Article at a Glance
- Cholesterol, often thought of as a triglyceride fat, is very different in structure, and performs differently in the body than saturated and polyunsaturated fats.
- Although some are genetic hyper-absorbers, most people absorb very little of the cholesterol they eat, and when absorption goes up, the amount of cholesterol produced in the liver goes down. As such, the body tends to highly regulate cholesterol levels.
- In some genotypes, saturated fat and high fat diets significantly increase levels of LDL-C, which has been associated with greater risk of heart disease.
- Long billed as heart healthy, polyunsaturated fats are prone to oxidation and damage.
- #1. Cholesterol is not a fatty acid
- #2. Cholesterol is essential for life
- #3. Cholesterol is unique to animals
- #4. Most of the cholesterol in the body is made by the body
- #5. Cholesterol is hydrophobic
- #6. Cholesterol doesn’t cause heart disease, but LDL does
- #7. Eating cholesterol doesn’t always mean high cholesterol
- #8. Not everyone has the same reaction to dietary cholesterol
- #9. Saturated fat and cholesterol are two different animals
- #10. Dietary cholesterol interacts with the microbiome
- In closing
Who would have thought this one organic molecule could inspire so much controversy? Well, if you follow the diet wars, you certainly believe it. In fact dietary cholesterol is one of the nutrition topics that inspires the fiercest debates, with health experts like Dr. Mark Hyman and Dean Ornish completely disagreeing on what is the best approach.
At Gene Food, our passion is empowering readers with a personalized approach to nutrition. To that end, we have compiled 10 science backed facts about cholesterol that will, hopefully, bring some clarity to your approach.
#1. Cholesterol is not a fatty acid
Because of the various health guidelines, most people think of cholesterol as a fat similar to the triglycerides. However, whilst cholesterol is a lipid, it is not a triglyceride fat. Very different in structure, it contains carbon rings rather than long chains of carbon atoms which results in a very different activity in the body.
#2. Cholesterol is essential for life
Indeed, cholesterol is essential for life, forming about 30% of all our cell membranes and providing flexibility in our cells. Additionally, cholesterol is the key component of many hormones including estrogen and testosterone, and is also required for the synthesis of vitamin D.
Cholesterol also forms bile acids which facilitate the digestion of fats and oils in the intestine as well as aiding the absorption of the fat-soluble vitamins A, D and E.
#3. Cholesterol is unique to animals
Cholesterol is associated with meat and dairy products, with plant based foods containing little, if any, cholesterol. Cholesterol is a type of zoosterol, meaning it is a lipid that is only found in animals.
By contrast, fats that are unique to plants are called phytosterols.
#4. Most of the cholesterol in the body is made by the body
Because cholesterol is essential to life, our bodies make the majority of cholesterol in the body.
The liver makes cholesterol, as do red blood cells. Cholesterol made by the body is called “endogenous” cholesterol, whereas the 20% or so we get from cholesterol in the diet is called “exogenous” cholesterol.
#5. Cholesterol is hydrophobic
This means cholesterol can’t move freely in blood, which is essentially water, without assistance.
As with triglycerides, cholesterol is not soluble in water, and so to be transported around the circulatory system it requires assistance. 1
#6. Cholesterol doesn’t cause heart disease, but LDL does
To transport the insoluble triglycerides and cholesterol around the body in the blood, lipoproteins are required. Lipoproteins are particles made up of thousands of molecules which encase triglycerides and cholesterol allowing these insoluble molecules to be transported around the circulatory system.
There are several different types of lipoproteins, the most commonly known being low-density lipoproteins (LDL) and high-density lipoproteins (HDL).
LDL delivers cholesterol to the tissues within the body. However, where there is an excess of LDL, harmful depositions of cholesterol, particularly in the blood vessels, can occur, contributing to the build-up of fatty plaques on blood vessel walls. This is why LDL is often referred to as ‘bad cholesterol’, even though LDL is not made of cholesterol, it just transports it!
This is a key lesson: it’s not cholesterol that causes heart disease, it’s LDL and other lipid carrying particles. The inflammatory process of heart disease begins when an LDL particle deposits a piece of cholesterol, fatty acid, or plant sterol in the artery wall.
