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Understanding Cholesterol

Posted in common conditions, tagged , on April 11, 2010| 3 Comments »

Cholesterol is probably the most talked about health concern, and based on my experience with patients (and doctors), the least understood facet of health. Some cholesterol is considered “good”, some is considered “bad”, and by all means, we certainly don’t want high levels of it! Hmmm, is this accurate? Does it make sense that some fractions of cholesterol should be considered “bad”. Keep reading and I’ll help to explain this highly publicized, ill-understood (in my opinion) aspect of health.

So what is cholesterol anyway? Contrary to popular belief, cholesterol is not a fat, it is in fact a sterol. This is simply a technicality, but I thought it was worth mentioning. Cholesterol is vital to the cells in the body, as it makes up part of the cellular membrane allowing them to maintain permeability (the passage of substances in and out of the cell) and fluidity. Additionally, cholesterol is necessary for hormone synthesis (e.g.: estrogen, testosterone, progesterone, cortisol, etc.), bile acid synthesis (necessary for fat emulsification/digestion), and some fat-soluble vitamins. This article will focus mainly on the cardiovascular effects of cholesterol.

Roughly two-thirds of cholesterol is made in the body (liver) and the other one-third is gotten from diet (only animal foods – so don’t get duped by vegetarian products touting to be “cholesterol-free”, that’s a given). This simple fact says that the amount of cholesterol you eat has less to do with your total levels than other factors. If the amount of cholesterol you consume was truly related to your cholesterol levels, then vegans would be in the clear and not have to be concerned with their levels; but that couldn’t be further from the truth, as many vegans have higher than normal blood cholesterol levels.

The reason cholesterol gets so much press (aside from cholesterol-lowering drugs), is because a build-up of cholesterol (along with other substances) in the arteries can lead to plaque-formation and have grave consequences. If too much plaque builds up in the arteries and a clot forms, it can cut off the blood supply to the heart (leading to a heart attack) and/or the brain (leading to a stroke). So the question now is, or should be: “Why does cholesterol get deposited in the arteries?”, and “What can we do about it?”. And the answer is not simply because some of it is “bad”. Let me first discuss the difference between so-called “good” and “bad” cholesterol before I answer the question about why cholesterol deposits in the arteries.

These good and bad cholesterol markers are in fact carriers or transporters of cholesterol, not actually cholesterol. They are like buses or taxis. “Good” cholesterol, or high-density lipoproteins (HDL) are coined “good” because they circulate through the blood vessels and pick up cholesterol for transport to the liver. “Bad” cholesterol, or low-density lipoproteins (LDL) deposit cholesterol in the vessels, possibly leading to the eventual clogging of arteries. This is why it’s stressed that we need to have low blood levels of LDL’s (cholesterol depositors) and high levels of HDL’s (cholesterol retrievers, if you will). Now on to the next question. Why would cholesterol get deposited in the arteries. Is the body stupid? Is it trying to self-destruct by giving us a heart attack or stroke? In fact, it is doing the opposite, trying to keep you alive and well!

Essentially, cholesterol gets deposited in the arteries in order to help us. That’s right, not to kill us, but to help us. When the inner lining of arteries get damaged, inflammation sets in. Now realize, inflammation is a necessary part of the healing process, but when it gets out of control (essentially not remitting due to an inability and constant struggle to repair) we can run into problems. Chronic inflammation in the arteries (or anywhere for that matter) can be likened to a fire that can’t be put out. If this fire continues to spiral out of control, your arterial wall will continue to “burn” and possibly even “leak”. So here comes cholesterol to the rescue! That “bad” (LDL) “cholesterol depositor” brings cholesterol to the damaged area in order to put the fire out. Is that really “bad”? Do you really want a fire burning out of control in your arteries? So as you can see, it’s not bad at all, it’s in fact good if you ask me, and possibly if your arteries could speak up, they’d say it was good also. Next, in an optimally functioning body, the HDL’s, or “good” cholesterol will swing into action when healing has taken place, and transport the cholesterol back to the liver in order for recycling into other vital substances (i.e.: hormone synthesis and bile acid synthesis).

