Cholesterol – Most Misunderstood Lipid

From the previous post we understood, Cholesterol is an integral part of human development and health. without it there is no life. Therefore, body syntheses of its Own, even you avoid.

The synthesized cholesterol needs to be circulated/sent all over the body and the only possible way to transport it thru blood stream. But, the blood and cholesterol (waxy substance) doesn’t mix! Hence, a shuttle or carrier required to transport the cholesterol molecules all over the body thru blood stream.

Those shuttles or carriers are known as LDL (fallaciously/commonly known as bad cholesterol) & HDL (commonly known as good cholesterol) But both, LDL & HDL are NOT cholesterol. They are lipoproteins.  (LDL – Low Density Lipoproteins and HDL   – High Density Lipoproteins) apart from LDL, HDL, there are other two types of proteins namely, chylomicrons and VLDL (very low-density lipoprotein)

Lipoproteins not only carries of cholesterol but, also carries the triglyceride, phospholipids and protein in different proportions. Lipoproteins can be differentiated on the basis of their density and the types of apolipoproteins they contain. The degree of lipid in a lipoprotein affects its density—the lower the density of a lipoprotein, the more lipid it contains relative to protein.

Chylomicrons are synthesized by enterocytes from lipids absorbed in the small intestine. Its triglyceride-rich lipoprotein. The function of Chylomicrons is to deliver energy-rich triacylglycerol to cells in the body.

VLDL is synthesized in the liver, from excess dietary carbohydrates.  (note: NOT from excess Dietary fat)  Also triglyceride-rich lipoprotein to deliver energy-rich triacylglycerol to cells in the body. Once, the VLDL loses or releases   the triacylglycerol, they become denser and these particles are remodeled by the liver and transformed into LDL.

LDL :  VLDL remodeled by liver as LDL (If no VLDL, No LDL) The function of LDL is to deliver cholesterol to cells, where it is used as a cell membranes and synthesis of steroid hormones. Such an important LDL is named as Bad cholesterol! If no LDL, your body cells can’t make cell membrane and steroid hormones. In other words, LDL carries “fresh” cholesterol from liver to the cells.  

HDL is synthesized and secreted by the liver and small intestine. The function of HDL is to remove the excess cholesterol from the cells (Also, when a cell die, it releases the cholesterol also picked by HDL) is brought back to the liver by HDL in a process known as reverse cholesterol transport. Then in the liver the excess cholesterol is converted into bile salts. In other words, HDL carries “recycled” cholesterol from the cell to liver. 

So, there is nothing called “Bad cholesterol” or “Good cholesterol” First of all, they are not at cholesterol, they are lipoproteins.  Like BMI and Calories people were misinformed about a vital substance cholesterol. 

Next time if someone talk about Bad cholesterol and Good cholesterol, simply ask them to write the chemical formula of both good and bad cholesterol   (They can write only the C27H46O the chemical formula of cholesterol) they can’t because there is no such thing. Technically, if there is no LDL, no HDL, As simple as that. Hence, it’s impossible to increase HDL, without increasing LDL.

Our body has got an ability (naturally) to regulate the amount of cholesterol at any given point of time. I.e. when we ingest more cholesterol from food, the body produces less; when our cholesterol intake is low, the body makes more. Therefore, there is no effect or relationship between dietary cholesterol and blood cholesterol levels. 

Also, it’s not possible to consume too much cholesterol (thanks to satiety hormones) but, it is possible to take less or no cholesterol. this case body (liver) needs to work hard to produce its own.

Now let’s see how the blood lipid profile (cholesterol test) was done……….. 

When your physician asked for standard blood lipid profile test. Where total cholesterol, HDL and Triglyceride are the ONLY measured parameters, the rest LDL and VLDL are derived parameters, using an equation derived by William Friedewald in 1972, Known as Friedewald equation.  

