When we think of high LDL cholesterol levels, heart disease is the first risk that springs to mind – and for good reason, but what we’ve failed to realise is the devastating effects on the liver. Here’s why researchers are warning about an influx of non-alcoholic fatty liver disease cases.
For decades, the relationship between high cholesterol and heart disease has been well-established. We've been warned about the perils of trans fats and their impact on our cardiovascular health. But emerging research is shedding new light on the connection between high cholesterol and fatty liver disease – findings from the Keck School of Medicine of USC have highlighted a fascinating yet concerning revelation: high cholesterol levels – we’re talking about LDL cholesterol (AKA the bad kind) here – in conjunction with a high trans-fat and high-sugar diet, can significantly worsen the progression of fatty liver disease, potentially leading to inflammation, scarring, and even cirrhosis. The consequences? Liver failure and even cancer.
“We saw that you may have a high-fat and high-sugar diet, but when you add high cholesterol to that, it will accelerate the process that causes inflammation in your liver,” said one of the study’s authors Ana Maretti-Mira. “People focus on high cholesterol as a risk for heart disease, but we showed that your liver may also be affected, causing inflammation, scarring and, potentially, cirrhosis.”
The Fatty Liver Dilemma
Fatty liver disease, a condition in which fat accumulates in liver cells, has long been associated with diets high in fats and sugars. This ailment, if left unchecked, can escalate to more severe conditions such as cirrhosis and liver cancer. The study marks the first investigation to explore how various cholesterol levels, when integrated into a high-fat, high-sugar diet, can affect the progression of fatty liver disease. The results, obtained through lab experiments with mice, were eye-opening. Researchers observed that a diet rich in cholesterol not only exacerbated fatty liver disease but also triggered inflammation and scarring. Disturbingly, scar tissue in the liver could persist even when transitioning to a low-cholesterol diet. Additionally, the study unveiled that a high-cholesterol diet could induce long-lasting dysfunction in specific immune cell populations known to be involved in the development of fatty liver disease.
What this research suggests is that while high cholesterol has primarily been seen as a risk factor for heart disease, it can significantly affect the liver's wellbeing too – not to mention the rest of the body! After all, our liver is imperative in filtering toxins and supporting the digestive process. When combined with a diet already loaded with fat and sugar, high cholesterol intensifies the processes that lead to liver inflammation, fibrosis, and potentially cirrhosis.
This research is a critical reminder of the interconnectedness of our diet and overall health – what we consume doesn't just affect one part of our body; it influences multiple systems, often silently until it’s too late to treat. High cholesterol, when in the context of an unhealthy diet, can be a hidden driver of liver complications, adding a new layer to our understanding of the relationship between nutrition and disease.
“Our daily diet has lots of carbohydrates, such as sugary drinks, bread, rice and pasta,” Ana said. “Then there’s high fat, since everybody likes deep fried foods. At the same time, we don’t have the same active life we used to, so we end up eating much more than our body needs.”
How to Prevent High Cholesterol
So, with that cheery news, you’re probably wondering what you can do to prevent all of this in the first place. We want to start off by saying that high cholesterol differs from person to person – some of us are more susceptible than others, and some may be able to treat their LDL cholesterol with lifestyle changes while others may need medical intervention, so it’s vital to take it as a case-by-case basis. (Basically, it’s not a one-size-fits-all!) Having said that, there are a number of simple things we can do to significantly lower our risk, and preventing high cholesterol is a crucial step in maintaining heart and liver health. Here are some strategies to help you keep your cholesterol levels in check:
Healthy Diet: Consume a diet rich in fruits, vegetables, whole grains, and lean proteins. Incorporate foods high in soluble fibre like oats, beans, and legumes, which can help lower LDL (bad) cholesterol levels.
Reduce Saturated Fat: Limit your intake of saturated fats found in red meat, full-fat dairy products, and processed foods. Opt for lean cuts of meat and low-fat or fat-free dairy alternatives.
Choose Healthier Fats: Replace saturated and trans fats with healthier unsaturated fats, such as those found in olive oil, avocados, and fatty fish like salmon. These fats can help increase HDL (good) cholesterol levels.
Watch Your Portions: Be mindful of portion sizes to avoid overeating, which can lead to weight gain and elevated cholesterol levels.
