fasting blood sugar testThe fasting blood sugar test will actually tell you more about your risk of heart disease than your cholesterol profile. Are you surprised?

Don’t be! While this is not a “cholesterol test,” it IS an important marker for heart disease risk!

Sugar is intimately involved with inflammation, and as we know, it is inflammation that is the real culprit in heart disease, cholesterol is just along for the ride!

According to Dr. Mark Houston associate professor of medicine at Vanderbilt University, for every additional point above 75 on your fasting blood sugar reading, your risk of heart disease goes up!

This is due to the fact that high blood sugar levels in your blood are an independent risk factor for cardiovascular disease.

The impact of elevated blood glucose levels

Sugar is a killer, a serial killer, where your health is concerned. Medical science is just now starting to figure out how damaging sugar can be in your system when the levels are high.

There are a number of reasons for this:

  • High blood sugar causes increased insulin (which is a pro-inflammatory hormone)
  • Elevated sugar levels make your blood more acidic and it tends to clot more readily
  • Sugar causes stiffening of arteries and blood vessels
  • Sugar decreases the oxygen carrying capacity of your blood
  • Nitric oxide is vital for heart health and high sugar levels lower it
  • High sugar levels also cause glycation which is a hardening of tissues in your heart and arteries

For all the reasons above, it’s important to know what your blood sugar levels are, so that if they are high, you can make the necessary changes that will bring the level down and reduce your risk of heart attacks, strokes, and high blood pressure.

How is the test performed?

A fasting blood sugar test, which is also called a fasting plasma glucose, or FPG test, measures your blood glucose level after you have fasted for at least 8 hours.

It’s a very accurate test, and does not vary by age or how physically active you are. It tends to be a physician favorite because it’s easy to do, cheap, and you get the results relatively fast.

The test is done first thing in the morning (so you can get the results by the afternoon), after at least an 8 hour period with no food, and nothing to drink but water.

A nurse or physician assistant will draw your blood and send the sample to the lab. When the results come back your doctor will discuss with you what the results mean, in terms of your risk for both heart disease and diabetes.

Levels for these tests are expressed in “millgrams per deciliter” (a deciliter is one 10th of a liter). Thus a reading of 100mg/dl is read as 100 milligrams per deciliter.

The threshold for normal fasting sugar levels should be below 100mg/dl, but some experts, most notably Dr. Mark Houston, feel the safe level is 70 -75 mg/dl!

What do the scores mean?

Doctors use what are called “reference ranges” to determine exactly what these tests indicate. All of this is of course relative to the results taken of sample populations to determine what is statistically healthy and what is not.

There are cut off points beyond which a clinical diagnosis is made, and these would appear to be splitting hairs so to speak, but of course the line must be drawn somewhere.  Whatever the result, you will have a much better idea of where you stand, and what you have to do to protect your health in the long term.

If your blood sugar measures between 100 mg/dl to 125 mg/dl, the doctor will probably order a follow-up test to eliminate error. This test result indicates “pre-diabetes” and your doctor may want to discuss steps you can take to bring your sugar levels down and prevent diabetes.

If you score 126mg/dl or above, the doctor will want to test you again to eliminate the chance of some anomaly that might have caused an inaccurate reading. If a follow-up test scores the same result, this will confirm that you are diabetic!

Of course it may seem silly to say that if your result on this test is 125mg/dl you don’t have diabetes and at 126 mg/dl you ARE diabetic, but they had to make a cut off point somewhere.

What is important is that if you are in the range 100-125 you need to make changes to your nutrition and exercise habits to get your blood sugar down to healthy levels.

Insulin is a factor too!

When your blood sugar levels spike, your body produces insulin to lower the sugar level. So if your fasting blood sugar test indicates higher than normal blood sugar levels, you can be sure your insulin levels are high as well.

Insulin is a very pro-inflammatory hormone that causes a lot of problems in your body when it is chronically elevated. This is another reason why you would want to get your sugar levels down to what is considered healthy.

Insulin causes inflammation and damage to the endothelial lining of your arteries, which is how the process of atherosclerosis begins. Thus your sugar levels have a direct bearing on the development of heart disease.

Connection with heart disease

If your blood glucose levels are chronically elevated, a process called glycation comes into play, which causes tissues like the heart and blood vessels to lose elasticity and become stiff.

This stiffening process, along with the damage from inflammation, makes you susceptible to heart attacks, high blood pressure and strokes.

