Tag Archives: cholesterol

High cholesterol drug could reduce SARS-CoV-2 infection by 70%

Credit: Pixabay.

A common medication prescribed for managing cholesterol and fatty substances in the blood may also have unintended antiviral properties, protecting patients from coronavirus infections. Experiments on human cells in the lab by researchers suggest that the drug, known as fenofibrate, could reduce severity and symptoms of infection due to COVID-19 by up to 70%, as well as virus spread.

SARS-CoV-2, the coronavirus responsible for COVID-19, infects humans using a so-called “spike” protein that attaches itself to ACE2 receptors on the surface of cells. Once it hooks, the virus hijacks the cell for its own purposes, commandeering the cell’s machinery to produce more viral particles.

But in the presence of fenofibrate and the drug’s active compound (fenofibric acid), this infectious pathway is disrupted. Of note is that this disruption occurred at standard doses which patients normally take in order to treat high cholesterol problems. Since Fenofibrate is a drug already approved by the U.S. Food and Drug Administration, its conversion into a COVID treatment should face no safety barrier.

The researchers didn’t investigate fenofibrate’s antiviral properties by accident. The findings are the culmination of a project that looked at hundreds of already licensed drugs to see if their chemical makeup could somehow disrupt the interaction between the coronavirus spike and the ACE2 receptor. Fenofibrate eventually turned up on the shortlist and was put to the test.

The project involved scientists from the University of Birmingham and Keele University in the U.K. and the San Raffaele Scientific Institute in Italy.

“Our data indicates that fenofibrate may have the potential to reduce the severity of COVID-19 symptoms and also virus spread. Given that fenofibrate is an oral drug that is very cheap and available worldwide, together with its extensive history of clinical use and its good safety profile, our data has global implications – especially in low-middle income countries and in those individuals for whom vaccines are not recommended or suitable such as children, those with hyper-immune disorders and those using immune-suppressants,” co-author Dr. Elisa Vicenzi from the San Raffaele Scientific Institute said in a statement.

Although vaccine coverage is fairly widespread, there is still an urgent need for new drugs that are effective in treating SARS-CoV-2-positive patients. Fenofibrate has been tested on human cells exposed to the alpha and beta variants. Research is ongoing into its efficacy against the delta variant.

The researchers are calling for clinical trials to test the drug in hospitalized COVID-19 patients, to be carried out in addition to two clinical trials currently underway in such patients in research led by the Hospital of the University of Pennsylvania in the US and Hebrew University of Jerusalem in Israel.

The findings appeared in the journal Frontiers in Pharmacology.

What is cholesterol?

Credit: Pixabay.

People seem to have a negative perception of cholesterol. However, the waxy substance is only unhealthy when it is present in too high quantities in the body. In truth, cholesterol is actually an essential substance that is critical to the body’s ability to divide cells and make vitamins, and also aids in the production of some hormones.

That being said, it’s important to keep your cholesterol in check because high cholesterol levels increase your risk of heart disease and stroke.

Where cholesterol comes from and what is it good for

Our body accesses cholesterol from two sources. One is internal, as the liver makes its own cholesterol — this is the main source of cholesterol in your blood. The other is external, from the various animal-sourced foods, such as meat, poultry, eggs, and dairy products — this is known as dietary cholesterol.

Cholesterol is oil-based, so it does not mix with the blood, which is water-based. Instead, it travels around the body transported in lipoproteins, in order to serve four basic functions:

  • strengthening the structure of cell walls;
  • making up digestive bile acids in the intestine;
  • priming the body to produce vitamin D;
  • contributing to the production of certain hormones.

There are also two main types of lipoproteins:

  • low-density lipoproteins (LDL), popularly known as “bad” cholesterol because LDL dumps the cholesterol into your arteries.
  • high-density lipoproteins (HDL), also known as “good” cholesterol because it removes cholesterol from your arteries by carrying it back to the liver.

