High levels of plasma cholesterol are not the cause of cardiovascular disease. In fact, the available evidence suggests that the relationship between plasma cholesterol and cardiovascular disease is not causal, but is controlled by another variable. This variable is likely the presence of the metabolic syndrome, a cluster of disorders that center on the development of insulin resistance. However, that being said high plasma levels of certain plasma lipoproteins are a risk factor for cardiovascular disease and as such those with elevated levels would do well to address the metabolic dysfunction that is leading to their modification. In particular high levels of the small dense fraction of the low density lipoprotein particle (LDL), the very low density lipoprotein (VLDL) particle (sometimes called plasma triglycerides) and the lipoprotein(a) (Lp(a)) particle, as well as low levels of the high density lipoprotein (HDL) particle significantly increase the risk of cardiovascular disease.
The current medical treatment for high levels of plasma cholesterol is the use of statin drugs. However, the efficiency of these drugs to lower cholesterol is offset by the damaging side effects they possess. In addition, there is no real strong evidence that forcing down plasma cholesterol with drugs is beneficial to the health because it does nothing to deal with the underlying cause of the raised plasma levels in the first place. In this respect individuals taking statins are more likely to continue with unhealthy lifestyle practices that are placing their health at risk. More natural mechanisms for lowering plasma lipid levels exist and many nutrients and dietary plans have been shown to lower plasma lipid levels to a greater extent and more safely than the best pharmaceutical drugs. Oats, legumes, niacin, garlic and fish oils have all been empirically shown to lower raised levels of plasma cholesterol and lipids. Addition of these foods to the diet is relatively easy and will bring many other health benefits as well.
However, a simpler method for lowering plasma cholesterol may be fasting. Why fasting is effective at lowering plasma levels of cholesterol and lipids is not fully understood, but may relate to the avoidance of the typical Western foods that drive the insulin resistant state, particularly sucrose, fructose and high fructose corn syrup. The effects of fasting on plasma lipid levels have been demonstrated in subjects following a 10-day modified fast1. Subjects with rheumatoid arthritis were fed tea and small amounts of nutrient rich fluids from 10 days which amounted to around 200 kcal per day. After 10 days the cholesterol and phospholipids in plasma were reduced by 21 and 11 %, respectively. All but one subject also experienced reductions in VLDL. The LDL fraction of the plasma was reduced by 27 %. The molar and fractional cholesterol esterification rates in plasma were reduced by 27 and 8.5 %, respectively. There was no change to the HDL plasma levels in the subjects.
The nutrient juice in this modified fast consisted of blueberry juice, potato or celery juice, carrot juice, pear juice, vegetable bouillon. The subjects also consumed tea. The authors pointed out that no other ingredients were used and the diet was free from added sugar. The presence of high concentrations of plant chemicals including antioxidants and other phytochemicals as well as the absence of added sugar may have significantly improved the diets of the subjects. This is because the subjects were in hospital and were being fed standard hospital food that has been shown to be of low quality (someone remind me why do we hire and pay dieticians to work in hospitals?). Interestingly the subjects also lost 5 % of their body weight, and weight loss has been shown previously to be beneficial at causing reductions in plasma levels of certain lipoproteins. Fasting may therefore have beneficial effects on plasma lipoproteins. Short duration fasting may be beneficial to the health, although care needs to be taken to prevent muscle loss.
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