This guest article by Heike Erner covers another factor of metabolic syndrome: lipid metabolism disorders. Metabolic syndrome, also known as the "deadly quartet," is associated with a significantly increased risk of cardiovascular disease as a consequence.
Heike Erner has been a naturopath and holistic nutritionist since 2009, as well as a business graduate specializing in personnel management/coaching. For 8 years, she has focused on nutritional counseling, health coaching, and micronutrient therapy. In addition, she advises and researches for companies in the nutrition sector regarding new, interesting findings in the field of naturopathy and nutritional medicine.
What are the four factors of metabolic syndrome?
Metabolic syndrome consists of the following factors or a simultaneous combination thereof:
- High blood pressure
- Overweight or obesity, with visceral fat playing a particular role in the development of metabolic syndrome
- Diet-related disorders of sugar metabolism such as insulin resistance and type 2 diabetes
- "Bad" blood lipid levels such as, for example, elevated triglyceride and cholesterol levels
What is understood by lipid metabolism disorders?
Lipid metabolism disorders are very common changes associated with elevated blood lipid levels (especially triglycerides – which are neutral fats – and cholesterol). If certain blood lipid levels are permanently elevated, blood lipids are deposited on the arterial walls, leading to arteriosclerosis, a feared complication. This, in turn, is responsible for many secondary diseases, including heart attacks, strokes, and peripheral arterial disease (PAD). Therefore, it is important to have these levels checked repeatedly during visits to your family doctor. There are also genetic predispositions that, regardless of lifestyle, lead to elevated blood lipid levels and are usually only treatable with medication. However, in the context of metabolic syndrome, if not genetically determined, they are often attributable to lifestyle and diet.
Essentially, the following lipid metabolism disorders are distinguished:
- Hypercholesterolemia – here, the LDL cholesterol level is elevated
- Hypertriglyceridemia – here, the level of triglycerides (neutral fats) in the blood is elevated
- Hyperlipidemia – here, both LDL cholesterol levels and triglyceride levels are elevated
- Dyslipoproteinemia – this shows a reduction in HDL cholesterol, elevated triglyceride levels, and small, dense LDL cholesterol particles
What do lipid metabolism disorders have to do with metabolic syndrome?
In most cases, metabolic syndrome is associated with overnutrition and consists of four factors (obesity, impaired blood sugar levels, lipid metabolism disorders, and high blood pressure). All four factors play together a bit like a "spooky" orchestra, i.e., a single factor promotes the development of further factors. Especially with an increased supply of sugar and saturated fats in the diet, the body can no longer sufficiently utilize blood lipids and can no longer break down excess fat. This not only leads to being overweight but consequently also to an increased concentration of cholesterol, neutral fats (triglycerides), and protein-bound fats (lipoproteins) in the blood.
What is cholesterol, and why does it play a special role?
Cholesterol plays a special role in lipid metabolism and should therefore be of particular importance in this article. Cholesterol is a fat-like natural substance found in all animal cells. First and foremost, cholesterol is indispensable for the human body. It is required, among other things, for the formation of certain hormones and is an essential building block for our cells. More on that later. Only an excess of cholesterol can increase the risk of cardiovascular disease.
Thus, cholesterol is initially needed by every cell in the human organism. The body produces the majority of its requirements in the liver itself. You read that correctly! Only a small portion is absorbed through food. The cholesterol produced by the liver is transported via the blood to the cells of all organs and tissues, where it is further processed. Excess cholesterol also returns to the liver via the blood. Greatly simplified, you can think of it as there being two taxis that transport the cholesterol: one taxi travels to the cells (LDL) and one taxi carries the excess cholesterol back to the liver (HDL). This special transport system is needed because cholesterol is not soluble in water, and therefore not in the blood either. For this reason, cholesterol is packed in the liver together with proteins, lipids, and other components. These packages can then be transported in the blood.
When is cholesterol dangerous?
As almost everywhere, the rule here is "the dose makes the poison." If cholesterol is essential for life on the one hand, why can it become a problem in excess? Let's stick with the simplified taxi analogy. Imagine the taxis that drive cholesterol to the cells suddenly get stuck in a traffic jam. The cells are saturated with cholesterol – no more taxis are needed – and there are also too few taxis to take the excess cholesterol back to the liver. Breakdown and removal no longer work, and as a result, excess cholesterol can now be deposited in the vessel walls, narrowing them and restricting blood flow. The notorious consequences are arteriosclerosis and high blood pressure, with their secondary diseases such as heart attacks and strokes.
The ratio of LDL to HDL plays a significant role here:
As already described, LDL is responsible for transporting the lipid molecule from the liver to the organs. An excess can, as mentioned above, lead to the notorious deposits on the vessel walls. HDL, on the other hand, transports excess cholesterol back to the liver, where it can be broken down. A low LDL level therefore has a positive influence on our vessels. Recent findings show that the earlier conclusion that the risk of arteriosclerosis constantly decreases with rising HDL is no longer tenable. Both values should be in the right ratio to each other, and the total cholesterol should not be too high.
