What actually causes high cholesterol? - Hei Man Chan

00:06:47
https://www.youtube.com/watch?v=EixIyh1gshM

Ringkasan

TLDRThe content discusses the historical recommendations by the American Heart Association to limit egg consumption due to cholesterol concerns. It explores the digestion process of fats, types of lipoproteins, and how diet and lifestyle affect cholesterol levels. Key points include the roles of LDL (bad cholesterol) and HDL (good cholesterol), the impact of different types of fats, and how exercise and smoking influence cholesterol. The importance of a balanced approach to diet and effective treatments like statins to manage cholesterol levels are emphasized.

Takeaways

  • 🥚 Eggs can be part of a healthy diet: One egg a day is generally seen as nutritious.
  • 📉 Saturated and trans fats can increase bad cholesterol levels (LDL).
  • 💪 Exercise helps lower LDL and increase good cholesterol (HDL).
  • 🌿 Unsaturated fats found in fish, nuts, and seeds are beneficial for cholesterol health.
  • 🥕 Fiber from fruits, vegetables, and whole grains helps lower LDL levels.
  • 🧬 Genetics also play a role in cholesterol levels, as some people may be predisposed to high cholesterol.
  • 💊 Statins are effective medications for managing high LDL levels.
  • 🚭 Smoking increases LDL buildup and impacts cardiovascular health.

Garis waktu

  • 00:00:00 - 00:06:47

    In 1968, the American Heart Association recommended limiting egg consumption to three per week due to concerns about cholesterol in egg yolks and its potential link to cardiovascular disease. However, the process of digestion reveals that fat emulsification and the formation of lipoproteins in the liver are more complex. VLDL carries lipids for energy use, converting to LDL, associated with cardiovascular risks, while HDL is beneficial, removing excess LDL. It's crucial to maintain a balance of different lipoproteins as lifestyle factors and food choices significantly impact blood lipid levels. Although egg yolks are high in cholesterol, the body's own production, influenced by other fats consumed, is more significant. With proper dietary habits focusing on unsaturated fats and fiber, eggs can be part of a nutritious diet, while exercise and minimizing smoking contribute positively to cholesterol management. In cases where lifestyle changes aren't enough, effective medications like statins can help regulate cholesterol levels.

Peta Pikiran

Video Tanya Jawab

  • Why did the American Heart Association recommend limiting egg consumption?

    They believed that the cholesterol in egg yolks could increase the risk of cardiovascular disease.

  • What are lipoproteins?

    Lipoproteins are lipid-protein packages that help transport fats through the bloodstream.

  • What is the difference between LDL and HDL?

    LDL (bad cholesterol) can accumulate in blood vessel walls, while HDL (good cholesterol) helps remove excess LDL from the blood.

  • How do saturated and unsaturated fats affect cholesterol levels?

    Saturated fats can increase LDL production, while unsaturated fats can have anti-inflammatory effects and help reduce LDL.

  • What lifestyle factors can influence cholesterol levels?

    Diet, exercise, and smoking can all impact lipoprotein levels in the blood.

  • What role do exercise and smoking play in cholesterol management?

    Exercise can lower LDL and increase HDL levels, while smoking tends to increase LDL levels.

  • What are statins?

    Statins are drugs that block an enzyme required for LDL production in the liver.

  • How can a diet help manage cholesterol levels?

    A diet high in unsaturated fats and fiber, including fruits, vegetables, and whole grains, helps maintain healthy cholesterol.