So why do the arteries get damaged and inflamed in the first place? It goes right back to the basics. One of the most common reasons would definitely be high blood sugar and insulin levels (really DIET and lifestyle). Other causes of arterial inflammation include, but are not limited to: food allergies and sensitivities, high levels of homocysteine, infections, and nutrient deficiencies. Additionally, high levels of stress hormones can begin a cascade of biochemical events that will eventually result in inflammation and poor blood sugar control. And last but certainly not least, we must consider environmental toxins, such as industrial pollutants, toxic chemicals and metals, and of course excessive alcohol consumption and cigarette smoking.

You see, your body is smarter than you think (or at least smarter than the drug companies think). It’s trying to survive, that is essentially it’s design. What happens when you cut yourself? Your body seals it up, and hopefully new tissue gets formed. Some cuts/wounds are worse than others, and the body forms a scar. But regardless, the body is doing the best job it can to heal. And so is your “bad” cholesterol. So if your cholesterol gets out of control, perhaps you’d be better off looking into the reasons why. If you lower your cholesterol artificially through medications, your body will again do it’s best job in trying to survive and heal the arterial damage – most likely by laying down calcium if it doesn’t have enough cholesterol. Hans Selye, the famous “stress” researcher, has shown that chronic inflammation (repair deficit) eventually leads to calcification. Then what? I guess we turn to stone.

Some people do have exceptionally high levels of cholesterol (that may need to be controlled with medication) due to genetic factors, but most people don’t. And many people have cholesterol levels that are too low! Remember, it’s absolutely necessary for the formation of other important biochemicals. This can be from overdoing cholesterol-lowering medication or supplements. And when medications or supplements aren’t being taken, I find that low cholesterol is the result of an under-functioning liver that needs to be addressed.

So high levels of cholesterol should really be seen as a symptom of another problem that’s taking place (and most definitely causing more problems than laying down arterial plaque). I’ll leave you with this. If parts of your house were constantly catching on fire and the fire department continuously came to put the fires out, would you blame the firemen as the problem and then force them away; or would you look to find out why all these fires continue to start?

I hope this article helped to give you a better understanding of the topic of cholesterol and how your body works.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Gallbladder symptoms

Posted in common conditions, tagged , , , , on December 8, 2009| Leave a Comment »

Gallbladder dysfunction is a fairly common clinical condition. According to the U.S. Department of Health and Human Services, cholecystectomy (or gallbadder removal) was the seventh most common ambulatory (or out-patient) surgery in the U.S. in 2003. This is rather unfortunate considering how important the gallbladder is in overall body function; in addition to the fact that there are many successful, non-invasive natural methods in order to help it function properly.

The gallbladder is located on the right side of your body, behind the lower edge of the ribcage underneath the liver; in line with the center of the clavicle (or collarbone). Its purpose is to store bile that is manufactured by the liver, and then release the bile into the small intestine. From a digestive standpoint, bile’s purpose is to emulsify (or break down) fats in the small intestine, which allows them to be absorbed efficiently. Additionally, this allows for the proper absorption of the fat-soluble vitamins A, D, E, and K. Another role bile plays is to carry cholesterol and toxins into the intestines in order to rid them from the body. The toxins include anything ranging from pesticides, estrogens, toxic metals, and any other fat-soluble toxins. As you can see, a sluggish gallbladder (or worse, cholecystectomy) can cause a wide variety of complications.

The most common symptoms of gallbladder dysfunction include nausea, constipation, indigestion (especially after eating fatty meals), bloating (especially about half-an-hour to an hour after eating), gas, pain in the area where the gallbladder is located, pain in the right shoulder, a bitter taste in the mouth, clay or light-colored stools, and stools that float (except if you’ve consumed large amounts of fiber).

The gallbladder constricts and releases its bile via the action of a hormone called cholecystokinin (CCK). Cholecystokinin secretion is stimulated by the presence of fat- and protein-rich food that enters into the small intestine. As a result, avoiding fat completely may not be the best way to avoid gallbladder complications; because the mere presence of fat is helpful in releasing the bile that resides in the gallbladder in the first place.