It should also be noted that damaged polyunsaturated fats, and trans fats, are not heart healthy, and the regular addition of these fats to processed foods in the form of vegetable oils has contributed to the rise of heart disease.
In contrast, HDL is responsible for transporting excess cholesterol from the tissues within the body (including removing cholesterol from the arteries) for disposal by the liver, and is referred to as “good cholesterol.” 2
#7. Eating cholesterol doesn’t always mean high cholesterol
Historically, studies proposed that eating high levels of cholesterol in foods like eggs, led to an increase in blood cholesterol levels, which congealed inside the blood vessels eventually resulting in poor heart health. And so, the idea that a high cholesterol diet is bad was born. 3
However, numerous studies have since pointed out several flaws with this hypothesis. 4
First, while a high level of total cholesterol is associated with an increased risk of heart disease, most people who suffer from heart disease have normal blood cholesterol levels. 5
Second, as cholesterol is so fundamental to life, it is directly synthesized in the body, mainly in the liver, but also in red blood cells. Excess dietary cholesterol is excreted in stool, and any dietary cholesterol which is absorbed results in a decrease in cholesterol synthesis in the liver. 6 7
Together this means that even a diet very high in cholesterol has little, if any, impact on the cholesterol levels in the blood which are maintained at a steady state in most people.
#8. Not everyone has the same reaction to dietary cholesterol
While much of the advice on dietary cholesterol has ignored the rule of cholesterol homeostasis, in which the body tightly regulates cholesterol levels, not everyone fits neatly under this umbrella.
In fact, there is tremendous variability in cholesterol absorption, with some of us absorbing only 20% of the cholesterol we eat, while others absorb as much as 85%! We now know that genetic variants in genes like ABCG5 and ABCG8 determine how much cholesterol an individual will absorb. Research by world renowned lipid expert Dr. Tom Dayspring also indicates that APOE4 carriers are far more likely to be hyper-absorbers.
In people who hyper-absorb cholesterol, eating high cholesterol foods like eggs will have an impact on their LDL levels, and as a result, their risk for heart disease over time.
It is shocking to me that, despite compelling science from some of our best medical journals, our nutrition experts and commentators still push one size fits all approaches with dietary cholesterol. There is no single rule for cholesterol, advice has to be tailored to each individual based on lifestyle and genetic predisposition.
For many people, eating eggs will have no impact on blood lipid markers, while others will be at increased risk. In a previous podcast, we covered the American Journal of Clinical Nutrition study on egg consumption and the impact on biomarkers like LDL-C. The ACJN study, which found minimal impact on cholesterol levels even when subjects ate 7 eggs per week, is well worth a read.
However, I also implore anyone interested in this topic to read the excellent 2020 paper from the European Heart Journal titled: Genetic variability in the absorption of dietary sterols affects the risk of coronary artery disease. So much of the cholesterol discussions you find online and via Google search are outdated and based on either old science, or partisan science.
A side note: you get op-ed style articles like this one, which appeared in the Guardian, discussing “cholesterol deniers.” We agree that cholesterol denial, to the extent that means arguing that LDL is not causal in heart disease, is a major problem in the nutrition community. There are two things to point out here:
- Yes, some people, tend to hyper-absorb cholesterol and plant sterol. These people need to keep a closer eye on cholesterol than others.
- The article lumps saturated fat in with cholesterol, but as we’ve learned, the two are very different. Especially in some genotypes, saturated fat may indeed increase the risk for heart disease, but let’s not conflate these two separate issues.
#9. Saturated fat and cholesterol are two different animals
In the majority of people, eating cholesterol doesn’t raise cholesterol levels because the body simply makes less cholesterol when it absorbs more. Conversely, when the body makes more cholesterol, it absorbs less. However, here is where the rubber meets the road. As pointed out in our first cholesterol fact, saturated fat and cholesterol are two different things.
The general rule for cholesterol is that eating it doesn’t meaningfully increase blood levels. If you’re in doubt, see the ACJN egg study cited above.
However, the same cannot be said for saturated fat.
