Its Added to Many Foods and May Be Raising Your Cholesterol

The Cholesterol Myth

Cholesterol is often demonized in public press and medical literature for increasing the risk of atherosclerosis and heart disease. This simplistic view has fueled a number of myths and clouded the truth about the role of cholesterol in the body.

Cholesterol is needed for the synthesis of sex hormones, adrenal hormones, bile acids, and vitamin D.

In fact, it is naturally produced in the liver. The liver makes about 75% of the cholesterol the body needs every day. The rest comes from the diet.

Although many physicians and health experts relentlessly advocate reducing blood cholesterol levels, there is no scientific evidence to suggest that lowering total blood cholesterol reduces the risk of heart disease.

In fact, a growing number of physicians report that many patients with heart disease have cholesterol levels well within normal ranges and that many who tested with high cholesterol levels are quite healthy.

There are generally 2 types of blood cholesterol. HDL (high-density lipoprotein) cholesterol and LDL (low-density lipoprotein) cholesterol. While HDL cholesterol is known as “good cholesterol” and LDL cholesterol is regarded as “bad cholesterol”, the truth is that cholesterol is neither good nor bad.

Of more importance to cardiovascular health are triglycerides, another group of fats found in the blood.

Studies show that measuring the number of triglycerides in the blood is a better way to predict the risk of heart disease. More importantly, the ratio of triglycerides to HDL cholesterol is a pretty accurate predictor of cardiovascular health.

Diet and Cholesterol

Over the years, we were repeatedly advised to cut back on foods rich in fats and cholesterol in order to reduce the risk of heart disease. This advice seemed inevitable: if we remove the sources of cholesterol, our blood cholesterol levels should drop.

However, new findings have proven that this seemingly logical advice is not only wrong but unhealthy.

Studies show that eating cholesterol-rich foods barely affects blood cholesterol levels. In fact, saturated fats (once promoted as especially bad for cardiovascular health) have been proven to be safe.

In addition, studies show that following the recommendation of the American Heart Association to replace saturated fats with carbohydrates is actually detrimental to health and can increase the risk of heart disease.

Not only is increased consumption of carbohydrates bad for your heart, added sugar in the form of simple sugar added to processed, refined foods and soda drinks, is especially bad for your health.

One of the landmark studies in the fat vs. carb debate was conducted by Harvard researcher, Dariush Mozaffarian. The paradoxical results of this study published in the American Journal of Clinical Nutrition showed that increased consumption of saturated fats slowed down the progression of atherosclerosis in the studied group of postmenopausal women.

In contrast, higher carbohydrate intake was associated with increased progression of coronary atherosclerosis.

The study showed that replacing saturated fats with high-caloric carbs increased the risk of heart attack by more than 30%.

Good LDL. Bad LDL

To better understand these new shifts in the relationship between foods and cholesterol, it is important to revisit our understanding of lipoproteins.

Although LDL cholesterol is commonly called “bad” cholesterol, this is not always true. In fact, low-density lipoproteins or LDL particles come in different sizes. The LDL particles associated with heart disease are the small, dense ones.

Large, less dense LDL particles are safe and may even be good for the heart. Therefore, it is important to raise the levels of large LDL particles in the same ways that we try to raise the levels of HDL particles.

Just as important, the amount of circulating small, dense LDL particles should be reduced.

Egg, once demonized for its high cholesterol content, is a good source of large, healthful LDL cholesterol. Carbohydrates, on the other hand, raise the level of small, dense LDL particles and also lower HDL cholesterol.

Overall, studies show that the best ways to lower the level of small, dense LDL are to cut back on carbs instead of dietary fat and cholesterol while exercising regularly.

Sugar and Cholesterol

Sugar is a good example of a carbohydrate with a high glycemic index. It can, therefore, increase the amount of small, dense LDL particles in the blood.

Although health experts used to advocate that we cut the amount of sugar we consume because high blood sugar can cause insulin resistance and increase the risk of diabetes, there is now another reason to cut down on our sugar consumption.

