 25% gets ingested externally[458]. Despite the lower dietary intake of cholesterol from diet in the US people still get heart disease.
Most of the cholesterol you eat gets esterified and is poorly absorbed. In the short term, cholesterol levels will rise as fats are being distributed around[459]. The body also reduces its own cholesterol synthesis when you consume it from food[460]. Therefore, eating more cholesterol will not raise your cholesterol in the long run. When you look at the mechanism of cholesterol transportation, then higher cholesterol in your blood also means that you’re burning more fat for fuel as well.
The body uses very low density lipoproteins (VLDL) to transport fatty acids, triglycerides, cholesterol, and fat-soluble vitamins around the bloodstream to either burn them off for energy or use in other cellular processes. Once the delivery has occurred, VLDL remodels itself into LDL.
Figure 67 Transport and conversion of cholesterol in the body
If there are more cholesterol and triglycerides in your blood due to diet, then it’s still going to be brought back down because of using them for cells.
On a low carb diet, your body uses triglycerides for energy because there’s no glucose around
Triglycerides are transported to the cells by VLDL, which turns into LDL
VLDL contains both cholesterol, triglycerides, and fat-soluble vitamins
Basically, if you’re using more fat for fuel, then you’ll by mechanism have higher fatty acids in the blood. Cholesterol just happens to be along for the ride.
Low carbohydrate ketogenic diets have been found to not lower LDL cholesterol but they do increase LDL particle size from small to large and decrease VLDL, all of which have positive effects on heart health[461].
The medical community should seriously re-evaluate the role of cholesterol in heart disease and what dietary recommendations they prescribe.
**DISCLAIMER**
This book is not supposed to be used as medical advice or recommendation in regards to atherosclerosis. I’m not a doctor and I’m not claiming to have the right answer. What I’m just sharing here is the physiology and research about how certain nutrients affect the body. Whether or not you should be eating a low-carb-high-fat diet depends on your medical history, current condition, goals, and eagerness to try less conventional approaches. The responsibility for your health and well-being is solely on you not me. Consult your doctor first before making any changes to your diet and lifestyle if needed. Let’s carry on…
Here are the current cholesterol ranges in conventional medicine:
Total Cholesterol – 200 mg/dl (5 mmol/L) or less. However, it’s mostly irrelevant because of not really giving enough detail about HDL and LDL etc.
Triglycerides – 150 mg/dl (1.7 mmol/L) or less. That’s a good guestimate because you would expect triglycerides to go down when eating fewer carbs and burning more fat for energy.
HDL Cholesterol – 40 mg/dl (1.0 mmol/L) or more. More HDL tends to be better and if you’re eating a healthy diet you should see HDL to be actually higher at about 50-60 mg/dl.
LDL Cholesterol – 100 mg/dl (2.6 mmol/L) or less. However, based on new research on low carb ketogenic diets, the amount of LDL for optimal health can vary greatly between people and is determined by many other things. If your triglycerides are low and HDL is high, then it means you’re using up those fatty acids. A higher LDL, in that case, isn’t that relevant. Inflammation or C-Reactive Protein (CRP) would then also have to be low.
If your triglycerides are high and you have high CRP, then a higher LDL and total cholesterol aren’t good because you’ll have more inflammation, which will create more scarring of arteries, which then can promote plaque formation.
For hunter-gatherers, free-living primates, healthy human neonates, and other wild animals, the normal LDL range is between 50-70 mg/dl, which prevents atherosclerosis[462]. Based on current medical guidelines, you can have a slightly bigger buffer zone while staying below 100 mg/dl. More is not definitely better nor protective against heart disease. Too much will still be detrimental, even if you think you’re eating a healthy diet.
Some people, around 20%, have a genetic variation that makes them absorb or synthesize so much cholesterol that their diet does influence their blood cholesterol level[463]. Even in these hypper-resonders, however, a high cholesterol diet does not generally negatively influence their cholesterol profile[464]. If total blood cholesterol increases at all during a high cholesterol diet, both ‘good’ HDL and ‘bad’ LDL cholesterol generally increase in the same proportion.
A review paper on the heart-related health effects of cholesterol concluded: “Epidemiological data do not support a link between dietary cholesterol and cardiovascular disease.”[465]
You can make the argument that high cholesterol leads to atherosclerosis because the plaques are created by cholesterol build-up. However, the root cause of the issue is inflammation and arterial scarring in the first place. If you’d have lower C-reactive protein, then cholesterol would simply be transported around the body by VLDL and if it’s not needed for nutrition it’d be transited back to the liver by HDL.
Therefore, the key to heart disease prevention is to avoid inflammation and foods that promote arterial scarring. That doesn’t go to say that having high cholesterol, especially LDL is optimal or something you want to take for granted...The diet heart hypothesis may still hold true if cholesterol levels are high in the wrong context, such as when people eat high fat foods with carbs or if they’re smoking.
The problem with going on a low-fat low-cholesterol diet is that your body would still keep producing its own cholesterol. Arguably you’d be making more of it because of not getting it from food.
