The traditional risk factors –family history, smoking, hypertension, diabetes, and cholesterol- explain less than half the cases of heart disease. In fact, people with heart disease who take drugs to lower cholesterol or who lower the fat content of their diets continue to suffer significant heart disease, and many die of heart attacks.
It is obvious that something has been missing here. And the missing link seems to be the immune system and inflammation.

Until recent, scientist thought that heart disease was caused almost entirely by high cholesterol levels in the blood. Although LDL cholesterol is an important culprit here, other factors also play a substantial role in coronary heart disease. We will review all of them within the next few days.

The immune reaction or inflammation

When we eat foods rich in fat, protein, and calories, certain substances become elevated in the blood. Among them we find, LDL cholesterol, the amino acid homocysteine, and blood fats known as triglycerides.

LDL cholesterol and homocysteine appear in the blood as tiny balls that can enter the artery walls. When their levels are high, hordes of these tiny balls penetrate the walls of the arteries. Once there they oxidize or decay. The immune system recognizes these decaying residues as a threat to health and immediately sends immune system cells to the artery tissue to devour them.

When the immune system gobbles up the LDL cholesterol and homocysteine particles, they become bloated. These bloated immune cells pile up and start forming a growth, also known as “fatty streak” inside the artery wall. As more LDL and homocysteine appear, more immune system cells ingest them and the streak keeps getting larger.

This growth hardens the artery and eventually becomes so large that can it can break out, leaving an open wound in the artery wall. Now, the body forms a blood clot over the wound in order to protect the blood vessel. The blood clot can become so large that it can block the flow of blood to the heart or the brain.

The immune reaction that helps create these events is known as inflammation. Inflammation is caused when the immune system sends out immune cells to fight an infection or too many toxins in the blood, including excess cholesterol. Immune reaction causes heat, redness and swelling and when this reaction happens inside the arteries, they become deformed, swollen and with plaques ready to erupt.

Factor #1 in heart disease: cholesterol

As we have seen, LDL cholesterol can trigger an immune reaction that can lead to a heart attack or a stroke. Therefore, the first thing we need to do is to bring down the LDL cholesterol level by following certain lifestyle practices.

Your cholesterol can increase by eating too much saturated fat or too many calories. Keep in mind that each gram of fat has 9 calories, while one gram of protein or carbohydrate contains only 4 calories. There are four types of fat and each affects cholesterol in different ways. Let’s take a look at them.

Saturated fats

The name of saturated fat comes from the fact that these fat molecules are saturated with hydrogen atoms. It is solid at room temperature and it is found mainly in animal foods. Fish is an exception because is very low in saturated fat. Saturated fat raises LDL cholesterol levels and increases your risk of cancer, overweight, obesity, and other serious illnesses.

Main sources of saturated fat:

  • Beef
  • Pork
  • Lamb
  • Chicken
  • Whole milk and cheese

Hydrogenated fats

Hydrogenated fats are basically saturated fats. They are artificially created when vegetable oils are stuffed with hydrogen atoms so they can become solid at room temperature. These fats are known as trans fats, trans fatty acids, or partially hydrogenated fats. These fats increase LDL cholesterol so I recommend you stay away from them.

Main sources of hydrogenated fats

  • Margarine (stick)
  • Processed foods
  • Fast food at fast food restaurants

Polyunsaturated fats

Polyunsaturated fats are not “saturated” with hydrogen atoms; therefore, they are liquid at room temperature. These fats are oils fabricated from whole grains, nuts, seeds, and fish. Some of these fats can lower your blood cholesterol, but it will depend on what type you eat.

Polyunsaturated fats are divided into:

Omega 3 fatty acids. Omega 3 fats are found in fish, flaxseeds, flax oil, almonds, and walnuts. They boost your immune system and they reduce inflammation, thus reducing the risk of inflammation diseases, such as heart disease.
Omega 6 fatty acids. Omega 6 fats are found in many vegetable oils such as corn, and sunflower oils and they oxidize very fast. They become rancid. They oxidize LDL cholesterol transforming it into a toxic substance. And we already know the series of events that oxidized cholesterol triggers.

Monounsaturated fats

Monounsaturated fats are more stable than polyunsaturated fats and do not oxidize so fast. There is evidence that these types of fats boost immune function and do not raise cholesterol levels. They may increase HDL cholesterol, the good one.

Main sources of monounsaturated fats:

  • Olive oil
  • Olives
  • Nuts
  • Seeds

Having some days of the week where your meals are vegetarian will help you lower the amount of saturated fat you ingest while you can emphasize monounsaturated fats.

Factor #2 in heart disease: Triglycerides

Triglycerides have been thought not too important in the making of heart disease. Today we know that high levels of triglycerides are a risk because 20 percent of blood triglycerides become LDL cholesterol. This means that more triglycerides leads to higher levels of cholesterol and a higher risk of heart attack.

We also know that high levels of triglycerides play a major role in metabolic syndrome or syndrome X, a group of factors that include:

  • Overweight
  • High insulin levels
  • High glucose levels
  • High LDL cholesterol
  • High triglycerides

Triglyceride levels go up when you ingest:

  • Saturated fat
  • Too many calories
  • Processed foods
  • Sugar
  • Excess intake of fruit

Stress and cholesterol levels

Stress is another cause of elevated cholesterol levels. Here is how it happens:

Evolution has trained us to react to stress either by fighting or flying when we face a treat.
To fight or flee the heart needs to work harder, which means it is going to need more fuel.
When our body is in the middle of a stressful situation, the adrenal glands release cortisol which in turn release fat from the cells and send it to the bloodstream and the heart.
More fat in the bloodstream means more cholesterol, including LDL cholesterol.

This will not be a problem if the moment we are experiencing stress is a short one. Unfortunately, stress is becoming chronic in our lives. To this we have to add the fact that we are physically active enough and we don’t burn that extra fuel exercising.

If we don’t exercise and we are constantly under stress, we will not get rid of the fat in the bloodstream. Thus, instead of utilizing it, it will poison us.

Is coronary artery bypass surgery a good alternative?

Sometimes the condition of a heart patient may require surgical intervention. There is a new type of coronary artery bypass surgery, which seems to be less invasive and safer than traditional bypass surgery and that surgeons are performing with the assistance of a robot.

The procedure seems to have fewer complications than traditional bypass surgery. You can get more information at coronary artery bypass surgery.

Final word

To lower your cholesterol you can do several things. Here is an overview:

  • Lower or reduce saturated fat from your diet
  • Lower your calorie intake, especially from fat and processed foods
  • Eat a diet high in fiber.
  • Eat antioxidant foods. Foods high in vitamin C are an excellent choice.
  • Exercise

I am Andy Carpenter and I would start by saying that I have a Bachelor Degree in Nutrition Science conferred by California State University, Los Angeles and that I am certified as a Registered Dietitian.

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