Lecture on Cholesterol and Nutrition

Introduction

• Speaker: Dr. Sarah Berry, Associate Professor in Nutrition at King's College London.
• Host: Jonathan, discussing the myths and facts about cholesterol.
• Key Myth: Cutting out fat reduces cholesterol is a myth; eating the right fats can improve cholesterol levels.

Importance of Cholesterol

• Role of Cholesterol:
  • Necessary for hormone production, vitamin D synthesis, and bile acids for fat absorption.
  • Integral to every cell membrane.
  • 40% of people in the US and UK have high cholesterol.

Types of Cholesterol

• LDL (Low Density Lipoprotein): Often referred to as 'bad' cholesterol.
• HDL (High Density Lipoprotein): Known as 'good' cholesterol.
• Key Idea: It's not only about good vs. bad cholesterol, but about the packaging of cholesterol in lipoproteins.

Dietary Impact on Cholesterol

• Diet Changes:
  • Can reduce cholesterol by about 30% quickly.
• Myths Debunked:
  • Eating dietary cholesterol (e.g., from eggs) has minimal impact on blood cholesterol.

LDL and HDL Dynamics

• LDL Dynamics:

  • LDL delivers cholesterol to cells and tissues; excess can cause artery plaque buildup.
  • LDL particles have a label (apolipoprotein B) that interacts with blood vessels.

• HDL Dynamics:

  • Transports cholesterol from the periphery back to the liver for processing.
  • Important to focus more on lowering LDL rather than just raising HDL.

The Role of Diet

• Portfolio Diet:
  • Includes phytosterols, soluble fiber, plant proteins, and nuts/seeds.
  • Can reduce cholesterol significantly.
• Fat Intake:
  • Increasing unsaturated fats (polyunsaturated) can lower LDL cholesterol.

Genetic and Lifestyle Factors

• Genetic Components: Influence how LDL receptors function, impacting cholesterol levels.
• Lifestyle Impact: Obesity, inactivity, and excessive alcohol can elevate cholesterol.

Gut Microbiome

• Impact on Cholesterol:
  • Studies show specific gut bacteria species correlate with cholesterol levels.
  • Probiotics may help lower cholesterol.

Advanced Measures of Cholesterol

• Apolipoprotein B (ApoB): A more precise measure than LDL, indicates cardiovascular risk.
• Triglycerides:
  • Important post-meal measure; high levels can indicate cardiovascular risk.

Actionable Diet Strategies

• Focus on Healthy Fats:
  • Avoid low-fat diets; instead, choose healthy fats like those found in nuts, seeds, and plant oils.
  • Avoid saturated fats from processed meats, some dairy.
• Carbohydrates:
  • Limit refined carbs which can convert to fats in the liver.
  • Whole grains and fibers are beneficial.

Statins and Cholesterol Management

• Statins: Effective but diet and lifestyle changes can also significantly manage cholesterol levels.
• Monitoring and Testing: Regular testing can help track and manage cholesterol changes over time.

Special Considerations

• Menopause:
  • Leads to a significant increase in LDL cholesterol due to loss of estrogen.
  • Diet becomes crucial during this phase.

Conclusion

• Summary:
  • Focus on lowering LDL cholesterol.
  • Increase healthy fats, reduce refined carbs, and incorporate fiber-rich foods.
  • Consider statins if dietary changes are insufficient, in consultation with healthcare providers.
• Zoe Program: Provides personalized advice based on individual test results to manage and improve nutrition and health.