To make it really simple and clear, elevated blood sugar=heart disease! This connection is far more important than cholesterol which does not directly cause heart disease. High blood glucose levels are also a factor in many other chronic diseases as well.

The fasting blood sugar test, by measuring how high your blood sugar is on average gives you a clear indication that your risk for heart disease is elevated, which in turn gives you a chance to lower your risk and avoid heart disease, by bringing your blood sugar levels down.

What is Cholesterol

What is cholesterol? Among other things it is a very much misunderstood substance that people have been unnecessarily frightened of. They have been told repeatedly by “experts and authorities” that it’s a dangerous substance, that must be lowered in your body before it kills you!

what is cholesterolIn this information website, we will try and demystify this perfectly natural substance and disprove once and for all that it causes heart disease! We will also provide good solid information and easy to implement strategies that will help you prevent heart disease instead of just “lowering cholesterol.”

Let’s start with a discussion of  what is cholesterol…

Cholesterol is a fat (also called a lipid) that is made in the liver. It’s part of a class of compounds called steroids which are made in the bodies of all animals. This substance is vital to your body, is transported through the blood, and is contained in the external layers of all cells.

The origin of the word cholesterol originally comes from the word chole which means bile in Greek. The other part of the word derives from the Greek word stereos meaning stiff or solid. This waxy fatty substance is necessary for your cells to maintain their structural integrity.

This is why it is absolutely vital for life, and in fact your body actually manufactures this substance for use in all of your cells. Statin drugs interfere with the production of cholesterol which is why they cause so many side effects.

What is cholesterol used for?

There are many functions for this amazing substance:

  • It is used in creating the myelin that coats and protects your nerves somewhat like the insulation on a wire.
  • It is used for synthesizing bile acids which your body needs for digestion.
  • Your body uses it to make sex hormones (androgens and estrogens) and also in the synthesis of the adrenal hormones such as cortisol and aldosterone.
  • It’s used in to metabolize vitamins A, D, E, and K (the fat soluble vitamins)
  • It is used in the reactions that synthesize vitamin D from sunlight.
  • It’s essential for maintaining the outer structural layer of your cells and also for keeping the cell membranes permeable so that certain molecules can pass through the membrane and enter the cell.

In order to travel through your bloodstream, it needs to have a protein coating and thus becomes something called a “lipoprotein.” They are called lipoprotiens because they contain both protein and fat.

The four main types of these lipoproteins are:

  1. LDL or low density lipoproteins often called bad and are associated with an increased risk of heart disease when they are high
  2. Chylomicrons (triglycerides) consisting of approximately 90%  fat
  3. HDL or high density lipoproteins (often referred to as the “good cholesterol”) HDL is thought to “protect” the arteries from damage by carrying away LDL particles so they can’t build up on your artery walls.
  4. VLDL or very low-density lipoproteins (often referred to as a very bad form of lipoproteins) These particles are considered to have the highest risk of contributing to heart disease because they are small dense highly inflammatory particles that can damage artery walls.

The role of triglycerides…

Triglycerides are fat molecules that come from the fat in the foods we eat, or can be synthesized from carbohydrates that are not burned for energy. These triglycerides are stored in your body and released to be burned for energy when your body does not get enough food to meet it’s energy needs. The truth is that it is triglycerides that really increase the risk of heart disease!
Hypertriglyceridemia is a term used to refer to high levels of triglyceries in the blood and researchers now know that this is a risk factor for cardiovascular disease. High glycemic carbohydrates can raise levels of triglycerides and greatly increase risk of heart disease.

While this area is still somewhat controversial, it’s clear that triglycerides have a major role in heart disease and they are increased by sugar consumption. It makes sense for this reason to keep your intake of sugar and high glycemic carbohydrates low to avoid setting yourself up for cardiovascular disease.

A Complex Question…

Doctors have been taught to calculate your risk of heart disease using ratios of these lipoprotein particles. They have also been given guidelines for what the “safe” and “dangerous” levels are.  Now these guidelines have been called into question, as new information has changed what the medical community “thought” they knew!

Even though the question of  what is cholesterol is a complex one, you will see that terms like good  and bad cholesterol are misleading and inaccurate. All of these forms of this vital substance have their necessary roles. Instead we should be looking at the effects of chronic inflammation and how we can neutralize it, because it is really inflammation that causes heart disease!

