7. Cholesterol: the most misunderstood marker

B. Lands

7. Cholesterol: the most misunderstood marker

In: Handbook of cholesterol

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B. Lands

B. Lands 6100 Westchester Park Drive, Apt.1219, College Park, MD 20740, USA

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Type:: Chapter

Pages:: 117–136

DOI:: https://doi.org/10.3920/978-90-8686-821-6_7

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A paradox developed during World War II as populations unable to maintain high calorie diets had fewer heart attacks which rose again in the post-war recovery years. Pathologists concluded that a ‘luxus diet’ produces diabetes and atherosclerosis that is prevented by ‘chill penury’. Ancel Keys considered an effective preventive action could be avoiding large temporary calorie excesses and periodic gorging, and dietary cholesterol needed no special attention. The liver converts excess food energy to triglycerides and cholesterol and secretes them as very low-density lipoproteins into the plasma where the triglycerides are hydrolyzed, releasing large amounts of non-esterified fatty acids (NEFA) plus residual low-density lipoprotein (LDL). Elevated LDL-cholesterol reflects an imbalance in food energy intake and expenditure, being less with lower caloric intakes and higher physical activity. Postprandial NEFA after each large meal initiate transient oxidative insults and endothelial dysfunctions which omega-6 actions amplify into chronic inflammatory disorders. Circulating cholesterol levels predict risk of coronary heart disease (CHD) death only to the degree that pro-inflammatory highly unsaturated fatty acids (HUFA) exceed less-inflammatory HUFA. Primary prevention of atherogenesis may succeed by eating fewer calories per meal, eating more omega-3 and fewer omega-6 nutrients.

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Handbook of cholesterol

Biology, function and role in health and diseases

Series: Human Health Handbooks, Volume: 11

E-Book ISBN:: 9789086868216

Publisher:: Wageningen Academic

Print Publication Date:: 08 Feb 2016

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  - General
  - Food & Health

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7. Cholesterol: the most misunderstood marker

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Handbook of cholesterol

Biology, function and role in health and diseases

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