The Logical & Scientific Facts about

Cholesterol

 Dr. Fathi Neana, MDChief of Orthopaedics

Dr. Fakhry & Alrajhy Hospital - ArabiaNovember, 29 - 2016

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Many people have been asking the Question :

“How to reduce blood cholesterol naturally without using harmful drugs? ”

But nobody ask the real question:

“Does high cholesterol really cause heart disease?”.

The answer to this question may be surprising to many!

My intention here is not to suggest that statins have no place in the treatment of

heart disease. My intention is to initiate brain storming and give you the objective

information needed to (Decide along withyour Doctor) whether they are appropriate for you.

The decision whether to take them should be based on whether you have pre-existing heart disease, what your

overall risk of a heart attack is, how healthy your diet and lifestyle is, what other treatments you’ve already tried, and

your own risk, tolerance and worldview.

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Era of informationsReal time communications

Evolution of evidence based scienceEra of Biochemistry

Way of thinking and change of Concepts

Global vs. key hole visionPriorities and the real threat

To whom we direct our arrows

New dietary guidelines : Shift away from focusing on specific nutrients toward a general focus on eating real food

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Alexandria is too cold in winterWe used to eat such foods

What happen > 1980

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Since the low-fat guidelines came out, the prevalence of obesity has

skyrocketed

This graph shows that the obesity epidemic started

full-force at the same time the low-fat advice

was peaking.

The type 2 diabetes epidemic followed soon

after.

The 2015 - 2020 Dietary Guidelines for Americans is the 8th edition released and remains the current edition until the 2020-2025 Dietary Guidelines for

Americans is released since 1980. Check out the archive of Previous Dietary Guidelines for Americans

Good News: after 4 decades in the Gail accusing the wrong enemyLimit on Dietary Cholesterol Has Been Removed

“Cholesterol is not considered a nutrient of concern for overconsumption.”8

In the past, the guidelines suggested a limit of 300 milligrams (mg) per day; equivalent of two eggs. Now, the limit on dietary

cholesterol removed entirely   

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Dietary Guidelines for Americans 2015 - 2020                                                                                                                                                                                                                               

A healthy eating pattern limits

Saturated fat (?? Why included) Trans fats

Added sugars (?? Non fiber Carbohydrates why not stressed upon)

Sodium

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Saturated fat (?? Why included) The widely circulated assumption that 

eating a diet high in saturated fats leads to heart disease is simply wrong, as they are actually necessary to promote health and

prevent diseaseReducing saturated fat intake to reduce LDL cholesterol seems to be specific to the (large, buoyant (type A) LDL

particles). In fact  the (small, dense (type B) LDL) particles)

(responsive to Carb. & Trans fat intake) are implicated in cardiovascular disease.

Recent prospective cohort studies: No significant association between saturated fat intake and cardiovascular risk.

Instead, saturated fat has been found to be protective."

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In Summary, Saturated Fats Are Healthy

•They increase LDL levels, but they increase the (large fluffy particles type A LDL) that are not associated with an increased

risk of heart disease•They Increase HDL levels . This compensates for any increase in

LDL•Do NOT cause heart disease as made clear in all the above-

referenced studies•Do not damage easily as other fats. no double bonds to be

damaged through oxidation•Serve to fuel mitochondria

•Produce far less damaging free radicals than carbohydratesFoods that are naturally rich in saturated fats, like grass-fed meats, grass-fed butter, pastured eggs and coconuts, come in a near-perfect package, as they are typically loaded with healthy,

fat-soluble vitamins like A, D, E and K

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Read more: http://www.dailymail.co.uk/home/you/article-3151962/HEALTH-Cholesterol-big-fat-lie-plus-prevent-heart-disease.html#ixzz42HPP54Vy

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HEALTH: Cholesterol: The big fat lie, plus how to prevent heart disease 

By SARAH STACEY FOR THE MAIL ON SUNDAYPUBLISHED: 00:02 GMT, 12 July 2015 | UPDATED: 00:04 GMT, 12 July 2015

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The graph is generated from data that represents food selection for the last two weeks.

Review of the molecular biology required to optimize mitochondrial function

 It is best to seek to have about 75 percent of your total calories as fat. That leaves approximately 10 percent of your calories as protein and 15 percent as carbs which should be twice as many fiber carbs as non-fiber carbs, like vegetables, seeds and nuts.