The most common problem you’ve probably heard of related to the gallbladder is gallstone formation. And the most common type of stone is known as a cholesterol stone. It is not fully understood why cholesterol gallstones form, but it is generally accepted that they stem from any of the following: too much cholesterol, too much bilirubin (a breakdown product of old red blood cells), insufficient bile salts, a lack of emptying of the gallbladder, or the gallbladder not emptying enough. Cholesterol and bilirubin are normal components of bile. It is when they increase in concentration that they may become a problem. The other less common stone is known as a pigment stone.

I spoke about what causes the gallbladder to constrict (i.e.:CCK). In addition to a possible inhibition of the constriction of the gallbladder, the bile can also become thick and lose its ability to flow freely; regardless of the amount of CCK release. When this occurs, it is called cholestasis, or a suppression of the flow of bile. There are several possibilities as to why this may occur. First, realize that the largest component of bile is water. Therefore, being sufficiently hydrated is of prime importance to keep the viscosity down. Next, you must have an adequate supply of essential fatty acids, particularly omega 3’s. These fatty acids help to thin the bile to keep it flowing freely. Additionally, certain nutrients can be helpful in aiding fat metabolism and bile flow. In particular, inositol, choline, taurine, and betaine (not betaine-HCl, though it is possible that betaine-HCl may be helpful through improving overall digestion and stimulating the release of CCK). The gallbladder (and liver) can also be helped by botanicals such as milk thistle, dandelion root, and ginger. By the way, beet leaves are high in betaine, and juicing them would be best.

Other factors that can affect bile flow need to be considered as well. In particular, estrogen dominance can be a problem. Estrogen dominance refers to either: 1) too much estrogen in relation to progesterone, 2) too little progesterone, or 3) too much estrogen with normal progesterone levels. The reasons for estrogen dominance are beyond the scope of this article. Essentially, excessive estrogen can result in lithogenic (or calculi/stone forming) bile according to this article from the Annals of Surgery. Additionally, eMedicine cites a study which “postulated that estrogens cause increased cholesterol secretion and progesterone promotes biliary stasis”, thus possibly leading to gallstones or bile stasis. Low thyroid function (which can result from estrogen dominance, but certainly not always) can also cause the gallbladder to become sluggish and congested.

Women tend to be more likely to suffer from gallstones and gallbladder complications, which may further point to excess estrogen levels as being a major problem. There is a profile of a person likely to get gallbladder problems coined the “4F’s”: 1) female; 2) (let’s just say overweight); 3) forties (age); and 4) fertile (implying high levels of hormones).

Otherwise, I’ve quoted the following characteristics that put people at risk for gallbladder complications from the National Digestive Diseases Information Clearinghouse:

  • women—especially women who are pregnant, use hormone replacement therapy, or take birth control pills
  • people over age 60
  • Native Americans
  • Mexican Americans
  • overweight or obese men and women
  • people who fast or lose a lot of weight quickly
  • people with a family history of gallstones
  • people with diabetes
  • people who take cholesterol-lowering drugs

However, don’t rule out a gallbladder problem if you don’t fit into any of the categories above. I commonly see gallbladder problems in all types of individuals. The most common related complaints I see are sharp, piercing pain at the right fourth rib (where it connects to the fourth thoracic vertebrae) sometimes extending upward into the neck and resulting in neck pain as well; knee pain; and digestive disturbances. If you suspect a gallbladder problem, please seek a licensed, qualified healthcare practitioner that can help you before the worst case scenario (cholecystectomy). It can be a very simple problem to manage through diet and lifestyle changes.

One last thing! For those who have had their gallbladders removed, it may be a good idea to take bile salts (in supplement form) with every meal, as there is a good chance that fat digestion will be impaired without them.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Omega-3 fatty acids: flaxseed oil or fish oil?

