Sticking with Cholesterol....

The subject of cholesterol and the whole fats question is something of a vexed issue of late. If you were to search online you would find a huge amount of information, much of it completely contradictory. Some will tell you it is wise to keep your cholesterol levels as low as possible whilst others will insist that having a high level of cholesterol in your bloodstream will have no bearing on your future health. To be as honest and straightforward with my readers as possible, I will admit to being a member of the first group and believe firmly, especially if a person has had any heart problems, that they would be well advised to control their cholesterol levels.

Firstly, we need to establish exactly what cholesterol is. If you were to hold some cholesterol in your hand you would find yourself looking at a waxy substance that might remind you of the scrapings from a whitish-yellow candle. Cholesterol is a lipid fat that is made in the cells of your body. There are many different types of cells that create cholesterol but the most productive are those in your liver that make approximately 25% of the total. You do need some cholesterol to keep healthy but your body creates all the cholesterol you need. You do not need to add cholesterol from outside sources (ie your diet!).

Cholesterol itself is performs three main functions in the body: it is used as part of the coating of cells; it makes up the bile acids that help in the digestion process; it allows the body to create Vitamin D and certain key hormones such as testosterone for men and oestrogen for women. Cholesterol is not bad, indeed it is vital to healthy bodily functions, but an excess of the wrong type is.

Cholesterol comes in two main types:

HDL (High Density Lipids) often referred to a good cholesterol.

LDL (Low Density Lipids) sometimes referred to a bad cholesterol but, the really bad ones are VLDL (Very Low Density Lipids) these are the ones that clog up your bloodstream and result in the problem of atheroma and the resulting cardiac issues.

Atheroma is the process of the degeneration of the walls of the arteries. This is generally caused by the build up of fatty deposits and scar tissue. Over time this will result in the restriction of blood flow and lead to cardiac events of all sorts. This formation is what we hope to prevent and reverse using these dietary and lifestyle methods.

A general reduction in cholesterol levels will offer a patient increasing levels of protection from the risk of heart attack but it needs to be stressed that it is not just the levels that are important but the ratio of LDLs to HDLs. Many in the field recommend going for a ration of 3:1 but some go even further and say that ideally one would achieve a ratio of 1:1. Commonly, in countries suffering high levels of heart problems such as the UK or the US, levels of 7:1 or 8:1 are commonly seen although the average is roughly 4.5:1.

Dr. Esselstyn sets a very clear goal in relation to the desired levels and ratios of cholesterol. He aims for a total blood cholesterol figure lower than 150mg/dl (milligrams per decilitre) and levels of LDL lower than 80mg/dl. By following the plant-based diet he recommends (as given in the previous blog) these levels are readily achievable. According to the doctor, at this kind of level you not only protect yourself from the possibility of a future cardiac event but even make possible the reversal of damage to the coronary arteries.

One of the good pieces of news about a plant-based diet is that plants themselves are very, very low in cholesterol. Many websites will tell you there is none at all, but this is not entirely accurate. The levels are so low though that they hardly register. Also, it should be noted, that the sort of cholesterol they do have is of a type that your body can use in a protective manner. To give some idea of the scale, the yoke of an egg (not recommended on the Esselstyn diet!) has 15000 mg/kg of cholesterol; the most concentrated form in the plant world is the European False Flax that contains as much as 200 mg of cholesterol per kg of plant oil. That is a ratio of 75:1. Note that this is in the oil form, again something that Esselstyn warns against, so even these very low levels would be avoided following his diet.

For interest, and to complete the picture, meat contains up to 5000 mg/kg and butter 2500 mg/kg. Without going into the issue of saturated versus unsaturated fats (a subject for a future blog), suffice it to say that the saturated fats are the ones to avoid. Dairy products and meat are high in saturated fats. One can readily see how the avoidance of meat and dairy products logically forms the foundation of Esselstyn's heart-friendly diet.

Finally, after quite enough technical information for one week, a little inspiration. Doctor Ellsworth Wareham was a cardio-thoracic surgeon for most of his long career. A few years ago, at the age of 95, he decided it was time to retire although there was no deterioration in his competence levels and the hospital he worked at tried everything they could to persuade him to continue. He is now 98 years of age and, as you can readily see from the video, remains remarkably healthy physically and sharp mentally. Doctor Ellsworth has been on a plant-based diet since his mid forties...