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It is inflammation and not cholesterol that causes cardiovascular disease

It is inflammation and not cholesterol that causes cardiovascular diseaseThere is absolutely no reason not to consume eggs, meat, butter and other cholesterol-filled foods with a good conscience. American dietary guidelines have finally exonerated cholesterol, which happens to be an essential compound. Many scientists actually claim that atherosclerosis and cardiovascular disease are both a result of inflammation and lack of specific micronutrients. It is important to pay attention to factors that are known to promote inflammation in the body and take the necessary steps by looking after your circulatory system, making healthy lifestyle choices, and possibly even using supplements.

Facts about cholesterol – the essential compound

  • The liver produces most of the cholesterol that is needed
  • Cholesterol is a structural component of all cell membranes and is important for the strength and defense of all cells
  • Cholesterol is a basic element in steroid hormones, including stress hormones and sex hormones
  • When we expose ourselves to sunlight (UVB rays), vitamin D is synthesized from a type of cholesterol that we have in our skin
  • Cholesterol is used to synthesize bile acids that are necessary for the uptake of lipid-soluble molecules such as vitamins A and D
  • The brain contains large amounts of cholesterol, which is vital for our nervous system
  • LDL, a particularly shamed type of cholesterol, binds and inactivates virus, bacteria, and toxins
  • LDL mends arterial lesion caused by inflammation
  • LDL is only dangerous if it oxidizes and goes rancid
  • A low cholesterol count is associated with an increased risk of dying of respiratory disease or gastrointestinal ailments
  • People with high cholesterol counts generally liver longer
  • Elevated cholesterol levels are a sign that the body is defending itself

Because of its many important functions, it makes no sense to call cholesterol dangerous. Animals also need cholesterol, which is why you find the same amount of cholesterol in a steak or chicken thigh as you would find in human muscle tissue.

American dietary guidelines have exonerated cholesterol – but not sugar

According to the official American dietary guidelines from 2015-2020 (Dietary Guidelines for Americans), previous warnings against consuming cholesterol have been repealed. Now, the guidelines state that cholesterol is a nutrient that is not harmful in greater quantities. However, the revised guidelines introduce limitations on sugar by recommending that the sugar intake stay within 10 per cent of the total calorie content in our diets. Many dietary experts still consider this limit too high because consuming too much carbohydrate may set the stage for elevated cholesterol and increased inflammation.

Did you know that atherosclerosis occurs with both high AND low cholesterol levels?

Anti-inflammatory drugs lower your risk of a heart attack

According to a placebo-controlled study sponsored by the pharmaceutical company Novartis Pharmaceuticals, patients in anti-inflammatory drug therapy (where the medicine did not lower cholesterol levels) had a significantly lower risk of dying of a heart attack or other cardiovascular diseases. The study, which was conducted at Brigham and Women’s Hospital in Boston, the United States, is the culmination of 25 years of research in cardiovascular disease. The study included 10,000 patients who had suffered a heart attack and had persistently elevated levels of C-reactive protein (CRP), a biological marker of inflammation.
To test the hypothesis that inflammation is what causes life-threatening cardiovascular diseases, the drug company developed canakinumab, a very expensive anti-inflammatory drug that does not lower cholesterol levels. As mentioned earlier, the drug lowered the risk of heart attacks and even the need for by-pass surgery, but there were side effects such as fatal infections linked to a weakened immune system. The study is described, among other places, in Forbes Magazine in August 2017.
The hypothesis about inflammation being the root cause of atherosclerosis and an array of different diseases is not entirely new. The pharmaceutical industry, needless to say, can see a huge potential in developing expensive, patentable drugs, but it is better to prevent and fight the underlying cause of inflammation with natural means like diet and lifestyle. After all, this is not associated with side effects.

Did you know that atherosclerosis is the leading cause of cardiovascular disease and death?

How do inflammation and free radicals create atherosclerosis?