Posted in food, remedies, tagged , , , on November 4, 2009| 3 Comments »

Essential fatty acids, or omega-3’s and omega 6’s as they are also known, are necessary for a number of different functions in the body. They are labeled “essential” because the body cannot synthesize them from other substances, and therefore must be obtained from the diet. Omega-3 fatty acids, found in large quantities in fish oil, flax seed oil, chia seeds, and walnuts (and others less so) are well-known for their health-promoting properties. On the other hand, omega-6’s, found in corn, soybean, safflower, sunflower oil, etc. are seen to hinder health (when eaten large quantities), despite being necessary. The key is to have a proper balance between the two; and research supports the best intake to be anywhere from a 3:1 to a 5:1 ratio of omega-6’s to omega 3’s. Unfortunately, the average American consumes a 25:1 ratio of 6’s to 3’s. [As an aside, the omega-6 fat known as gamma-linolenic acid (GLA) found in black currant seed, evening primrose, and borage seed oil can be quite beneficial to one’s health.]

Some of the health-giving attributes of omega-3’s include the following: regulation of inflammation, alleviation of pain, prevention of excessive blood clotting, maintenance of the integrity of cell membranes, reduction in elevated cholesterol and triglycerides, optimal fetal development, reduced cardiovascular risk factors, anti-cancer properties, better cognitive function, reduced incidence of depression, among many others.

The way that omega-3’s produce their health-giving effects is through the conversion of a substance called eicosapentaenioc acid (EPA) into eicosanoids. Specific eicosanoids, known as prostaglandins and leukotrienes are ultimately responsible for the beneficial effects.

As mentioned above, omega-3 fatty acids can be obtained from both vegetarian and non-vegetarian sources. Despite the obvious differences, there’s more you need to know to determine which one will be effective for you. So even though both sources are technically omega-3 oils, there is still a difference.

Again, the health-promoting biochemicals that are produced from omega 3’s originate directly from EPA. Omega-3 fats from fish oil actually contain EPA in them naturally. On the other hand, vegetarian sources of omega-3 fats do not actually contain EPA. Instead the body must convert the components contained in those (vegetarian) sources into EPA. Here is an example of how it works. Flax oil contains something called alpha-linolenic acid (ALA) which then needs to be converted to stearidonic acid. Stearidonic acid then gets converted to eicosatetraenioc acid, which then finally gets converted into EPA. Then of course, the EPA gets converted into the beneficial eicosanoids. Remember, these eicosanoids (certain prostaglandins and leukotrienes) are the biochemicals that exert the anti-inflammatory, etc. responses that we hope to achieve from ingesting the omega-3’s in the first place.

The problem that can result with having to make all these conversions (ALA to EPA to prostaglandins) is that those processes can be impeded by various things. Essentially the main issue arises in the initial conversion of ALA. This step will be impeded or blocked in the presence of alcohol, trans fats (partially hydrogenated oils), and/or deficiencies in vitamin B6, magnesium, and/or zinc. Considering that magnesium and zinc tend to be the most deficient minerals in people, it’s quite probable that many people are not reaping the full benefits of omega 3’s from vegetarian sources. Recall fish oil on the other hand already contains EPA, and therefore does not require the conversions that vegetarian sources do. As a result, one is much more likely to benefit from taking fish oil. It is certainly possible to attain all the benefits from flax seed oil (and other vegetarian sources) as you would fish oil, assuming the “impeding factors” are a non-issue.

When determining which oil is best for my patients, I use in-office procedures that include specific types of muscle testing, palpatory pain threshold levels, and range of motion tests.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Differences between drugs and natural therapies

Posted in common conditions, remedies, tagged , , on October 12, 2009| Leave a Comment »

Understanding the biochemical pathways involved in nutrient and drug actions is of prime importance when working with patients. Using this information can help the practitioner choose the best treatment while also helping to inform a patient about the processes that occur in their body.

In studying these these interactions over the years, I’ve long-noticed a primary distinction between the way drugs affect the body and the way natural therapies affect the body. From what I can see, many drugs work “against” the body, while natural therapies work “with” the body. I’ll detail a few examples to show you my point.