References:

Curr Cardiol Rep. 2011 Dec;13(6):544-52. doi: 10.1007/s11886-011-0220-3.
The role of triglycerides in atherosclerosis. Talayero BG, Sacks FM.
Source: Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. btalayer@hsph.harvard.edu

Eggs and Cholesterol – A Pervasive Nutritional Myth!

Many people have heard dire warnings about eggs and cholesterol, but is there any truth to this widely held belief at all? The answer is NO! Eggs have not been shown to significantly raise LDL (low density lipoproteins) levels when eaten in moderation. In fact eggs are actually be considered beneficial  when cooked and eaten properly and in moderate amounts.

eggs and cholesterol

Please note that the term LDL refers to the form considered by cardiologists to be “bad,”  however we will show in other posts that the idea of good and bad cholesterol is a misapplication of the science!.

Lipoproteins are another term for cholesterol. Thus HDL cholesterol is high density lipoproteins, and LDL is used  to refer to “low density lipoprotein.” The type that is believed by scientists to actually cause problems is called vldl cholesterol, (very low density lipoproteins). However even in this case the truth is more complicated than this and we will explain this as we go along.

The Facts about Eggs…

The fact is that egg yolks also contain lecithin which is a phosopholipid compound that actually lowers the amount your body absorbs. Thus the cholesterol in an egg does not have the same effect in your body, that it does when it comes from other sources.

Eggs contain about 185 milligrams of cholesterol (for a large egg), but they are also high in vitamin-d, choline (a b-vitamin) and lecithin. Interestingly, the saturated fat content in eggs is low. Research studies have shown that foods that you eat, does not have necessarily cause high cholesterol levels in your body, and in some cases may actually lower it!

It appears that the eggs and cholesterol myth began when the concern over lipoprotein levels being a factor in heart disease emerged. Researchers jumped to conclusions and people were warned that eggs greatly increased the risk of heart disease, based on this assumption, (based on poorly done research).

Eggs are Essential Sources of Choline

One negative result of this eggs and cholesterol hysteria was that people stopped eating eggs, or at least significantly cut down on egg consumption. The b-vitamin choline is essential to good health, especially of the brain.

The most abundant source of this vitamin in most people’s diets came from eggs. As a result the population as a whole became deficient in choline, leading to other serious health problems like Alzheimer’s Disease, and even increased rates of heart disease!

Choline is vital to the healthy function of the brain and nervous system, which in turn has a huge impact on heart health. Thus by limiting egg consumption and producing deficiency of choline in the diet, people were actually making the situation with regard to heart disease even worse!

What The Research Says…

Some people who have a genetic tendency toward higher levels called (familial hypercholesterolemia) may be affected by the amount they consume in their foods, but the mechanism is not totally clear. In fact the famous Framingham Study of heart disease shows that people with the highest hdl cholesterol levels actually lived the longest!

Recent research conducted on eggs and cholesterol at the University of Surrey by Dr. Bruce Griffin found that two eggs per day consumed by healthy people for a 12 week period actually lowered their LDL levels on average! It was concluded that eggs will not significantly raise cholesterol numbers in a healthy person. In this instance eggs actually lowered their levels!

In face the research subjects in the experimental group actually lost weight as well. This may seem surprising, but in light of the fact that egg yolks contains beneficial vitamins and high quality protein, it supplies your body with vital nutrients, without which you can’t achieve optimal health.

Recent research has also suggested that eggs may act in a way to reduce high blood pressure and that they contain antioxidants that help prevent heart disease. While this evidence is not yet conclusive, it suggests that eggs, far from being dangerous to our health are actually beneficial in preventing both cancer and heart disease!

Nutritional myths about eggs and cholesterol still persist in medicine and are accepted by the public at large, but gradually the word is getting out that eggs are not a bad food at all, in fact you need the beneficial nutrients in eggs for good health, including heart health!

References:

Chamila Nimalaratne, Daise Lopes-Lutz, Andreas Schieber, Jianping Wu. Free aromatic amino acids in egg yolk show antioxidant properties. Food Chemistry, 2011; 129 (1): 155 DOI:
Majumder et al. Angiotensin I Converting Enzyme Inhibitory Peptides from Simulated in Vitro Gastrointestinal Digestion of Cooked Eggs. Journal of Agricultural and Food Chemistry, 2009; 57 (2): 471 DOI: