Cholesterol and atherosclerosis: the investigation is not over
The case of plaques
Natalia Alexandrova, Telegraph "Around the World" Cholesterol may still be less dangerous than methods of combating it
In the era of fashion for a healthy lifestyle, a person needs some "extreme" - bad habits that should be abandoned, foods that cannot be eaten, something that must be monitored by all means.
Cholesterol, which is blamed for the development of atherosclerosis, has become so "extreme".
Although atherosclerosis was described more than a hundred and fifty years ago, American doctors began to actively study it only during the Korean War of 1950-1953. Apparently, fearing the use of new types of weapons, the Americans conducted an examination of all the dead soldiers. Despite their young age, many have pronounced atherosclerotic phenomena. And they were scared – what's going on with older Americans then? The passion machine started working, statistics of mortality from cardiovascular diseases were showered from various institutions, an advertising campaign for a healthy lifestyle was launched, which included the promotion of high physical activity and low-cholesterol products.
Nevertheless, there is still no irrefutable evidence of the negative role of cholesterol in the development of cardiovascular diseases. There were heated debates about this, many conferences and committees were created, test tubes were used, animals were ruined. Pathologists worked tirelessly in search of an answer to the question whether there is a relationship between cholesterol levels, atherosclerosis and coronary heart disease.
Cholesterol received its name in 1815 from the French chemist Michel Chevreul (Michel Eugène Chevreul, 1786-1889). Later, his compatriot Marcellin Berthelot (Marcellin Berthelot, 1827-1907), having determined that cholesterol belongs to alcohols, found fault with the unfortunate name, and the French, according to the existing nomenclature, assigned him the "alcoholic" ending "-ol". It turned out to be "cholesterol".
Cholesterol is formed mainly in the liver, intestines, kidneys, and only 20% comes from food. Saturated fats, from which cholesterol is synthesized, are rich in dairy products, some oils. To one degree or another, all products containing animal fats contain cholesterol – cheese, egg yolk, beef, pork, poultry meat and even shrimp that are dietary in all characteristics.
Cholesterol is a mandatory component of the cell membranes of all animals, a precursor from which vitamin D and steroid hormones are synthesized – such as cortisol and aldosterone, progesterone, estrogen, testosterone. It plays an important role in the activity of brain synapses and the immune system, including protection against infections and cancer.
Cholesterol is poorly soluble in water. Therefore, the blood cannot deliver it to its "destination" – to the cells. Instead, cholesterol in the blood is in the form of highly soluble complex compounds with special transporter proteins, the so-called apolipoproteins. Such complex compounds are called lipoproteins. According to the degree of solubility of the complexes in the blood, size and other indicators, they are divided into high-density lipoproteins and low-density lipoproteins. And people say "good" and "bad" cholesterol, respectively.
The accusationDaniel Steinberg, a professor at the University of California, San Diego, the author of the book "Cholesterol Wars" ("The Cholesterol Wars"), released in 2005, could act as a cholesterol accuser.
Numerous studies have shown a correlation between the level of "bad" cholesterol and atherosclerotic changes in the body. In fact, low–density lipoproteins tend to precipitate in the most inappropriate place - the bloodstream, accumulating there and forming atherosclerotic plaques, narrowing the lumen of the artery and causing chronic slowly increasing insufficiency of blood supply to the organ. In addition, an acute blockage of the vessel lumen is possible either by a thrombus or by the contents of a decayed plaque.
Once upon a time, in the distant 1850s, everything began as a "lipid cytotesis" - it was necessary to explain a multi–stage and complex vascular disease called atherosclerosis. The lipid hypothesis had less successful competitors: the theory of endothelial disease, explaining the development of atherosclerosis by a violation of the protective properties of the vessel walls; autoimmune theory, which explained atherosclerosis by a violation of the functioning of immune cells; monoclonal hypothesis – the appearance of a pathological clone of muscle cells in the vessel walls. There were other theories that explain any problems in our body: genetic ("bad heredity"), viral (viruses are to blame for everything). The lipid hypothesis proved to be the most tenacious. It was checked and rechecked, and although there is still no absolute unanimity, the overwhelming majority of doctors accepted the hypothesis as law.
No issue of biochemistry was given as much attention as cholesterol deserved. In order to "shut up" the opponents, an unprecedented huge number of large-scale, well-planned, long-term and duplicated experiments were conducted, both epidemiological and on animal models, which were intensively fed with high-cholesterol products and then observed with satisfaction the development of atherosclerosis. Back in the early twentieth century, academician Nikolai Anichkov (1885-1964) showed that feeding many animals (including primates) with high-cholesterol products leads to the formation of atherosclerotic plaques in the aorta and other arteries, where cholesterol penetrates from blood plasma.
