Reversing Heart Disease: CardioMetabolic Health

Cardiovascular Disease: Understanding the Foundation

According to the World Health Organization. Cardiovascular diseases (CVDs) stand as the leading cause of death globally, claiming approximately 17.9 million lives each year (1). More than half of U.S. adults don’t know heart disease is the leading cause of death according to a 2023 Harris Poll survey conducted on behalf of the American Heart Association (10).

In my membership model, I prioritize addressing metabolic health as a foundational aspect of comprehensive system-based care in order to prevent and reverse heart disease and metabolic disorders.

Biochemical Foundations: Energy and Mitochondria

Understanding the intricacies of biochemistry is essential before delving into strategies for preventing or reversing cardiovascular disease. The body primarily derives energy from three sources: carbohydrates, fats, and proteins, with mitochondria serving as the powerhouses of cells responsible for harnessing this chemical energy. Healthy mitochondria are crucial for generating sustainable energy. How a person can utilize and burn these 3 forms of energy will either make them metabolically healthy or efficient or metabolically unhealthy or inefficient.

Cholesterol and Fats: Clarifying Misconceptions

Before proceeding further, it’s crucial to establish distinctions between cholesterol and fats. Fats encompass mono-unsaturated, poly-unsaturated, saturated, and trans fats, present in the form of triglycerides composed of three fatty acids. Triglycerides are typically stored in adipocytes (fat cells) for future energy production but may overwhelm the liver if excessively accumulated.
Conversely, cholesterol, often misconceived as detrimental, serves as a vital molecule in the body. It acts as a precursor for synthesizing vitamin D, bile acids, and steroid hormones (2) while also stabilizing cell membranes! Due to its lipid solubility, cholesterol requires transportation via lipoproteins (8).
How we balance the cholesterol in our body with excessive carbohydrates and triglycerides is what contributes to the harmful effects of cardiovascular disease. This is crucial in understanding how to start reversing heart disease and metabolic disorders.

Carbohydrates and Cardiovascular Risk

Research spanning over four decades has established a link between excessive carbohydrate intake and heightened production of very low-density lipoprotein (VLDL) particles by the liver (4,5). These VLDL particles eventually metabolize into intermediate-density lipoproteins (IDL) and low-density lipoproteins (LDL) (6). LDL, known as low density lipo-protein, by itself isn’t a bad molecule rather it is the mode by which cholesterol is transported. What is harmful is when the concentration of our LDL particles increases. Atherosclerosis, the major cause of Cardiovascular disease, is triggered by the accumulation of LDL particles in the arterial wall (7). Learn how to prevent or reverse cardiovascular disease before it’s too late.

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  1. Coronado, F, Melvin, SC. Global Responses to Prevent, Manage, and Control Cardiovascular Diseaes. 2022 Dec 8, Vol 19.https://doi.org/10.5888/pcd19.220347
  2. Hu J, Zhang Z, Shen WJ, Azhar S. Cellular cholesterol delivery, intracellular processing and utilization for biosynthesis of steroid hormones. Nutr Metab (Lond). 2010 Jun 1;7:47. doi: 10.1186/1743-7075-7-47. PMID: 20515451; PMCID: PMC2890697.
  3. Soliman GA. Dietary Cholesterol and the Lack of Evidence in Cardiovascular Disease. Nutrients. 2018 Jun 16;10(6):780. doi: 10.3390/nu10060780. PMID: 29914176; PMCID: PMC6024687.
  4. Witztum JL, Schonfeld G. Carbohydrate diet-induced changes in very low density lipoprotein composition and structure. Diabetes. 1978 Dec;27(12):1215-29. doi: 10.2337/diab.27.12.1215. PMID: 214369.
  5. Parks, Elizabeth. Effect of Dietary Carbohydrate on Triglyceride Metabolism in Humans, The Journal of Nutrition, Volume 131, Issue 10, 2001, Pages 2772S-2774S, ISSN 0022-3166, https://doi.org/10.1093/jn/131.10.2772S.
  6. Feingold KR. Introduction to Lipids and Lipoproteins. [Updated 2024 Jan 14]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK305896/
  7. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002;105:1135–1143.
  8. Feingold KR. Introduction to Lipids and Lipoproteins. 2024 Jan 14. In: Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, de Herder WW, Dhatariya K, Dungan K, Hofland J, Kalra S, Kaltsas G, Kapoor N, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, Levy M, McGee EA, McLachlan R, New M, Purnell J, Sahay R, Shah AS, Singer F, Sperling MA, Stratakis CA, Trence DL, Wilson DP, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000–. PMID: 26247089.
  9. Feingold KR. Introduction to Lipids and Lipoproteins. [Updated 2024 Jan 14]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK305896/
  10. AHA. Published: January 24, 2024. https://newsroom.heart.org/news/more-than-half-of-u-s-adults-dont-know-heart-disease-is-leading-cause-of-death-despite-100-year-reign

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