Dietary Guidelines for Americans 2015 - 2020                                                                                                                                                                                                                               

A healthy eating pattern limits

Saturated fat (?? Why Included) Trans fats

Added sugars (?? Non fiber Carbohydrates why not stressed upon)

Sodium

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Harmful Effects of Sugar(NB: Non fiber Carb rapidly absorbed)

1- Lipoprotein Oxidation & Glycation

2- Hyper insulinemia syndrome -> Insulin resistance (type 2 DM…),

-> increased triglycerides VLDL ->Cholesterol (small dense LDL particles)

3- State of chronic inflammation

(?? Non fiber Carbohydrates why not stressed upon)

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What is Cholesterol? A waxy substance – technically a sterol

(unsaturated steroid alcohol)

>80% of cholesterol is made in the liver, the rest is absorbed from food . It is Synthesized in many

cells, but mostly in the liver and intestine

Cholesterol travels in particles called lipoproteins: high-density lipoproteins (HDL) and low-Density

Lipoproteins (LDL)

Acetyl coenzyme A (acetyl CoA) is the precursor to cholesterol synthesis

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What is Cholesterol?All cholesterol is the same. LDL & HDL, are referred to

lipoproteins

Saturated fats raise protective HDL and also increase LDL. There are different types of LDL.

• Large, "fluffy" LDL cholesterol (Type A)• Small, dense LDL cholesterol (Type B)

Saturated fat, increases (large, fluffy, —benign — LDL (Type A))Synthetic trans fat & sugar increases (small, dense LDL (Type

B)) Saturated Fats Increase (Large, Fluffy LDL Cholesterol Type A )

That's a Good Thing

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How to reduce blood cholesterol naturally without using harmful drugs.This is the wrong question.

The real question to be answered is“Does high cholesterol really cause heart

disease?”

You may be surprised to learn the answer to this !

Why We’ve Been Asking the Wrong Question

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HypotoniaMuscle pain -

crampsMyopathie

s Rhabdomy

olysis

Vit DDefiecinc

y

STATINS

HMG CoA Reductas

e(3-hydroxy-3-

methyl-glutaryl-CoA Reductase

Cholesterol

phobia

Vit D deficient Rickets & Osteomalacia spread like

an epidemic(PTH – VITD – Ca - ALK

PHOS)

Egg yolk +Vit D rich food vs. Cholesterol phobia

Walk & Exercises vs. Muscle pain & dysfunction

+ Body pain (statin induced)

Why this lecture ?Is it related to Orthopedic

practice ?

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What is Dolichol, Cholesterol, Coenzyme Q10?Statins are non selective - What is the side effects

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Registered as a hepatoprotector) in relation to neurodegenerative diseases (including

Alzheimer's disease

Biosynthesis of biologically important N-linked glycoproteins.

A major part of glycoproteins are those for our  emotions, our neuropeptides.

Aggression, hostility, sensitivity, paranoia, road rage type feelings, depression, suicidal ideation, homocidal ideation and a number of

both suicides and homocide attempts all associated with statin drug use.

Dolichol, cholesterol, coenzyme Q10?Why we need Dolichol

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Dolichol, Cholesterol, Coenzyme Q10?Why we need Cholesterol

• Vitamin D precursor

• Precursor to Hormones Deal with stress (Cortisones) Sex hormones (like estrogen, progesterone, & testosterone)

• Cell membrane) Rigidity to our cells organ dysfunction

• Keep the intestinal wall healthypreventing “leaky gut”

• Bile salts – Digestion of fats

• (Powerful antioxidant)Did you catch this last surprise ?

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Similar to a vitamin. It is found in every cell of the body.

cells use it to produce energy , cell growth and maintenance. It is functions as an antioxidant &

Coenzymes help enzymes to digest food and perform other body processes, protect the heart and skeletal

muscles.

What is CoQ10 used for?Help in :  heart failure, cancer, muscular dystrophy,

periodontal diseasesIt boost energy and speed recovery from exercises

Some people take it to help reduce the effects certain medicines on the heart, muscles, and other organs.particularly high in organ meats such as heart, liver,

and kidney, beef, soy oil, sardines, mackerel, and peanuts.

Dolichol, cholesterol, coenzyme Q10?Why we need Coenzyme Q10?