1) statin cholesterol-lowering medications
These drugs interfere with (or block) the body’s natural production of cholesterol. This is turn lowers the cholesterol level in the blood.

A natural approach would be to increase the body’s natural ability to break down cholesterol, and hopefully look in to addressing the reason why the body is making more than is considered healthy.

2) aromatase inhibitors
Aromatase is an enzyme involved in the production of estrogen. Excess levels of estrogen have been implicated in breast and ovarian cancer. So these drugs are mainly used in those with breast and/or ovarian cancer, in order to block the production of estrogen.

A natural approach might be to help the body (specifically the liver) break down, detoxify, or “clear” these estrogens from the system more efficiently; rather than to outright block the natural production of estrogen.

3) “osteoporosis” medications
Bone is constantly remodeling. That is, new bone is continuously being formed, while old bone is continuously being broken down. Certain medications used to treat osteoporosis (known as bisphosphonates) are designed to inhibit the body’s natural breakdown of (old) bone; in an attempt to maintain the bone density that already exists.

A more natural approach would be to facilitate the growth of new bone cells through supplying the body with the raw materials necessary to build bone; amongst other methods.

4) antidepressant medication or SSRI’s (selective serotonin reuptake inhibitors)
A lack of the neurotransmitter serotonin is commonly considered one of the hallmarks of depression. Let me first say that serotonin and other neurotransmitters are constantly “floating” in the area between nerve cells called the synaptic cleft. Generally, one nerve cell (the pre-synaptic) will release serotonin into the cleft in order for an adjacent nerve cell (the post-synaptic) to take-up the serotonin and allow it’s effects to take place in the body. Normal metabolism dictates that the first nerve cell (pre-synaptic) will also naturally “reuptake” (i.e.: take back if you will) much of the serotonin it released into the cleft or space. These SSRI drugs are designed to prevent serotonin from naturally being removed (or re- taken up) from the area between nerve cells. Again, it blocks the normal action of the body, in turn leaving more serotonin “around” in hopes that the second nerve will use it and allow its action(s) to take effect.

A more natural approach would be to see if perhaps the body’s production of serotonin is low is the first place. If so, a natural approach would work with the body in order to produce more serotonin, as opposed to blocking the natural self-regulating mechanism of reuptaking it.

There are many other examples of how the action of drugs work to block or impede the body’s natural functions; while the aim of natural therapies is to help facilitate or enhance the body’s natural functions in order to accomplish a desired result. Perhaps the reason that natural therapies have few known side-effects is because they work “with” the body’s natural processes as opposed to working “against” them. When looking to achieve a desired result, wouldn’t you rather work “with” your body than “against” it?

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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High cholesterol? What about high homocysteine???

Posted in common conditions, remedies, tagged , , , , , , , on September 3, 2009| 3 Comments »

These days cholesterol still gets all the attention when it comes to heart disease. In fact, I think way too much attention. There are other, often better predictors of heart disease than standard cholesterol tests. And these are routinely missed, even when the patient’s (and doctor’s) motive is to assess the potential risk of future cardiovascular events. I’ll talk about one very important one of those risk factors now. It is an amino acid called homocysteine.

Homocysteine was discovered by a man named Dr. Kilmer McCully. He is a Harvard Medical School graduate; and discovered this amino acid was responsible for arteriosclerosis (or hardening of the arteries) while researching a rare condition called homocysteinuria, forty years ago. He was researching two cases where an eight year-old child and and a two-month old child both had arteriosclerosis. Through further research he eventually made a connection between homocysteine and arteriosclerosis. Unfortunately though, when he first voiced this discovery, he was shunned by just about every medical professional. In 1976, the (“new”) chairman at Harvard said the “elders” at the school “felt” he had not proved his theory; and unless he could get grant money he would lose his position. They went as far putting his lab in the basement so he would have no contact with others, and then he decided to leave. For the next 27 months he could not find a single position in North America that would allow him to continue his research. McCully was later told that Harvard and Massachusetts General Hospital did not want to be associated with his work, because it did not go along with the conventional wisdom that cholesterol and fats caused heart disease. You can read more about that story in an interview with McCully here. By the way, one main reason that he was discredited might be because one of the most common ways to treat excess homocysteine levels is through nutritional supplements.

