Cholesterol - Myth

Since, I was quite busy at work and personal commitments, couldn’t post for the past two weeks. Thanks for your WhatsApp messages, asking about my well-being. Coming back to the business……….

In the past two posts (post1 & post 2) we have seen, how cholesterol is important for life and the erroneousness in the present lipid profile calculations. In this post, let’s see how to reduce the Triglyceride and Increase the HDL. Also, the relation between lipids and heart diseases.

Though Hypertriglyceridemia (high triglyceride level) is not only associated with Coronary Heart Diseases (CHD) Also, correlate more closely with waist circumference (abdominal obesity) Type II diabetes, pancreatitis (inflammation in Pancreas) non-alcoholic fatty liver, obesity, conditions like, low HDL and small, dense LDL particle formation. 

Definitely, hypertriglyceridemia is not a good sign for our health. As per the present standards, between 101-150 mg/dl is considered as Normal. (Less than 100 mg/dl is Optimal) before knowing the way to reduce the triglyceride level less than 70, let’s understand what it is.

Triglycerides are the main constituents of vegetable oils or animal fats. Triglycerides less dense than water (floats on water), and at normal room temperatures may be solid or liquid. When solid, they are called "fats" or "butters" and when liquid they are called "oils". Hence, they are known as neutral fat(s)

Our body uses the triglycerides as an energy reservoir and later uses for energy (to support starvation periods) also account for the vast majority of fat stored in the human body. Triglycerides are the mechanism for storing and transporting the fatty acids as a fuel also, help to maintain the blood sugar level. (refer: Human vs Food)

We get triglycerides directly from the food (like animal fat and Oils) or the Liver synthesis from the excess carbohydrate we eat. (that’s the reason in HFLC, we restrict the carb’s to 50 grams / day)  Triglycerides are released into the blood stream, in the form of VLDL where it is delivered to fat cells for long-term storage. (Adipose tissue) High triglycerides levels are the major causes of Obesity and Insulin resistance (diabetic) 

As their name suggests, the triglycerides are composed of one molecule of glycerol and joined via ester bonds with three molecules of (free) fatty acids. 

Glycerol (commonly known as glycerin, is a simple polyol compound, colorless, odorless, viscous liquid that is sweet-tasting liquid belonging to the alcohol family) is the backbone for triglycerides. In short, if there is no Glycerol, there is no triglycerides.

In HFLC, we consume triglycerides directly from the food source (not allowing or pretty much limiting the liver to produce) and during the digestive process, the triglycerides in our food are broken down into glycerol and fatty acids. Glycerol used to maintain the blood sugar level and the fatty acids are used as energy. There is no storage (no weight gain, no blood sugar surge) 

HFLC allows the body to start breaking the stored triglycerides, for energy and blood sugar maintenance. Which leads to lose weight. Specially the waist size, where the triglycerides stored as adipose tissue.

So, by eating fat, you actually burring the fat. By eating carb, you store the fat.  If you want to reduce the triglycerides level, the one and only possible way is to cut down (all forms of) the carbohydrate to less than or around 50g per day and consume (good, old) saturated and mono-saturated fats without any guilt. 

In my case, when I quit, all grains, cereals, sugar, fruits, legumes, lentils and start eating meat, animal fat and butter, my triglycerides levels come down about 56%. i.e. from 121 mg/dl to 53 mg/dl. (I have many evidences of such drastic change in triglycerides level, those who follow HFLC)

Mar 2015

Feb 2017

According to the Basic Medical Biochemistry—A Clinical Approach, pages 476, 510-12  “Adipose tissue (fat) is stored only when eating carbohydrates. Excess energy from dietary carbohydrate is stored away as triglyceride in adipose tissue”     

HFLC is not only decreasing the triglycerides level, also it increases the HDL. In my case 40 to 56 mg/dl, which is about 40% increase.