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http://www.functionalmedicineuniversity.com/statin-CoQ10.pdfThe CoQ10-Statin Secret

Ronald Grisanti D.C., D.A.B.C.O., D.A.C.B.N., M.S.What many people are unaware of is the fact that : CoQ10 depletion causes

LDL cholesterol Oxidation. The Oxidized LDL cholesterol drill holes in the arterial wall causing major inflammation. This increases the risk of getting a

heart attack or stroke.CoQ10 deficiency can cause fatal cardiomyopathy, heart attack, congestive heart

failure (which usually carries a death sentence of 5 years), exhaustion, cancer, myopathy, depression resistant to anti-depressants, high blood pressure, gum disease

and tooth loss, hair loss, liver disease, sudden complete memory loss or amnesia, cataracts, angina, cancer, folic acid deficiency, damaged cell membranes, and much

more.This a major reason why taking statins drugs is no guarantee you will not die of a heart

attack.  the pharmaceutical giant, Merck, decided to add CoQ10 to a statin medication zocor. 

 should be illegal to prescribe a statin without also prescribing CoQ10. any doctor who prescribes a statin medication then turns you loose without prescribing

CoQ10 shows lack of scientific Knowledge of the very drug he is authorized to prescribe.

Take a look at the wealth of scientific references listed below.

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References:Thomas S. R., Neuzil J., Stocker R, Inhibition of LDL oxidation by ubiquinol-10. A protective mechanism of coenzyme Q in atherogenesis? Mol Asp Med, 18 (suppl.): s 85-103, 1997Bargossi AM, Battino M, Gaddi A, et at. Exogenous CoQ10 preserves plasma ubiquinol levels in patients treated with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, Internal J Clin Lab Res, 24: 171-6, 1994Fuke C, Krikorian, SA, Couris RR, Coenzyme CoQ10: A review of essential functions and clinical trials, Pharmacist, 28-41, Oct 2000Langsjoen PH, Langsjoen AM, Coenzyme Q10 in cardiovascular disease with emphasis on heart failure and myocardial ischaemia, Asia Pacific Heart J ,7; 3: 160-168, 1998Langsjoen PH, et al, Treatment of statin adverse effects with supplemental coenzyme Q10 and statin drug discontinuation, BioFactors, 25 (1-4): 147-52, 2005Langsjoen PH, et al, The clinical use of HMG CoA-reductase inhibitors and the associated depletion of coenzyme Q10. A review of animal and human publications, BioFactors, 18 (1-4): 101-11, 2003Mabuchi H, et al, Reduction of serum ubiquinol-10 and a ubiquinone-10 levels by atorvastatin in hypercholesterolemia, patients, J Atheroscler Thromb, 12; 2:111-19, 2005Lamperti C, Muscle, coenzyme Q10 level in statin-related myopathy, Arch Neurol, 62; 11: 1109-12, Nov 2005Mortensen AS, et al, Coenzyme Q10: clinical benefits with biochemical correlates suggesting a scientific breakthrough in the management of chronic heart failure, Int J Tissue React, 12; 3: 155-62, 1990Folkers K, Langsjoen P, Tamagawa H, Lovastatin decreases coenzyme levels in humans, Proc Nall Acad Sci USA, 1990; 87:8931-34Bliznakov EG, Wilkins DJ, Biochemical and clinical consequences of inhibiting coenzyme Q10 biosynthesis by lipid-lowering HMG COA reductase inhibitors (statins): a critical overview, Advances in Therapy, 15; 4:219-28, Jul/Aug 1998Ghirlanda G, Oradei A, Manto A, et al, Evidence of plasma CoQ 10-lowering effect of HMG-CoA reductase inhibitors: a double-blind, placebo-controlled study, J Clin Pharmacol, 33: 226-29, 1993Willis RA. Folkers K, Tucker JL, Tamagawa H., et al., Lovastatin decreases coenzyme Q levels in rats, Proc Nat Acad Sci USA, 87: 8928-30. 1990Folkers K, Langsjoen P, et al, Lovastatin decreases coenzyme Q10 levels in humans, Proc Nat Acad Sci USA, 87:8931-4, 1990Bliznakov EG, Lipid-lowering to drugs (statins), cholesterol, and coenzyme Q10. The Baycol case-¬-a modern Pandora's box, Biomed Pharmacother, 56:56-9, 2002Jameson S, Statistical data support prediction of death within six months on low levels of coenzyme Ql0 and other entities, Clin Invest, 71 (suppl):137-39, 1993

Logical Observations

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By reading and studying Dr. Bernstein Diabetes solution book extensively; I knew how to use insulin the right way and knew how to eat. I cut all sugars, Juices, most of fruits and fast acting Carbohydrate  and finally I was able to get my A1C

from 11 to 55.

