Cardiovascular disease (CVD) remains the leading cause of death in adults worldwide, and lipid metabolism disorders are significant risk factors.
Cholesterol is a waxy and fat-like substance made in our body. It is made in all cells, but mostly in the liver. Cholesterol is a back bone building block for steroid hormones, bile acids and vitamin D.
Cholesterol comes from the liver making its own and the diet. Foods like egg yolks and shellfish are high in cholesterol. If you eat only 200 to 300 milligrams (mg) of cholesterol a day (one egg yolk has about 200 mg), your liver will produce an additional 800 milligrams per day from raw materials such as fat, sugars, and proteins. You need cholesterol. Interesting fact: the liver typically stops making cholesterol when 800–1000 mg of dietary cholesterol is provided. Dietary fibre is known to help support the excretion of cholesterol through the stool. Levels of cholesterol are tightly regulated to maintain a “just right” level in the body. Disturbed cholesterol balance is the basis of cardiovascular and cerebrovascular diseases, neurodegenerative diseases and cancers.
Triglycerides
High levels of triglycerides (TAGs) identified at an earlier onset age was associated with higher risks for CVD and all‐cause death. A diet high in refined carbohydrates, processed foods and sugar is related to higher levels of TAGs. A reduction in processed foods and sugars is shown to lower levels of TAGs.
LDL
Higher levels of low‐density lipoprotein cholesterol (LDL‐C) levels in the middle‐aged and older population are associated with increased of risk of CVD and death. Low-density lipoprotein (LDL) is brought into cells around the body to make things like bile (liver cells), vitamin D and hormones like testosterone and estrogen.
LDL increase is associated with poor thyroid function, small intestinal bacterial overgrowth and H. Pylori bacterial infection. Blood tests and breath tests will help diagnose these conditions. LDL cholesterol levels, as well as all other lipid levels, can be expected to increase in later stages of normal pregnancy to meet increased energy demands of the mother and the fetus. Certain diseases of the kidney and liver can elevate LDL cholesterol levels.
Metabolic associated fatty liver disease (MAFLD) additionally leads to dysregulation of cholesterol metabolism and increased risk of cardiovascular disease. MAFLD typically begins with dysregulation in gut health. Endocrine diseases such as hypothyroidism and diabetes mellitus, especially type 2 diabetes, may raise LDL cholesterol levels. Various prescription and nonprescription drugs have been shown to cause elevated LDL cholesterol in some individuals. LDL also tends to increase in women as estrogen declines in post-menopausal years.
Causes of high LDL cholesterol that are potentially modifiable through behavioral change include MAFLD, sedentary lifestyle, obesity, and excessive alcohol use.
HDL
HDL removes excess cholesterol from cells and takes it to the liver for recycling or disposal. That’s why higher levels are generally a good thing. HDL has a ApoA-1 protein core. Apolipoprotein A1 (ApoA1) level is a significant factor in central nervous system inflammation as well as vascular, neuronal, and synaptic changes related to poor cognition in T2DM and those individuals at the preclinical stages of Alzheimer’s disease. Lower levels of HDL are a risk factor for insulin resistance, inflammatory conditions including autoimmune disease. Diet and lifestyle factors can help increase this good cholesterol.
Infections
Another cause of high cholesterol profile is infection. Multiple studies have shown associations between bacterial infections like Chlamydia pneumoniae and H. pylori, which is the bacterium causes duodenal ulcers, and viral infections like herpes and cytomegalovirus and elevated lipids. For example, H. pylori leads to elevated levels of total cholesterol, LDL cholesterol, lipoprotein (a), ApoB or LDL particle number, and triglyceride concentrations as well as decreased levels of HDL. Naturopathic medicine can help identify and treat H. Pylori.
Leaky gut
One of the primary functions of the intestinal barrier is to make sure that stuff that belongs in the gut stays in the gut. When this barrier fails, endotoxins such as lipopolysaccharide (LPS) produced by certain species of gut bacteria can enter the bloodstream and provoke an immune response. Part of that immune response involves LDL particles have an anti-microbial effect. A protein called LPS-binding protein, which circulates with LDL particles, has been shown to reduce the toxic properties of LPS by directly binding to it and removing it from the circulation. Studies have also shown significant increases in LPS-binding protein (and thus LDL particles) in cases of endotoxemia—a condition caused by large amounts of circulating endotoxins.
Though more research is needed in this area, the studies above suggest that a leaky gut could increase the level of LPS and other endotoxins in the blood, and thus increase LDL particle number as a result.
This article is for educational purposes only and is not medical advice.
Want to find out more? Ask drlaura@southendguelph.ca or book an initial appointment at https://southendguelph.janeapp.com