Dietary cholesterol, has very less impact on serum LDL. A study in Metabolism (Ref: Metabolism 2001 May;50(5):594-597.) showed that “With even a 30% fat diet, increasing dietary cholesterol from 319 mg to 941 mg per day (about 300% increase), the blood LDL only increased a mere 6% (18 points)!” 

From the above study is in line with my case. With HFLC, my fat consumption increased around 300% but my LDL percent increased only about 84% (my fat consumption increased from 30g to 120g) Instead of small and dense LDL, it’s become large and fluffy ones.

As far as LDL is concern, high level or count doesn’t matter. It’s a mere number. It doesn’t revel anything about the CHD. But, the LDL pattern is very crucial. The small sized, high dense LDL are the one stuck (rancid and became a plaque) in the artery. The large and fluffy LDL’s are totally harmless and can’t stuck or block the artery.

Again, please bear in mind, the LDL is there in, the artery only to cure/heal the inflammation that caused by high carb food, elevated blood sugar and insulin levels. (will write the separate post on this)  In HFLC, your liver start to produce large and fluffy LDL. Also, doesn’t cause an inflammation. HFLC address the root cause rather than just to treat the symptom.

Finally the total cholesterol level, as per the present standard above 200mg/dl considered abnormal level and you may be advised to take cholesterol drug to reduce. But, the truth is above 200mg/dl (with low TG and Large LDL) is a good sign that your liver is in healthy condition. In my case, the total cholesterol level increased from 190mg/dl to 300mg/dl. Which is about 58% (But, my fat consumption increased around 300%) 

According to the Framingham Study (largest study ever done on cholesterol) up to 340 mg/dl is perfectly normal. In fact, it’s Healthy! (refer: here  Also, will write in detail in the next post)

So next time, if you doctor ask to reduce the total cholesterol to less than 200mg/dl, ask him two simple questions, 1) who fixed the total cholesterol level up to 200 as a healthy level?  2) On what basis they arrived to this magical number 200.

If he can’t answer, don’t worry. I will tell you in the next post about big cholesterol scam.

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 

Macronutrients

Hello all,

Before jumping directly into HFLC diet, it’s better to understand some basics and terminology.  Let’s begin with ………..Nutrients.

The word nutrition comes from the Latin word “nutrire” meaning “to nourish”.  Nutrition is nothing but, the substances required by the body that must be obtained from the diet.

Nutrients required for the survival of all living being and can be divided into two categories. They are macro-nutrients and micro-nutrients. 

In this post, we will see only about Macro-nutrients. 

Macronutrients are the chemical substances required for growth and other human body functions. Our body needs in large amounts (of macronutrients) to provide energy (calories).

The major macro-nutrients are carbohydrate, protein and fat which contribute the major portion of our food as energy-giving caloric constituents.

Carbohydrates :  are sugar compounds that found to be simple or complex (Depending on their chemical structure) The shorter length of the carbohydrate molecule chain is known as simple carbohydrate and the longer length of the carbohydrate molecule chain is known as complex carbohydrate.

Simple carbohydrates (are easily broken down) and complex carbohydrates (like starch, takes longer time to break down) are break down in our body to single units of sugar, called glucose.

 

Foods with high glycemic index are known as simple carb (raises the blood sugar rapidly) and the foods with low glycemic index are known as complex carb. (raises the blood sugar tardily) 

Complex carbohydrates are found (as starch form) in cereals, grains, legumes, dairy, fruits and vegetables. Simple carbohydrates found in natural foods like grains, cereals, vegetables ect.

Also, there are man-made (“manufactured”) carb’s (sugars) are available in the processed food (by many hidden names) are known refined carbohydrate sources. (fast food,  candy, cola,  juice, ice cream, refined white sugar, brown sugar and wheat and corn based sugar products) 

Apart from complex, simple and refined carb’s listed above, the non digestible carbohydrates like cellulose are found in grains, cereals, fruits and vegetable is known as dietary fiber.  Since, it’s not digestible, doesn’t contribute any calories (energy) to the body.

In general, carbohydrates can provide 4 calories per gram. (In Physics calorie is defined as “A calorie is the amount of energy it takes to raise the temperature of one gram of water one degree”).  