The body doesn’t make saturated fat and eating it causes an uptick in LDL-C in all people, it’s just a matter of degree as to how much LDL goes up. In some of us with genetic predispositions, eating a high saturated fat diet causes the body to make a lot more cholesterol which results in lab results that make physicians very uncomfortable. To demonstrate this point, have a look at this study from 2019. Study authors measured blood lipid markers for 30 healthy individuals placed on a ketogenic style diet. On average the participants saw a 44% increase in LDL-C levels on the high fat diet, but the results varied by individual from between 5-107%! This means that some of us can incorporate healthy amounts of saturated fat in the diet without the corresponding rise in LDL, while others have to be much more cautious. Part of what we are doing at Gene Food is developing an algorithm that will help classify people into different camps so they have a good idea of how much dietary fat is healthy for them.
As I discussed in the point above, there are a lot of LDL skeptics, some of whom can rightly be classified as “cholesterol deniers.” For example, paleo advocates will tell you that there is no evidence that eating saturated fat causes heart disease, but this isn’t exactly right.
In order to conclusively “prove” that saturated fat causes heart disease, you would need to control the diets of different groups of people for decades and then report results. It is simply not possible to create the types of nutrition studies we need to settle the matter. Instead, we have biochemistry and cardiovascular trials. Paleo advocates suggest that statin trials which are aimed at lowering LDL-C, fail to show a drop in all-cause mortality, and therefore we needn’t concern ourselves with LDL at all. This is just flat out bad science. If you are eating a high fat diet and you don’t see the corresponding uptick in LDL, it could be a sign that that diet is working for you, perhaps as a way of controlling blood sugar. Conversely, if you go high fat and see severely elevated levels of LDL, you are very likely at an increases risk for heart disease.
There are a few things to note here:
- Some statin trials do show drops in all cause mortality when LDL-C is lowered. For example, this 2018 JAMA meta analyses of over 270,00 participants found that all cause mortality dropped when LDL-C was lowered from 160 mg/DL to 130 mg/DL and again from 130 mg/dL to 100 mg/dL, but that all cause mortality benefits ceased when LDL-C went below 100 mg/dL. In other words, lowering LDL beneath 100 mg/dL didn’t show increased drops in all cause mortality although heart attack and stroke risk continued to go down as LDL levels fell.
- Statin trials are designed to prove the efficacy of a drug as quickly as possible, they aren’t designed to demonstrate the lifetime impact of high cholesterol caused by a fat heavy diet. This issue came up when we interviewed Dr. Tom Dayspring last year.
- Lowering LDL-C, and especially APOB, is associated with lower incidence of heart disease across the board.
So, what is the bottom line here? Know your baseline levels of LDL and other heart health biomarkers. Watch how they change when you go on a high fat diet. If your numbers go through the roof, don’t think a healthy TG/HDL ratio will lower your risk. Eating cholesterol won’t contribute to heart disease in most of us, but eating loads of saturated fat will increase LDL and heart attack risk in some populations.
Know your numbers and listen to your cardiologist, not the blogosphere. If you have some time, listening to this podcast interview with Dr. Peter Attia and low carb diet advocate Dave Feldman is valuable.
Dr. Attia so throughly debunks Dave’s “energy model” of cholesterol metabolism that I have been surprised Dave kept on publicly advocating for it after the interview.
#10. Dietary cholesterol interacts with the microbiome
We close on cholesterol and the microbiome. It’s not just about how we make and absorb cholesterol, another important factor is what the microbiome does with the cholesterol we eat.
The New England Journal of Medicine has published some excellent studies on how eating eggs and dietary cholesterol changes the microbiome, specifically causing the production of a compound known as TMAO, which is linked to heart disease.
For example, in one trial, the NEJM researchers fed subjects eggs and measured TMAO levels, which went up. When the same subject were placed on antibiotics and then fed eggs, TMAO levels didn’t rise, suggesting that it is the composition of the microbiome which leads to TMAO production and the increased cardiovascular risk that comes with it. I’ve had the privilege of interviewing Integrative Cardiologist, and television personality, Dr. Joel Kahn on the Gene Food Podcast. Dr. Kahn tests his patients for TMAO and reduces eggs and supplements, like L-carnitine, that cause increases in TMAO when levels are high.
In closing, while it’s true that dietary cholesterol has been improperly demonized, there are exceptions to every rule.
