How are ye doing, guys!
Time for part 2 of this series in which I explain why it's important to adopt a healthy
diet, now, even if you're young and healthy.
We've known for decades that atherosclerosis begins in childhood and that the higher young
peoples' cholesterol is the more atherosclerosis they have.
Such that high cholesterol can increase the risk of an advanced atherosclerotic lesion
in the coronary arteries of young people up to 8 times more than smoking can!
In fact, atherosclerosis appears to begin before we are even born, depending on what
our mothers ate.
Similarly to how a bad maternal diet is associated with increased rates of cancer, obesity and
aberrant immune function in her offspring as I discussed in part 1, increasing maternal
cholesterol has been found to result in more atherosclerosis in the aorta of the unborn
child.
It can also impair the function of the umbilical and placental vasculature and hence impair
blood flow and potentially result in adverse outcomes in the unborn fetus, in addition
to raising lifelong risk of cardiovascular disease, strikingly demonstrated in this plot
showing more rapid progression of atherosclerosis up to age 14 in kids whose mothers had high
cholesterol during gestation.
With all of this in mind it appears that having a low cholesterol level THROUGHOUT life is
neccessary for effective prevention of coronary heart disease, starting in and indeed even
before childhood.
Cholesterol-lowering later in life, no matter how effective, may already be too late.
It is also worth remembering that atherosclerosis is a systemic disease - the vascular tree
of almost the entire body is affected.
As such, when we hear "atherosclerosis" we immediately think not only of heart attacks,
but also strokes, gangrene and triple-As, since these are consequences of it that can
kill.
However, there are two manifestations of atherosclerosis that can show up years before symptomatic
heart disease or other consequences and can serve as warnings for our number 1 killer
and these other killers.
Manifestations that you may already be exhibiting.
Unlike blood supply to our heart, the blood supply to our spine consists of a large
amount of narrow-caliber arteries.
This, in addition to some other haemodynamic factors makes them highly susceptible to atherosclerosis,
and the disease can start closing off the openings of these arteries long before the
big arteries that supply our heart begin to narrow.
In addition to reducing blood supply to the vertebrae, flow to the nerves, muscles and
intervertebral discs can also become compromised.
This is of special importance to the discs, since they receive no direct blood supply
and require nutrients to diffuse in from the outside, rather than relying on direct perfusion.
These factors combined make our backs exquisitely sensitive to decreased blood supply.
Lower back pain is now our second leading cause of disability.
Why has this problem become such an epidemic?
Although lower back pain and degenerative disc disease have multiple causative agents,
this alteration in nutrition of the discs appears to be the final common pathway.
Consistent with the findings of atherosclerosis in children, the beginnings of degenerative
disc disease have been observed in kids as young as 11, and lower back pain is an increasing
problem in school-aged children.
Similarly, erectile dysfunction is now thought to be largely a cardiovascular disease, with
the psychogenic element likely less important than once believed even in younger people.
Erectile dysfunction and heart disease are both manifestations of the same disease, but
symptoms of erectile dysfunction show up years before symptoms of heart disease, possibly
due again to these narrower-caliber arteries succumbing to the effects of vascular dysfunction
years sooner than the larger coronary arteries.
In fact, erectile dysfunction may be the one of the BEST predictors of future cardiovascular
disease.
New erectile dysfunction in men in their 40s is associated with a 50-fold increase in the risk
of coronary artery disease over the next 10 years!
Erectile dysfunction may serve as a warning for life-threatening manifestations of atherosclerosis
down the road.
The only factor neccessary for development of atherosclerosis and hence these diseases
appears to be high cholesterol.
The problem is, even if your cholesterol is in the normal range it may not be "normal"
at all - around 35% of heart attacks occur in people with a total cholesterol of under
5.2 mmol/L, or 200 mg/dL, which is the current definition of "normal."
We may need to push our levels at least under 3.8 and if possible much lower to begin to
reverse atherosclerosis, and this is just what a plant-based diet can do.
This same paradigm of normal being actually abnormal also applies to blood pressure.
"Normal" blood pressure is defined as under 140/90.
However, there appears to be benefit in lowering blood pressure all the way down to 110 over
70, and indeed death from stroke and ischaemic heart disease doubles with every 20/10-point
increase in blood pressure starting at just 115/75.
Again, the only people averaging this blood pressure are those eating a strictly plant-based
diet.
In addition to the blood pressure-raising effects of meat and refined fructose that
I have explored previously, various types of studies including randomised controlled
trials have shown that excessive salt is an important causative factor in the development
of high blood pressure.
Low salt intake even in children seems to confer the same cardiovascular protective
effects seen in adults that I have discussed, and part of this protective effect comes from
the lowered blood pressure.
But even if your blood pressure is optimal at around 110/70, excessive salt has many
detrimental effects on the body independent of whether it raises your blood pressure or
not.
One of the most important mechanisms by which it causes these damaging effects is through
it's ability to cause endothelial dyfunction and stiffen our arteries.
These latter effects are becoming increasingly recognised as important predictors of cardiovascular
disease, just like high blood pressure and high cholesterol.
Refined carbohydrates and saturated fat have also been shown to have a detrimental impact
on this endothelial function.
This effect is not as clear-cut with refined plant oils and part of the reason for this
may be that these oils are often co-consumed with antioxidant-rich foods, amongst other
confounding factors.
Another good reason to eat your fruit and veg, especially if indulging in an unhealthy
meal!
The bottom line is that unhealthy foods cause an immediate drop in endothelial function
regardless of our age and health, and this dysfunction is not good for us, and certainly
not causing it three times a day with breakfast, lunch and dinner.
The pathological processes I have discussed thus far in this video may all be adding up
to begin the pathogenesis of one of the most frightening diseases of all - Alzheimer's
disease.
High cholesterol and it's consequences are thought to be the primary driving forces behind the
development of the disease and genetics play a much less important role compared with the
cumulative risk from modifiable risk factors, as I have discussed before.
Oxidised cholesterol, found especially in red meat, eggs, milk, cheese and ham and increased
during the cooking and storing of these products, appears to be particularly harmful.
And it is now recognised that Alzheimer's disease is not a disease of the elderly, but
in fact begins decades before diagnosis.
The first stages of Alzheimer's disease become visible on autopsy starting in just our 20s
- the time to act to prevent the disease is now!
In summary, atherosclerosis and cardiovascular disease begin very early in life, and the
disease may provide some warning signs before it starts killing us off, such as lower back
pain and erectile dysfunction.
However, if you eat the standard Western diet the odds are that this disease has already
started to affect you whether you have any warning signs or not.
The best way to combat this disease, and hence it's consequences like heart attacks and Alzheimer's
disease is to maintain a low cholesterol level and eat a healthy whole foods, plant-based
diet throughout life.
Thanks for watching!
If you have any questions or comments leave them in the comment section below and I'll
get back to you.
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you don't miss part 3 of this series.
Sláinte!