Why too much cholesterol can be unhealthy and dangerous

Too much cholesterol in the blood can form plaques that block your arteries. Credit: Health Direct.

Cholesterol combines with other substances found in the blood to form a thick, hard deposit on the inner walls of the arteries. The more cholesterol found in your blood, the higher the risk of cardiovascular diseases. For instance, too much cholesterol can naturally narrow the arteries and make them less flexible, causing a condition known as atherosclerosis in which blood flow is restricted. Sometimes, too much cholesterol can form blood clots, clogging the arteries, and thereby triggering a heart attack or stroke.

How do I know if I have high cholesterol?

In order to determine whether you have high levels of cholesterol, you’ll have to take a blood test that measures both HDL and LDL levels. The doctor will then examine these readings, along with other risk factors of heart disease or stroke, such as high blood pressure, obesity, type 2 diabetes, triglycerides, and smoking, in order to determine whether you have too much cholesterol.

Generally, the guidelines below can help inform you whether or not your cholesterol is too high.

Total cholesterol (U.S.)Total cholesterol (Canada and most of Europe)Results
Below 200 mg/dLBelow 5.2 mmol/LDesirable
200-239 mg/dL5.2-6.2 mmol/LBorderline high
240 mg/dL and aboveAbove 6.2 mmol/LHigh
LDL cholesterol (U.S. and some other countries)LDL cholesterol* (Canada and most of Europe)Results
Below 70 mg/dLBelow 1.8 mmol/LBest for people who have heart disease or diabetes.
Below 100 mg/dLBelow 2.6 mmol/LOptimal for people at risk of heart disease.
100-129 mg/dL2.6-3.3 mmol/LNear optimal if there is no heart disease. High if there is heart disease.
130-159 mg/dL3.4-4.1 mmol/LBorderline high if there is no heart disease. High if there is heart disease.
160-189 mg/dL4.1-4.9 mmol/LHigh if there is no heart disease. Very high if there is heart disease.
190 mg/dL and aboveAbove 4.9 mmol/LVery high
*Canadian and European guidelines differ slightly from U.S. guidelines. These conversions are based on U.S. guidelines.
HDL cholesterol (U.S.)HDL cholesterol(Canada and most of Europe)
Below 40 mg/dL, men Below 50 mg/dL, womenBelow 1 mmol/LBelow 1.3 mmol/LPoor
40-59 mg/dL, men 50-59 mg.dL, women1-1.5 mmol/L1.3-1.5 mmol/LBetter
60 mg/dL and aboveAbove 1.5 mmol/LBest
Triglycerides (U.S.)Triglycerides (Canada and most of Europe)Results
Below 150 mg/dLBelow 1.7 mmol/LDesirable
150-199 mg/dL1.7-2.2 mmol/LBorderline high
200-499 mg/dL2.3-5.6 mmol/LHigh
500 mg/dL and aboveAbove 5.6 mmol/LVery high

What causes high cholesterol

Sedentarism, obesity, and an unhealthy diet all contribute to high LDL cholesterol and low levels of HDL cholesterol. The main risk factors for high levels of cholesterol are:

  • A poor diet consisting of too much saturated and trans fats.
  • Obesity. Having a body mass index (BMI) over 30 statistically puts you at a greater risk of high cholesterol than the general population.
  • Lack of exercise. Rigorous, frequent physical activity can boost the body’s HDL (good cholesterol) while increasing the size of LDL particles (bad cholesterol), which makes it less harmful.
  • Smoking. Nicotine damages and constricts the walls of blood vessels, making them more prone to the accumulation of fatty deposits.
  • Age. As we age, the liver becomes less capable of removing LDL cholesterol.
  • Diabetes. People with diabetes have high blood sugar, which puts them at risk of producing a dangerous type of cholesterol called very-low-density lipoprotein (VLDL) while also lowering HDL cholesterol.
  • Genetics. Some people inherit genes from their parents that can cause them to be susceptible to high cholesterol levels in their blood — it’s called familial hypercholesterolemia.