In order to determine what the best approach is for your health, learn how much cholesterol you absorb, how your body responds to saturated fats, and last, the state of your microbiome.
As Carl Jung famously said, “the more a law lays claim to universal validity, the less it does justice to the individual facts.”
Cholesterol, ambayo mara nyingi huonwa kuwa mafuta ya triglyceride, ni tofauti sana katika muundo, na hufanya tofauti katika mwili kuliko mafuta yaliyojaa na yasiyojaa. Ingawa baadhi ya watu wana uwezo wa kuingiza kiasi kikubwa cha kolesteroli, watu wengi huchukua kiasi kidogo sana cha kolesteroli wanayokula, na wakati kunyonya kunapoongezeka, kiasi cha kolesteroli inayotokezwa katika ini hupungua. Kwa hiyo, mwili huelekea kudhibiti sana viwango vya kolesteroli. Katika baadhi ya genotypes, mafuta saturated na mafuta ya juu ya chakula kwa kiasi kikubwa kuongeza viwango vya LDL-C, ambayo imekuwa kuhusishwa na hatari kubwa ya ugonjwa wa moyo. - Kwa muda mrefu huonwa kuwa yenye afya ya moyo, mafuta yasiyo na unyevu ni rahisi kuharibiwa na kuharibiwa. - # 1. Kolesteroli si asidi ya mafuta - #2. Kolesteroli ni muhimu kwa uhai - #3. Cholesterol ni ya pekee kwa wanyama - #4. Cholesterol nyingi katika mwili hutengenezwa na mwili - #5. Cholesterol ni hydrophobic - #6. Cholesterol haisababishi ugonjwa wa moyo, lakini LDL hufanya - #7. Kula kolesteroli si lazima kumaanisha kolesteroli ya juu - #8. Si kila mtu anayetenda kwa njia ileile kwa kolesteroli inayopatikana katika chakula - #9. Mafuta ya saturated na cholesterol ni wanyama wawili tofauti - # 10. Cholesterol ya chakula huingiliana na microbiome - Kwa kumalizia Ni nani angeweza kufikiri kwamba molekuli hii moja ya kikaboni ingeweza kusababisha ubishi mwingi hivyo? Ikiwa unafuata vita vya lishe, basi unaamini. Kwa kweli, cholesterol ya chakula ni moja ya mada ya lishe ambayo huchochea mjadala mkali zaidi, na wataalamu wa afya kama Dk Mark Hyman na Dean Ornish hawakubaliani kabisa juu ya nini ni mbinu bora. Katika GeneFood, shauku yetu ni kuwawezesha wasomaji na mbinu ya kibinafsi ya lishe. Kwa hivyo, tumekusanya ukweli 10 wa kisayansi kuhusu cholesterol ambayo, kwa matumaini, itakuletea uwazi zaidi. # 1 - Mfano wa kwanza. Cholesterol si asidi ya mafuta kwa sababu ya miongozo mbalimbali ya afya, watu wengi hufikiria cholesterol kuwa mafuta yanayofanana na triglycerides. Hata hivyo, ingawa kolesteroli ni lipidi, si mafuta ya triglyceride. Kwa sababu ya muundo wake, ina pete za kaboni badala ya minyororo mirefu ya atomu za kaboni, ambayo husababisha shughuli tofauti sana katika mwili. #2. Cholesterol ni muhimu kwa maisha, kwa kuwa hufanyiza asilimia 30 ya utando wa seli na huwezesha seli zetu kubadilika. Cholesterol ni sehemu muhimu ya homoni nyingi, ikiwa ni pamoja na estrogen na testosterone, na pia inahitajika kwa synthesis ya vitamini D. Cholesterol pia huunda asidi za bile ambazo zinawezesha kumeng'enya kwa mafuta na mafuta katika matumbo na kusaidia kunyonya vitamini A, D na E. Cholesterol ni ya kipekee kwa wanyama, kwa sababu inahusishwa na nyama na bidhaa za maziwa, na vyakula vya mimea vina cholesterol kidogo, ikiwa kuna. Cholesterol