CHAPTER 11
The Heart of the Matter: Dietary Fat & Vessel Health
Blood Simple
Fats are vital to health and wellbeing throughout our lives. Fats are essential nutrients and critical building blocks. The importance of fats, however, is often overshadowed by their bad reputation as the cause of heart disease and obesity. Yes, fats have played a role in both, but the connection is more complicated than you might think.
PART 1
The dietary dilemma: good fats vs. bad fats
Not all fats are equal. They all share basic chemical similarities, but they also have important differences: in the length and shape of their molecules and the chemical bonds that hold the molecules together. Because of these individual characteristics, fats can have very different roles and effects in the body. READ MOREThe American public can be excused if it feels a bit mislead when it comes to fats. Once upon a time, we didn’t worry about fats much because they were pretty scarce for most people (hence the description of a fatty diet as “rich”). But in the second half of the 20th century fats were demonized as the cause of heart disease. More recently, however, diet books have urged us to eat all the bacon cheeseburgers and whipped cream we want, but avoid the real culprit: processed carbs and high-fructose corn syrup.
Fats, just like proteins and carbohydrates, are essential to a healthy diet. But it does matter what kind of fats you eat. Fats can be classified according to two basic categories: saturated and unsaturated. Nearly all foods contain a mixture of the two, but saturated fats come mainly from animal and dairy sources, and unsaturated fats come mainly from plant sources.
Despite the recent boom in fad diet books that seem to argue otherwise, the majority of medical experts believe that saturated fats should be considered “bad” fats because research has shown that they boost total cholesterol in the blood and increase the risk for heart disease. Unsaturated fats, on the other hand, are considered “good” fats, because research has shown that they reduce cholesterol levels as well as the risk of heart disease and diabetes. LESS
PART 2
Kidney Disease
The kidneys are particularly susceptible to damage from hypertension. No other organ in the human body is so densely packed with capillaries as the kidneys. Hypertension can damage these tiny blood vessels and disrupt the ability of your kidneys to filter waste products from your blood. In a hypertensive kidney, connective tissue overtakes the normal tissue that surrounds the glomeruli (tiny ball-shaped structures, composed of capillaries, that filter the blood). The capillaries shrink and harden, leaving the glomeruli unable to function.Hypertension can also damage the arteries that supply the kidneys, potentially leading to kidney disease and kidney failure.
What’s more, the kidneys have a major role in keeping blood pressure at healthy levels. They secrete an enzyme that causes blood vessels to constrict as well as a hormone that increases the volume of blood in the bloodstream. If the kidneys are damaged and these functions are impaired, hypertension can become even worse.
PART 3
What should I worry about when it comes to my cholesterol levels?
Cholesterol tests are used to estimate risk. And while cholesterol levels can vary widely among healthy individuals, the statistical evidence suggests that low levels are good and high levels are bad when it comes to being at risk for heart disease and strokes (other substances found in the blood, such as C-reactive protein, which indicates inflammation, are also among the key blood biomarkers for cardiovascular health). READ MOREEvidence that diet could exert a powerful effect on heart disease risk began to accumulate more than 50 years ago, when the landmark Seven Countries Study compared the diets and mortality from heart disease among different countries and found that a strong correlation between saturated fat intake, blood cholesterol levels and coronary heart disease.
Medical experts still argue over the evidence, but nonetheless, cholesterol testing is a routine part of preventive health care. It can still be difficult, however, to untangle the various factors that determine a person’s cholesterol. For some people, cholesterol levels seem relatively impervious to diet. For others, though, cholesterol levels rise and fall very sharply depending on diet. Why the difference? The underlying reasons appear to be genetic. People who respond strongly to dietary cholesterol appear to be “hyper-responders” whose cholesterol follows their diet in lockstep. Unfortunately, there’s no reliable way, other than trial-and-error, to predict who will be a hyper-responder.
There are many other factors that can potentially influence cholesterol levels. Exercise may be an important one, though evidence is not definitive; studies have shown that endurance athletes have higher HDL levels, and aerobic athletes in general, particularly lean ones, have lower LDL levels. High cholesterol levels may be caused by uncontrolled diabetes and biliary cirrhosis. LESS
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theVisualMD Wishes to Thank our Scientific Collaborators:
- Michael J. Stein, MD, FACR
Chief Medical Director at TheVisualMD.com Professor of Medicine and Community Health Butler Hospital/Brown University - Canyon Ranch
Lenox MA. - University Medicine
Providence, RI - Nichols Institute
Website - 55 Kip Center
Rutherford, NJ - Martha Stewart Center For Living
Mount Sinai Medical Center New York, NY
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