My mentor in Diabetes and Nutrition are Dr. Richard Bernstein, Gary Taubes, Dr. David Perlmutter, Dr. William Davis, Dr.

Rob Thompson, Dr. Atkins, Maria Emmrich and Dr. Garry Fettke.I am the owner of diabetes management Facebook page 

https://www.facebook.com/amdiabetic 

About Me - Ahmed Afifi   

I am a T1 Diabetic and a Mechanical Engineer who savor life, able to smell the beauty out of soft

breeze, appreciate the taste of coffee, quit smoking, in love with fishing, love my wife and feel happy

when helping people and support whoever in need. 

Logical Observations

Logical Observations

Breast milk is ideally rich in Cholesterol

& contains a special enzyme for the baby to properly utilize it.

Babies and children need Cholesterol for proper growth and development of the Brain, nervous system, and

immune function.

Logical ObservationsEgg Yolk (very rich in

Cholesterol) contain full package of nutrients

needed for the embryo

Again Cholesterol is important for proper

growth and development especially for the

Brain, nervous system, and immune function.

NORTH CAROLINAEGG ASSOCIATIONRepresenting NC 

Farmers.

Quick Linksincredibleegg.orgEgg-cyclopediaEgg Nutrition CenterEgg Safety CenterEgg RecipesEducator Lesson Plans K-12

The yolk is about 34% of the liquid weight of the egg

It contains all of the fat in the egg & a little less than half of the protein

The yolk of a large egg contains about 55 calories

With the exception of niacin & riboflavin, It contains a higher proportion of the egg’s vitamins than the white, as vitamins B6

and B12, folic acid, pantothenic acid & thiamin.

All of the egg’s vitamins A, D, E , K are in the yolk. (Fat soluble vitamins)

Egg yolks are one of the few foods naturally containing vitamin D.

It contains, calcium, copper, iron, manganese, phosphorus, selenium & zinc more than the white.

Egg Yolk

Albumen accounts for about 66%. of an egg’s liquid weight

It contains more than half the egg’s total protein, a majority of the egg’s niacin, riboflavin, magnesium,

potassium , sodium, and none of the fat.

The white of a large egg contains about 17 calories

Albumen color is opalescent and doesn’t appear white until an egg is beaten or cooked. The cloudy appearance comes from carbon dioxide. As eggs age, carbon dioxide escapes, so the

albumen of older eggs is more transparent than that of fresher eggs.

Egg White (Albumen)

The egg boasts all the nine Essential amino acids ( histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan and valine) In a pattern that matches very

closely the pattern the human body needs, In addition to the nine essential amino acids, there are nine other

amino acids in an egg.The Biological Value (BV) of eggs

is rated between 88 and 100, only whey protein rated higher (100).

Each Large egg provides a total of 6.29 grams of high-quality, complete protein

(eggs are classified with meat in the Protein)

Egg Protein & Other Nutrients

The inuit diet consists primarily of protein and fat . Similar to the low-

carbohydrate diets (Ketogenic diet) a popular weight-reducing diets

The currently established human essential nutrients are water, energy, amino acids (histidine, isoleucine, leucine, lysine, methionine,

phenylalanine, threonine, tryptophan, and valine), essential fatty acids (linoleic and α-linolenic acids), vitamins (ascorbic acid, vitamin A, vitamin D, vitamin E, vitamin K,

thiamine, riboflavin, niacin, vitamin B-6, pantothenic acid, folic acid, biotin, and vitamin B-12), minerals (calcium, phosphorus, magnesium, and iron), trace minerals (zinc, copper, manganese, iodine, selenium, molybdenum, and chromium), electrolytes

(sodium, potassium, and chloride), and ultratrace minerals

Note the absence of specific carbohydrates from this list. A little evidence that exogenous carbohydrate is needed for human

function

Logical Observations

Logical ObservationsThe Sources of

Vitamin D Anti oxidants

Fat soluble VitaminsAll are very rich in Cholesterol and

fatsWhether Plant or Animal sources e.g. Seed

oils, Polyunsaturated plant oils, Nuts, seeds, Sea food, Meat, liver, milk, butter,

egg yolk

المأكوالت واشهى انفع فى دائما الكوليسترول لماذاIs it logical to discard all these items due to Cholesterol phobia ?