ni aina ya zoosterol, ikimaanisha ni lipid ambayo hupatikana tu katika wanyama. Kinyume cha hilo, mafuta ambayo ni ya mimea pekee huitwa phytosterols. # 4 - Mfano wa Cholesterol ya mwili ni muhimu kwa maisha, kwa sababu mwili wetu hufanya kiasi kikubwa cha cholesterol. Ini hutokeza kolesteroli, kama vile chembe nyekundu za damu. Cholesterol inayotengenezwa na mwili huitwa "endogenous" cholesterol, wakati 20% au zaidi tunayoipata kutoka kwa cholesterol katika chakula huitwa "exogenous" cholesterol. # 5 - Mfano wa Uaminifu Cholesterol ni hydrophobic Hii ina maana cholesterol haiwezi kusonga kwa uhuru katika damu, ambayo ni kimsingi maji, bila msaada. Kama ilivyo na triglycerides, cholesterol haiwezi kuyeyuka katika maji, na hivyo kusafirishwa kuzunguka mfumo wa mzunguko wa damu inahitaji msaada. # 16 - Mfano wa Uwezo Cholesterol haisababishi ugonjwa wa moyo, lakini LDL hufanya Ili kusafirisha triglycerides zisizoweza kuyeyuka na cholesterol kuzunguka mwili katika damu, lipoproteins zinahitajika. Lipoproteini ni chembechembe zilizojengwa na maelfu ya molekuli ambazo hufunika triglycerides na cholesterol, na kuruhusu molekuli hizi zisizoweza kuyeyushwa kusafirishwa katika mfumo wa mzunguko wa damu. Kuna aina kadhaa za lipoproteini, ambazo zinajulikana zaidi kama lipoproteini zenye wiani wa chini (LDL) na lipoproteini zenye wiani wa juu (HDL). LDL hutoa cholesterol kwa tishu za mwili. Hata hivyo, mahali ambapo LDL ni nyingi kupita kiasi, cholesterol inaweza kuhifadhiwa, hasa katika mishipa ya damu, na hivyo kuchochea kuunganishwa kwa mafuta kwenye kuta za mishipa ya damu. Hii ndiyo sababu LDL mara nyingi huitwa "cholesterol mbaya", ingawa LDL haifanyizi cholesterol, inasafirisha tu! Hii ni somo muhimu: si kolesteroli inayosababisha ugonjwa wa moyo, ni LDL na chembe nyingine zinazobeba lipidi. Ugonjwa wa moyo huanza wakati LDL inapoweka kipande cha cholesterol, asidi ya mafuta, au sterol ya mimea kwenye ukuta wa mshipa. "Kama ilivyoelezwa hapo juu, ""mafuta ya polyunsaturated na trans si afya ya moyo, na kuongeza kwa kawaida mafuta haya kwa vyakula vilivyotengenezwa katika fomu ya mafuta ya mboga imesababisha kuongezeka kwa magonjwa ya moyo.""" Kwa upande mwingine, HDL ni wajibu wa kusafirisha cholesterol ziada kutoka tishu ndani ya mwili (ikiwa ni pamoja na kuondoa cholesterol kutoka mishipa) kwa ajili ya kuondolewa na ini, na ni inajulikana kama <unk>good cholesterol<unk>. Kwa kawaida, kula cholesterol haimaanishi kuwa cholesterol ni ya juu, lakini utafiti unaonyesha kuwa kula cholesterol nyingi katika chakula kama mayai huongeza kiwango cha cholesterol katika damu, ambayo hufyonza ndani ya mishipa ya damu na kusababisha afya mbaya ya moyo. Na hivyo, wazo kwamba mlo wenye kolesteroli nyingi ni mbaya ulizaliwa. Hata hivyo, uchunguzi wa miaka kadhaa umeonyesha kwamba kuna kasoro kadhaa katika nadharia hiyo. 4 Kwanza, ingawa kiwango cha juu cha kolesteroli ya jumla huhusianishwa na hatari ya kuongezeka ya ugonjwa wa moyo, watu wengi wanaopatwa na ugonjwa wa moyo wana viwango vya kawaida vya kolesteroli katika damu. 5 Kwa sababu cholesterol ni muhimu sana kwa uhai, hutengenezwa moja kwa moja katika