It’s insulin—not cholesterol you should watch like a hawk
It’s insulin—not cholesterol—you should watch like a hawk
Lots of patients have low LDL cholesterol readings, but their triglyceride (TG) levels are on the high side and their HDL (“good”) cholesterol is on the low side. Their ratio of TG to HDL is greater than 4-to-1, which suggests insulin resistance. It also promotes the formation of small, dense LDL particles, which can be dangerous even if your LDL levels are low.
Chronically elevated insulin levels are bad news and have a lot more to do with heart disease risk than LDL levels. Aside from promoting unfavorable LDL particle types, elevated insulin promotes high blood pressure and inflammation—all drivers of heart disease risk.
Many people think a diet high in fat is the cause of insulin buildup and resistance, but that’s not true. Fat doesn’t trigger high insulin levels. Cheap, processed carbs do. These carbs can make you fat and destroy your heart, while delivering far fewer calories than you might get from foods rich in fat.
Really, fat doesn’t make you fat unless, as with anything, you eat too much of it. Plus there are healthy fats like the omega 3 fats found in fish. Mono-saturated fats found in olive oil, nuts and avocado are healthy fats, and are a dietary staple in Mediterranean countries that have a far lower rate of heart disease than America. Even moderate amounts of saturated fats from healthy organic or natural sources are OK, although you still should avoid the trans fats so common in processed baked goods, frozen foods and margarines. Trans fats—and high fructose for that matter—have no place in the human body. Period.
The lesson here is that insulin resistance will tell you far more about your heart disease risk than some crude cholesterol test. And if you want to prevent insulin resistance, try a diet that incorporates more healthy fats and fewer cheap, processed carbs.
Your immune system is attacking your heart—here’s how to make it stop
Another huge risk factor for heart disease is inflammation. When your immune system perceives a threat—such as infection or injury—it revs up. This is inflammation. Once the threat is contained, your immune system is designed to dial itself down.
So far, so good. But when your body perceives a constant threat, often because of stress or other lifestyle issues, you end up with chronic inflammation that has been associated with diabetes, arthritis, dementia, cancer and, yes, heart disease.
High levels of inflammation promote unstable plaque. You can measure inflammation with a test called highly sensitive C reactive protein (hsCRP). Levels above 2.0 are a red flag and should be a call to action. The most common cause of elevated hsCRP’s in my practice appears to be obesity. Fat cells pump out a horde of pro-inflammatory chemicals called adipokines. It’s also worth noting that hsCRP may be temporarily high if you have an infection or allergy problem. Follow-up an elevated hsCRP with another one or two measurements over two or three months to get a better idea, if necessary.
You can bring down inflammation by losing weight and changing to an anti-inflammatory diet that emphasizes fruits, vegetables, whole grains, beans, healthy fats and natural-source fish, poultry and other meats. Even incorporate some full-fat organic dairy, if you like. Other inflammation fighters are exercise (especially muscle-building strength training), adequate sleep, identifying and removing heavy metals such as lead, mercury or cadmium, and reducing stress. Also try fish oil (1000-2000 mg total DHA and EPA) and vitamin D3 (1000-2000 IUs daily).
While insulin resistance and inflammation are two overlooked causes of heart disease, there are three other risk factors that require your attention—belly fat, stress and genetics. DR.I.
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