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Metabolic Health: Carbs, Cholesterol and Heart Disease Risk

Metabolic Health: Carbs, Cholesterol and Heart Disease Risk


Do you have high cholesterol? Have you been told to reduce saturated fat in your diet? Even more horrifying, have you been told you need to take a statin drug?

Then listen up.

A new study published in BMJ Evidence-Based Medicine found no evidence to support the long-time recommendation of reducing saturated fat! The study was reviewed by an international team of heart experts—including 5 cardiologists.

Instead, they found that cutting carbs was a more effective way to reduce the risk of heart disease in people with high cholesterol.

The reason is that lots of people with high cholesterol also have trouble processing sugar. It’s called insulin resistance. You may even have insulin resistance without knowing it. But behind the scenes, foods like bread, muffins, and sweets are creating chaos in your system. Insulin resistance can lead to the metabolic syndrome with abdominal weight gain, higher blood pressure and lipid profiles that are not heart healthy. If left unchecked, metabolic syndrome can turn in to Type 2 Diabetes which really raises the risk of heart disease.

In fact, it has now been shown that the worst way to reduce heart disease risk is by eating a low fat diet. The best way to reduce heart disease is by eating a low carbohydrate diet with higher natural fat and moderate protein foods. How is it that we’ve heard to reduce fat in our diet for 40 years and it is the least effective way to eat and prevent heart disease? Well, science can always lead us in the right direction. The truth is that cholesterol really has no effect on arteries in the absence of inflammation. It is now established that chronic inflammation of arterial walls damages them and allows for plaque formation to build up. Within the plaque there is continuing inflammation which your body is continually fighting and that can lead to clot formation. Heart attacks are caused by blood clots occluding the coronary arteries, no by cholesterol plaques.

So what leads to chronic inflammation.? Air pollution, smoking, alcohol, pesticides, stress etc. We could go on and on and most of those things you already know are bad for you. Yet, perhaps the single most common reason for chronic inflammation building up in your body, you’re probably doing without even thinking about it. It’s the way eat. The thing we eat the most that causes inflammation in our bodies is simple carbohydrates in the form of sugar and high fructose corn syrup. These two little problems are in almost off of the processed food that we eat. Look at nutrition labels when you buy food, especially anything that is packaged. You will almost always find added sugars and high fructose corn syrup. Fructose is a naturally sugar (it’s half of the sugar sucrose commonly known as table sugar) but is not metabolized by your body in the same way.

Sucrose (table sugar) is a disaccharide made up of glucose and fructose. Fructose is used in processing since it is cheaper and sweeter than sugar. It was introduced into the food market from Japan in 1975. Glucose is the energy of life and much of it is used in your brain. However, fructose is not metabolized in your brain. Virtually all of it is metabolized in your liver. The details are not as important as some of the end products. Fructose is eventually turned into Very Low Density Lipoproteins (VLDL) and free fatty acids (FFA). VLDL are metabolized to triglycerides which are then carried by Low Density Lipoproteins (LDL) and High Density Lipoproteins (HDL). Increases in triglycerides are a risk factor for development of heart disease and elevated FFA levels can lead to insulin resistance and the metabolic syndrome which is also known as prediabetes.

In fact, the lipid panel and total cholesterol levels really don’t tell you much about your heart disease risk. A better predictor is the ratios of the different components of a fasting lipid profile. One is the total cholesterol to HDL ratio with less than 5 being the goal. In other words, if that ratio is less than 5, you have an average risk for heart disease and if higher than 5 you have an elevated risk for developing heart disease. Another ratio to calculate is the Triglyceride to HDL ratio, the closer that ratio being to 1 being ideal. Total cholesterol levels are pretty irrelevant and mean little if you don’t know the other numbers. In fact, total cholesterol levels are not predictive for heart disease until they approach close to 300. And in the absence of inflammation, even that level would not be predictive.

Fructose to free fatty acid formation not only leads to insulin resistance overall, but the liver is unresponsive to insulin in the face of fructose. All of these little interactions lead to the production of reactive oxygen species also known as free radicals. These reactive compounds are the source for chronic inflammation and chronic disease.

If you have high cholesterol and feel confused about what you should be eating or taking to protect your heart, call us for an evaluation. We’ll look at your labs and health history to craft a personalized plan to get you healthy and keep you that way!


Find us at www.healthwithoutrisk.com or on Facebook, Instagram and YouTube .



Diamond DM, Alabdulgader AA, de Lorgeril M et al. Dietary Recommendations for Familial Hypercholesterolaemia: an Evidence-Free Zone. BMJ Evid Based Med. 2020. https://ebm.bmj.com/content/early/2020/07/05/bmjebm-2020-111412

Here is another global study from 2018 called “Global Correlates of Cardiovascular Risk: A Comparison of 158 Countries”. In this study, elevated blood sugar was most correlated with cardiovascular risk and obesity.


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