In fact, a lot of people suffer from low levels of HDL cholesterol, which prevents their body from clearing out cholesterol from the blood. Most Americans don’t have enough HDL to decrease their risk of cardiovascular disease[466]. Crazy enough, low cholesterol levels are actually associated with increased mortality from stroke and heart disease[467].
Low Carbohydrate ketogenic diets with less than 50 g of carbs a day have been found to be better for long-term cardiovascular risk factor management compared to low-fat diets with less than 30% of calories coming from fat[468]. They can also raise HDL 4x times as much as a low-fat diet[469]. Long-term ketogenic diets reduce body weight, decrease triglycerides, lower LDL and blood glucose, and increase HDL cholesterol without any side-effects[470].
If you’re going on a low carb ketogenic diet, then you still have to take responsibility for your own cholesterol levels and other biomarkers. It doesn’t matter if you don’t think cholesterol causes heart disease if you still end up getting a heart attack. Too high LDL and triglycerides in the blood can still be a risk factor because you can’t control all the other invisible variables in your everyday life that promote atherosclerosis. In reality, the cause of heart disease isn’t the cholesterol – it’s the inflammation and high sugar diet combined with oxidized fats.
The Standard American Diet
Speaking of such diets, The Standard American Diet or SAD as it’s called is indeed a recipe for cardiovascular disease, obesity, and general health problems.
It doesn’t take a rocket scientist to realize how bad fast food is and what it does to you long-term. Everyone can cognitively grasp the idea that French fries and Happy Meals can’t be good for you. Unfortunately, there’s still a lot of confusion about what’s healthy and people are still eating foods that are quite lethal for them without even knowing it. The SAD diet encompasses more than just your average Big Mac menu because not everyone eats out all the time and they
still follow the recommended dietary recommendations. Unfortunately, those guidelines are very misleading and out-dated.
Here are some of the most lethal components of the Standard American Diet that not many people know about:
Trans Fats and Vegetable Oils
High Fructose Corn Syrup
Artificial Sweeteners
GMO Foods and Pesticides
Refined Carbohydrates and Sugar
Processed Grains and Wheat
These are all the staples of the food industry because they’re very cheap, easy to manufacture, even easier to over-consume, and to hide it in every packaged food possible. I’ll now go through each one of these groups and show why you don’t want them in your diet.
Vegetable Oils and Trans Fats
When the diet heart hypothesis became more mainstream, the US dietary recommendations were quick to shift from an animal-based model to a low-fat one that minimized meat, egg, and saturated fat content. Instead, polyunsaturated fatty acids and vegetable oils were considered to be much healthier and protective of heart disease. Unfortunately, they have many negative effects on the body that actually promote heart disease.
Vegetable oils are extracted from various seeds, such as rapeseed (canola oil), soybean, corn, sunflower, peanut, and safflower. To get the oil from these plants, they have to be extracted through processing and heat, which damages their fatty acid composition.
These „heart healthy“ vegetable oils are heated at unnaturally high temperatures, which makes the fats oxidize and go rancid. Oxidized fats accelerate aging, promote inflammation and damage the cells of your body when consumed. In addition to that, before the oils get put onto store shelves, they get processed even more with different acids and solvents to improve the composition of the product. As a bonus, they get deodorized and mixed with chemical colorings to mask the horrible residue of the processing process.
If you take it a step further and hydrogenize the vegetable oil, then it will eventually become more solid and intact. Meet margarine and all of the other trans-fatty acid type vegetable spreads that I can’t believe aren’t butter... All that work to get a cheaper product. But is it actually any healthier?
A Medical Research Council survey showed that men eating butter ran half the risk of developing heart disease as those using margarine[471]. Consumption of trans fats has been linked to obesity, metabolic syndrome, increased oxidative stress, heart disease, cancer, and Alzheimer’s[472][473]. Friends don’t let friends eat margarine…
Paradoxically, after the introduction of heart-healthy vegetable oils and trans fats, the situation of cardiovascular disease didn’t get better but actually got worse. What gives?
As we described earlier, it’s not the saturated fat or cholesterol that is driving atherosclerosis but it’s mainly caused by inflammation and sugar that’s making the arteries become inflamed in the first place. Cholesterol is just going there to do its job and tries to heal the injuries but if you keep causing damage to the blood vessels it doesn’t matter how little cholesterol you eat from your diet as your body will still manufacture it from within. It’s a vicious cycle of trying to fix the symptoms instead of going to the root cause, which is inflammation.
Unfortunately, vegetable oils and trans fats are one of the most inflammatory substances in our diet that are heavily driving this process of arterial clogging.
The body tries to maintain homeostasis in every regard, starting with stable blood sugar, metabolic rate, as well as the balance between essential fatty acids. One of the most important ones for survival omega-9, omega-6, and omega-3 fats can’t be produced by the body itself, thus they need to be derived from diet.