mwili, hasa katika ini, na pia katika chembe nyekundu za damu. Cholesterol ya ziada hutolewa katika mkojo, na cholesterol yoyote ya mlo ambayo huingizwa husababisha kupungua kwa synthesis ya cholesterol katika ini. "Hii ina maana kwamba hata chakula chenye kiwango cha juu sana cha kolesteroli kina athari ndogo, ikiwa kuna yoyote, kwa viwango vya kolesteroli katika damu ambavyo huhifadhiwa katika hali ya kawaida kwa watu wengi. """ # 8 - Mfano wa Uaminifu Ingawa ushauri mwingi juu ya cholesterol ya chakula umepuuza sheria ya homeostasis ya cholesterol, ambayo mwili unadhibiti kwa nguvu viwango vya cholesterol, sio kila mtu anafaa vizuri chini ya mwavuli huu. Kwa kweli, kuna tofauti kubwa katika kunyonya cholesterol, na baadhi yetu tunameza tu 20% ya cholesterol tunayokula, wakati wengine wanameza hadi 85%! Kwa mfano, kuna chembe za urithi za ABCG5 na ABCG8 ambazo huamua kiasi cha cholesterol mtu anaweza kuchukua. Utafiti uliofanywa na mtaalamu maarufu wa lipid, Dk Tom Dayspring, pia unaonyesha kuwa waendeshaji wa APOE4 wana uwezekano mkubwa wa kuwa hyperabsorbers. Kwa watu ambao wana hypercholesterol, kula vyakula vyenye cholesterol ya juu kama mayai itakuwa na athari kwa viwango vya LDL na kwa hivyo hatari yao ya ugonjwa wa moyo kwa muda. "Ni jambo la kushangaza kwangu kwamba, licha ya sayansi ya kuvutia kutoka kwa baadhi ya majarida yetu bora ya matibabu, wataalamu wetu wa lishe na wasemaji bado wanapendekeza ""saizi moja inafaa kila mbinu"" na kolesteroli ya chakula." Hakuna sheria moja kwa cholesterol, ushauri lazima uendane na kila mtu kulingana na mtindo wa maisha na mwelekeo wa maumbile. Kwa watu wengi, kula mayai hakutaathiri viwango vya lipid katika damu, wakati wengine watakuwa katika hatari kubwa. Katika makala ya hivi karibuni, tulijadili utafiti wa American Journal of Clinical Nutrition kuhusu matumizi ya mayai na athari zake kwa viashiria kama vile LDL-C. Uchunguzi wa ACJN, ambao uligundua athari ndogo kwa viwango vya cholesterol hata wakati masomo yalikula mayai saba kwa wiki, ni thamani ya kusoma. "Kwa hivyo, kwa wale ambao wanavutiwa na mada hii, tafadhali soma karatasi bora ya 2020 kutoka kwa Jarida la Moyo la Ulaya lenye kichwa: ""Utofauti wa urithi katika kunyonya kwa steroli ya chakula huathiri hatari ya ugonjwa wa mishipa ya moyo.""" """Mazungumzo mengi ya cholesterol unayopata mtandaoni na kupitia utafutaji wa Google ni ya zamani na kulingana na sayansi ya zamani au sayansi ya upendeleo." "Kama ilivyoelezwa katika makala ya kwanza ya jarida la The Guardian, ""Kukataa Cholesterol"" ni tatizo kubwa katika jamii ya lishe." Kuna mambo mawili ya kuashiria hapa: - Ndiyo, baadhi ya watu, huwa na hyper-absorb cholesterol na mimea sterol. Watu hao wanahitaji kuchunguza kiwango cha kolesteroli zaidi kuliko wengine. - Makala hiyo inatia ndani mafuta yaliyojaa na kolesteroli, lakini kama tulivyojifunza, mafuta hayo mawili ni tofauti sana. Hasa katika baadhi ya genotypes, mafuta yaliyojaa inaweza kweli kuongeza hatari ya ugonjwa wa moyo, lakini hebu si conflate masuala haya mawili tofauti. #9. Mafuta yaliyojaa na cholesterol ni wanyama wawili tofauti: Kwa watu wengi, kula cholesterol