1- What is behind the excessive endogenous

Cholesterol production ?? 2- Protective mechanism

against what ??

Logical ObservationsIt very clearly shows

that there is no correlation between

cholesterol and heart disease.

Notice that the country with the highest levels of

cholesterol —Switzerland — has one of the lowest rates of

heart disease.

Endogenous production of Cholesterol > 80%. means that There is a feedback mechanism (means an increased demand as a protective mechanism)

It’s clear that statins reduce heart disease as well as the risk of death in those below 80 y.

that have already had a heart attack,Who already tried diet and lifestyle interventions

without much impact on lipid or inflammatory markers

Logical ObservationsEra of evidence based medicine vs old delusions & myths

But after 40 years “Statins used in a very wide scale 1 out of 2 men and 1 out of

3 women Significant Increase in heart diseases,

sudden death, memory disturbances, Alzheimer, cancer, aggression & mood

changes

Cholesterol levels naturally rise with age and are beneficial to the elderly.  Women with the highest cholesterol actually live

the longest

Cholesterol is needed to repair damaged cells.!

That is why there is a risk of severe muscle damage (myopathy & rhabdomyolysis) with

statins in the elderly

Logical ObservationsEra of evidence based medicine vs old delusions & myths

. Hypercholesterolemia is not a risk factor for mortality in persons older than 70 years & risks from statin drugs are more increased

after age 85.[1]

Vitamin D deficient Osteomalacia in adultsWhy do we need Cholesterol ? Do you know that Cholesterol is a Vitamin D precursor

Vitamin D deficient Osteomalacia in adultsWhy do we need Cholesterol ? Do you know that Cholesterol is a Vitamin D precursor

Vitamin D deficient Osteomalacia in adultsWhy do we need Cholesterol ? Do you know that Cholesterol is a

Vitamin D precursor

Vitamin D deficient Osteomalacia in adultsSecondary hyperparathyroidism &

parathyroid adenoma

Primary hyperparathyroidismThe most common reason a non-cancerous parathyroid adenoma Too much PTH cause

calcium to be too high in the blood, and poor bone health

Sometimes doctors treat primary hyperparathyroidism surgically

Secondary hyperparathyroidismLong term vitamin D deficiency or kidney failure.

This can be corrected by treating vitamin D deficiency.

In kidney failure, activated vitamin D.

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Vitamin D deficient Osteomalacia in adults

Vitamin D deficient Osteomalacia in adults

Vitamin D: Sunshine Vitamin

Cardiac Dysfunction, Hypertrophy and Failure. The leading cause of mortality in the developed

world

Essential for blood clotting.Stabilizes blood pressure.

Contributes to normal brain function.Critical for communicating essential information

among cells.Helps insulin open cells to glucose

Chemicals that transmit a signal from a nerve cell to a target cell

(for example, when a nerve tells a muscle to move)Facilitates the actual process of contraction of the

muscle cellAssists the movement of sperm to fertilize the egg

Calcium Non-bone functionsonly 1 percent of the calcium in the body is found outside the bone

This form of calcium is critical for many functions in the body

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Functions of Vitamin D Calcium and Phosphorus

Homeostasis Calcium and Phosphorus absorption (small intestine)

Calcium reabsorption (bone and kidney)

Maintain blood calcium levels Bone formation Stimulate calcium uptake for

deposition as calcium phosphate (Osteoblasts: bone-

forming cells) Hormone

Regulation of gene expression Cell growth

PTH:Parathyroid Hormone

Vitamin D: Sunshine Vitamin (Sources) Body can make it if exposed to enough

sunlight Made from cholesterol & stored in

the skin Synthesized in body

Plants (ergo sterol) Sun-cured forages

Fluid milk products are fortified with vitamin D

Oily fish Egg yolk

Butter Liver

Daily Value 10 micrograms

Vitamin D (Calciferol) There are 2 major precursor forms

7-dehydrocholesterol Vitamin D3 = chole calciferol

Produced photo chemically by the action of sunlight or ultraviolet light from the

precursor sterol 7-dehydrocholesterol

ErgosterolVitamin D2 = ergo calciferol

Completely synthetic form produced by the irradiation of the plant steroid ergosterol

Calcitriol (1,25-dihydroxy-cholecaliferol, 1,25 DHCC)

Vitamin D Deficiency symptomsRickets in children

Inadequate calcification, resulting in misshapen bones (bowing of legs)

Enlargement of ends of long bones (knees, wrists) Deformities of ribs (bowed, with beads or knobs)

Delayed closing of fontanel, resulting in rapid enlargement of head

Lax muscles resulting in protrusion of abdomen Muscle spasms

Vitamin D Deficiency symptomsOsteomalacia in adults

Bones that fracture very easily are the most common symptom.