For mg/dl :

Total cholesterol  (TC) = LDL + HDL + Triglyceride/5   or  LDL = TC – HDL – (TG/5)    

For  mmol/L   :  

Total cholesterol  (TC)  = LDL + HDL + TG/2.2     or     LDL  = TC – HDL  – (TG/2.2)  

  

From the above, to derive the total cholesterol, there are only three different variables (3 different lipoproteins) are present. Whereas we have 5 different (variables) lipoproteins namely, chylomicrons, VLDL, LDL, HDL and TG !

But, in the equation Chylomicrons were totally ignored and VLDL, LDL were estimated. (VLDL = TG divide by 5 for mg/dl and TG divide by 2.2 for mmol/L) In order to find all the variables precisely (without estimation) we need to find at least one more variable, which is LDL. 

The ratio of TG and VLDL is (assumed as) constant at 5:1 for mg/dl and 2.2 for mmol/L. But, there is no valid physiological justification/reasoning provided for the constant.

After reviewing the lipid profile report, Physicians advise to decrease the LDL, Total cholesterol (TC) and Triglyceride (TG) and Increase the HDL.

It’s really possible to do so ? Here is an example…….

Case 1 :   LDL = Total cholesterol – HDL – (Triglyceride/5)           =>              128  = 200 – 60 – (60/5)

(Where, LDL = 128 ; TC = 200 ; HDL=60 ;  TG = 60 and VLDL = 12 )

Case 2 :  LDL = Total cholesterol – HDL – (Triglyceride/5)           =>              60  = 200 – 60 – (400/5)

(Where, LDL = 60 ; TC = 200 ; HDL=60 ; TG = 400 and VLDL = 80)

Observe both the cases, if you want to reduce LDL so called “bad cholesterol” then your Triglyceride levels will go very high. I.e. LDL and TG inversely proportional!  But, your doctor will advise to reduce both LDL and TG (because he believes LDL blocks the artery and TG is the cause for Obesity) but he won’t say how.  Because he, himself doesn’t know!

Your physician ask you to reduce LDL (because he was told to believe it’s bad) and increase the HDL. It’s impossible to increase HDL without increasing the LDL. Because, HDL production is controlled by LDL. The function of HDL is to remove the excess cholesterol from cell surfaces and from other lipoproteins. If there is no excess cholesterol, how body produce more HDL?

In Case 1, VLDL is 12 and LDL is 128, and the Case 2, VLDL is 80 and LDL is 60. We know, VLDL remodeled by liver as LDL (by removing triacylglycerol and some proteins, the percentage of weight that is cholesteryl esters increases and become LDL) other words LDL not produced directly by the liver. Just comparing the LDL, VLDL ratios, Is there any correlation between them?

Also, your doctor may tell you to reduce the total cholesterol level and Increase the HDL (because he was told to believe it’s good) but, as per the equation both TC and HDL are directly proportional. If you increase HDL (It possible ONLY by eating saturated fat, but your Doctor will say don’t eat!) your total cholesterol also will increase, then he will prescribe cholesterol drug to reduce TC!  Does it make any sense?

This is how the cholesterol formula works!! It’s still in practice and medications were prescribed based on this estimations! Is there any way to measure LDL directly? There are more than one technique is available to measure LDL accurately but not in practice. 

Moreover, LDL count doesn’t reveal anything. Rather the the count, LDL particle size and the ratio between the TG and HDL will reveal much more about CHD (Will write in detail later)

So, why this flawed formula still in practice?  All the credits goes to the Medical Associations, Drug Industry, food industry, Insurance companies and the media were joined their hand together to sell the pack of lies to the common people, to protect their interest (business)

Still do you believe cholesterol is bad for us? If yes, ask yourself, then why does the body (liver) needs to produce ? If you say No, wait for the next post 

Cholesterol - Vital Substance

Even though, cholesterol is often portrayed as a Villain, Ironically without cholesterol there is no life on earth!    Cholesterol is essential to life. Hence, called Queen of Fats.