Anyhow, homocysteine is naturally produced in the body through the necessary breakdown of the essential amino acid, methionine. However, just because it is naturally produced does not mean that it is benign. An article in the Journal of the American Medical Association concluded this: “An increased plasma total homocysteine level confers an independent risk of vascular disease similar to that of smoking or hyperlipidemia” (or high blood lipids/fats). There are many more studies in existence that speak of the risk of high homocysteine levels in relation to (cardio)vascular disease so I won’t bore you with repeating this information.

Homocysteine causes several problems. For instance, it can oxidize cholesterol (making it harmful to blood vessels), cause scarring inside the lining of blood vessels, and increase blood clotting. Essentially, high levels of homocysteine will ultimately damage cells and the walls of the blood vessels. As a result, cholesterol will get deposited in the arteries in an attempt to “patch” up the damage. That is why cholesterol can “cause” cardiovascular events such as heart attacks and strokes. Also, this damage can lead to peripheral arterial disease, usually in the legs and feet, which in a worst case scenario can eventually result in the need for amputation like in diabetics. So does cholesterol really “cause” vascular problems? Well, that can be argued, but it is really the body’s attempt to heal. Hmmm, I guess cholesterol is not so bad to begin with. I will talk about that in another article. By the way, there are many causes of blood vessel damage.

High homocysteine levels have been implicated in coranary artery disease, heart attack, stroke, deep vein thrombosis, rheumatoid arthritis, osteoporosis, Alzheimer’s disease and more.

So what’s the solution? Some fancy well-marketed drug? No, B-vitamins of course! That’s right vitamins B6, B12, and folic acid (in addition to other biochemicals) will metabolize homocysteine properly and prevent high levels in the bloodstream. Folic acid and B12 will recycle homocysteine back into methionine and B6 will convert it down to cystathionine (and then hopefully down into cysteine and sulfate). So if these vitamins lower homocysteine levels, then a deficiency in them can cause high blood levels. McCully also reports other causes such as imbalances in thyroid and “female” hormones, in addition to kidney problems.

Please don’t get me wrong, many doctors are aware of homocysteine, but not enough in my opinion. I have seen blood tests from patients with known peripheral artery disease and cardiovascular complications without reporting their homocysteine levels. Also, some patients show me their blood tests with normal cholesterol levels (but no homocysteine); and report that their doctor has told them they don’t need to be concerned with heart disease. Also, look at a recent blood test of your own and (depending on the lab) you may find that they claim to determine your heart disease risk factor based on cholesterol levels alone.

One more thing, measuring homocysteine can also be used to find out if you have a deficiency in these B-vitamins. Again, there could be other causes, but it’s as simple as doing a follow-up test after supplementation for a few months.

PS: One common sign I have discovered in patients, which stems from high homocysteine (perhaps B-vitamin deficiency) is easy bruising. Bruising is basically damage to blood vessels. This is true even in those who “should” be bruising like some of the professional aerial acrobats (or intense athletes) I work with; but it’s also common in people who are not extremely active. The flip side to easy bruising would therefore also mean an inability to heal the vessels as well. And interestingly your body will not produce collagen (a main component of blood vessels and other structures) properly if your homocysteine levels are too high. But that concept, along with the other necessary nutrients to make proper collagen is for another discussion. Now don’t go trying to judge your homocysteine levels based on if you bruise easily or not; that’s just one observation I’ve made working with patients. It is worth asking your doctor to run this test – and remember those B-vitamins are necessary for a lot more functions than homocysteine metabolism.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Cholesterol and Fiber – do you have ALL the information?