Omega-3 Fatty Acids are an integral part of cell membrane and they regulate many other hormonal processes. They have great anti-inflammatory benefits that protect against heart disease, eczema, arthritis, and cancer[474]. Omega-3s are polyunsaturated fatty acids, which refers to their multiple unsaturated double bonds. Great sources of omega-3s are salmon, grass-fed beef, sardines, krill oil, algae, and some nuts. There are 3 types of omega-3s: EPA (EicosaPentaenoic Acid) and DHA (DocosaHexaenoic Acid) are animal sourced long chain omega-3 fats both essential for the nervous system, brain, and general health. They’re found especially in seafood.
ALA (Alpha Linolenic Acid) is mostly a plant-based short chain omega-3 fatty acid. Most animals, including humans, can’t directly use ALA so it gets converted into DHA first. Humans can convert only about 8% of ALA into DHA[475], which is why animal foods like salmon and oysters are much better sources of omega-3s and DHA.
Omega-6 Fatty Acids are also essential polyunsaturated fats. They differ from omega-3s by having 6 carbon atoms at the last double bond instead of 3. Omega-6s are primarily used for energy and they have to be derived from diet. Unfortunately, most people are getting too many omega-6s. The most common omega-6 is linolenic acid (LA). Another omega-6 is conjugated linoleic acid (CLA) with some health benefits. Vegetable oils, processed foods, salad dressings, and some nuts are the highest sources of omega-6 fatty acids.
Omega-9 Fatty acids are monounsaturated fats with a single double bond. These ones aren’t necessarily essential as the body can produce its own. In fact, omega-9s are the most abundant fats in cells. They’ve been found to lower triglycerides and VLDL[476] as well as improve insulin sensitivity[477]. You can get omega-9s from olive oil, and some nuts.
In general, omega-3s are very healthy for you and there doesn’t seem to be many negative side-effects to over-consuming them. However, the body operates best when in homeostasis and that’s why you need to balance omega-3s with omega-6s. Omega-9s aren’t that important to pay attention to because most omega-3, as well as omega-6 foods, contain some omega-9s.
Anthropological research suggests that our hunter-gatherer ancestors consumed omega-6 and omega-3 fats in a ratio of roughly 1:1[478]. That’s what we evolved with over the course of hundreds of thousands of years and that’s probably optimal for general health. After the industrial revolution about 140 years ago, the ratios between omega-6s and omega-3s shifted heavily towards the consumption of omega-6s[479]. That’s the result of food processing and using low-quality ingredients for the sake of increased profit. Today, the average American eats a ratio of 10:1, 20:1, or even as high as 25:1[480], which is definitely not good for you. No wonder there are so many chronic diseases related to inflammation and cardiac events.
The high amounts of omega-6 fatty acids in the Western diet are directly caused by the high amount of vegetable oils and trans fats. These things are everywhere – in pastries, ’healthy vegan restaurants’ chips, chocolate, ’ low-fat granola’, frozen pizza, pre-cooked meals, fast food joints,– basically everything that comes in a package.
In addition to that, most dietary recommendations are skewed towards using these oils for home-cooking as well. In fact, almost 20% of the calories of Americans comes from a single food source - soybean oil. That makes 9% of all their daily calories to come from omega-6 fatty acids alone[481]! I mean, it doesn’t matter how much kale or chicken breast you eat if you cook it in a bath of oxidized fat – you’ll still damage your health.
Omega 6 fatty acids are unstable because they’re made of polyunsaturated fats that get oxidized at high heats as do omega-3s. They’re linked to increased risk of cardiovascular disease, cancer, and brain degeneration[482][483], and vegetable oils are very high in omega-6s. That’s why you’d want to limit your intake of these fats, especially if they’re processed.
So, if there’s one food group you should avoid ALWAYS no matter what diet you follow, then let it be the camp of highly processed and oxidized vegetable oils/hydrogenated trans fats. This single change alone may prevent you from getting heart disease altogether.
Here’s a list of the different oils and their fatty acid content:
FOOD
OMEGA-6 (g)
OMEGA-3 (g)
RATIO 6:3
FISH
Salmon (4 oz/113 g)
0.2
2.3
1:12
Mackerel (4 oz/113 g)
0.2
2.2
1:11
Swordfish (4 oz/113 g)
0.3.
1.7
1:6
Sardines (4 oz/113 g)
4.0
1.8
2.2:1
Canned Tuna (4 oz/113 g)
3.0
0.2
15:1
Lobster (4 oz/113 g)
0.006
0.12
1:20
Cod (4 oz/113 g)
0.1
0.6
1:6
VEGETABLES
Spinach (1 cup/110 g)
30.6
166
1:5.4
Kale (1 cup/110 g)
0.1.
0.1
1:1
Collards (1 cup/110 g)
133
177
1:1.3
Chard (1 cup/110 g)
43.7
5.3
8.2:1
Sauerkraut (1 cup/110 g)
37
36
1:1
Brussels Sprouts (1 cup/110 g)
123
270
1:1.3
NUTS AND SEEDS
Walnuts (1 oz/28 g)
10.8
2.6
4.2:1
Flaxseeds (1 oz/28 g)
1.6
6.3
1:4
Pecans (1 oz/28 g)
5.7
0.3
21:1
Poppy Seeds (1 oz/28 g)
7.9
0.1
104:1
Pumpkin Seeds (1 oz/28 g)
2.5