Cholesterol, from the Ancient Greek chole- (bile) and stereos (solid) followed by the chemical suffix -ol for an alcohol, is an organic molecule. It is a sterol (or modified steroid), a lipid molecule and is biosynthesized by all animal cells because it is an essential structural component of animal cell membranes that is required to maintain both membrane structural integrity and fluidity. Cholesterol enables animal cells to (a) not need a cell wall (like plants & bacteria) to protect membrane integrity/cell-viability and thus be able to (b) change shape and (c) move about (unlike bacteria and plant cells which are restricted by their cell walls).
In addition to its importance within cells, cholesterol also serves as a precursor for the biosynthesis of steroid hormones, bile acids, and vitamin D. Cholesterol is the principal sterol synthesized by animals. All kinds of cells in animals can produce it. In vertebrates the hepatic cells typically produce greater amounts than other cells. It is almost completely absent among prokaryotes (bacteria and archaea), although there are some exceptions such as Mycoplasma, which require cholesterol for growth.
François Poulletier de la Salle first identified cholesterol in solid form in gallstones in 1769. However, it was not until 1815 that chemist Michel Eugène Chevreul named the compound "cholesterine".
In keeping with this month's theme of obesity, the brain and weight loss I want to look at some clinical trial research.
Brain Posts does not endorse any type of diet or weight loss pills or substances. Personal dietary and obesity medication use choices need to be made with a qualified health professional.
However, I do post some dietary research that I find interesting. I have previously posted summaries of research related to the Mediterranean diet and beneficial cognitive and cardiovascular effects.
I ran across a clinical obesity trial that combined a brief two-phase low carbohydrate diet on top of a Mediterranean diet maintenance.
As some of you know, I had knee surgery recently. One of my priorities to improve my recovery is getting enough sleep.
That just makes sense.
But the lack of enough sleep might well bring about even more serious consequences, even among the young. A recent article details how insomnia may raise stroke risk:
Over the course of four years, researchers found that insomnia seemed to raise the likelihood that a person will be hospitalized due to stroke by 54 percent.
Photo from U.S. Centers for
Disease Control and Prevention
That risk skyrocketed for people between the ages of 18 and 34, who were eight times more likely to suffer strokes if they had insomnia when compared to their peers who got good sleep, the study found.
"We pay a lot of attention to high blood pressure, to obesity, to issues related to cholesterol. Those are known risk factors," said Dr. Demetrius Lopes, director of the Interventional Cerebrovascular Center at Rush University in Chicago and a spokesman for the American Heart Association. "But I think what is underrated is if you don't have a good sleep routine, how much it can harm you, especially at a young age."
Unfortunately, we live in a noisy, distracting, 24/7 world. And that makes it harder to get a good night's sleep. And that's on top of the difficulty many people have getting a good night's sleep even with ideal circumstances.
I love a good night's sleep. And now more than ever it seems, getting a good night's sleep is a serious matter.
I’m way young to have had this happen. I’ve heard that A LOT. That’s like an automatic response from people who first meet me. I think they just don’t know what else to say so they say “oh my God you’re so young.” Yeah, I am but I’m not the youngest person to ever have a stroke. I met a guy who has had 3 strokes starting at the age of ten. I know of a little girl who had a stroke in utero. At least I finished my education and started a career before getting sick, these people didn’t really have a chance before their lives were turned upside down. I think that part of the reason that it took so long to diagnose me was because no one thought it could be a stroke. That’s no excuse, they should’ve given me an MRI long before they did but that’s part of the reason. Strokes in young people happen and are on the rise. This research says that there are more strokes in young people because of increasing rates of obesity, diabetes, and high cholesterol. I didn’t have any of these, sometimes s*** just happens. :( One doctor told my family “sometimes 30 year-olds just have strokes.” Umm, ok. I live in a city with the best doctors in the world – that’s not a good explanation. I have a patent foramen ovale (hole in the heart) but the most current research says this doesn’t increase stroke risk when it was long thought that it did. There is more research coming out soon on this subject, so we’ll see.
Today we feature a guest post by Philip J. Reed titled "5 Tips for Stroke Prevention". We extend Philip a very warm welcome and we hope you find his post motivating, informative and actionable. - Gary --Philip J Reed, on behalf of The George Washington University Hospital Cardiovascular Center.
When a stroke occurs, brain cells can begin dying within seconds. Even prompt symptom recognition and quick access to stroke services may not be enough to prevent long-term damage.The best way to maintain full function is to reduce your risk factors, and we will discuss five ways to do that below.