Cholesterol is a waxy organic chemical substance, found in all cells of the body. In 1758, French Doctor Francois Poulletier de La Salle isolated solid cholesterol from gallstones. “Cholesterol is the Greek word. "Chole" means bile, "stereos" means solid, and the chemical suffix "ol" means alcohol.”

Almost, every cell in the body can produce its own cholesterol and the production is regulated by certain proteins. However, the liver is the primary producer of the cholesterol and supply/share with other parts and organs of the body.

Please note that, Cholesterol will be produced by the body, even if you avoid the dietary Cholesterol. In other words, even if you are in completely cholesterol-free diet, the body will produce its own cholesterol about 1500 – 2000 milligrams per day for normal adult.

When we eat more (saturated) fat, our liver makes less. I.e. you are not over loading the liver. (Liver has got plenty of other task to do) but, by restricting or eliminating cholesterol, liver had to produce the cholesterol from carbohydrates thru its enzymes by thirty different complex chemical process. Which not only overburdens the liver also the (produced) cholesterol profile is much inferior.

If Cholesterol is nemesis of our health, why liver (overburdens himself and) needs to produce?  Due to the flawed research data, it projected as a deadly poison. Will see later in a separate post. Today, we will focus only the importance of this vital element.

Cholesterol is responsible for several vital biochemical processes in our body and plays an important role in order to keep us healthy. That’s why liver is working hard to produce cholesterol, even you avoid. Such “hard working” liver may end up with fatty liver or liver cirrhosis condition.

Cholesterol is a building block of cell membranes and a necessary component to synthesis hormone, bile acids, vitamin D from the sun, and playing a pivotal role in brain neuro-transmission.

Building blocks: Cholesterol is a structural component of cells. Cholesterol is necessary to form the outer coating of cells (plasma membrane) Which makes the cell waterproof (as protective barrier) so there can be a different chemistry on the inside and the outside of the cell. It also, provide rigidity and stability of the cell thus preventing membranes from freezing, shrinking and damaging.

Cholesterol is preventing the fatty acid crystallization to provide optimal temperature to maintain the desired fluidity of membranes and also prevents accumulation of phospholipids in the cell membrane.

Hormone production: Cholesterol (steroid alcohols) are vital elements to produce steroid hormones and sex hormones.

Without Cholesterol, Human sex hormones like estrogen, progesterone and testosterone can’t be synthesized. These hormones are vital to trigger the development of the physical traits, characteristic of adult women and men, also play an important role in reproduction.

The steroid hormones produced from cholesterol include cortisol and aldosterone. Cortisol plays an important role in blood-sugar regulation and defending the body against infection and Inflammation. Aldosterone, is an important hormone to regulate the blood pressure and retaining correct salt (electrolytes) and water in the body.

Vitamin D:  According to me, Vit D is not a vitamin, it’s a hormone. Yes, it’s Hormone D!  Is a very important substance for human life and will write a separate and detailed post later. I strongly recommend to read the book "Power of Vitamin D" is written by Dr. Sarfraz Zaidi, MD,

Such important vitamin (hormone) can’t be produced without cholesterol and sunlight.  Cholesterol is the precursor of vitamin D.

Bile Production: Cholesterol is integral to the production of bile, a greenish fluid that is produced by the liver and stored in the gallbladder. Without bile body can’t digest foods that contain fat. Bile acts as an emulsifier also helps to absorb the nutrition’s and fat soluble vitamins.

Immune system: Life-saving immunoglobins are made from cholesterol! Our immune system depends on cholesterol (especially LDL-cholesterol) to fight against infections and repair functions. In other words, those who are with low blood cholesterol are prone to various infections.  Also, Cholesterol is a powerful antioxidant in the body and helps heal the damage caused by free radicals and playing an important role in the healing process of wound and inflammation.

Cholesterol is a “feel-good” substance that protects us against depression and stress. Cholesterol is vital to the function of the brain, nervous system and proper synthesis of neurotransmitters, which is essential for propagation of nerve impulses through neurons.