haiongezi viwango vya cholesterol kwa sababu mwili hufanya cholesterol kidogo wakati unachukua zaidi. Kwa upande mwingine, mwili unapotengeneza kolesteroli nyingi, huchukua kidogo. Hata hivyo, hapa ndipo mpira unapokutana na barabara. Kama ilivyoelezwa katika ukweli wetu wa kwanza wa kolesteroli, mafuta yaliyojaa na kolesteroli ni vitu viwili tofauti. Kanuni ya jumla kwa ajili ya cholesterol ni kwamba kula haina maana kuongeza viwango vya damu. Kama wewe ni katika shaka, angalia ACJN yai utafiti zilizotajwa hapo juu. Hata hivyo, jambo hilohilo haliwezi kusemwa kuhusu mafuta yaliyojaa. Mwili haufanyi mafuta yaliyojaa na kula husababisha kuongezeka kwa LDL-C katika watu wote, ni suala la kiwango tu cha LDL kupanda. Kwa baadhi yetu wenye mwelekeo wa maumbile, kula chakula chenye mafuta mengi ya kutosha husababisha mwili kutengeneza cholesterol nyingi zaidi ambayo husababisha matokeo ya maabara ambayo huwafanya madaktari wasijihisi vizuri. Ili kuelezea hii, angalia utafiti huu wa 2019. Watafiti walichunguza viwango vya lipid katika damu ya watu 30 wenye afya waliopatikana katika mlo wa ketogenic. Kwa wastani, washiriki waliona ongezeko la 44% katika viwango vya LDL-C kwenye lishe yenye mafuta mengi, lakini matokeo yalitofautiana kutoka kwa mtu mmoja hadi mwingine kutoka 5-10%. Hii inamaanisha kwamba baadhi yetu tunaweza kuingiza kiasi kizuri cha mafuta yaliyojaa katika chakula bila kuongezeka kwa LDL, wakati wengine wanapaswa kuwa waangalifu zaidi. "Kati ya kile tunachofanya katika GeneFood ni kuendeleza algorithm ambayo itasaidia kuainisha watu katika kambi tofauti ili wawe na wazo nzuri la kiasi cha mafuta ya chakula ni afya kwa ajili yao. """ "Kama nilivyojadili katika hatua ya juu, kuna watu wengi ambao wanashuku LDL, na baadhi yao wanaweza kwa haki kuainishwa kama ""wanakataa cholesterol"" Kwa mfano, wanasheria wa paleo watakuambia kwamba hakuna ushahidi kwamba kula mafuta yaliyojaa husababisha ugonjwa wa moyo, lakini hii sio kweli." Ili kuthibitisha kwamba mafuta yaliyojaa husababisha ugonjwa wa moyo, unahitaji kudhibiti lishe ya vikundi tofauti vya watu kwa miongo kadhaa na kisha kuripoti matokeo. Ni vigumu sana kufanya utafiti wa lishe unaohitajiwa ili kuamua jambo hilo. Badala yake, tuna majaribio ya biokemia na ya moyo na mishipa ya damu. Watetezi wa Paleo wanapendekeza kwamba majaribio ya statin ambayo yana lengo la kupunguza LDL-C, hushindwa kuonyesha kupungua kwa vifo vya sababu zote, na kwa hivyo hatuhitaji kujishughulisha na LDL kabisa. Hii ni tu wazi nje sayansi mbaya. Ikiwa una chakula chenye mafuta mengi na huoni kuongezeka kwa LDL, inaweza kuwa ishara kwamba chakula hicho kinakufanyia kazi, labda kama njia ya kudhibiti sukari ya damu. Kwa upande mwingine, ikiwa una kiwango cha juu cha mafuta na viwango vya juu vya LDL, uwezekano mkubwa wa ugonjwa wa moyo unazidi. Kuna mambo machache ya kuzingatia hapa: - Baadhi ya majaribio ya statin huonyesha kupungua kwa vifo vya sababu zote wakati LDL-C inapopunguzwa. Kwa mfano, utafiti wa JAMA wa mwaka 2018 uliohusisha washiriki zaidi ya 270,000 uligundua kuwa vifo vya sababu zote vilipungua wakati LDL-C ilipopunguzwa kutoka 160 mg kwa 130 mg na