Loss of calcium -> soft, flexible, brittle, & deformable bones

Bone pain, hips dull, aching spread to lower back, pelvis, knees, legs, & ribs

Progressive muscle weakness. a hard time walking and a waddling gait.Non Skeletal symptoms

Irregular heart rhythmsNumbness around the mouth, in arms &

legsSpasms in hands and feet

Sleep disturbances, depression

Cholesterol is the (vitamin D precursor) 

What other functions of cholesterol ?• Precursor to Hormones deal with stress (Cortisones) Sex hormones (like estrogen, progesterone, &

testosterone) 

• Gives rigidity to our cells (cell membrane) organ dysfunction

• Keep the intestinal wall healthy preventing “leaky gut”

•Powerful antioxidantDid you catch the last one?

Cholesterol – The Unsung AntioxidantSEPTEMBER 25, 2012

Unsung : not noticed or praised for hard work, courage, or great achievementsan unsung heroIt is easy to assume that cholesterol is bad

( In reality, cholesterol is the unsung antioxidant)

 It serves an important role in the health of our

body.

Our body produces it ! by most of its cells & the liver.

Endogenous production > three times the dietary intake!

We know antioxidants in berries, dark green vegetables and other foods

But cholesterol is a powerful antioxidant ? we are told to avoid ????

Cholesterol is the rescue of cells damaged by free radicals and help repair damage done to the arteries?

Cholesterol, is not the culprit of heart disease, but an antioxidant rushing to the scene of an accident to help with repairs.

Leucocytosis treatment vs. Hypercholesrolaemia treatment

High blood cholesterol levels indicate that the body is in need of it to protect itself from free radicals and the damage they cause. It seems that we have been blaming the firefighters for the fire

 

Cholesterol is a powerful antioxidant !

The major source of dietary cholesterol is eggs, beef, pork, cheese, poultry, fish

and shrimp.

 It is time to stop robbing our bodies of these excellent sources of animal fats,

proteins and antioxidants. 

Cholesterol is a powerful antioxidant !

They are good for you!Get your antioxidants from dark green veggies, berries

but don’t skip out good quality sourcesStop blaming the firefighters and the vultures !

Thanks to Almighty Allah for the Endogenous Production of substances necessary for our life like (Cholesterol)

Elsheikh Alshaarawy

Allah in His infinite Wisdom has designed everything on this planet earth so there is No monopoly with

life dependant issues (Air – Sun – Water - etc )

Myth – 2015 High Cholesterol Does NOT cause Heart Disease

Myth : a widely held but false belief or idea.The Old Concept : High Cholesterol level contribute

to heart disease by clogging the arteries

The latest literature :

Hypercholesrolaemia is not the reason for heart disease or atherosclerosis .

Heart disease is caused by a state of chronic inflammation of blood vessels (which is the

Culprit)

1- What is behind state of chronic inflammation ??

2- How it affect the heart ??

Myth – 2015 High Cholesterol Does NOT cause Heart Disease

1- Chronic inflammation -> endothelial injury & increased permeability

2- Oxidation of Small dense particles LDL (Chronic inflammation + Hyperinsulinemia) -> accumulation in the

intimal sub endothelium

Monocytes migrate to the subendothelial space Mature into Macrophages and uptake oxidized LDL -> 'foam' cells that

eventually form the lipid core of the atherosclerotic plaque after apoptosis occurs

The inflammatory mediator cascade promotes a phenotype change of vascular smooth muscle cells (VSMCs) from the

'contractile' phenotype state to the active 'synthetic' state. VSMCs in the synthetic state can migrate and proliferate from

the media to the intima,

where they produce excessive amounts of extracellular matrix (e.g., collagen, elastin and proteoglycans) that

transforms the lesion into a fibrous plaque 

The typical atherosclerotic plaque comprises of the lipid core and the fibrous cap, and is the most commonly classified histologically by the American Heart Association  

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1- Chronic inflammation 2- Oxidized Small dense particles LDL

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2- Small dense particles LDL) is a type B of LDL cholesterol .

