How does cholesterol cause heart disease?
Here’s a question I was recently asked:
How does high cholesterol affect your cardiovascular system?
Let me see if I can explain and keep the process easy to understand!
First the endothelium (thin inner lining of your blood vessels) becomes damaged and inflamed. This damage can be caused by a variety of factors, such as high blood pressure, high stress level, poor diet, toxic chemicals and metals, tobacco smoke, etc.
So, your inflamed endothelium becomes susceptible to attracting fatty particles like cholesterol. The cholesterol particles work their way into the lining. These deposits of cholesterol can then be damaged by free radicals to form oxidized LDL cholesterol.
The immune system responds to the inflamed site by secreting a substance to make the endothelium sticky. The process leads to the formation of macrophages whose goal is to “seek and destroy” foreign objects. However, the oxidized LDL is toxic to macrophages, causing macrophages to be immobilized and unable to return to the blood stream.
The process continues to draw white cells to the area where they too are immobilized by oxidized LDL leading to the formation of a “fatty streak” on the artery wall.
A number of steps now take place involving C-reactive protein, fibrinogen, white blood cells, elastin, and collagen that eventually form a tough, fibrous cap over the fatty steak. Under the fibrous cap, dead cells accumulate, decay, and produce pus. You now have the development of a dangerous plaque within your artery walls. Plaque can continue to grow and instigate the development of additional plaque within the arteries leading to the narrowing of your blood vessels, reduced blood flow, heart attacks, etc.
FYI – Cholesterol does not necessarily need to be elevated for the above steps to take place. It’s becoming more clear that knowing your LDL and HDL particle size gives you a better overview of your heart health than typical cholesterol levels. Particle size can be determined with lab work, such as a Lipoprotein Particle Profile.
All the best,
Lisa Nelson RD
Heart Healthy Tips
Heart Disease – Does green tea lower heart disease risk?
All right, this green tea article has been hanging over my head for at least a month now. I just couldn’t get motivated to wade through all the research to determine if yes, this is an effective way to lower cholesterol and prevent heart disease, or no, it’s just a lot of hype.
Well, I sat down and sorted it all out today and here’s what I found.
Health Claim
The proposed health claim for green tea is that drinking at least 5 fluid ounces as a source of catechins may reduce risk factors associated with cardiovascular disease.
What are catchins?
Green tea contains catechins, which are a type of flavenoid with antioxidant properties. Antioxidants slow the oxidation process. The oxidation of LDL molecules is what results in plaque formation. Therefore, increasing antioxidant intake should slow oxidation of LDL, resulting in less arterial plaque formation.
Also, when molecules are oxidized, free radicals are released that damage cells. These free radicals can increase inflammatory issues associated with cardiovascular disease.
How flavenoids work
The body recognizes flavenoids as foreign particles and works to eliminate them from the body. Flavenoids themselves do not act as an antioxidant and they are poorly absorbed by the body. However, the proposed benefit of extra flavenoids is that as the body eliminates the unwanted flavenoids, damaging free radicals are also eliminated.
Tea production
The various types of tea are produced differently. The leaves of oolong tea and black tea are allowed to oxidize (enzymes in the tea change catechins to larger molecules). Green tea is not oxidized, but produced by steaming fresh-cut leaves whereby enzymes are inactivated and little oxidation occurs. The least processed tea is white tea, which contains the highest levels of catechins. Green tea contains the second highest catechin level, approximately 125 mg catechins per serving (or ~25% dry weight of fresh tea leaves).
Here’s a little breakdown on tea oxidation:
Black tea – Highest oxidation; also, highest caffeine content and strongest flavor; 90% of all tea served in the West is black tea
Oolong tea – 10-70% oxidized
Green tea – Low oxidation
White tea – Minimal oxidation; Uncured, unfermented; Lower caffeine content that other teas
FDA Review
In 2005, the FDA did not approve the health claim for green tea, because the link between green tea and reduced cardiovascular disease risk was too weak and more conclusive evidence was needed.
Recent Research
This past June, 2008, a study was published that links green tea to reduced flow-mediated dilation of brachial arteries (major blood vessels in the upper arms). Flow-mediated dilation is related to coronary endothelial function and is an indicator for cardiovascular disease risk. Increased dilation is good. It means the heart has to do less work to move blood throughout circulation. (The endothelium is the inner layer of an artery, which blood flows against.)
This was a study of 14 healthy individuals that consumed 6 grams of green tea, followed by a measure of flow-mediated dilation. The results showed an increased flow-mediated dilation with tea (peak at 30 minutes post consumption). There was no change to antioxidant status after consumption. It’s proposed that the improved flow-mediated dilation is how green tea reduces cardiovascular disease risk.