Cholesterol circulates in the blood tied to LDL (Low-Density Lipoprotein) or HDL (High-Density Lipoprotein). LDL primarily moves from the liver to the cells and tissues, while HDL primarily moves back to the liver. Cholesterol is essential and is not dangerous, unless free radicals attack it. Free radicals are aggressive molecules that are a byproduct of our respiration, and their number increases as a result of infection, poisoning, smoking, stress, and ageing processes.
Our only source of protection against free radicals is different types of antioxidants. The antioxidants that we get from our diet are e.g. vitamins A and C, selenium, zinc, manganese, and different plant compounds.
Free radicals create ideal conditions for local irritation of the endothelium, which is the thin layer of cells that lines the inside of blood vessels. LDL works like a bandage on the lesion, but with too few protective antioxidants, there is a risk that free radicals also attack the cholesterol, causing it to oxidize. The endothelial cells react to the local irritation by attracting macrophages from the immune system. They “gorge” on the oxidized and destroyed LDL particles and then turn into so-called “foam cells” that are embedded in the vessel wall, where they cause increased damage. Eventually, this process may thicken the vessel wall, thereby narrowing the passage through the blood vessel and increasing the risk of a blood clot.
In the part of the article that follows, you can read about free radicals and inflammation and why this can be a result of too many carbohydrates, insulin resistance, having too large a waist circumference, paradental disease and bacteria, tobacco, food intolerance, excess iron and calcium, or lack of nutrients like omega-3, vitamin D, magnesium, and selenium.

 The figure shows the development of atherosclerosis in a coronary artery and how the oxidized cholesterol is embedded in the vessel wall

The figure shows the development of atherosclerosis in a coronary artery and how the oxidized cholesterol is embedded in the vessel wall

Carbohydrate, insulin, and inflammation

Decades of anti-cholesterol campaigns and fear of fat have made people consume more carbohydrates and more light-products. The increased carbohydrate intake, especially in the form of white flour, white sugar, and corn syrup or HFCS (high fructose corn syrup), cause large blood glucose oscillations and untimely hunger. The high consumption of carbohydrates may eventually lead to insulin resistance with chronically impaired cellular uptake of glucose.
Insulin resistance leads to elevated insulin levels that promote inflammation, and the condition is part of metabolic syndrome that is also characterized by having an apple-shaped body, elevated cholesterol levels and hypertension. Metabolic syndrome is an early stage of type 2 diabetes, and both conditions are spreading like a bushfire. Cholesterol levels increase with metabolic syndrome and type 2 diabetes, and this is primarily a result of consuming too much carbohydrate that burdens the blood sugar levels and the liver.

Did you know that elevated cholesterol levels are of caused by blood sugar disturbances and chronically elevated insulin levels?

Waist circumference and inflammation

Most overweight individuals’ waist circumference is too large. However, there also people who are normal weight or are even slim but still have too much abdominal fat. They are called TOFIs (thin-outside-fat-inside). Excess abdominal fat releases pro-inflammatory substances that may cause cardiovascular problems, type 2 diabetes, and a number of other conditions.
As a rule of the thumb, women’s waist circumference should not exceed 80 centimeters, and men’s should stay below 94 centimeters.
Other factors are involved such as height and ethnicity. Make sure always to measure your waist circumference the same place, which should ideally be two centimeters above your navel.

Atherosclerosis, bacteria, and inflammation

Atherosclerotic vessel walls show signs of at least 50 different bacterial strains and several virus types, but this is not the case in normal arteries. The bacteria often originate from the gut flora or oral cavity as a result of leakages or lesions. Paradental disease is believed to play a major role.
The immune defense is designed to fight bacteria, and the white blood cells use free radicals as ammunition. However, with too few protective antioxidants, there is a risk that the free radicals attack and oxidize cholesterol, setting the stage for atherosclerosis. If the immune system is too weak, a small abscess (vulnerable plaque) may occur in the arterial wall. In the case that this abscess bursts, it spills out its content of bacteria and toxins. This may result in the formation of a blood clot right by the opening in the arterial wall.

Tobacco and smoke in general

Smoking tobacco, water pipe, or any other form of smoking produces a cascade of free radicals in the bloodstream, and they can easily attack cholesterol. Tobacco contains over 4,000 different toxic compounds, including cadmium, lead, and other carcinogens, and the cocktail of toxins is one of the most harmful things for your circulatory system and health.

According to the World Health Organization (WHO), tobacco and sugar are the two worst enemies of public health.

Food intolerance

Your intestinal lining may become leaky if the microflora is thrown off balance because of taking antibiotics or eating an unhealthy diet, or if a person uses painkillers frequently. Besides bacteria, partially decomposed proteins may enter the bloodstream, causing the immune system to react in the same way as it does with an infection. This may lead to chronic inflammation. There is evidence to suggest that whole-grain (especially gluten), dairy products (especially protein like casein), and legumes may be responsible for the development of inflammation and other unpleasant symptoms in people who are sensitive to these foods. The phenomenon is known as “leaky gut syndrome”.
For people with a leaky gut, it is vital to eliminate from their diets the foods that provoke the immune system, and to strengthen the intestinal mucosa and normalize their gut flora with fermented foods and lactic acid bacteria.