1. Know your numbers. Your blood pressure and cholesterol can both be major risk factors. High blood pressure, which often has few or no symptoms, is one of the leading causes of stroke. It creates stress in blood vessel walls, and left untreated, can lead to blood vessel deterioration, blood clots, brain hemorrhage and stroke. High cholesterol can be just as damaging as it builds up on the walls of the arteries, blocking and damaging them. Positive lifestyle changes, such as exercise and weight loss, may be able to help you gain control over your blood pressure and cholesterol. Your doctor can help you explore other avenues for reducing your numbers if lifestyle changes are ineffective or do not reduce your numbers enough.
Here's news from across the pond. For all my foreign readers, "across the pond" is a standing idiom, or expression, between the United States and Great Britain. We laugh harder because we won the American Revolutionary War lasting from 1775 to 1783. For Britain, that's a touchy subject -- still. But back to the news.
Late last year, the American Academy of Neurology published a study about an increasing number of younger people having strokes. I don't want you to get all nuts, my dear reader. But while the stroke rate has declined among all age groups, the average age of stroke survivors--and non-survivors--is also diminishing. And do you know what that means? The elderly aren't the only ones who could have strokes.
The researchers, Dr. Brett Kissela from the University of Cincinnati and his collaborators, conducted a study of a sample population that examined the number of new stroke cases at three intervals: only 12.9 percent of all new cases of stroke in 1993 were found to be in people under 55, in 1999, using the same under-55 criteria, this percentage elevated to 13.3 percent, and 2005, 18.6 percent of all new stroke cases were found in the under-55 crowd, representing about a 50 percent increase over the first figure.
A spokesman for the Stroke Association, Dr. Clare Walton, said, "With the number of younger people having strokes increasing, greater strain will be placed on health services to support them with their recovery." She went on to say that stroke risk could be reduced by healthy lifestyle changes.
Clinicians are concerned about the increased number of strokes in young adults. Researchers are investigating silent strokes that don't produce recognizable stroke symptoms, but significantly raise the risk for a visible stroke. Silent strokes are caused by small blood vessel disease. Unlike clots that interrupt blood flow in large arteries, small blood vessels are plugged up by cholesterol.
Cholesterol creates plaque inside blood vessels. Plaque has a soft core of dead white blood cells that have engulfed oxidized LDL (the bad cholesterol) and a hard surface that is calcified and stiff. As plaque grows it narrows a small blood vessel until no blood gets through and a tiny bit of the brain dies. These small lesions show up as pinpoints of light on an MRI scan. When enough pinpoints of damaged brain get close to each other they join to form a bigger lesion that causes a visible stroke.
Doctors initially told me "we don't know why you had a stroke." A year after my stroke I asked for a copy of a follow-up MRI report and learned that there were a dozen tiny lesions in my sub-cortical white matter. When small blood vessel disease produces a stroke in sub-cortical areas like the brain stem it's called a lacunar stroke (lacuna = lake). Now I cringe every time I see young children holding a french fry in their little fists. High cholesterol is not a trivial issue because stroke is the number one cause of physical disability in adults.
Surgeons get an adrenalin rush when they open someone's skull to repair an aneurysm, but surgeons can't get into small blood vessels. For now controlling blood pressure and taking cholesterol lowering drugs (statins) are the only ways to prevent strokes in small blood vessels.
If I had been able to tolerate the first statin I tried I wouldn't have wasted five years trying different drugs to lower my cholesterol. When I had my first colonoscopy a gastroenterologist told me about Miralax powder that counteracts the severe constipation statins cause. Unlike laxatives that gradually lose their ability to stimulate the gut, Miralax powder pulls water into the intestines. Miralax is so effective I take it in teaspoonfuls instead of the capfuls recommended by the manufacturer. Preventing strokes is as boring as watching paint dry --- until disaster strikes.
If you're avoiding eggs because you think they'll raise your cholesterol, stop it. Revisionist science says the anti-egg crusade was a mistake.
In the 1960s, doctors thought cholesterol in good clogged the arteries and that egg yolks were prije villains. But just because eggs themselves are high in cholesterol doesn't mean they raise your blood cholesterol.
That idea has bitten the dust, says Anthony L. Komaroff, MD, in Harvard Health Letter. Research shows people who eat an egg a day are no more likely to have heart disease than those who eat eggs less than once a week, he says. "The cholesterol in food doesn't afect the levels in your blood all that much," Komaroff says. "My wife and I have eggs several times a week - guilt free!"
Another high cholesterol food that does not raise your blood cholesterol: shrimp...
10 Health Benefits of Eggs:
Eggs are great for the eyes. According to one study, an egg a day may prevent macular degeneratondue to the carotenoid content, specifically luteinand zeaxanthin. Both nutrients are more readily available to our bodies from eggs than from other sources.
