I just listened to a really interesting Robb Wolf podcast where he had Dr. Rhonda Patrick on his show.
She outlined some very interesting research that simply explained how sugar and refined carbohydrates can lead to endothelial inflammation and subsequent heart disease.
We know that sugar and refined carbohydrates can lead to both intestinal permeability and elevated cholesterol and triglyceride levels.
But the mechanism of how hasn’t quite been figured out.
Dr. Patrick found new research that shows not only can insulin resistance occur in muscles and tissues, but it can also occur in the gut cells.
Therefore, if we eat too much sugar and refined carbohydrates, this can lead to insulin resistance in the gut cells. Then, as the gut cells are not able to get the energy they need, they experience mitochondrial dysfunction and eventually die.
As gut cells die off, intestinal permeability results.
(Remember, there is only a single layer of cells the separates the contents of our intestines from our bloodstream.)
As gaps in the intestinal lining happen, bacteria that reside in the gut are able to make their way into the bloodstream.
Gram-negative bacteria are surrounded by an endotoxin (also called lipopolysacchrides). When in the gut, the endotoxins aren’t necessarily harmful to us as other bacteria in the gut keep these endotoxins in check.
But once they get into the bloodstream, bad things start to happen.
One is that the immune system can react directly against the endotoxin, creating an inflammatory response.
Another much worse scenario is that the endotoxin binds to a receptor on a VLDL particle.
(A VLDL particle is a smaller denser LDL particle that has just dropped off its cholesterol load to the cells that needed it, and is headed back to the liver to be recycled.)
Now that the endotoxin is bound to the VLDL, its can no longer be recycled by the liver.
And the immune system, flagging the endotoxin, initiates an inflammatory response against the particle, creating a foam cell.
This traps the particle against the endothelial wall and unleashes an inflammatory cascade that can lead to plaque formation.
This just makes so much sense and it really ties the whole picture together.
Robb Wolf and Dr. Patrick both recommend getting a particle count done when you have blood work. This will measure to total number of VLDL particles. The more VLDL, the greater the risk of heart disease. Just getting a total cholesterol count and HDL/LDL numbers will not show the whole picture. CRP is a good inflammatory marker to get as well though it’s not a sensitive as they would prefer.