How to lower cholesterol

If you have high cholesterol, the first thing you must address is diet. This is why it’s important to:

  • Limit the amount of animal fats and use good fats in moderation
  • Eat a balanced diet that emphasizes fruits, vegetables, and whole grains

Additionally, the following will help lower your cholesterol:

  • Exercise regularly and maintain a healthy weight;
  • Quit smoking;
  • Drink alcohol only in moderation, if at all;
  • Manage stress;

The above recommendations can also help prevent you from having high cholesterol in the first place.

If a patient has made significant lifestyle changes but bad cholesterol and triglyceride levels remain high, your doctor may recommend medication. These may include statins (drugs that effectively prevent the liver from making as much cholesterol), bile-acid-binding resins, cholesterol absorption inhibitors, and injectable medications such as PSCK9 inhibitors. Additionally, those with high triglyceride levels may benefit from medication such as fibrates, niacin, and omega-3 fatty acid supplements. 

Did a study claim there’s no link between eggs and cholesterol? It might be biased

You’ve probably read at some point a news story or research claiming eggs don’t actually raise cholesterol levels. But those findings may have been biased because of faulty industry-funded research, according to a new review.

Image credits: Wikipedia Commons

A group of researchers from the Physicians Committee for Responsible Medicine looked at all the research studies from 1950 to March 2019 that assessed the effect of eggs on blood cholesterol levels. They studied funding sources and if they influenced the findings.

The results, published in the American Journal of Lifestyle Medicine, showed that before 1970 the industry didn’t have a role in cholesterol research. But industry-funded studies increased over time, from none in the 1950s to 60% in 2010-2019 — and industry-funded studies are well known to be associated with biases.

“In decades past, the egg industry played little or no role in cholesterol research, and the studies’ conclusions clearly showed that eggs raise cholesterol,” said study author Neal Barnard. “In recent years, the eggindustry has sought to neutralize eggs’ unhealthy image as a cholesterol-raising product by funding more studies and skewing the interpretation of the results.”

As a whole, more than 85% of the studies the researchers looked at, no matter if they were funded by the industry or not, found that eggs have negative effects on blood cholesterol. But those industry-funded downplayed the findings, the researchers claimed.

That means that when the data showed cholesterol levels increased because of egg consumption, the conclusions focused on something else. Almost half of the industry-funded studies had conclusions that didn’t match with the actual study results, compared to 13% of the non-industry funded studies.

For example, a 2014 study, associated the addition of two eggs at breakfast five days a week over 14 weeks to mean LDL cholesterol. Despite the results, the investigators said that an extra 400mg per day of dietary cholesterol didn’t affect blood lipids.

Such studies didn’t just cause misleading headlines, there have also been implications in policies. Back in 2015, the U.S. Dietary Guidelines Advisory Committee said that “available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol.”

Nevertheless, after looking at the evidence, the US government didn’t carry that statement forward in the final guidelines, which called for eating “as little dietary cholesterol as possible.”

“The egg industry has mounted an intense effort to try to show that eggs do not adversely affect blood cholesterol levels,” added Dr. Barnard. “For years, faulty studies on the effects of eggs on cholesterol have duped the press, public, and policymakers to serve industry interests.”

There have been many meta-analyses that concluded that egg consumption does raise cholesterol levels. A 2019 study showed that eating an egg each day raises low-density lipoprotein (LDL, or “bad”) cholesterol by about nine points. The study found that every 100 milligrams of added dietary cholesterol raised LDL cholesterol levels by about 4.5 mg/dL.

The report published in the American Journal of Lifestyle Medicine analyzed 153 studies, 139 of which showed eggs raise blood cholesterol — and not a single one of them reported a significant net drop in cholesterol concentrations associated with egg consumption.