More sun and vitamin D means less inflammation

Vitamin D contributes to the uptake of calcium, but it is also important for the immune system, the circulatory system, and many other body functions. Researchers from National Jewish Health in Denver, the United States, have observed how vitamin D inhibits inflammation by means of molecular mechanisms. The effect depends on how much vitamin D you have in your blood. The best anti-inflammatory results are seen with a vitamin D blood levels above 50 ng/ml.
Over the years, studies have shown that vitamin D is vital for our circulatory system and blood pressure. For instance, the Mediterranean diet is associated with fewer cardiovascular diseases, and this is also because people in that part of the world generally get much more vitamin D from the sun.

How much vitamin D do we need?

The summer sun is our major vitamin D source. Even if we follow the official dietary guidelines, it is very difficult to get enough vitamin D all year round. Regular vitamin pills normally only contain 5 micrograms of vitamin D, but an increasing number of scientists claim that we need much more than that.
Vitamin D is a lipid-soluble vitamin that we absorb and utilize the best by taking capsules with vitamin D in an oily solution. It is perfectly safe to take strong supplements with 30-80 micrograms of vitamin D.

Did you know that during the winter period, the sun sits too low in the sky for us to be able to synthesize vitamin D?

Nobel Prize winners revealed how fatty acids regulate inflammatory processes

In 1982, the three biochemists, Bergström, Samuelson, and Vane, were awarded the Nobel Prize in Medicine for their research in some hormone-like substances called prostaglandins that are known to control inflammatory processes in the body.
The different prostaglandins are synthesized from omega-3 fatty acids (that we get from oily fish) and omega-6 fatty acids (that we get from plant oils). In general, the omega-6 type called AA (arachidonic acid) promotes inflammation, while the omega-3 form called EPA (eicosapentaenoic acid) inhibits inflammation.
The Western diet typically contains omega-6 and omega-3 in a 20:1 ratio that promotes inflammation. The optimal ratio is believed to be 4:1 or even less.

Fish oils are often the best source of anti-inflammatory EPA

At our latitude and ever since the Stone Age, the primary source of omega-3 and EPA has been fish and shellfish. For this reason, many people have difficulty with converting omega-3 in the form of ALA from linseed oil, simply because there has not been an evolutionary demand for this enzymatic action.
A therapeutic fish oil dosage is around 2-4 capsules daily and corresponds with the amount of omega-3 that you would get from eating about one salmon steak (from fish that has consumed a maritime diet).

When the body produces the different types of prostaglandins that regulate inflammation, it also needs vitamins and minerals to support various enzymatic processes

Danish research reveals that selenium inhibits inflammation

The immune defense is overactive whenever there is inflammation in the body. For instance, scientists have observed increased levels of the pro-inflammatory compound, interleukin-6, in the case of selenium deficiency. They also found that the selenium-containing GPX proteins block interleukin-6 and prevent inflammation. This was seen in a study from Århus University where selenium supplements stimulated the GPX activity in patients with rheumatoid arthritis.
Various selenium-containing proteins also function as powerful antioxidants that neutralize free radicals, thereby protecting cholesterol and the circulatory system. It is difficult to get enough from the diet, even if you eat healthily. This is because European soil contains very little selenium.
Selenium supports around 30 different selenoproteins. If you choose to take a selenium supplement, you are better off with a selenium yeast that provides a variety of different organic selenium types.

Magnesium supplements counteract inflammation

Researchers from Mexico, Iran, and Australia collected data from different studies that focused on CRP (C-reactive protein), which is a biological marker of inflammation. According to the researchers, magnesium supplements can significantly reduce this protein. Because magnesium deficiencies are common, using magnesium supplements as part of the anti-inflammatory therapy makes perfect sense. Inflammation is not always noticeable but sets the stage for atherosclerosis, osteoporosis, and number of other diseases.