Such a vital substance was wrongly associated with heart diseases, by misguided theories about cholesterol, and  the flawed research data’s which supported / backed up by Medical associations, Pharma, food industry in order to protect their business interest. Unfortunately, the Government also blindly supported such cholesterol guidelines is a shame!

If cholesterol is harmful to body, why does it produce? Body produces the cholesterol to clog up its own arteries? This would be against Natural Law and survival of the Species.

Finally, I end this topic with a Quote from Thomas Jefferson, 3rd President of USA………

“If people let government decide what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as are the souls of those who live under tyranny”

Calories ?!

Lately, there was a discussion regarding calories and realized how people were lead strayed about the calorie concept. So, this post is for those who count and calculate calories, either to lose weight or to maintain. This post focuses the term calorie in biological point of view.

The calorie story beings in 1825, A French Professor Nicolas Clément defined the Calorie as the quantity of heat needed to raise the temperature of 1 kg of water from 0 to 1°C. (Calorie originated in studies concerning fuel efficiency for the steam engine)

In 1887, nutrition expert Wilbur O. Atwater translated the steam engine-inspired idea of the calorie for the food research community and started to use the “term” calories in his articles. Therefore, the Calorie became the “preferred” unit of potential energy in nutrition science and dietetics.

The term “calories” was displaced when the joule, g-calorie and kcal were introduced. Later, the “original” calorie usurped in 1948, during the period of international standardization. As a result, no form of the calorie is recognized as an SI unit.

Since from 1970, nutrition scientists made the transition from calories to kcal. (1kcal =100 calories and 1 kcal = 4.186 kJ) However, according to the Department of Foods and Nutrition, it’s believed, “the calorie of present food labels is similar to the original French definition of 1825.” !!! And the problem begins……..

Complex Metabolic Pathways........

From the above its pretty clear that, calorie is not a biological term. Energy in biology is not the same as energy from steam engine. In other words, human body is not powered by steam engine! Our energy production, from food (metabolism) is much more complex chemical process than steam engine. Our metabolism extract far more than heat-based energy from food.

It’s quite unfortunate that based on this “calorie” haphazard, the other calorie theories were built. The beginning of era of metabolic disorders!

The concept of "Calorie In, Calorie Out” (CICO) is frequently referenced by the nutrition’s and dieticians in the weight loss program. CICO must be derived from Energy In equal to energy out (calorie is the unit of energy and law of thermodynamics)

As per the first law of thermodynamics dictates that body mass remains constant when caloric intake equals caloric expenditure. If intake more than the expenditure, weight gain and if intake less than the expenditure weight loss occurs. Again, metabolic process is not as simple as thermodynamics. Our body process, different calories in different way.

Different foods go through different metabolic pathways. Some foods can cause hormone changes that encourage weight gain, while other foods can increase satiety and boost the metabolic rate. In high carb meal, hormone insulin dominates and in high fat meal hormone glucagon dominates. Also the other hormones, like Leptin and Ghrelin behaviors differently in high carb vs high fat meal. (Refer : Obesity) Hence, generalizing the calorie is a calorie is a fundamentally flawed view in biology.

CICO was famously supported by Fred Stare, Founder of Harvard University of Nutrition Department, who believed that: “Calories are all alike, whether they come from beef or bourbon, from sugar or starch, or from cheese and crackers. Too many calories are just too many calories.” But, in reality calories from Carb and calories from fat are not the same. The calorie source plays a major role here……different macro nutrition’s are metabolized differently and triggers different hormones and enzymes. Again, metabolic process is not as simple as thermodynamics.

The Quality and Type of the Calories Matters Not the Amount.  As per the CICO, 250 ml of diet cola (claims zero cal) and 250 ml of water is same! Is that make any sense?

Let see in more depth…..

