Sunday 8 January 2017

Eggs and cholesterol

There are some facts about cholesterol that the majority of the public does not know and even some doctors seem to have forgotten because it has been so long since they learned about them in the early years of medical school.
a) cholesterol is an animal product from the catabolism of heamoglobin. As plants do not have blood, they produce phytosterols which inhibit cholesterol absorption in the guts. The claim "no cholesterol" on labels of plant-base food is non-sense, a commercial trick.
b) Human body needs quite a lot of cholesterol and manufactures about 1g daily (with a total body amount of 35g), and mother Nature gives us the ability to recycle most of the cholesterol from the guts.
c) cholesterol is produced by the liver and secreted into the gallbladder, stored there under the form of bile salts. When the stomach content moves down to the upper portion of the small intestine, it triggers a contraction of the gallbladder which forces the bile into the guts. The bile salts (with their cholesterol component) are water soluble and can be easily absorbed through the blood vessels in the intestine wall, then into the blood.
d) on the other hand, the cholesterol in the food are under the esterified forms, not water soluble and not easily absorbed through the intestine wall. Most of them ends up to be food for the gut bacteria.
d) consequently, most of the cholesterol in our blood comes from ourselves, less than 20% come from food.
e) go ahead and enjoy egg, butter, crustaceans (crab, shrimp, lobster ...) because the recommendations about them the last 50 years concerning cholesterol have been wrong on biochemical and physiological basis.
*** for people who want to lower cholesterol but don't know what to believe, these are other tidbits:
a) as the largest source of cholesterol comes from bile. the most logical way to reduce cholesterol is to prevent the bile salts from being absorbed.
b) soluble fiber in grains and fruits is the most effective and SAFE weapon to do that because the bile salts adsorb (with a d, not b) onto the fiber, cannot be released to be absorbed (with a b) and will be eaten by the bacteria or .... pooped out.
c) this is the caveat: as bile is not secreted into the guts all day long but only in spurts (especially during meals high in lipid), eating high fiber in the form of oat meal or high fiber cereal once a day in breakfast is non-sense, mainly because that breakfast is fat-free, that is without egg, bacon, butter!
So, the best way to lower cholesterol inexpensively, without a doctor visit or a prescription is to go to the pharmacy, ask for one of the fiber caplet or pill available OTC and take one of them three times daily WITH EACH MEAL.
If your blood cholesterol does not drop in few weeks, you can think about asking your doctor for extended-released niacin or a statin. 50% of my patients did not need anything beyond a high fiber diet and only 30% more needed a fiber supplement.
Further reading
Daily egg consumption in hyperlipidemic adults - Effects on endothelial function and cardiovascular risk. Valentine Njike, Zubaida Faridi, and David L Katz

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