Eating a lot of cheese doesn’t raise your cholesterol and is associated with lower body mass index

Cheese eaters, rejoice! A new study conducted by Irish researchers has found that contrary to popular belief, eating a lot of cheese doesn’t really raise your cholesterol levels. It might even make you thinner.

Cheese might not be as bad for you as we thought. Image credits: Chris Buecheler.

Researchers from the University College Dublin studied the impact of cheese and dairy eating on 1500 participants from Ireland. They wanted to assess the current health guidelines, which warn that eating cheese (which is rich in saturated fats) can increase your risk of developing high blood cholesterol. What they found was that, surprisingly, participants who ate large amounts of cheese didn’t actually have higher cholesterol levels. According to the American Heart Association for instance, adults shouldn’t consume more than 300 milligrams of cholesterol per day. Since one ounce of cheddar contains 30 milligrams of cholesterol, that’s 10% of your daily intake. If you eat too much cholesterol, it accumulates in your bloodstream and eventually deposits in your arteries restricting blood flow to your heart.

“What we saw was that in the high consumers [of cheese] they had a significantly higher intake of saturated fat than the non-consumers and the low consumers and yet there was no difference in their LDL Cholesterol levels,” said Dr Emma Feeney, UCD School of Agriculture and Food Science and Food for Health Ireland, who was lead author on the paper.

Researchers believe that it is the mixture of nutrients that many types of cheese contain nutrients that counterbalance the increased consumption of saturated fats. Scientists even found that dairy intake was positively correlated with lower body mass index, lower percentage of body fat, lower waist size and lower blood pressure.

Pictured: Dr Emma Feeney, UCD School of Agriculture and Food Science and Food for Health Ireland, who led the research on the study that shows that eating large amounts of cheese does not raise LDL cholesterol levels.

Of course, correlation doesn’t imply causation — in other words, this doesn’t mean that cheese itself is good for your cholesterol or for your weight. Cheese eating is just a piece of the puzzle, and we have to consider the entire diet of people. More likely than not, higher dairy intake is part of a larger eating pattern that we should consider. However, if you’re a cheese fan, it’s pretty encouraging news.

“We have to consider not just the nutrients themselves but also the matrix in which we are eating them in and what the overall dietary pattern is, so not just about the food then, but the pattern of other foods we eat with them as well,” Feeney added.

Ironically, researchers also found that people who consumed low-fat yogurt and milk tended to have a higher intake of carbohydrates. However, the cause and effect may be the other way around — people who eat more carbohydrates may be more likely to consume low-fat dairy because they want to lose weight. Another surprisingly finding was that people who ate a low-fat diet tended to have higher cholesterol levels.

It would be really interesting to see this study replicated on a larger sample size, and in different parts of the world. Culture and geography have a huge impact on our nutrition, and at the moment, it’s not clear if there’s something specific to the Irish diet which led to these results or if we simply overstated the negative effects of cheese. As it is almost always the case, a good balance is key to eating a healthy diet and living a healthy life — no matter where you’re from.

Journal Reference: E L Feeney, A O’Sullivan, A P Nugent, B McNulty, J Walton, A Flynn and E R Gibney — Patterns of dairy food intake, body composition and markers of metabolic health in Ireland: results from the National Adult Nutrition SurveyNutrition & Diabetes (2017) 7, e243; doi:10.1038/nutd.2016.54

Being healthy and obese is impossible – the two are mutually exclusive, researchers say

It’s surprising to me that this has to be said, but … oh well. If you are obese, you’re unhealthy. Even if you have normal blood pressure, cholesterol and blood-sugar, you’re still unhealthy. A study, published in the Annals of Internal Medicine, concluded that so-called “healthy obesity” was a myth.