Limit Processed Foods: Processed and fried foods often contain unhealthy trans fats. Check food labels and avoid products with partially hydrogenated oils.
Regular Exercise: Engage in regular physical activity, such as brisk walking, jogging, or swimming. Aim for at least 150 minutes of moderate-intensity exercise per week.
Maintain a Healthy Weight: Losing excess weight can help lower LDL cholesterol and improve overall heart health.
Moderate Alcohol Intake: If you consume alcohol, do so in moderation. Limit alcohol to one drink per day for women and two drinks per day for men.
Don't Smoke: Smoking damages blood vessels and lowers HDL cholesterol. Quitting smoking can lead to improvements in cholesterol levels and overall health.
Stay Hydrated: Drink plenty of water throughout the day. Staying well-hydrated supports overall health, including heart health.
Manage Stress: Chronic stress may contribute to high cholesterol levels. When you're under stress, your body releases stress hormones like cortisol and adrenaline, and these hormones trigger the "fight or flight" response, which can lead to increased production of triglycerides and very low-density lipoprotein (VLDL) cholesterol. Elevated VLDL and triglyceride levels are associated with an increased risk of heart disease. Practice stress-reduction techniques like meditation, deep breathing, or yoga.
Regular Check-Ups: Visit your healthcare provider for regular check-ups and cholesterol screenings. Knowing your cholesterol levels allows you to make informed decisions about your health.
Medication (if needed): In some cases, medication may be prescribed by your healthcare provider to manage high cholesterol. If lifestyle changes alone are not effective, medication can be a valuable addition to your treatment plan. Ultimately, being able to avoid medication can be preferable, but if you can’t alter your LDL cholesterol levels on your own, you won’t want to take the risk of living with chronic high cholesterol as the consequences can be dire.
Remember that genetics can also play a role in cholesterol levels. If you have a family history of high cholesterol or related health issues, it's especially important to focus on lifestyle modifications and work closely with your healthcare provider to manage your risk. By following these guidelines and working with your healthcare team, you can take steps to prevent and manage high cholesterol effectively.
The Link Between Sugar and High Cholesterol
Trans fats often get the blame for high LDL cholesterol – and yes, it is so warranted! – but often we overlook a culprit that creeps in unnoticed. Sugar. How? Well, diets high in added sugars, especially fructose, can elevate triglyceride levels in the blood. High triglycerides are often associated with low levels of HDL (good) cholesterol and an increased risk of heart disease. Here’s what else too much sugar does:
- Lowers LDL Cholesterol: Excessive sugar consumption may lead to insulin resistance, a condition in which your body's cells don't respond effectively to insulin. Insulin resistance can increase LDL (bad) cholesterol and contribute to the buildup of arterial plaque.
- Reduces Inflammation: Sugar can trigger inflammation in the body, including in the blood vessels. Inflammation plays a significant role in the development of atherosclerosis (hardening of the arteries) and can lead to high cholesterol levels.
- Aids Weight Management: High sugar intake is linked to weight gain and obesity. Being overweight or obese is a risk factor for high cholesterol. Reducing sugar helps with weight management, which, in turn, supports healthier cholesterol levels.
To reduce sugar intake and lower the risk of high cholesterol:
- Read Food Labels: Be mindful of hidden sugars in processed foods. Ingredients like high fructose corn syrup, sucrose, and other sugars can lurk in unexpected places.
- Limit Sugary Beverages: Sugary drinks like sodas, fruit juices, and sweetened teas can contribute significantly to daily sugar intake. Opt for water, herbal teas, or unsweetened beverages.
- Choose Whole Foods: Focus on whole, unprocessed foods that are naturally low in added sugars. Fresh fruits, vegetables, whole grains, lean proteins, and healthy fats should form the basis of your diet.
- Cook at Home: Preparing meals at home allows you to control the ingredients and avoid hidden sugars commonly found in restaurant and takeout meals.
- Moderate Desserts: If you have a sweet tooth, enjoy desserts in moderation. Consider healthier sweeteners like rice malt syrup or use cinnamon to add flavour.
- Limit Highly Processed Snacks: Snack foods like cookies, candies, and pastries often contain high levels of sugar and unhealthy fats. Opt for nutrient-dense snacks like nuts, yogurt, or fresh fruit.
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