A group was created at the American National Institutes of Health (National Institutes of Health), which included hundreds of well-known scientists from two dozen institutes, and this crowd spent taxpayers' money for more than ten years to prove the defendant's guilt.
By the 1980s, long-term mass surveys of the population in different countries of the world were mostly completed to clarify risk factors, that is, the conditions and circumstances leading to the appearance of atherosclerotic lesions of the heart and brain. These studies have shown that the leading risk factors for coronary heart disease are smoking, high blood pressure (hypertension) and high cholesterol in blood plasma (hypercholesterolemia).
Professor at the University of Minnesota Ancel Benjamin Keys (1904-2004) wrote the book "Multidimensional statistical analysis of the incidence of cardiovascular diseases" (Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease). The results of the study were impressive: the decrease in cholesterol levels in blood plasma was directly proportional to mortality from cardiovascular diseases. A ten percent decrease in cholesterol levels led to a drop in mortality from coronary heart disease by 8-10%.
The US National Institute of Nutrition has developed a National Program and National Recommendations for lowering cholesterol levels in the population, and even a National Cholesterol Education Program to teach the basics of proper nutrition from a young age. Since the introduction of the "anti-cholesterol program", mortality from cardiovascular diseases in this country has been steadily falling. During the period from 1980 to 2000, it slipped from 542.9 to 266.8 deaths per year per 100 thousand men and from 263.3 to 134.4 – per 100 thousand women. Impressive.
And protectionHowever, the defense has something to object to all these arguments of the accusers.
In the "lawyers" of cholesterol, you can write a doctor Uffe Raunskou (Uffe Ravnskov), who published the book "Myths about cholesterol" (The Cholesterol Myths) in 2000. She was severely criticized, but also gained a lot of adherents, who in 2003 opened the "International Network of Cholesterol Skeptics", inviting Rounscow to preside.
Cholesterol is not a deadly poison, but a substance vital for the cells of all mammals. Thus, the diet of the Maasai and Eskimos is rich in animal fats, consists of either meat, blood, milk, or fatty fish. At the same time, the "diseases of civilization", including atherosclerosis and cancer, are unknown to them. It is claimed that high cholesterol in the blood contributes to atherosclerosis and coronary heart disease. But many studies have shown that people with low cholesterol develop atherosclerosis as often as those with "high cholesterol". And even more researchers found the absence of any correlation between the occurrence of atherosclerosis and compliance with a low-cholesterol diet.
The benefits of high–density lipoproteins have been repeatedly proven - a high level of "good" cholesterol protects against cardiovascular diseases, preventing the formation of blood clots.
Our body produces about 80% of cholesterol, and we get about 20% from food. A low–cholesterol diet not only cannot significantly reduce cholesterol levels, but, on the contrary, causes the liver to "counteract", which increases its production to compensate for the lack of necessary cholesterol - we are doing the body a disservice. This is written by the famous doctor and journalist James Le Fanu in the book "The Rise and Fall of Modern Medicine" (The Rise and Fall of Modern Medicine).
The study, the results of which were published in 2007 in the reputable medical journal The Lancet and in which 55 thousand people were involved, states that cholesterol levels are poorly correlated with mortality from coronary heart disease and mortality from heart attacks in young and middle-aged people.
There is a hypothesis that cholesterol is an important antioxidant, and we do our best to prevent it from entering the body with our own hands. The only effective way to lower cholesterol is to take medication; dieting won't help. But medications that lower only cholesterol levels do not affect either overall mortality or mortality from cardiovascular diseases. Moreover, they are dangerous to health and can themselves lead to death.
New hypocholesterolemic agents, statins, do prevent cardiovascular diseases, but this is due to other mechanisms, and not because of lowering cholesterol levels. Unfortunately, they also stimulate the development of cancer, disrupt the functions of muscles, heart and brain, and pregnant women taking statins are more likely to give birth to children with developmental defects.
All these facts have been written about in scientific journals and books for many decades. The reason non-professionals, doctors and most scientists have been misled is that the results of these studies are systematically ignored and misquoted by the press.
To date, medicine clearly separates the concepts of "bad" and "good" cholesterol, their levels are determined separately in blood tests. High-density lipoproteins, that is, "good" cholesterol, are fully justified, and even recognized as useful, although the public looks askance at them, as well as at a convicted and acquitted person. "Bad" cholesterol, that is, low-density lipoproteins, is found guilty of the development of atherosclerosis. The verdict is subject to appeal if ever someone wants to try to do it.
Portal "Eternal youth" http://vechnayamolodost.ru13.07.2009