“Healthy obesity” or “benign obesity” is a relatively new term, which has been used to describe a subset of individuals who are defined as obese based on their Body Mass Index (BMI), but don’t have any other metabolic abnormalities commonly associated with obesity (increased blood pressure, high cholesterol, etc). The BMI is the standard way to measure if someone is obese or not. People with a BMI of 30-40 are considered to be obese. But since obesity has only become a global problem in the past few decades, the long term effects are not as well documented as with other conditions.

Researchers wanted to check the validity behind the ideas of “benign obesity”; in order to do this, they conducted meta-analysis on more than 60,000 people across three weight categories – normal, overweight and obese – in eight studies carried out over the last decade. Meta analysis is a statistical method which focuses on contrasting and combining results from different studies, in the hope of identifying patterns among study results.

Their results showed that while metabolically healthy obese people showed a similar risk of problems compared to those with normal weight in the short term, when they analyzes studies that had ten years of follow up, things were significantly different. Study participants in all weight categories with unhealthy metabolisms showed an increased risk of mortality and cardiovascular problems.

“The main finding is that metabolically healthy obese individuals are indeed at increased risk for death and cardiovascular events over the long term as compared with metabolically healthy normal-weight individuals,” Retnakaran said. “These data suggest that increased body weight is not a benign condition even in the absence of metabolic abnormalities.”.

It’s still not clear exactly why some people have an apparently normal metabolism. Out of the over 60.000 people considered in the study, 8.9% had metabolically healthy obesity while 6% had metabolically unhealthy normal weight. The one thing that appears certain is that estimating someone’s status based on BMI alone is not enough.

“It is important to consider both BMI and metabolic status for estimating long-term risks of these outcomes,” Retnakaran said.

Journal Reference:
Caroline K. Kramer, MD, PhD; Bernard Zinman, CM, MD; and Ravi Retnakaran, MD. Are Metabolically Healthy Overweight and Obesity Benign Conditions?: A Systematic Review and Meta-analysis. Ann Intern Med. 2013;159(11):758-769. doi:10.7326/0003-4819-159-11-201312030-00008

Study shows marijuana smokers are thinner

“Marijuana use is associated with an acute increase in caloric intake” – marijuana preconception #234. The thing is, even though they eat more while high, pot smokers have been showed to be thinner, have a lower body mass index, and even lower cholesterol.

marijuana-skinny

Researchers at the University of Nebraska, the Harvard School of Public Health, and Beth Israel Deaconess Medical Center analyzed data from an American nationally representative sample of over 4000 people. Some 12 percent of the interviewed people admitted to constantly consuming marijuana, while almost half of them admitted to some pot smoking in the past. The participants were tested for several measures of blood sugar control: their fasting insulin and glucose levels; insulin resistance; cholesterol levels; and waist circumference.

First thing that popped up – marijuana users had much thinner waists than participants who had never used marijuana – (of course), even after researchers balanced out after other physical factors (age, sex, physical activity, etc). They also had significantly higher levels of HDL – what is called “good cholesterol”. But perhaps the most surprising discovery was the fact that for marijuana consumers, insulin levels were reduced by 16 percent and their insulin resistance (a condition in which the body has trouble absorbing glucose from the bloodstream) was reduced by 17 percent.

But there seemed to be a strong correlation between recent consumption and these factors. For people who had previously smoked marijuana, but not in the past 30 days, the same effects were noticed, but at a much smaller scale.

Although they’re not exactly clear why this happens, doctors believe that marijuana somehow works to improve insulin control, regulating body weight and perhaps explaining why marijuana users have a lower incidence of diabetes.

Mummies revealed that clogged arteries plagued the ancient world

You’d be tempted to think that clogged arteries are a problem of the modern world, with all the lack of exercise and unhealthy eating; but as ancient mummies revealed, even when we were hunter-gatherers, people still had arterial issues.

“There’s a belief that if we go back in time, everything’s going to be OK,” says cardiologist Greg Thomas of the University of California, Irvine, a senior member of the study team. “But these mummies still have coronary artery disease.” The paper is published in the current issue of The Lancet.

