In order to remedy the cholesterol plaque problem, we have to start with what is causing it. It is not cholesterol itself - a waxy, non-sticky substance, which normally won't deposit on blood vessel walls, be it "good" (HDL) or "bad" (LDL). What makes things change is

either inflammation of the inner blood vessel lining,
or oxidation of the cholesterol by free radicals,
or - most often - both.

This is why CRP (C-reactive protein, part of body's inflammatory response) blood level has proven to be much better indicator of your cardiovascular risk than cholesterol level itself.

What causes the inflammation? It can have multiple origins. One of them is bacterial - from opportunistic bacteria migrating from either intestinal tract, or your mouth, into the bloodstream, or silent bugs like Chlamydia or Herpes simplex that can wait long time in the bloodstream for the moment of weakness to over-multiply and start inflicting damage.

Also, inflammation can have dietary origins, for instance, high intake of foods of animal origin, or polyunsaturated oils high in Omega-6 fatty acids (and no Omega-3), like safflower, sunflower and corn. They stimulate production of pro-inflammatory prostaglandins and leukotrienes, which also promote blood platelet aggregation (stickiness). Junk- and over-processed foods, often containing chemical additives that create free radicals, while at the same time low on antioxidants and nutrients in general, also have pro-inflammatory effect.

Free radicals, produced either by toxic metal ions (mercury, lead, cadmium, iron, copper), by inhaled or ingested activated foreign chemicals, or in the process of cellular respiration, inflict damage to the inner vessel lining, endothelium, which also has pro-inflammatory effect. Any inflammation of the inner vessel lining inflicts further tissue damage and prompts the body to patch it with sticky repair proteins - fibrinogen and apo(a) - which also bind cholesterol, loose calcium from the bloodstream, and anything else that gets caught in.

Free radicals also oxidize cholesterol. Effectively, cholesterol plays the role of an antioxidant, absorbing and neutralizing charged particles. It is possible that the body produces more cholesterol for that purpose when the level of antioxidants - nutrients and enzymes - is low (in other words, as a part of its response to the increased levels of oxidative damage). However, this comes at a price.

Oxidized cholesterol molecules become sticky, attracted to blood vessel walls, thus more actively involved in forming deposits narrowing the arterial walls.

Only when these conditions exist, will cholesterol end up depositing on the blood vessel walls. Only then will elevated cholesterol levels become significant risk factor for developing cardiovascular disease, and suffering the consequences.

In all likelihood, free radical damage is the key factor linking cholesterol and cardiovascular disease. It calls for a few more words on where free radicals come from, and how the body deals with them.

Free radicals are charged molecules - or molecular fragments - which makes them highly reactive and damaging to body tissues. There are three main sources of free radicals:

• One is body's own energy production inside every cell (cellular aerobic metabolism, i.e. Krebs cycle, β-oxidation and oxidative phosphorylation).

• The other are chemical contaminants like chlorine, pesticides, food additives, drugs, fine particulate chemical coatings, gaseous air pollution (sulfur dioxide), heavy metals (mercury, lead), and many others.

• And the last one is ionizing radiation, including the high-ultraviolet portion of sunshine (non-ionizing radiation can also enchance cellular production of radicals through different mechanism). While particulate sources of free radicals either arrive activated into the body, or become activated during the metabolic/detox process, radiation activates tissue molecules by disturbing their electron structure with the flux of energy (ever wondered why plant leafs are so rich in chlorophyll, a potent antioxidant?).

By loosing single electron, an activated molecule or atom splits into two free radicals: one is now charged remaining particle, and the other is active oxygen (superoxide anion), potentially highly destructive form of oxygen formed when that lost electron enters and destabilizes the neighboring oxygen molecule.

Free radicals peroxide (burn) polyunsaturated fatty acids (PUFA) in the cellular membranes, altering their structure and damaging cellular function (just as it occurs when trans-fatty acids sneak in and replace these PUFAs in the cell membrane). Inside the cell, they can cause cross-linking (fusion) of proteins, interfering with enzyme activity, or damaging the DNA. These attacks turn on cell's inflammatory response, which only does more damage to the cell.

Free radicals would do a great deal of damage to the body

if it wouldn't be for the suppressing action of antioxidants.

They inactivate free radicals by reducing them to harmless compounds. In the process, most antioxidants are also destroyed; hence good body protection requires constant intake of antioxidant nutrients.

Antioxidant nutrients come either as ready-to-use antioxidants - such are some vitamins (C, A , E), number of phytochemicals (curcumin, chlorophyll, carotenoids, flavonoids, hesperdin, rutin, quercetin, anthocianidins, and many others), and some amino acids (cysteine, methionine) - or as the components of major body-synthesized antioxidant enzymes, superoxide dismutase (SOD), and glutathione (which the body synthesizes from amino acids glycine, glutamic acid and cysteine, and which comes in peroxidase, reductase and transferase "flavors").

Antioxidant enzymes require minerals for functioning: selenium is needed for glutathione peroxidase, while zinc, manganese and copper are needed for the SOD.

All these antioxidants - and others - are needed to protect body cells - including blood vessel cells - from the damaging effects of free radicals. They have different roles - glutathione peroxidase, as well as fat soluble vitamins E and A protect cell membranes from lipid peroxidation, while vitamin C (water soluble), high-sulphur amino acids methionine and cysteine, as well as ceruloplasmin (requires copper) are protecting body's aqueous mediums, including blood. Inside the cell, it is the SOD providing primary defense against free radicals, by dismantling activated oxygen.

It is the SOD antioxidant enzymes that form the first line of defense against cellular damage by free radicals. This is not to say that the second defense line - vitamins C, A (beta-carotene), E, glutathione, methionine, cysteine and ceruloplasmin - are not important. To the contrary. All these major antioxidants work in a complex synergistic relationship. They have different roles and, at the same time, they often reinforce or protect each other; we need them all for the effective protection from free radicals.

This explains why having diabetes

increases your chances of suffering cardiovascular complications threefold.

Diabetes weakens blood vessel tissue by altering its cells' metabolism with excessive glucose. This, among other things, makes it more vulnerable to free radical damage. In addition, diabetes is usually accompanied by low SOD level, as well as low vitamin C, A and E levels. Increased urinary excretion worsens mineral deficiencies and, on top of that, compromised immune function makes diabetes sufferers more susceptible to bacterial infections in general, and in particular to infections of the blood vessel's inner lining.

In short,

the root of cholesterol-laden plaques (atherosclerosis)
is damage to blood vessel lining by free radicals,
toxins and/or pathogens,

resulting from body's inefficient free radical, detox and immune protection. And the main reason for it are usually nutritional deficiencies and imbalances.

Consequently, by far the most important factor in minimizing your risk of cardiovascular disease is a balanced, nutrient-rich diet, and an overall healthy lifestyle, combined with minimizing your free radical and toxic exposure. This wall of protection can be enhanced with appropriate supplementation, as well as with natural substances safely lowering cholesterol levels.

This leads us to alternatives to statin drugs.

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