In another study, researchers found that people who eat eggs every day lower their risk of developing cataracts, also because of the lutein and zeaxanthin in eggs.
One egg contains 6 grams of high-quality protein and all 9 essential amino acids
According to a study by the Harvard School of Public Health, there is no significant link between egg consumption and heart disease. In fact, according to one study, regular consumption of eggs may help prevent blood clots, stroke, and heart attacks..
They are a good source of choline. One egg yolk has about 300 micrograms of choline. Choline is an important nutrient that helps regulate the brain, nervous system, and cardiovascular system.
They contain the right kind of fat. One egg contains just 5 grams of fat and only 1.5 grams of that is saturated fat.
New research shows that, contrary to previous belief, moderate consumption of eggs does not have a negative impact on cholesterol. . In fact, recent studies have shown that regular consumption of two eggs per day does not affect a person's lipid profile and may, in fact, improve it. Research suggests that it is saturated fat that raises cholesterol rather than dietary cholesterol.
Eggs are one of the only foods that contain naturally occurring vitamin D.
Eggs may prevent breast cancer. In one study, women who consumed at least 6 eggs per week lowered their risk of breast cancer by 44%.
Eggs promote healthy hair and nails because of their high sulphur content and wide array of vitamins and minerals. Many people find their hair growing faster after adding eggs to their diet, especially if they were previously deficient in foods containing sulphur or B12.
A current study by the MedUni Vienna has shown that changes to the "good cholesterol" HDL (High-Density Lipoprotein) can be associated with cardiovascular diseases: by developing a new laboratory test, scientists at the Institute of Medical Genetics and the Department of Nephrology & Dialysis (University Department of Internal Medicine III) at the MedUni Vienna have demonstrated for the first time that the presence of certain proteins in the HDL can lead to an increased risk of cardiovascular disease and mortality.
HDL (High-Density Lipoprotein) is a class of proteins that plays a key role in the body's metabolism of cholesterol. HDL causes the cholesterol to be transported to the liver, where it is broken down. This gives rise to the popular name for HDL of "good cholesterol". A team led by Thomas Weichhart (Institute of Medical Genetics), Marcus Säemann and Chantal Kopecky (both from the Department of Nephrology & Dialysis at the University Department of Internal Medicine III) have demonstrated in a study involving over 1,200 patients that the presence of two specific proteins in the good HDL can be associated with a poorer prognosis in diabetic patients who require dialysis. The study has just been published in the Clinical Journal of the American Society of Nephrology.
At an annual physical several years before I had the stroke, the LPN at my PCP’s office measured my BP and discovered it was a bit high. I don’t remember the exact number, but it wasn’t shockingly high; all that was a surprise was that my BP had been on the low side (100/70 or so) my whole adult life.
The LPN lectured me about the stroke risk associated with high BP, but I opted for a low-sodium diet rather than a pill. I have always been against using drugs to fix a problem if some other way is available. Reasons? Side effects – known and unknown. Who hasn’t taken some drug for a short term that resulted in an unpleasant side effect the doctor swore was unrelated to the medication?
When I was in my 30’s, I was diagnosed with arthritis in my sacro-iliac joint; it was a problem to me because the pain interfered with my sleep. My PCP (who didn’t last long) prescribed an NSAID (nonsteroidal anti-inflammatory) for 6 weeks. In the course of treatment, I had a horrendously heavy menstral flow.
“Not possible [that it was caused by the Naproxen]," my doc said, “because it contains no steroids …"
Co-incidence that it happened while taking the drug? Or maybe it hadn’t been tested in 35-year-old female patients? How many would have been in that test group?
If it tastes good, it must be bad for you, right? Of course, anything eaten in excess can add weight (have you heard that dinner plates today hold 25% more food than they did 15 years ago?), including peaches, pecans, or pumpernickel.
But here's the good news: Chocolate itself does not make you fat. In fact, research shows that people who eat chocolate tend to have a lower body mass index than people who don’t.
Many of us tend to think of chocolate as junk food, but that is a misconception. Chocolate comes from fruit; it is made from the seed of the fruit of the cocoa tree – so you could say it grows on trees. Most of the fat in the American diet comes from animal products. Also, cocoa beans themselves are quite bitter, and chocolate contains no sugar until we add it. The Olmecs, Mayans, and Aztecs drank chocolate, not with sugar, but with chilis. Most of the sugar we consume in the U.S. comes from sugary beverages, baked goods, and frozen desserts such as ice cream.
Out of all the organs in the human body we know the least about the brain. Every other organ in the body and we know to the cellular, if not the molecular level.