It isn’t only the quantity of LDL circulating it’s the quality, too. Smaller and heavier than typical LDL cholesterol Small enough to penetrate the walls of arteries, Susceptible to being oxidized (electron donor)

Stays in the blood stream longer.Electron donor = (Antioxidant)

1- Chronic inflammation 2- Oxidized Small dense particles LDL

Small, dense LDL particles was associated with1- more than a three-fold increase in the risk of CHD.

2- Rarely an isolated disorder Usually with the insulin resistance syndrome

The treatment should not only aim at reducing plasma triglyceride levels, but also at improving all features of the insulin resistance syndrome

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CHD

INFLAMMATION PROCESSED FOOD

(SUGAR – NON FIBERCARBOHYDRATE

)OXIDANTSBACTERIA

TOXINS-POLLUTION HOMOCYSTEINE

SUGAR+ NONFIBERCARBOHYD

RATEHYPERGLYCAEMIA

HYPERINSULINAEMIAINSUINSULIN RESISTANCEDYSLIPIDAEMIA

OBESITY

1 -ENDOTHELIAL PERMEABILITY

2 -SMALL DENSE LDL

EASY OXIDIZABLEELECTRON DONOR

(ANTIOXIDANT)

Way of thinking who is (The Culprit)Broad minded vs. key hole vision

Processed foodToxins - Oxidants

Dietary sugarNon fiber Carbohydrate

Triglycerides VLDL Hypercholesterolemia

(small dense LDL particles)

Electron donor (antioxidant)

Hyperglycemia1- Lipoprotein Oxidation

& Glycation2- Hyper insulinemia -> Insulin resistance

-> increased triglycerides VLDL

3- State of chronic inflammation (The Culprit)

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How to Lower the Risk of Heart Disease Without Drugs ?

The answer is the Control of1- Chronic inflammation

2- Small dense particles LDL

How ? The answer is by 1- Anti-inflammatory lifestyle

Example: Pay attention to your oral health.. In one 2010 study,20 those with the worst oral hygiene increased their risk of developing heart disease by 70 percent, compared to

those who brush their teeth twice a day. 2- Control hyper- insulinaemia & insulin resistance

s.Example : Reduce dietary sugar and non fiber carbohydrates

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Myth – 2015 High Cholesterol Does NOT cause Heart DiseaseChronic inflammation of blood vessels is the enemy

Etiological factorsProcessed & Fried foods

diet high in Sugar & trans fatty acids

Chronic inflammation is caused by a laundry list of items such as:

Oxidized cholesterol (cholesterol that has gone rancid, such as that from overcooked, scrambled

eggs)Eating lots of sugar and grains

Eating foods cooked at high temperaturesEating trans fats

So to sum it all up, in order to lower your inflammation and cholesterol levels naturally,

you must address the items on this list.The more refined foods humans consume, the

more the inflammation switch is turned on, minute by minute, hour by hour, and day by day. Your body was not meant nor designed to deal

with such excesses. 

Processed foods creates overloaded fat cells that dump out large quantities of pro-

inflammatory chemicals that cause injury by having high blood sugar.

As the inflammatory process continues unabated, it becomes a vicious cycle that creates heart disease, diabetes, high blood

pressure, and finally Alzheimer's.

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Myth – 2015 High Cholesterol Does NOT cause Heart DiseaseChronic inflammation of blood vessels is the

enemyEtiological factors

Processed & Fried foods diet high in Sugar & trans fatty acids

Homocysteine (non-protein amino acid a causes

endothelial injury -> inflammation in the blood vessels -> atherogenesis and

result in ischemic injuryToxins, Oxidants

(pollution , alcohol ,smoking)Wide spectrum of Infectious

agents

Risk factors

Sedentary indoor lifestyleEmotional stress

Overweight or Obese (almost half of U.S. adults).

Family history of heart disease

High blood pressureDiabetes

High cholesterol has been blamed for heart problems for far too long.

Its time to set the record straight and stop worrying about high cholesterol! 

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SUMMARY

The major source of dietary cholesterol is eggs, beef, pork, cheese, poultry, fish and shrimp.  It is time to stop robbing our bodies of these excellent sources of animal fats, proteins and

antioxidants. 

Cholesterol is a Vitamin D precursor & a powerful

antioxidant !

Get your antioxidants from dark green veggies, berries

But don’t skip out good quality sources

Thank you

Stop blamingThe firefighters for the fire

and The vultures for the cow’s

death