"Good" and "bad" cholesterol are therefore misleading terms, as both lipoproteins are needed by the organism—just in the right amounts.
What can contribute to elevated cholesterol levels?
Briefly and concisely – essentially 3 factors:
- Lack of exercise
- Stress
- An unbalanced, nutrient-poor diet
The influences that play a role in metabolic syndrome remain the same for almost all four factors. And just because a large part of the cholesterol is produced by the liver itself, that does not mean that diet no longer plays a significant role. An unbalanced diet with many animal fats, too much sugar, many industrially processed foods (especially fast food), and few vital substances, essential fatty acids, and vitamins is stress for every body. And stress is an alarm signal for the body.
Our organism assumes, as in primeval times, an emergency situation and expects to be brought down by a saber-toothed tiger at any moment. This also explains why the body produces more cholesterol during permanent stress, as it anticipates an attack and therefore cell death. Ergo, it prophylactically provides the building material for the cells that are to be newly built. The problem is, there are no more saber-toothed tigers today and no cell death either, just a traffic jam with the LDL "taxis."
Why cholesterol is a vital substance and what our body needs it for
A very decisive question is this: If cholesterol were only bad, why would our highly intelligent organism produce it voluntarily at all? As mentioned, cholesterol is required as an essential component and "building material" for all our cell walls. Cholesterol serves to stabilize every cell membrane. But that is by far not the only thing for which the body produces and needs cholesterol.
- Cholesterol is indispensable in the construction of sex hormones – this includes, for example, estrogens, gestagens, and androgens.
- Cholesterol is also needed for the vital synthesis of vitamin D3.
- Bile acids are formed from cholesterol. These, in turn, are a component of bile fluid, which is indispensable for the body to break down fats.
Cholesterol is therefore by no means something bad. The principle that often applies is: not too much of a good thing! It should be expressly emphasized that there are pathological, hereditary metabolic disorders and other diseases of the liver and thyroid (hypothyroidism) that are not linked to an unhealthy lifestyle and can also lead to an increase in cholesterol levels. Therefore, the cause of elevated cholesterol levels should always be assessed in the overall context. If you are unsure, please be sure to ask your family doctor.
What can you do yourself to lower blood lipid levels?
- Nutrition: Eat a balanced, nutrient-rich diet and eat several portions of fresh fruit and vegetables a day. Vitamins are catalysts of metabolism and are particularly numerous in fresh plant-based foods such as fruits and vegetables. Ensure an adequate intake of vital omega-3 fatty acids, which can be found, for example, in fatty fish and linseed oil. A high intake of dietary fiber can directly and indirectly help lower blood cholesterol levels.
- Exercise: Ensure you get enough exercise; do gentle endurance sports regularly, at least 2–3 times a week.
- Reduce stress: Ensure you have a balance in your everyday life and perform relaxing exercises regularly. This can be meditation, yoga, mindfulness exercises, or simply a walk in the forest. Pay conscious attention to your breathing. Several times a day, for several minutes, breathe deeply and consciously into your abdomen – in and out.
- Medication: There are cases where it is not possible without cholesterol-lowering medication (statins) – especially hereditary lipid metabolism disorders or pre-existing conditions. However, you can still follow the measures mentioned above in parallel in this case.
Conclusion
Metabolic syndrome consists of four factors: high blood pressure, obesity (especially on the torso), diet-related sugar metabolism disorders (e.g., insulin resistance or type 2 diabetes mellitus), and lipid metabolism disorders (elevated blood lipid levels (triglyceride and cholesterol levels). For lipid metabolism disorders, the right diet, exercise, stress relief, and, depending on the case, the intake of cholesterol-lowering medication can help lower blood lipid levels.
Mini-series in the online health and nutrition magazine with nutritionist Heike Erner
Together with Ms. Erner, Medicom will provide simple health and nutrition advice in a mini-series to support the optimization of individual factors. This allows everyone to adopt tips and advice for themselves individually. This does not replace a visit to the doctor, but serves as motivation to find ways to begin a healthy lifestyle.
For each of the four factors of metabolic syndrome (obesity, disorders of sugar metabolism such as type 2 diabetes mellitus, and lipid metabolism disorders such as elevated cholesterol levels), you will find an article with explanations and health-promoting advice. We are convinced that everyone should and can do something actively for their health. Taking active responsibility for your own health means self-love and self-care, and it pays off twice in the end.
• Did you miss the interview with Heike Erner "Metabolic syndrome is treacherous"? You can read it here.
• Do you want to know how healthy eating works simply? Then listen to the podcast interview: Managing cholesterol with Prof. Dr. med. Michaela Döll.