Good about Carb : Easily digestible, provides (quick) energy, triggers insulin (by raising blood sugar) which enable the storage of glycogen and fat. (used during starvation) {will discuss later, in detail on the metabolism post}

Bad about Carb (if exceeds more than 50g/day)  : reason for blood sugar roller-coaster, causes insulin resistivity, triggers the appetite cravings and contributes to obesity, diabetic, hypertension, high triglycerides, small and sense LDL and coronary artery /cardiovascular diseases.

The bottom line is, whatever the carb, the digestive system changes carbohydrates into glucose, (glucose is the most simple sugar compound) which raises the blood sugar. (cells uses as an energy) The excess sugar in the blood stored in the liver and muscles as glycogen and the rest converted into fat and stored in the fat cells.

Fat (s):

The most misunderstood macro-nutrient (Thanks to the flawed research) Most of the people believe (or told) that eating fat will makes you fat, which is NOT true.

Fat is one of the three important and most calorie-dense macro-nutrients. Fat has about 9 calories per gram which is more than double of carb and protein. Extra fat is stored in adipose tissue and around the organ as subcutaneous as reserve, to burn when the body run out of fuel or need more fuel. (We will discuss later, in detail on the metabolism post)

Fat is an essential to human life and we cannot live without it. The basic units of fats are fatty acids and glycerol.  (Glycerol is a water-soluble compound that can bind up to three fatty acids)

Fatty acids can be divided into three groups namely, Saturated, Unsaturated fatty and Trans fatty acids, based on their chemical structure. We will discuss about this in detail in another post.

Fat is the calorie-dense nutrient and not only essential for growth and development, also acting as the backbone to important hormones, insulation for nerves, skin and hair health, and absorb nutrients and vitamins from foods we eat.

Saturated fat : mostly tend to be solid at room temperature as it contain more saturated fatty acids. Foods that are rich in saturated fats are animal products like, red meat, lard, tallow, poultry , Dairy products, such as fresh /heavy cream, butter, cheese, whole milk, from plant, coconut oil.

Saturated fats are totally healthy, only on low carb diet. They are harmful when combined with refined carb and high carb.

Unsaturated fat : mostly tend to be liquid  at room temperature as it contain more unsaturated fatty acids. It further classified into Monounsaturated fatty acids & Polyunsaturated fatty acids (depends on the kind of chemical bond)

Monounsaturated fatty acids (MUFAs) also known as omega-9 fatty acids. Good sources of monounsaturated fats are olive oil, avocados, and most of the nuts. Our body is capable to convert the saturated fat into monounsaturated if required.

Monounsaturated fats are totally healthy only on low carb diet. They are harmful when combined with refined carb and high carb.

Polyunsatured fats (PUFA) provide essential fatty acids, including omega-6 (linoleic acid) and omega-3 (linolenic acid) fats. (Body can’t make omega-6 and omega-3 fatty acids of its own. Food is the only source)

Fatty fish such as salmon, mackerel, and sardines, flaxseeds, walnuts, canola oil, and hydrogenated soybean oil are few examples, for Good sources of omega-3 fatty acids.

Foods rich in omega-6 fatty acids are safflower, soybean, sunflower, walnut, and corn oils.

The body functions well (ideal ratio) with an omega-3 and omega-6 ratio between 1:1  - 1:2.

Trans fatty acids:  When unsaturated plant oils are treated industrially with hydrogen to make them semi-solid, some of the molecules are converted into a form known as ‘trans’fat and chemically similar to saturated fats.

Commonly found in commercially produced baked goods, snack foods, fast foods and margarine.  Trans fat should be completely avoided.