A number of studies show that sugar can affect the kind and amount of cholesterol released into the blood.

The most commonly quoted study demonstrating the negative impact of sugar on cholesterol levels and cardiovascular health is discussed below.

The JAMA Study

In a 2010 study published in the Journal of the American Medical Association by researchers from Emory University, the nutritional data and blood lipid levels collected in a large survey spanning 1999 to 2006 were analyzed.

The researchers divided the results of more than 6,000 adults into 5 groups by the amount of added sugar and related caloric sweeteners consumed.

The data for this study were obtained from the National Health and Nutrition Examination Survey (NHANES), a regular epidemiological program conducted by the National Center for Health Statistics. Such surveys are done to determine the health and nutritional status of the population.

The JAMA study found out that the highest consumers of added sugar eat the equivalent of 46 teaspoons of added sugar daily. The lowest consumers in the pooled data only consumed 3 teaspoons daily.

The huge difference in sugar consumption, however, tripled the risk of heart disease.

This study suggests that the consumption of added sugar may cause a condition known as dyslipidemia (low HDL cholesterol and high triglyceride levels) as well as obesity.

The Sugar Status of the Nation

The source of simple sugar is really immaterial. Even though some believe that the sugar found in honey and molasses are healthful and the sugar found in fructose corn syrup and soda drinks are bad for our health, the simple truth is sugar is sugar.

However, most Americans consume more sugar from refined, processed foods and soda drinks than from fruit juices.

The latest data from the American Heart Association show that Americans consume an average of 22 teaspoons of added sugar per day. This is in sharp contrast to the recommended 6 teaspoons per day for women and 9 teaspoons per day for men.

Increasingly, added sugar is making up more of our daily calories. The increased consumption of added sugar can either add more calories to our diet or displace nutritious foods.

All of these facts suggest there is an urgent need to cut back on the amount of added sugar in our diet.

Sugar and Triglycerides

The simple, refined sugar commonly added to processed foods and soda drinks is meant to be quickly burnt to provide a ready energy source for the body.

However, consuming more sugar than is needed simply increases blood glucose levels. The body responds by releasing more insulin and storing excess blood sugar as fat. One of the means by which the body removes excess sugar from the blood is by storing them as triglycerides in the liver.

Triglycerides are a particularly unhealthy kind of fat. They are made from glycerol and fatty acids.

Triglycerides are used to transport fats and they are also important energy sources. In fact, triglycerides contain double the energy store of carbohydrates (9 kcal/g vs. 4 kcal/g).

The high energy content of triglycerides make them high caloric macronutrient and, therefore, potentially worse than the simple sugar used to synthesize them.

The body uses triglycerides to manufacture small-sized lipoproteins such as chylomicrons and VLDL (very low-density lipoproteins). These lipoproteins are even smaller than triglycerides and can, therefore, increase the risk of heart disease too.

The VLDL produced from triglycerides can also be converted to small, dense LDL which are known to get trapped in the walls of arteries and, therefore, increase the risk of heart disease.

Sugar, Inflammation and Heart Disease

While high sugar intake causes insulin resistance, it also wrecks the natural balance of the body. High blood sugar level coupled with high levels of circulating insulin can damage the walls of arteries.

Sugar causes inflammation and new studies have established that inflammation (and not cholesterol) is the root cause of heart disease.

When high sugar and insulin levels disrupt cellular and metabolic processes, a number of harmful compounds cause small tears in the lining of the arteries. The body responds to this injury by sending pro-inflammatory cytokines to the sites of injury.

Even as the lining of the arteries becomes damaged, small, dense LDL cholesterol becomes oxidized and then trapped in the inflamed sites of the lining.

The trapping of oxidized LDL cholesterol not only worsens the inflammation but also promotes the formation of plaques and the narrowing of the arteries.

Therefore, high sugar consumption can cause inflammation and increase the risk of atherosclerosis and heart disease.