Important: Magnesium and calcium should be taken in the right balance

Technically, magnesium functions as a doorman in our cell membranes. It makes sure that 99% of the body’s calcium enters the cells in our bones and teeth, while very little calcium is allowed to enter cells in soft tissues such as muscles. With too little magnesium in our system, there is no way of controlling where the calcium goes.
It is believed that the molecular background for inflammation may be related to a surplus of calcium ions in soft tissue cells, including the endothelial cells of the blood vessels. This “stresses” the cells and causes them to release various pro-inflammatory substances. Because of this interplay between calcium and magnesium, it is vital to have the two nutrients in the right balance.
Normally, the balance between calcium and magnesium should be around 2:1. In Western Europe, most people get around 800 mg of calcium and 37 mg of magnesium. However, in Asia where the majority of the population does not consume dairy products but more vegetables, it is more of a 1:1 ratio (500 mg of calcium and 500 mg of magnesium). This balance appears to benefit bone health, and it even seems to be good for preventing inflammation, atherosclerosis, and many chronic diseases that are less common in the Asian countries.
It is also important to get enough vitamin K2 that removes calcium from the blood and helps embed it in bones and teeth.

Important note: Taking a magnesium supplement separately is not a problem, but NEVER take calcium without magnesium.

Q10 protects cholesterol in the bloodstream

Coenzyme Q10 is essential for cellular energy turnover and as an antioxidant. In fact, cholesterol carries Q10 through the circulatory system, and this is where Q10 helps protect cholesterol against free radicals and oxidation. We humans produce most of the Q10 that we need. However, from the age of 20 or so, our endogenous synthesis of Q10 drops. Many people notice this difference around the age of 50 where their energy levels and vitality go down. The cells and cholesterol also grow increasingly vulnerable to free radical attacks, even though this is not something we can feel.
Studies show that Q10 supplements are able to lower blood levels of interleukin-6, which is an inflammation marker.
The body has difficulty with absorbing Q10 from supplements. Always make sure to choose a high-quality product that can document its bioavailability.

Cholesterol-lowering medicine and Q10

Cholesterol-lowering medicine (statins) have been shown to block the body’s Q10 synthesis. Therefore, it is advisable to take at least 100 mg of Q10 daily to reduce the side effects of the lowered Q10 synthesis, which include fatigue, poor concentration, sore muscles, and impotence. It is also a good idea to take Q10, because it is a vital antioxidant that protects cholesterol in the body.

Avoid excess iron

Iron is essential, but the mineral is also catalyzes free radicals and should therefore be ingested in the right amounts. Scientists believe that a high intake of iron (especially from meat and supplements) may increase the risk of inflammation, atherosclerosis, and blood clots. People who get sufficient iron should not use iron supplements that contain more iron than a regular multivitamin.

Promotes inflammation

Inhibits inflammation
Free radicals Antioxidants
Omega-6 Omega 3 (especially EPA)
Elevated insulin Vitamin D
Too much iron and calcium Magnesium
Leaky mucosa Selenium
Bacteria and food intolerance Q10
Stress and too little sleep Plenty of time and sleep


Harlan Krumholz. Inflammation: Is it the New Cholesterol? Pharma & Healthcare medicine. August 2017

Johns Hopkins Medicine. Calcium supplements may damage the heart. ScienceDaily. 2016

Andrea Rosanoff et al. Essential Nutrient Interactions: Does Low or Suboptimal Magnesium Interact with Vitamin D and/or Calcium status. Advances in Nutrition 2016

Mark J Bolland et al. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ 2008

L-.E. Simental-Mendia et al. Effects of magnesium supplementation on plasma C-reactive protein concentrations: A systematic review and meta-analysis of randomized controlled trials. Current Pharmaceutical Design. 2017

Stephen Daniels. Magnesium supplements show potential anti-inflammatory effects: Meta-analysis. 2017

Aya Mousa et al. Effect of vitamin D supplementation on inflammation: protocol for a systematic review. BMJ Open 2016

National Jewish Health. How vitamin D inhibits inflammation. ScienceDaily 2012

Hoffmann Peter R et al. The influence of selenium on immune responses. Mol Nutr Food Res.

Uffe Ravnskov. Kolesterol – myter og realiteter. Hovedland 2008

Pernille Lund. Q10 – fra helsekost til epokegørende medicin. Ny Videnskab 2014

Pernille Lund. Sådan får du styr på dit blodsukker og din vægt. Ny Videnskab 2013

Pernille Lund. Immunforsvarets nye ABC. Hovedland. 2012

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