Atherosclerosis and Hypoglycemia

Some notes from

Hypoglycemia and Atherosclerosis by Jurriaan Plesman —> Page 6

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1) In atherosclerosis[1],  80% of plasma cholesterol originates from synthesis by the liver and only 20% comes from lipids in the diet.[2] 

2) The body synthesizes cholesterol from acetyl-CoA[3] a product of glucose, amino acids, or fatty acids metabolism.

high blood cholesterol can also be produced as a result of an inherited condition known as familial hypercholesterolemia[4].

3) The cells in the endothelium[5] of blood vessels possess receptors for LDL-cholesterol, but not for HDL-cholesterol. Hence, LDL- cholesterol alone plays a role in atheroma formation.

4) One theory has it that people with hypercholesterolaemia have livers with a low number of LDL receptors or dysfunctional receptors, so that they are less able to remove LDL from the blood.

5) The good news from a treatment point of view is that LDL Cholesterol has to be oxidized (ie., react with oxygen) before they can attach to the lining of the endothelium.  This explains why high cholesterol levels alone is not sufficient to produce atherosclerosis.

The oxidation of saturated fats is speeded up by high iron in the blood. Red meat consumption is a major source of that iron.

Oxidized LDL[6] will delay any endothelial wound healing.

Hence, if the blood stream has high concentrations of antioxidants, such as vitamin C, vitamin E, zinc, selenium, beta- carotene, vitamin A etc[7]. they will be able to destroy any pre-formed oxidized fats before they combine with LDL to damage blood vessels walls.

Ascorbate stimulates conversion of cholesterol to bile, which is then excreted. Thus it helps to reduce cholesterol levels. It protects against cancer of the colon and strengthens the immune system among the many other benefits. It even helps to prevent cataracts[8] of the eye. It would seem that the adverse effects of an occasional sugar-binge could be lessened by taking extra vitamin C.

 Myocardial ischaemia[9] (heart muscle) is associated with increased concentrations of blood lactic acid[10] produced by anaerobic respiration of the ischaemic tissue. This condition causes pain as in angina pectoris[11] and intermittent claudication[12].

Hypoglycemia & Ischemia: It is suggested that the effect of sucrose in producing hyperinsulinism may be more relevant to its possible role in the aetiology of ischaemic heart disease than its effect on blood lipids. It is further suggested that only some individuals are susceptible to the development of ischaemic heart disease by dietary sucrose, and that these may be identified as those that show ‘sucrose-induced hyperinsulinism’. PMC2466139 

Glucose is very readily oxidized, hence a major factor in the development of atherosclerosis. When table sugar is heated in the presence of oxygen it turns brown. This is oxidation of sugar and explains in simple terms the Maillard reaction[13]. It is possible that the age-related changes in collagen are partially mediated through the Maillard reaction; it has been suggested that a similar, if not identical, reaction is involved in certain neurodegenerative diseases—e.g., Alzheimer’s, Creutzfeldt-Jakob[14] and Parkinson’s[15] diseases. See its connection in Alzheimer’s Disease[16] etc

What essentially happens is that people with high levels of blood sugar - as in diabetes and reactive hypoglycemia - produce superoxide radicals[17] and hydrogen peroxide in the Maillard reaction. This is bound to happen with diets that are high in sugar and proteins. Superoxides and hydrogen peroxides[18] attack the unsaturated fatty acids in membrane cells of arteries. The body can protect itself by an enzyme, called superoxide dismutase (SOD)[19], which converts superoxide to hydrogen peroxide.

The addition of a glucose molecule to protein is technically called glycosylation[20]. Thus, oxidized glucose is a free radical[21] generator. The most exposed cells are endothelial cells lining blood vessels in atherosclerosis. Glucose-induced free radicals give rise to cross-linking of proteins, deactivating some enzymes and stiffening lung, heart muscles and arteries, usually seen as part of the process of ageing.

Diabetics and hypoglycemics - and pre-diabetic conditions - are therefore particularly vulnerable to the development of atherosclerosis.  

See Hypoglycemia and Atherosclerosis by Jurriaan Plesman —> Page 6


[1]Atherosclerosis:  a disease of the arteries characterized by the deposition of plaques of fatty material on their inner walls.

[2] Florence TM, Setright RT (1994), The handbook of preventive medicine, Kingsclear Books, Crows Nest Australia, 140

[3] Acetyl coenzyme A or acetyl-CoA is an important molecule in metabolism, used in many biochemical reactions. Its main function is to convey the carbon atoms within the acetyl group to the citric acid cycle to be oxidized for energy production.

[4] Familial hypercholesterolemia is an inherited condition that causes high levels of LDL (low density lipoprotein) cholesterol levels beginning at birth, and heart attacks at an early age. Cholesterol is a fat-like substance that is found in the cells of the body. Cholesterol is also found in some foods. The body needs some cholesterol to work properly and uses cholesterol to make hormones, vitamin D, and substances that help with food digestion. However, if too much cholesterol is present in the blood stream, it builds up in the wall of the arteries and increases the risk of heart disease. Source

[5]Endothelium: the tissue that forms a single layer of cells lining various organs and cavities of the body, especially the blood vessels, heart, and lymphatic vessels. It is formed from the embryonic mesoderm..

[6] Oxidized LDL cholesterol - LDL cholesterol that has been bombarded by free radicals; it is thought to cause atherosclerosis

[7] See  Rich Sources of Nutrients

[8] a medical condition in which the lens of the eye becomes progressively opaque, resulting in blurred vision

[9] Myocardial ischemia occurs when blood flow to your heart muscle is decreased by a partial or complete blockage of your heart's arteries (coronary arteries).

[10] Lactic Acid: a colorless syrupy organic acid formed in sour milk and produced in the muscle tissues during strenuous exercise

[11]Angina Pectoris: 1) a condition marked by severe pain in the chest, often also spreading to the shoulders, arms, and neck, caused by an inadequate blood supply to the heart.. 2) any of a number of disorders in which there is an intense localized pain.: "Ludwig's angina".

[12] Intermittent Claudication: a condition in which cramping pain in the leg is induced by exercise, typically caused by obstruction of the arteries. Herbs2000

[13]Maillard Reaction: A nonenzymatic heat-activated chemical reaction between sugars (especially ribose) and amino acids, which occurs in foods as they form  glycosylamines and Amadori compounds. The Maillard reaction is responsible for “browning” of baked or cooked foods (e.g., bread crusts and barbecued steak), which are mutagenic by the Ames assay.

[14] Creutzfeldt-Jakob disease (CJD) is a transmissible, rapidly progressing, neurodegenerative disorder called a spongiform degeneration related to "mad cow disease."

[15] Some association between PD and diabetes. See here

[16] http://www.hypoglycemia.asn.au/2011/research-evidence-for-hypoglycemia/#ALZHEIMERS

[17] oxidized LDL cholesterol - LDL cholesterol that has been bombarded by free radicals; it is thought to cause atherosclerosis

[18] Hydrogen peroxide a compound containing two oxygen atoms bonded together in its molecule or as the anion O22−.. Anion Is a negatively charged ion, i.e., one that would be attracted to the anode in electrolysis.

[19] See Rich Sources of Nutrients

[20] Glycosylation: (Biochemistry) the process by which sugars are chemically attached to proteins to form glycoproteins

[21] Free Radical: an uncharged molecule (typically highly reactive and short-lived) having an unpaired valence electron.