A lack of exercise and a diet rich in saturated fat — both of which increase levels of ‘bad’ cholesterol in the blood — are thought to increase the risk of plaque building up. These plaques are made up of cholesterol and immune cells called macrophages that can build up in arterial wall arteries. If this happens, the risk of heart attack and other cardiovascular diseases increases dramatically.

Thomas and his colleagues performed CT scans on 137 mummies from four very different ancient populations: Egyptian, Peruvian, the Ancestral Puebloans of southwest America and the Unangans of the Aleutian Islands in Alaska. Egyptian mummies were artificially embalmed, while the other ones were simply well preserved by very dry or cold conditions.

mummies

The four groups studied did not only live in very different areas, but they also had very different lifestyles. Ancestral Puebloans were forager–farmers, while Unangans were hunter–gatherers with an exclusively marine diet. Researchers were searching for calcified plaques in the wall of an artery or along the expected course of an artery. They successfully identified atherosclerosis in 47 (34%) of the 137 mummies, and in all four populations, ranging from 25% of the 51 ancient Peruvians to 60% of the five Unangans.

What’s extremely interesting about that is that the disease levels are about as big as modern ones, which comes as a big shock. However, despite the fact that elite people then ate a diet that resembles that of today’s gluttons, the cause for the disease may be different:

“Now we’ve scanned the common man and woman and they’ve got the same disease,” says Thomas. Rather than excess cholesterol, he suggests that high levels of inflammation — caused by smoke inhalation or chronic infection, for instance — may have triggered the disease in these individuals.

The study also puts modern cardiovascular diseases in perspective, as Thomas explains:

“We’ve oversold the ability to stop heart disease,” he says. “We can slow it down, but to think we can prevent it is unrealistic.”

Breakfast sandwich? The effects are felt before lunch

An increasing number of people are starting to take their breakfast in the form of a sandwich, be it pork roll, bacon and eggs, sausage, or even a hamburger. While tasty and full of energy, this breakfast is a ticking bomb for your body, a tremendous amount of fat which makes your body very unhappy.

 

According to the head of cardiac science at the University of Calgary, eating just one of these a day almost certainly leads to atherosclerosis, the narrowing of the arteries over a lifetime and a huge number of associated risks. But a new research concluded that aside from the long term risks, the ill effects of a high fat breakfast are felt even before lunch time.

Experiments were set up in the laboratory of Dr. Todd Anderson, director of the Libin Cardiovascular Institute of Alberta and head of cardiac science at the University of Calgary and were led by a student researcher, Vincent Lee. Tested subjects were healthy, non-smoking college students (who else?). The purpose was to test the “happiness” of the arteries – the increase in blood flow through the arm in response to a brief interruption of blood flow; this increased is called Velocity Time Integral (VTI).

“VTI tells us how much blood flow you can you get in your arm,” says Dr. Anderson. Simply put, the higher the VTI, the happier the artery.

The idea was to see just how much one single high fat breakfast affects the human body. They tested the students twice – once on the day they ate the sandwich, and once when they ate nothing at all for breakfast. There wasn’t a special type of sandwich, just something you typically find in a supermarket or a fast food – some 900 calorie, 50 grams of fat sandwiches. Their VTI was examined two hours after eating and it showed a decrease of 15-20% after eating the sandwich, highlighting the speed at which fatty foods can damage the body. The increase however, wasn’t long lived – meaning you shouldn’t say never to your guilty pleasure, just avoid it as much as possible.

“This study reminds us that our behaviours are the backbone of preventing heart disease,” says Heart and Stroke Foundation spokesperson Dr. Beth Abramson. “Remember that whether you eat at home or go to a restaurant, you’re still in charge of what you eat. So consider all the choices, and try to cut down on saturated and trans fats, calories and sodium. That’s one of the keys to decrease your risk of heart disease and stroke.”

Source: University of Calgary