Triglycerides (Lipids)

The body converts the excess calories (to provide energy between meals) in the form of triglycerides in the fat cell. (Triglycerides formed by attaching a glycerol with three fatty acids) Most fats in food and in our bodies are in the form of triglycerides. (kind of safety mechanism build-into withstand starvation)  (We will discuss later, in detail on the metabolism post)

High triglycerides level in the blood has been shown to increase the risk of developing heart disease. Note that, glycerol is the backbone of triglyceride. (formation of triglycerides directly proportional to glycerol availability or formation of triglycerides depends on glycerol availability) Body produces Glycerol thru Carb (rich food) metabolism or directly from the processed Food

Cholesterol :

Sterols are compounds that have a multiple-ring structure. Cholesterol is an example of sterols. Both plant and animal foods contain sterols, but only animal foods contain cholesterol.

Our body needs cholesterol every day. (that’s why body equipped to synthesis to make its own cholesterol) Cholesterol serves as the starting material for many important body compounds including bile acids, sex hormones, adrenal hormones, and vitamin D. Cholesterol is also needed to form cell membranes and the myelin sheath around nerve fiber.

Apart from your diet source, the liver synthesis about 800 to 1500 mg of cholesterol each day and  Our body requires around 2000 mg of cholesterol per day (for Adult).

Cholesterol is made in many cells, but liver cells make the majority of cholesterol. If we eat more dietary cholesterol, the body makes less cholesterol. If we eat less dietary cholesterol, the body makes more cholesterol. (Strain or more work to liver)

Since, Cholesterol doesn’t mix with blood, and need to be transported all over the body; we need the lipoproteins (as a shuttle) to carry cholesterol from the liver through the body. These are known as LDL.

HDL lipoproteins are released from the liver and circulate in the blood to pick up excess cholesterol from the body and carry it back to the liver and to be removed from the body.

Total blood cholesterol measurements include cholesterol in both the LDL and HDL lipoproteins.

Small and dense LDL increases your risk of heart disease. Large and fluffy LDL and Higher HDL cholesterol decreases your risk of heart disease.

Measuring LDL cholesterol pattern, Ratio of HDL cholesterol and triglyceride is a better indicator of heart disease risk. NOT the total cholesterol.

Good about Fat : Fat function as structural building blocks of the body, forming cell membranes for every cell in your body, to build nerve tissues, hormones, control the inflammation and brain function

Fat also helps your body absorb fat soluble vitamins A, D, E and K (micronutrients) from the food we eat.

Fat acts as an insulator, helping us to maintain the correct body temperature. Fat provides a cushion to help protect our vital organs (subcutaneous)

Fat is the key to manage our moods, stay on top of your mental game, fight fatigue, and even control the body weight. Fat is a vital for proper brain development and function. Provide foods with good taste, flavor and texture.

It is efficient to store energy as fat instead of carbohydrate because fats are calorie dense. Storing fat means the body has less weight to carry.

Less or no dietary fat, the body becomes exposed to malnutrition since fats are needed to absorb crucial nutrients.

Protein :

Like Fats, many not aware of the importance of protein and its daily requirement. The word protein comes from a Greek word meaning “of primary importance,” 

Proteins are the building blocks of the body and repairs and maintain body tissues, making essential hormones and enzymes and supporting immune function and as an energy source. (providing energy is not protein’s most important function)

The proteins we consume as part of our diet are broken down in the gut into 20 different amino acids. Nine of these amino acids are described as ‘essential’, which means that the food we eat must contain proteins capable of supplying them. The other amino acids can be synthesized by the liver if not provided by the diet.

Protein in the diet that comes from animal sources contains all of the essential amino acids needed, whereas plant sources of protein do not.  Protein provides 4 calories per gram. (Same as carb’s)

Other Sources of energy :

Alcohol provides 7 calories per gram. Alcohol, however, is not a macro-nutrient because we do not need it for survival. (toxic to the body, irrespective of quantity)

Water might not always be considered a macro-nutrient and not contain any calories, but it sure is an essential nutrient needed for all body functions in large amounts. (USDA lists water as part of Macro-nutrients but, UNICEF is not) Water is found in the body’s cells and transports nutrients to cells and removes toxins from our body. Water regulates the body temperature by our sweat. We get about 50% of the water we need from our food.