tena kutoka 130 mg kwa 100 mg, lakini faida za vifo vya sababu zote ziliacha wakati LDL-C ilipungua chini ya 100 mg. Kwa maneno mengine, kupunguza LDL chini ya 100 mg dL haikuonyesha kupungua kwa vifo vya sababu zote, ingawa hatari ya mshtuko wa moyo na kiharusi iliendelea kushuka wakati viwango vya LDL vilipungua. Majaribio ya statin ni iliyoundwa kuthibitisha ufanisi wa dawa haraka iwezekanavyo, wao si iliyoundwa kuonyesha athari ya maisha ya cholesterol ya juu inayosababishwa na chakula mafuta nzito. "Hii ni kwa sababu ya mahojiano ya mwaka jana na Daktari Tom Dayspring, ""Mwanamke wa kwanza wa kwanza wa kwanza.""" Kupunguza LDL-C, na hasa APOB, inahusishwa na kiwango cha chini cha ugonjwa wa moyo katika bodi. Kwa hiyo, ni nini msingi wa jambo hili? Kujua viwango vya msingi vya LDL na biomarkers nyingine za afya ya moyo Angalia jinsi inavyoweza kubadilika wakati wa kula vyakula vyenye mafuta mengi. Ikiwa idadi yako inapita kupitia paa, usifikiri uwiano mzuri wa TG/HDL utapunguza hatari yako. Kula kolesteroli hakutachangia ugonjwa wa moyo kwa wengi wetu, lakini kula mafuta mengi yenye saturated kutaongeza LDL na hatari ya mshtuko wa moyo katika idadi fulani ya watu. Jifunze kuhusu idadi ya watu wanaosikiliza na usikie daktari wako wa moyo, sio blogi. Kwa wale ambao hawajui, podcast ya Dr. Peter Attia na Dave Feldman ni moja ya njia bora ya kuongeza mafuta. Dr. Attia kwa njia hiyo huficha "mfano wa nishati" wa Dave wa kimetaboliki ya cholesterol kwamba nimeshangazwa Dave aliendelea kuitetea hadharani baada ya mahojiano. # 10 - Kuhusu Cholesterol ya chakula huingiliana na microbiome Sisi kufunga juu ya cholesterol na microbiome. Si tu kuhusu jinsi tunavyofanya na kunyonya cholesterol, jambo jingine muhimu ni kile microbiome hufanya na cholesterol tunayokula. Jarida la New England Journal of Medicine limetoa utafiti wa kuvutia kuhusu jinsi kula mayai na cholesterol ya chakula hubadilisha microbiome, hasa kusababisha uzalishaji wa kiwanja kinachojulikana kama TMAO, ambacho kinahusishwa na ugonjwa wa moyo. Kwa mfano, katika jaribio moja, watafiti wa NEJM waliwapa watu mayai na kupima viwango vya TMAO, ambavyo viliongezeka. Wakati mtihani huo ulipowekwa kwenye dawa za kuua viini na kisha kulishwa mayai, viwango vya TMAO havikuongezeka, ikidokeza kuwa ni muundo wa microbiome ambayo husababisha uzalishaji wa TMAO na hatari ya moyo na mishipa inayokuja nayo. Nimekuwa na upendeleo wa kuhoji Integrative Cardiologist, na utu wa televisheni, Daktari Joel Kahn juu ya Gene Chakula Podcast. Dr. Kahn anafanya uchunguzi wa TMAO kwa wagonjwa wake na kupunguza mayai na virutubisho, kama vile L-carnitine, ambayo husababisha ongezeko la TMAO wakati viwango vya juu. Kwa kumalizia, ingawa ni kweli kwamba kolesteroli ya chakula imedhaniwa vibaya, kuna mambo yanayotofautiana na kila sheria. Ili kujua jinsi ya kuokoa maisha yako, unapaswa kujua kiasi cha cholesterol unachokunywa, jinsi mwili wako unavyoitikia mafuta yaliyojaa, na hali ya microbiome yako. Kama Carl Jung alivyosema kwa usahihi, " kadiri sheria inavyojitahidi kuwa halali ulimwenguni pote, ndivyo inavyofanya mambo madogo madogo yawe halali kwa kila mtu".