The Hype
I came across multiple articles with headlines screaming “Green Tea Protects Against Heart Disease” since this study was published in June. I think there is significant research that still needs to be completed before it can be determined for sure how tea works to prevent heart disease. A study of 14 individuals is a small study.
Drinking 6 grams of green tea, would equal about three – 6 ounce cups of green tea each day. (Based on making 1 six ounce cup of tea with 1 teaspoon or 2.25 grams of green tea.) However, the study results are based on consuming 6 grams of tea in one setting followed by improved flow-mediated dilation at peak levels 30 minutes after consumption. How likely is it for you to drink three cups of tea quickly, back-to-back to reproduce the short-term benefit shown in this study?
To me, that is not a very effective way to reduce heart disease risk. But, I will say that if you like green tea – drink it. Many studies are showing that green tea is beneficial to heart disease. The what, how, and how much is yet to be determined. Who knows what future studies will find?!
To receive regular heart health and weight loss tips for dietitian Lisa Nelson, sign up for The Heart of Health and grab your copy of the special report “Stop Wasting Money – Take Control of Your Health” today!
All the best,
Lisa Nelson RD
Heart Healthy Tips – 3 Key Minerals to Lower Blood Pressure
1. Reduce your SODIUM intake.
Too much sodium in your diet can contribute to high blood pressure and make your blood pressure treatment less effective. Simply reducing your sodium intake to 2.3 grams (6 g table salt) daily can decrease your blood pressure.
The average American consumes 6-18 grams of table salt daily (about 3 teaspoons). The body only needs 200 mg daily. That is 30 times less than what American’s typically consume.
To be heart healthy, sodium intake should be reduced to less than 2300 mg (1 teaspoon) daily.
Quick tips to cut back on sodium:
- Don’t add salt when boiling water.
- Leave the salt shaker off the table.
- Read food labels to avoid foods high in sodium.
- Avoid foods high in sodium, such as gravies, cheese, and soy sauces.
2. Increase your POTASSIUM intake.
Potassium works to balance out the sodium in your diet. An adequate potassium intake can lower systolic pressure ~4.4 mm Hg and diastolic pressure ~2.5 mm Hg.
Good potassium sources:
Cantaloupe, bananas, dates, nuts, oranges, and green leafy vegetables
Maintaining an adequate intake of potassium is especially important if you are taking diuretics. Some diuretics increase potassium loss via the kidneys.
3. Add more MAGNESIUM to your diet.
Research has shown an inverse relationship between magnesium and blood pressure. In other words, individuals with a high magnesium intake, typically have a low blood pressure.
Good sources of magnesium include:
Peas, beans, whole grains, nuts, seeds, lima beans, squash, broccoli, spinach, and seafood
Supplemental magnesium of ~500 mg can effectively lower blood pressure. Some studies have found magnesium supplements to reduce systolic blood pressure 2.7 mm Hg and diastolic 3.4 mm Hg. Discuss all supplements with your MD!
All the best,
Lisa Nelson RD
Heart Healthy Tips
Sleep Weight Loss – Lose Weight by Getting a Goodnight’s Sleep
Do you get enough sleep? 7-9 hours each night? If you are struggling to lose weight, adequate sleep is essential.
Sleep deprivation affects the balance of two hormones that regulate appetite and satiety – leptin and ghrelin. Leptin is produced by fat cells and signals the brain when you are full. Ghrelin is produced by stomach cells and signals the brain when you are hungry and should eat. Studies show when you are sleep deprived, leptin levels decrease and ghrelin levels increase. This causes you to feel the urge to eat more when you do not get enough sleep.
Here are five tips to help you get a good nights sleep:
1. Exercise regularly.
Being regularly active during the day makes falling asleep easier. As little as 20-30 minutes of activity helps. Don’t exercise too late, which can actually stimulate the body and make sleep more difficult.
2. Avoid alcohol, caffeine, and tobacco.
Alcohol makes falling asleep easier, but reduces the quality of sleep you receive. Caffeine can still interfere with sleep up to 10-12 hours after consuming it. Nicotine found in tobacco acts as a stimulant which may disrupt sleep.
3. Select bedtime snacks that promote sleep.
A light snack before bed may promote better sleep, especially if it contains the amino acid tryptophan, calcium, and carbohydrates. Some good bedtime snacks include:
Warm milk with half a peanut butter sandwich
Low fat yogurt with granola
Hot chamomile tea with a piece of fruit
4. Avoid a large meal or too much liquid close to bedtime.
Consuming a large meal before bed can make sleep difficult due to the bodies focus on digestion. Too much liquid before bed can cause you to wake for frequent bathroom trips.
