Atherosclerosis
is thickening or hardening of the arteries caused by a buildup of plaque in the inner lining of an artery.
For as long as I remember,, most people including myself have been told that LDL cholesterol is the bad villain of plaque build-up and HDL cholesterol is the good guy.
Of course with this hypothesis it would make perfect sense that the higher your LDL cholesterol the greater the chance of getting atherosclerosis.
However, there is much more to the story and my hope today is to share a different angle that will shed some light on the real issues with LDL cholesterol and its nemesis called atherosclerosis.
THE SIGNIFICANT ROLE OF LDL IN OUR BODIES
Cholesterol isn't inherently bad. In fact, it's the building block for creating healthy cells. It also helps your body make testosterone and estrogen. Without LDL, these and many other steroid hormones wouldn't be made effectively.
Contrary to what we have been told, LDL cholesterol also has another good side and that is its
ability to fight infections.
LDL plays a valuable and important role in the body's response to assault by infectious invaders. When bacteria invade our body, they release a cell wall component known as endotoxin. What is critically important and something we will dig in deeper in this article is the fact that endotoxins are
super inflammatory and can strongly trigger the immune system.
But research has shown that your friend LDL cholesterol is around to bind up this toxin preventing things from getting out of hand.
In a study using mice it was discovered that increased levels of LDL cholesterol were eight times more resistant to endotoxins. This showed a significant decrease in overall mortality when injected with gram negative bacteria. On the other hand rats with the lowest LDL cholesterol had an increase rate of mortality and levels of inflammation when injected with endotoxin.
WHAT ABOUT HUMANS?
There is evidence that
higher levels of LDL cholesterol is protective against infections
in humans. In fact there are many studies proving that higher levels of LDL cholesterol are protective as we age. This is more likely due to the positive impact on the immune system.
LDL itself is not harmful, but in certain situations can be involved in the process of responding to injury and inflammation. This, of course, makes LDL look like more of a firefighter than simply a criminal causing atherosclerosis.
So the question that we must ask ourselves is:
Is there something more sinister behind the scenes that is actually driving heart disease (atherosclerosis)?
As I have discussed in a prior article the real issue is
insulin sensitivity and
the stickiness factor.
In people who are insulin sensitive, rising LDL levels do not correlate with increased rates of heart disease. On the other hand in those who are insulin resistant, the higher the LDL the greater opportunity for plaque formation. Remember it is not all about elevated levels of LDL but the more important villain of insulin resistance.
What will make our head spin is the fact that higher levels of LDL in the blood do not consistently correlate with the progression of atherosclerosis in the absence of
insulin resistance.
LDL STICKINESS IS THE REAL ISSUE
Here is the important take away from this important article. LDL under certain circumstances (which I will mention in a minute) have the ability to
get stuck within the arterial wall.
So it is not the size or amount of LDL particles moving into the arteries that is important but rather if it sticks to the wall of the artery that determines whether or not it contributes to atherosclerosis.
Plaque Build-up Due to LDL Stickiness
WHAT DETERMINES HOW STICKY THE LDL PARTICLE & INTIMAL SPACE ARE?
There is now growing evidence during states of
insulin resistance and inflammation both the LDL particle and the arterial wall get coated in "molecular velcro" making everything more sticky increasing the progression of atherosclerosis.
You may now be asking: really how common is insulin resistance?
Would you believe that a massive
88 percent of the American population has some degree of metabolic syndrome (insulin resistance).
TO CONCLUDE
In the absence of
insulin resistance and inflammation, higher levels of LDL cholesterol are probably protective because of their roles with the immune response.
The information on this site is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Grisanti and his functional medicine community. Dr. Grisanti encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.
We offer whole-person functional and integrative care at The Healing Collective.
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