In 1944 Ancel Keys (yes, the same person who classified fat as the villain with blemished data. Later, will write a separate post on Ancel key and his flawed study) did a long-term study of starvation on Eastern European population (Reference : The Great Starvation Experiment: Ancel Keys and the Men Who Starved for Science) and 36 young healthy, normal weight male volunteers had been chosen and fed with energy intake of 1570 calories per day. I.e. Protein 100 gm, fat 30 gm, and carbohydrate 225 gm.  

After twenty-four weeks of the study, the subjects have not only lost a considerable percentage of their body weight, but also suffered a number of problems. They became lethargic, they were cold all the time, they became depressed, they developed bleeding disorders, their ankles became edematous and some developed more serious psychological disorders.

 

After 25 years of the Ancel Keys long-term starvation study, In 1960 John Yudkin (Author of Pure, White and Deadly, the book that changed my life! You can see on the left side of my blog at top position) conducted the study to treat obesity in low carb diet which in in view of the Keys’ semi-starvation study.

 

Dr. J.Yudkin’s objective is to determine the dietary intake of the essential nutrients in the low-carb diet to see if there were inadequacies. Eleven subjects of aged 21-51 years were selected for the study and fed with 83 grams of protein, 105 grams of fat and 67 grams of carbohydrate, which constitutes 1560 calories per day.

At the end of the study, none of the subjects were complained of hunger or any other ill effect. And they had an increased feeling of well-being and decreased lassitude.

Yes, in both studies, the intake of energy (calories) per day is almost the same. But, with huge differences in outcome. 

This is the clear evidence to say "A Calorie" is not equal to "A Calorie". In other words, it’s not the number of calories that makes the difference, but the composition of the calories instead.

Since, the scope of this post is only about the calorie, I am not going in depth with low carb high fat diet benefits now and will see later.

Now, the second part……..Often, nutrition’s and dieticians give calories based diet like 2200 calorie diet. They used to arrive these magical number by basal metabolic rate calculations (BMR). There are many different BMR equations (mathematically derived by using certain constants) available by different authors.

Again, our body is not a Math equation. Metabolism is very complex chemical process, it’s not as simple as to find the area of circle or triangle. It’s almost impossible to bring all the different variables of metabolism into an equation (formula) form.

That’s the reason, I always say do not go behind the calorie based diet. In HFLC, there is no calorie restriction. Eat until your body feels full and satisfied. Let your body decides how much calories it requires. You can’t drive the calorie requirement outside the body. 

Our body has two special hormones (Leptin and Ghrelin) to control your food intake. All you need to do is your carb count. Do not exceed more than 50g of carb per day. If you are diabetic, 20g per day.  With adequate amount of protein (from animal source) 1g per kg (of body weight) is the minimum requirement for normal. Also, metabolism is a self-regulating process, it slows down, when fed with less calorie and vice versa.  

Finally, calorie counting on food (on food labels) is also not accurate. Different food companies uses different methods (up to 5 different methods are available with 20% tolerance) In general, however, bomb calorimeter is widely used to measure the amount of energy (calorie) contained in the food.  Unfortunately, body is not an incinerator like bomb calorimeter, it doesn’t burn the food rather it process the food (bio-chemically) to extract energy.

We don’t absorb all calories we consume, our body absorbs the energy from different food differently. Food preparation method’s greatly alters the energy absorption. Individuals absorb energy from food uniquely and variably, also burn the energy uniquely and variably and different people measure their portion differently.

Hence, all theory’s based on calorie is baseless and flaw. So why these theories were promoted? Food manufacturing and processing companies, want us to believe it’s all about calories and that their low calorie products are the best choice in order to keep calories down and lose weight. The mass-media and the medical associations are join hands with food companies and keep the truth under wraps, in order to protect their business.

You need to take control of your food choices and chose the food that your body prefer and keep the blood sugar and other vitals in normal range. (refer: Normal vs Abnormal ) Do not allow the food companies to dictate what to eat and what not to eat. Eat the food that your body capable to understand and process.