Posted in common conditions, food, remedies, tagged , on August 27, 2009| Leave a Comment »

Much talk has been generated about how fiber can help lower serum cholesterol levels. So much that some products with it are even “stamped” by the American Heart Association with a label saying: “Can Help Lower Cholesterol”. First of all there are two types of fiber: soluble and insoluble. They are both necessary, but it’s the soluble fiber that CAN contribute to lowering cholesterol.

OK, let’s discuss how fiber helps. There are in fact three theories as to why this works. And all three may in fact be true. The precise mechanism doesn’t really matter as much as the information I’m going to give you about it at the end of this article.

First, soluble fiber dissolves in water and then becomes gelatinous in consistency. It is in this form that it becomes able to literally bind to substances in the intestinal tract. When these substances are bound, they are then excreted from the body as part of human waste. First, one theory says the fiber is able to bind to bile (which contains cholesterol) in the intestines so that it does not get reabsorbed into the bloodstream.

Second, another theory says that it binds to bile acids in the intestines; again in order to prevent reabsorption. This mechanism would eventually cause a decrease in the amount of bile acids in the liver. As a result, the liver gets a “signal” to make more (whole) bile. The liver will then take up cholesterol from the blood in order to create more bile, as cholesterol is one of its components. So bile contains cholesterol and bile acids (in addition to other biochemicals). By the way, toxins are often bound to bile as well, so it becomes a route for detoxification. Hence, you’ll get lower blood cholesterol levels as it is pulled from the blood to make bile.

The third, more complicated theory basically says that soluble fiber shifts “bile acid pools” which leads to a decrease in the enzyme the liver uses to make cholesterol in the first place. Less production of cholesterol, means less serum cholesterol levels. You can read more technical information about that here, but I’ve covered the gist of it. The other two theories are “common” knowledge.

OK, what’s the common denominator in all three theories? Bile, of course. By the way, in case you didn’t know, bile’s function is to be released into the gut when fats are available to emulsify them in order for proper absorption of those fats (and fat-soluble vitamins).

Here is where the information stops! My question is: What is going to determine if you have bile in the intestines in the first place? As I stated above, fats must be available in the intestines. So now you go ahead and have a healthy “cholesterol-lowering” breakfast: some oatmeal and some added fruit, maybe you add psyllium to really increase the soluble fiber. More sources can be found here. And don’t forget the skim milk, you certainly wouldn’t want any added fat. Nah, you’re vegan or sensitive to dairy, you use water. Here’s another million-dollar question. Where’s the fat in this meal to stimulate the flow of bile in order for it to get bound by the fiber? As you know, the answer is nowhere. Now what? Well, your good intentions just got flushed down the toilet. No pun intended, but now that I think of it, pun intended.

The take home message is to include fat in the meal. So you can use whole milk and the vegan can use a grain-based milk. Nuts may be sufficient as well, if you’re not sensitive (and CHEW them properly). But if there is no other added fat, don’t use water or skim milk (I wouldn’t even use 2%). If you want to, use added coconut oil, then you’d really be doing yourself a favor. Oh wait, there’s saturated fat in it. So what? This notion of fat (even saturated fat) being bad for you is utter nonsense and terrible misinformation! And avoiding it to lower cholesterol is even worse information. Even if you avoid cholesterol itself, a negative-feedback loop will cause your body to make more cholesterol as your body senses the absence of it. If avoiding cholesterol was key, how could a vegan have high cholesterol? And believe me, some do. That’s all for another time. If you still won’t use any of these “oatmeal” combinations, eat it for dinner in hopes that there’s some bile left over in your gut from breakfast or lunch. Now, there may be a slight amount of bile released into the intestines with any meal, however that amount will be very poor without fat in the meal.

One last thing. Take a look at these foods (excuse me, name-brand products) with the stamp from the American Heart Association. Many of them, especially the breakfast cereals, breads, and desserts are not a good idea if you ask me. Read all the ingredients. It’s kind of like an investment banker showing you a document stamped with a seal that says “guaranteed 10% return on your investment”. Please don’t miss the print in the rest of the document stating that the fees equal 80%. You have to go the extra mile these days. Good luck everyone!

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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