The 1 Easy Steps to Atherosclerosis:
1) Become chronically inflamed
Congrats!! You are now on your way to getting all the great benefits that atherosclerosis provides such as the heart attack, chronic heart disease, and much much more!!!
Chronic inflammation is the catalyst for everything that happens afterward that leads up to atherosclerosis.
So first let's look at why we become inflamed....
Inflammation is the bodies immune response to internal and external stressors. If you get a cut the area around the damage will inflame which says "Hey we need help over here!" and this allows the healing process to begin. If inflammation didn't exist then that cut would stay wide open and your body would go about its normal business. That would be pretty bad and so we must be able to become inflamed when necessary.
But now image that you are constantly getting small cuts all over your body all day, everyday of the week... apart from being a really crummy week and a lot of pain your immune system is being taxed beyond what it is comfortable operating at. The body is constantly calling for more help but never seems to have enough.
So what's this got to do with atherosclerosis? Patience, we're getting there... a complex process deserves at least a semi-complex answer.
So now image that all those small cuts are occurring inside your body, in your veins and arteries, all day, everyday... this is what it means to be chronically inflamed, you are not inflamed as much as you would be during an illness and so you have few symptoms at the start, but instead you suffer from a low level of inflammation all the time. So your immune system is constantly sending help to the area of inflammation, trying to return to its homeostatic environment.
What foods cause inflammation you might ask?
Most pro-inflammatory foods are those that either cause an allergic reaction (of any degree), a spike in insulin, contain synthetic trans-fats, or contain high levels of arachidonic acid (omega-6). I'm sure there are others but these are the biggies.
When I say allergic reaction of any degree I mean that you may not even notice the reaction if you are used to eating the food. Dairy protein and gluten are two very common allergens that people are not even aware that they are sensitive to unless they avoid them for an extended period of time. That's why you see people like Robb Wolf advocating the idea to go grains, legumes, and dairy free for a month, see how you feel, and then, if you desire, slowly add them back in and see how you respond.
A spike in insulin occurs whenever we eat protein or carbohydrate, but in the case of inflammation we are really only concerned with foods that cause insulin to rapidly increase. The common measurement for speed of insulin release is the glycemic index, where a solution of pure glucose is given a level of 100 and everything else is based around that.
So what's highly glycemic? Processed carbs (like cereal, bread, pasta), some fruits, and other things... see a listing here.
Synthetic trans-fats, which are by-products of hydrogenated oils, are probably one of the few things that everyone agrees are pretty bad for you. Study after study (see a few below) show that trans-fat decrease HDL and increase inflammation. Do not confuse synthetic trans-fats with natural trans-fats found in meat and diary, such as conjugated linolenic acid, as these fats have been found to have similar effects as saturated fats.
Arachidonic acid, commonly know as omega-6, is pro-inflammatory by its very nature. It is an essential polyunsaturated fat commonly found in vegetable and seed oils, nuts and seeds, grain-fed meats, and high fat processed foods. Even though it is an essential fat the average person is getting far to much omega-6 and not enough omega-3 (which is anti-inflammatory) to counteract the omega-6's effect.
Are you asleep yet?
Next up... Oxidation
Ever see a rusty beat up car and think what a piece of junk? Well that rust is just oxidized ferrous material... and the same thing happens inside your body all the time. Oxidation is the interaction of oxygen with any other material and is very important for our daily function, but once again too much of it can be detrimental to health.
Recall that if you are chronically inflamed help will constantly be coming to the inflammation area to try and heal it. Now who exactly is this help? Well a major one is LDL which shuttle lipid material to the trouble area. But I thought LDL was bad!? Well, no, its actually one of the most important molecules in the body.
Image a world with no cars. It would take a really long time to get anywhere and you'll probably wind up getting mugged, losing something, or just wind up disheveled. This is what would happen to cholesterol, fat, and other lipid materials if it weren't for lipo-proteins (the last L in LDL)
Ok, so the LDL is at the inflammation site doing its thing and all is good (except your chronically inflamed!). But now imagine that on its way to the site in ran into a oxygen free-radical and reacted with it. Now we have an oxidized LDL particle and now we are in trouble. This oxidized particle still goes to the inflammation site but now it burrows itself behind the epithelial tissue, which is the protective tissue in the vessels and is not very think in most vessel locations, and there you have it.... the dreaded plaque buildup and the start of atherosclerosis. The worst part is that this is a positive feed-back loop in that once you have oxidized molecules inflammation increases and vis versa and they keep building on each other.
So how do we reduce these nasty oxidizing agents?
The best way to reduce these agents are to:
1) Eat foods with anti-oxidant nutrients. Common anti-oxidants are vitamin C, vitamin E, vitamin A, selenium, and astaxanthin (found in krill oil). There are lots more, but these are rather well know ones that are easy to get from whole foods.
2) Eat little unsaturated fat. Because the fat is unsaturated (it has one or more double bonds) it is much more prone to react with oxygen and become oxidized (often times before you even consume it). If you do have any have it cold, as heating unsaturated fat (like olive oil) will just about guarantee that the oil becomes oxidized. Do any cooking with saturated fat, my favorite is coconut oil.
3) Consume just enough omega-3 to balance the omega-6. This is similar to number two but deserves special attention because of all the hype the omega's get these days. Ideally you want your ratio of omega-3:omega-6 to be between 1:1 and like 1:5. You really don't want to go higher than 1:1 or lower than 1:5... and if your eating a good (by my definition good means grass-fed beef, free-range chicken, pasture lamb, pastured eggs, coconut oil for cooking, lots of leafy greens) diet and are in good health you should hit this ratio without any supplementation or very little.
4) Avoiding common allergy foods like gluten and dairy protein until you know that you don't have an adverse reaction to it; which is achieved by staying off the stuff for at least a month and then very carefully watching yourself as you add it back in.
5) Stay low carb. If you have an abundance of glucose swimming in your blood your body is going to start building new molecules and that means more reactions and more free-radical bi-products. If instead you eat low carb, less than 100g per day, you are allowing your body to repair what it already has, which means less growth and less chance for bi-product and mutations.
So there you have it... the main cause of atherosclerosis.
Studies:
--Atherosclerosis and Lipoproteins
http://atvb.ahajournals.org/content/22/7/1162.full
--Hypertension and the Pathogenesis of Atherosclerosis
http://hyper.ahajournals.org/content/25/2/155.fullhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC185985/pdf/jcinvest00018-0223.pdf
--Atherosclerosis -- An Inflammatory Disease
--Triggering of inflammatory response by myeloperoxidase-oxidized LDL
--Replacement of dietary saturated fat with trans fat reduces serum paraoxonase activity in healthy men and women
--Consumption of Trans Fatty Acids Is Related to Plasma Biomarkers of Inflammation and Endothelial Dysfunction
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