Understanding cholesterol and cardiovascular disease – Functional Medicine 101
When some people think of cholesterol, they may be concerned about its association to heart disease and stroke, however many of us may not be aware that cholesterol also plays an important role in healthy living and graceful aging. Cholesterol can become an issue when elevated levels of inflammation in the body lead to tissue damage. It has been shown that diet and lifestyle play the biggest part in how we use our cholesterol to control inflammation and keep us healthy and happy in our lives.
Once cholesterol is produced by our bodies (70 to 90%) or ingested in the diet (10 to 30%), it is packaged into transport molecules called lipoproteins. The different types of lipoproteins are very important to consider when assessing if cholesterol is supporting health or producing inflammatory changes in blood vessels. Low density lipoproteins (LDL), from a standard cholesterol panel, estimates the total amount of LDL-C that is found in our blood. It is important to note however that not all low density lipoproteins are created equal and when LDL levels are evaluated further, it has been found that the subtype, LDL pattern B is the lipoprotein associated more with cardiovascular disease than it’s counterpart LDL pattern A. When looking at a cholesterol test, it is also important to consider the high density lipoproteins (HDL’s) or “good cholesterol” in the blood, as HDL levels reflect the level of repair in the arteries and the rest of the body.
Beyond Cholesterol; What to consider testing when assessing for cardiovascular disease risk. Lets get functional!
| Lipoprotein (a) | High Lp(a) predicts risk of early onset atherosclerosis. Associated with a genetic tendency toward heart disease. |
| Apolipoprotein B | Helpful for people who have a genetic tendency towards heart disease and may be used to monitor the effectiveness of lifestyle changes. Higher levels of small dense LDL particles are associated with increased cardiovascular risk. |
| Apolipoprotein A-1 | Helpful for people who have a genetic tendency towards heart disease and may be used to monitor the effectiveness of lifestyle changes. Lower levels of large fluffy LDL particles are associated with increased risk. |
| Homocysteine | High levels have been connected to increased cardiovascular risk and indicate if vitamin B deficiencies may be contributing to the progression of heart disease. |
| Fatty acid profile | Evaluates for omega 3, 6 and 9 fatty acid deficiencies in the body |
| High-sensitivity C-reactive Protein | Evaluates inflammation in the body and can help predict cardiovascular disease risk. |
| Ferritin | Elevated ferritin is associated with inflammation and cardiovascular damage. |
| Red blood cell glutathione | The major antioxidant in the body that helps reduce cardiovascular damage and risk. |
| Fibrinogen | Part of the clotting mechanisms in the body. When elevated fibrinogen can increase clotting risk. |
| Magnesium | Very important mineral in energy production and cardiovascular function. |
| Fasting insulin | Connected to both high blood sugar and high blood lipids. Indicates exercise requirements when high |
| Thyroid Stimulating Hormone | Low thyroid function is associated with increased risk of heart disease and high cholesterol. |
Cholesterol is also essential to our health. Coenzyme Q10, a derivative of cholesterol is used by every cell in the body to make energy. Cholesterol is also the precursor to Vitamin D production, which has numerous health benefits. Our bodies utilize cholesterol to make steroid hormones (e.g. Estrogen and Testosterone), which contribute to mental and physical fitness as well as slowing the aging process. Further, cholesterol levels that are too low have been associated with learning disabilities, premature aging, cognitive decline and neuropsychiatric conditions such as anxiety and depression.
Healthy ways of lowering cholesterol and heart disease risk clearly start with lifestyle and diet. The elimination of all refined sugars, along with all fried foods (refined and damaged vegetable fats) should be a priority to lowering bad cholesterol and insulin levels. High fructose syrups, known in Canada only as fructose-glucose on labels, are a major contributor to cardiovascular disease through the production of lipoproteins by the liver. Reducing other refined sugars and refined grains, along with the excessive consumption of (high glycemic) tropical fruits and saturated animal fats should also be considered. Lowering insulin resistance and cholesterol through exercise and the reduction of body fat is essential. Mild to moderate endurance and strengthening exercises are a surefire strategy to prevent cardiovascular disease and increase HDL levels.
Optimizing your diet to reduce LDL and increase HDL cholesterol starts with nutrient dense whole foods, such as local fruits (e.g. apples and berries) and vegetables, lean protein sources and healthy fats from fish, certain nuts and olive oil. Specific dietary strategies for lowering cholesterol begin with slow cooked oatmeal daily, along with two tablespoons of fleshly ground flax seed and/or equivalent. Lecithin granules may be added to enhance the effects of the oatmeal by further reducing the absorption of cholesterol by the stomach. Raw almonds, walnuts or macadamia nuts, cold water fish and olive oil (two tablespoons) daily are all strategies when used to together to balance our cholesterol and help maintain a healthy quality of life.