arterial plaque regession pt 2 how your body does it
autophagy and hdl
I get the best questions from from viewers David Iver asked the other
day he said what is the process by which LDL is pulled out from between the media
and intima layers of the artery wall a brief answer that I gave had to do with
three different mechanisms one was inflammation which is not a good way
another is otology autophagy is helpful it's very helpful more in cellular
processes and what is autophagy again break it down auto phage
of Ag Auto means self and phagy means eating so it's your your cell eating
pieces of itself - trash that have proteins lipids things that have been
used in the past but are no longer necessary that's actually a very good
process and it has to do very much with the obesity epidemic and it has to do
with fasting if you never go through fasting stages and if you are
continually eating gaining weight your cells never get to go through a healthy
process called autophagy inflammation as I mentioned earlier is not a good way to
get to deal with plaque in your artery walls it's where your immune system says
that plaque shouldn't be there that LDL should not be between the the intima and
the media layers of the artery walls so I'll send in white cells monocytes
leukocytes and attack those however I've really majored on the minors here I've
talked about the two ways that are really not important there's one key way
that's important for pulling LDL out of artery walls and we'll cover that in
just a minute but first a brief introduction my name is Ford brewer
fOrd brewer BREwer with prevent heart attack stroke cancer
prevention we spend a lot of time helping you understand how to prevent
the major killers and disablers like heart attack stroke cancer dementia and
most of those are driven by this process cardiovascular inflammation inflammation
the number one driver is insulin resistance diabetes carbohydrate
metabolism problems and if you're thinking well that's diabetes I don't
have to worry about that well if you're an adult in the state of California the
UCLA says you've got a 50% chance one in two chance that you have this in other
words you're burning your arteries right now with cv inflammation
cardiovascular inflammation due to insulin resistance and if you're age 60
it's much higher than that what's interesting about this study is this is
based only on fasting blood glucose and hemoglobin a1c it doesn't deal with the
far more sensitive tests of oral glucose tolerance and or insulin surveys so
actually the reality is it's far more than that so if you haven't had those
tests if you haven't made sure that you don't have carbohydrate metabolism
problems I would ask you to consider again now if you're not inflaming your
arteries but you still have plaque what is the most common and the most
important way of getting plaque out of those artery walls
David Ivers again thanks for asking and Jon Lorscheider thanks for providing a
great citation in this area it's HDL we've talked about that in the
past several times and it actually brings up a good point for me to talk
about the importance of HDL what is HDL what is LDL and why are the
important and again I haven't voiced it but as you see here's the here's the the
image LDL will drop and deposit fat in the arteries HDL is like an empty dump
truck and empty wheelbarrow taking that LDL back out of the artery so it can be
metabolized now again I said what is HDL and LDL the the final L stands for
lipoprotein so it's high density lipoprotein and low-density lipoprotein
we'll talk about that in other words when you go to the doc most of us have
heard this term HDL is called the good cholesterol LDL is called the bad
cholesterol HDL is actually again that empty wheelbarrow what our lipoprotein
so let's go back in and break that down for a second and clarify that lippo
means fat or oil and protein obviously means protein so this is a protein made
to transport fat and or oil now why am i holding this beat-up old water bottle
with water and olive oil in it to demonstrate a very important point which
most of us already know oil and water don't mix but we eat oil we have oil we
have fat with hamburgers if you eat those and if you're a very
healthy person and you eat a lot of olive oil extra virgin olive oil like
this is even olive oil does not mix with blood because blood is over 95% water
well you know there's a thing called fat embolus and if you didn't have something
in your body to break down these these big to keep this oil from coalescing
you'd have what's called a fat embolus and those do actually occur
they occur in car wrecks major trauma where major bronze bones are broken
because our bone marrow has fat in them when that fat is released into the
bloodstream from trauma it can cause a heart attack stroke massive injury again
because you've got this floating around in your blood your when you digest it
you have the lipoproteins on HDL LDL apoE and what they do is they keep the
those fat particles in a tiny microscopic area so you don't get these
large emboli or embolus meaning a big blob that's going to cut off the blood
supply so what is the most important way of getting fat out of the area but
between the the intima in the media it's HDL this helps actually underline the
importance if you go back to some very very basic science you understand
something that is just you know difficult to understand it until after
you've seen patient after patient after patient and that is HDL is far more
protective than LDL is destructive and let's go back if you look at this
there's a way to begin to understand that and that's comparing let's compare
these two bars for example before I do this is from the Framingham Heart Study
most people have heard of Framingham it's you see it at in Haines you see it
in a bunch of other studies so here is the risk associated with heart attack
and stroke cardiovascular risk and here is LDL and this is HDL sorry about my
graphics they're almost always bad but again you
can tell it you can see the point here someone with an HDL of 65 has
lower heart attack and stroke risk even if they have a LDL of 220 then another
person with an LDL of 100 if their HDL is only 25 so let me repeat that so you
get that again HDL 25 very low LDL 100 so the LDL is
very low this person's safe right that's where we always focus on the LDL the bad
cholesterol look at the risk this person has this person on the other hand has an
LDL of 220 but their risk is far lower why because their HDL is 65 so the point
being again HDL is incredibly important it's far more protective than LDL is
destructive John I didn't get to cover the your citation yet on different types
of HDL and HDL metabolism hopefully I'll be able to do that in a in another video
soon thanks for your interest