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Cholesterol-Part III :Rightsizing the LDL.

Posted Apr 18 2010 12:00am
" a somewhat counterintuitive way, it’s starches and sugars that raise the bad form of LDL."
                                      Dr.Ronald Krauss.
In the last post, we discussed how LDL size-when small is dangerous ,as far as risk of Heart Disease is concerned.Understanding what drives LDL particles to become smaller is essential for a preventive strategy.
In one word,the key is chronic,low-grade cellular inflammation .In this environment the unhealthy type of LDL becomes predominant.
According to Dr Dwight Lundell ,an open heart surgeon flummoxed by droves of normal weight,normal cholesterol level younger age men ending on the surgery table,the one common thread in all of them was vascular inflammation.While environmental factors like pollution and Stress are inflammatory,nutritional factors play a decisive role in tipping the inflammation scales.
So what are the dietary sources of inflammation?
1.Foods which cause sudden spike in blood sugar e.g refined flour,all forms of sugar,candy etc.
These foods are fast sugars,which flood our cells immediately placing increased demand on the finely tuned sugar balancing system captained by insulin .Sugar in the blood,when not needed for immediate energy needs by the cells,is deposited in the liver as Triglycerides.Triglycerides drive the production of VLDL and coexist with small LDL.                                 
2.Foods that contain fats in forms not metabolized by our cells.  
The evil trans fats are known to cause inflammatory riot in the arteries.They not just raise small sized LDL but lower the HDL.Avoid like plague.
 The refined,bleached and deodorized oils are another form of fat which contain few nutrients(heat destroys them) and are replete with inflammatory Omega-6's.They upset the cell membrane environment which craves for saturated fats and Omega-3 rich fats.
3.Foods that contain free radicals which cause oxidative stress.
   Free radicals are bad guys -an oxygen molecule with an unpaired electron looking to stabilize itself by stealing an electron from a neighbouring molecule thereby starting off a chain reaction.This leads to oxidation of the victim molecules.A Free Radical rampage causes structural damage in the cells.Small LDL is easily oxidized and prone to harden in arterial plaques.
Foods which contain pesticides,metals,chemical additives,artificial sweetners,heat destroyed fats and oils all cause Oxidative Stress and are likely to oxidize LDL .
Thus,if you are eating a carbohydrate heavy,low fat diet with a lot of sugar,chemical additives,artificial sweetners and refined oils thrown in (the Inflammatory Diet)-you are keeping the door open for CHD despite all the exercising and stress-management. 
So which foods are anti-inflammatory?

 So you start by cutting out the bad inflammatory stuff i.e simple carbs and sugars,refined oils,trans fats and artificial food additives.The old chestnuts about Exercising,maintaining healthy body weight,cutting smoking and keeping Stress under control,continue to hold importance in the Anti-Inflammation battle.The nutritional angle has been dramatically reviewed.Saturated Fat is no more the villain.Excessive Carbs are.The five steps to making your diet heart healthy are:
1.Moderate whole Carbs and ample Fats and Proteins.
 The next step is  keeping your total carbohydrate intake moderate. A Carb heavy diet elevates triglycerides and this interferes with circulation of healthy cholesterol.Your carbohydrates should come predominantly from a rainbow of fruits and vegetables-get organic if you can.They are rich in antioxidants,vitamins,fibre.Grains should be whole and again from a bouquet -oats,barley,millets,ragi,sorghum.These traditional grains are also less likely to be ridden with pesticides.
The natural corollary of tilting the macronutrient balance away from carbs is upping the intake of other macro-nutrients-fats and proteins.These have higher satiety value,modest effect on blood sugar,besides being the source of critical micronutrients.
Nature packs Good fats with proteins and fat soluble vitamins-as in eggs,nuts,dairy, fish,unprocessed grass-fed meat,so there is nothing complicated here,if you are sticking to real food
2.Balancing the Omegas  Due to rampant use of refined vegetable oils which are ironically termed as 'Heart Healthy',our diets contain unhealthy amounts of Omega-6's and too little Omega 3's which sets off an inflammatory cascade at cellular level.Omega-3's are anti-inflammatory.Daily intake of fatty fish,fish oil,walnuts,flax seed is an established cardioprotective strategy.As is consciously minimizing the excessive Omega-6(as in corn,sunflower,safflower oils) in your diet
3.MUFA's  Monounsaturated fatty acids. as found in Olives,Almonds and pecans not only lower LDL but raise HDL levels.Remember the highest anti-oxidant levels are in extra-virgin oils and the mediterranean food uses liberal quantity of olive oil  drizzled cold.Heating EVOO destroys the good stuff.
4.Sat Fats Saturated fats raise  LDL-but as Dr.Krauss found,only the benign big LDL.Saturated fats form an important and at times the only source of coenzymes,trace minerals and vitamins like B-12 (B-12 is absent in plant sources) and B-3(Niacin) which are cardioprotective.Being heat stable,sat fats are one of the best cooking mediums.
5.Herbs,Spices and other stuff .Herbs and spices like ginger,garlic,onions,cinnamon,turmeric are powerful anti-inflammatories.As are reservatol rich red wine(in moderation) and anti-oxidant rich green teas.
So the issue is not so much as reducing cholesterol or even LDL.It is rightsizing the LDL and keeping inflammation at bay.Nourishing yourself with a diet rich in antioxidants and quality sources of Good Fats and Proteins will help you cover the nutritional bases.
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