5. Keep a regular bedtime schedule.
This is one of the most important habits you can maintain to achieve adequate sleep. Go to bed and wake up at the same time each day, including weekends. This will make it easier to fall asleep and improve your overall quality of sleep.
What is one thing you can do this week to get more sleep?
Drs. Chris and Kara Mohr developed the 21 Days to Better Sleep program. I highly recommend it. Their videos with instructions are engaging and the content can be put to good use so you achieve quality sleep each night. Learn more and purchase the program here.
All the best,
Lisa Nelson RD
Weight Loss – Do you need to change the way you think to lose weight?
It’s the New Year and there’s a good chance you’ve set a weight loss goal for your New Year’s resolution. By losing weight you’ll dramatically reduce your heart disease risk, lower blood pressure, and lower cholesterol. However, according to studies, the chances of you achieving your weight loss goal this year are slim.
I want to increase your chance of success, but it might require a mind shift! I have a couple issues I want you to explore your thoughts on.
1. Dieting
The first is whether or not you should make a mental shift around the whole “dieting” issue. Let’s focus on the word itself – “diet”. I want you to think about and explore your reaction and feelings when you hear the word “diet” and when you think about “going on a diet”. What comes to mind?
Examples would be feelings of restriction, thoughts of the short-term, such as I’ll do the South Beach Diet for two weeks to jump start my weight loss, another thought may be limits, and thought’s of what you can and can’t have once you start a diet. Of course, it’s possible you have a more positive reaction, such as hopeful and excited about the possibilities. My gut reaction is negative, which is probably why I can come up with a longer list of negatives for examples! I feel a tightening in my stomach when I think about “going on a diet”. I immediately have thoughts about the foods I can’t have, I feel restricted, and I think about when the diet will be over.
Have you considered another option to reach your weight loss or other health goals besides dieting? Here’s what I want you to consider now and in the days to come. Do you have to go on a diet to meet your goals? Instead, could you focus on healthy living and making healthy choices. Generally the word diet implies a short term approach and gives short term results. If you like statistics, statistics show 95% of people who lose weight on a diet gain it back. That’s not very encouraging. If you make a commitment to healthy living or healthy choices you shift to a long term mindset. A type of thinking that supports small changes over time that lead to permanent results.
Take some time and explore your reaction to the two statements:
“I’m making healthy choices.”
Versus
“I’m starting a diet.”
Which has a more positive feel for you?
If this isn’t something you’ve considered before, it’s simply a shift in thinking I’d like you explore. See if you need to adjust your mindset.
2. All or Nothing Approach
Okay, let’s move on to the second issue I want you to consider – Does if have to be an “All or Nothing Approach”?
Do you have to change all your bad habits at once to be successful?
For example, going on a raw food diet is probably a drastic change for most of us. (FYI – I’m in no way recommending a raw food diet, simply an example.) Is that the type of approach you need or would you be more successful targeting one or two not so healthy habits to change at a time? Once you’ve successful changed those habits, you move on to new ones.
“Strict diets” and “all or nothing approaches” generally fail. It is unrealistic to expect yourself to stick with a strict diet plan forever. Many people are gung ho at the beginning of a diet, after a week or two they start to slack off and “cheat” on the diet. Feelings of guilt and failure come in and thoughts of “well I’ve already blown today, I’ll start fresh tomorrow”, and then the gradual plummet back to old unhealthy habits.
So, I encourage you to consider a more open approach to achieving your health or weight loss goals. Does it have to be all or nothing?
Receive nutrition coaching from dietitian Lisa Nelson, as well as heart health and weight loss tips when you sign up for The Heart of Health. Subscribers receive the free bonus report “Stop Wasting Money – Take Control of Your Health”.
All the best,
Lisa Nelson RD
Lipoprotein a – How to Lower Lipoprotein a
Lipoprotein(a) levels are not affected by the foods you eat or your activity level. There are no prescription medications, including statin drugs, that have an impact on reducing levels. That doesn’t mean you don’t have options if you live with an elevated lipoprotein(a). Using supplements, such as omega 3’s, niacin, and vitamin C are three options for reducing lipoprotein(a).
Work with your doctor to learn your lipoprotein(a) and the best treatment approach for you.
Testing lipoprotein a
Function of lipoprotein a
Dangers of elevated lipoprotain a
All the best,
Lisa Nelson RD
How to Lower Cholesterol in 8 Simple Steps