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Gulir Otomatis:
  • 00:00:06
    In 1968, the American Heart Association made an announcement
  • 00:00:11
    that would influence people’s diets for decades:
  • 00:00:15
    they recommended that people avoid eating more than three eggs a week.
  • 00:00:21
    Their reasoning was that the cholesterol packed into egg yolks
  • 00:00:25
    could increase cardiovascular disease risk.
  • 00:00:29
    But it turns out that the reality is more complicated.
  • 00:00:32
    Let's delve into digestion to understand why.
  • 00:00:36
    As your body processes a meal, it emulsifies fats into lipid droplets
  • 00:00:42
    that can then get absorbed in your small intestine.
  • 00:00:46
    These lipid droplets make their way to various tissues,
  • 00:00:50
    including your liver.
  • 00:00:52
    There, specialized cells unpack and reassemble them
  • 00:00:56
    into lipid-protein packages, called lipoproteins,
  • 00:01:00
    that are optimized to flow through your bloodstream.
  • 00:01:04
    Lipoproteins are composed of different ratios of protein and fat,
  • 00:01:09
    so their density varies.
  • 00:01:12
    VLDL, or very low-density lipoprotein,
  • 00:01:17
    is mostly packed with fatty molecules, including triglycerides and cholesterol.
  • 00:01:24
    VLDL delivers lipids to your muscle and fat cells
  • 00:01:28
    to be stored and used for energy.
  • 00:01:31
    Afterwards, it’s converted into LDL, or low-density lipoprotein.
  • 00:01:37
    LDL is informally known as “bad cholesterol”
  • 00:01:42
    because it’s associated with cardiovascular diseases.
  • 00:01:47
    This is because LDL is more prone to accumulating on blood vessel walls,
  • 00:01:53
    which can cause inflammation.
  • 00:01:55
    The inflammation attracts specialized white blood cells, called macrophages,
  • 00:02:01
    to remove the LDL buildup.
  • 00:02:03
    But absorbing too many lipids can compromise macrophages,
  • 00:02:08
    causing more inflammation and triggering more macrophage recruitment.
  • 00:02:13
    As the cells clump together, they form a fibrous, scab-like cap,
  • 00:02:19
    effectively narrowing the artery.
  • 00:02:22
    This can interfere with blood flow and weaken vessel walls,
  • 00:02:26
    making clots and ruptures more likely.
  • 00:02:30
    High-density lipoprotein. or HDL, on the other hand,
  • 00:02:34
    packs more protein.
  • 00:02:36
    It picks up excess LDL in the blood and brings it back to the liver,
  • 00:02:41
    where it can be excreted.
  • 00:02:44
    Because HDL is anti-inflammatory and keeps LDL in check,
  • 00:02:50
    it’s commonly called “good cholesterol.”
  • 00:02:53
    Doctors order lipid panels to understand
  • 00:02:56
    the concentrations of different kinds of lipoproteins
  • 00:03:00
    and their building blocks in your blood.
  • 00:03:03
    All lipoproteins are essential to your body’s functioning—
  • 00:03:07
    but it can become a problem if the different kinds get out of balance.
  • 00:03:13
    Some people are simply predisposed to having higher cholesterol.
  • 00:03:17
    For example, certain gene variants cause LDL receptors to behave abnormally,
  • 00:03:24
    leaving more LDL circulating.
  • 00:03:27
    Otherwise, different lifestyle factors can influence blood lipid levels.
  • 00:03:33
    And food is one of them.
  • 00:03:35
    So, what’s the deal with eggs?
  • 00:03:37
    Their yolks are indeed high in cholesterol,
  • 00:03:40
    which prompted the American Heart Association’s three egg weekly limit
  • 00:03:45
    in 1968.
  • 00:03:47
    But while some of the cholesterol in your blood comes directly
  • 00:03:51
    from cholesterol found in food,
  • 00:03:53
    your body actually makes a vast majority of it from the different fats you consume.
  • 00:03:59
    Saturated and trans fats, found in animal, palm, and coconut products
  • 00:04:05
    can drive your liver to create more VLDL and LDL packages.
  • 00:04:10
    Unsaturated fats, meanwhile, are abundant in foods like fish, nuts, and seeds,
  • 00:04:16
    and have anti-inflammatory properties that help counteract LDL buildup.
  • 00:04:22
    A food’s fat composition has a greater effect
  • 00:04:26
    on blood lipid concentrations than its cholesterol levels.
  • 00:04:30
    So the high cholesterol found in egg yolks isn’t actually of too much concern.
  • 00:04:37
    Egg yolks contain some saturated fat, but not too much—
  • 00:04:40
    and they also contain unsaturated fats.
  • 00:04:44
    Generally, an egg a day is considered nutritious.
  • 00:04:48
    But it's not just what fats you eat, but what you eat them with.
  • 00:04:53
    Fibrous fruits, vegetables, and whole grains help lower LDL levels
  • 00:04:58
    by affecting how fats are absorbed in the digestive tract.
  • 00:05:03
    Overall, getting plenty of unsaturated fats and fiber
  • 00:05:08
    seems to help keep LDL in check.
  • 00:05:11
    And other activities can also impact lipid levels.
  • 00:05:15
    It's not yet totally clear why,
  • 00:05:17
    but resistance training and aerobic exercise
  • 00:05:21
    can lower LDL and increase HDL.
  • 00:05:25
    This might be because they use more blood lipids for energy
  • 00:05:29
    and boost the activity of HDL-producing enzymes.
  • 00:05:34
    Meanwhile, smoking increases LDL buildup,
  • 00:05:38
    perhaps by unleashing unstable free radical molecules
  • 00:05:42
    that damage lipids and vessel walls.
  • 00:05:46
    But when lifestyle changes don’t help to manage cholesterol levels,
  • 00:05:50
    as can be the case when genetics are at play,
  • 00:05:52
    we luckily have some pretty effective therapies.
  • 00:05:57
    Statins are drugs that block a liver enzyme required to produce LDL.
  • 00:06:03
    Other cholesterol medications increase the production of enzymes
  • 00:06:06
    that break down triglycerides and promote LDL receptor activity,
  • 00:06:11
    helping clear it from the bloodstream.
  • 00:06:14
    When it comes to cholesterol health,
  • 00:06:16
    it’s important to keep the whole picture in mind— on and off the plate—
  • 00:06:22
    so things don't get all, you know, scrambled.
Tags
  • cholesterol
  • egg yolks
  • cardiovascular health
  • lipoproteins
  • LDL
  • HDL
  • diet
  • lifestyle
  • unsaturated fats
  • statins