But the brain... You've heard the clichés, I'm sure; given the interdependence of neurons, the human brain is the most complex structure in the known galaxy, including the galaxy itself. The estimate of planets in the galaxy is upwards of 1 trillion. The most conservative estimate of the number of synaptic connections in the human brain is 1000 trillion!
"But," you may think, "I can't even figure out which socks match my shoes." That maybe true, but remember: while you're trying to figure that out, your brain is keeping every one of the trillions of cells in your body in relative harmony.
We need to start looking at the brain. Yes, its squishy, yes its bloody, yes it is huge and pulsates in aliens from Mars. But we need to get over this "Its too weird!" posture, or we, its owner, can't really understand the darned thing.
Here's a place to start... Below is a video of the surgery for a subdural hematoma. This type of stroke is the least common (about 7%), but the most deadly.
Warning: this video is graphic. Frankly, I had a hard time sitting through it. I would suggest watching just one portion – a few seconds, from 1:32 to 1:39. This is the good part, where the surgeon rids the brain of this sort of cap of blood that has accumulated between the skull and the brain. If this sort of surgery is not done, the brain will continue to compress, furthering damage.
Well, Bob started his new stroke rehab program at the fitness center, and, I must say, it is totally different than any therapy he's done before. Usually, at rehab, the PT's would just push and push Bob to get out of that chair, stand up and walk, usually at the first session. And when Bob couldn't keep up to their expectations, well, he was booted out the door...
This trainer is exactly opposite and is taking things slowly. Starting with Bob's neck and what the PT calls "unkinking the garden hose":
The trainer also says that Bob is not ready to stand up and walk yet. He needs to work on strengthening all the individual muscles needed for the job first:
Like me, my dad had a stroke that limits his ability to walk. Like me, he resisted buying a mobility scooter but, once he bought one, he loved it.
Dad also loves my dog – one of the few creatures on the planet with whom he can still communicate. Most of all, he loves lakes and waterfowl. My goal, since relocating him to Los Angeles after his stroke, has been to put him in the presence of these treasures as often as possible.
The challenge? How do I transport two scooters, two disabled people, and an elderly golden retriever in one car? Scooter trailers hold only one scooter, and anything bigger would be a hassle.
My solution was to have a Bruno Curbsider installed in my SUV. Dad operates the remote control to hoist the scooters while I keep them from hitting the car bumper (a concession in the position of the hoist that had to be made to accommodate the size difference in the two scooters). When I’m on my own, I can perform the entire operation single-handed – literally.
Once the scooters are loaded, I board the dog and stow the pet stairs she needs to climb in and out of the car, allowing just enough room for her to ride with her head out the window or to curl up and rest after our long stroll by the lake.
Clinical patient dignity is not equal to real patient dignity, trust me!
We talk about patient dignity and compassion all the time but aren’t they simply fashionable new buzz words?
In the back of my mind I’m thinking that the phrase ‘patient or person-centred’ feels like a term we often use but don’t actually fully embrace.
Being patient-centred is‘where the rules and procedures of the health care fit the person, rather than making the person fit the rules and procedures of the health service’ according to The Royal College of Nursing.
We also talk about treating ‘the whole patient’. The phrase sounds nice doesn’t it? So does that mean we treat the whole patient by understanding that patients’ former life, interests, motivations, family AND FRIEND dynamics, before they got ill? If it is then great but this was often not the case with me or other patients..
Have no idea what that is? It's my high cholesterol count. Not all cholesterol is bad. Your liver produces it and it has a job to do. I mean everything in life has a purpose and cholesterol is no different. It makes Vitamin D to prevent Rickets, help digest your food, and it produces hormones. Sounds like a good thing, doesn't it? Your body needs the HDL and LDL to do its job.
But like everything in life, too much of a good thing is bad for you. Too high and it leads to trouble in you arteries. I have high cholesterol. It led to my heart attack in 2006.
Meat products are to blame, usually, for high LDL (bad) cholesterol. Sometimes as with me, it's a genetic make up. My German half not my Japanese half. No matter what cholesterol lowering drugs they put me on, my number of total cholesterol is over 250. I'm on two now too. The American Heart Association recommends a number of 100 or lower if you've had a heart attack or stroke. So I basically out of luck, if high cholesterol is listed as a fixable risk factor.
Over 80% of my food consumption is plant based now. Think 1/4 of a plate in meat, and the other 3/4 vegetables, but still my number is high. My liver, where cholesterol is produced in the body, just generates too much.
So I did some research this past month on how the liver produces cholesterol. Things like sugar and carbohydrates create cholesterol in the liver. This kind of puzzled me because I'm a diabetic and haven't eaten much sugar in years. I use whole grain wheat, rice, and soy flours to bake with so where was my body getting all these carbohydrates from to produce all this cholesterol.
