Paul Saladino· MD
if you eat a high carbohydrate know your VLDL your triglyceride concentration can go four or five times as high the only source of LDL is the LDL and the LDL concentration remains the same which means that 80 or 90 or 95 percent between LDL that turns to LDL is just immediately removed from the circulation along with oxidized LDL again you can stick high concentrations of oxidized LDL in test tubes expose them to endothelium and it appears to cause damage but the total amount of oxidized LDL you have any blood streamers it's absolutely my new it's almost unmeasurable small because the body just takes it away so it's a kind of explanation to kind of continue to make the LDL hypothesis continue to live on but it doesn't work for me maybe there is some damage from oxidized LDL but compared to say smoking a cigarette it's like I don't know what it's like I could use analogous but it's it's just that's all this tiniest thing versus huge gigantic thing it's grasping at the tiniest straw to maintain I go this is in my opinion so it's quite interesting that you mentioned this that endothelial cells in the liver have specific receptors for oxidized LDL that take it up out of the circulation probably recycle it and get rid of it I just want to back up for people listening and again I would refer people to previous podcasts I've done where we talked about the cholesterol transport system in the human body but in a basic high level and correct me if I get any of this wrong in your opinion when we eat fat it's usually in the form of dietary triglycerides that could taken up in the gut by insi and they form particles called chylomicrons which are marked by a specific AP lipoprotein b48 those travel in the lymph they go to the liver and they kind of get recycled into VLDL very low-density lipoprotein which is a repackaging of both cholesterol and triglycerides yes right there's only one thing wrong with that okay hello kind of microns travel straight from the big yuck through the body called the thoracic duct and straight into the bloodstream right through the lymph yeah and then they end up in the bloodstream and they they shrink down to chylomicron remnants they don't become really else they shortly deliver they sort of got a liver right but but so the I suppose this thing there is that most 95% of the fact that you ingest never goes anywhere near the liver it just goes straight to the cells from the gut and has no impact on the production of the LDL in the liver right it's not associated with it at all so if you eat a high fat meal at your triglyceride IV LDL level will not go up it's funny if you eat a carbohydrate rich meal that that will happen right all right no make sense yes yes perfect thank you for clarifying that for the listeners and so what's interesting about this process is that when we eat fat there are these chylomicrons in the body that are circulating in the book I sort of describe them as buses and they are dropping off precious cargo and as you're saying these chylomicrons are becoming smaller they're becoming remnants because our body is taking up cholesterol and fat from our and then circulating it throughout the body because that's valuable nutrients for our body I think of it as a bus system people get off the bus the bus gets smaller the chylomicron bus goes to the liver the people get off the bus and then those you know that the liver can then repackage passengers from the chylomicron bus or just things it's making in general triglycerides cholesterol into VLDL the LDL is a bus that departs the liver it's very low-density lipoprotein and just like chylomicron was circulating in our blood VLDL circulates in our blood people get off the bus cholesterol triglycerides get off the bus the bus becomes smaller it becomes intermediate density lipoprotein become smaller and then it becomes low-density lipoprotein as the relative concentrations of triglyceride and cholesterol change in that particle as it drops off precious cargo to our body then it goes back to the liver right do you think that's reasonable yeah I think that's pretty much spot-on so yes the I think the interesting thing possibly within that that people I've written about and trying to explain to people is it's the liver liver can create it's old fast as well from carbohydrate which is really where the fat comes from that goes into the LDL because carbohydrates are all converted to sugars and sugars fructose and glucose primarily fructose especially is turned into fat in the liver in a process called Enuma lipogenesis so it's you know when people say that eating fat raises your LDL I was like well um since fat doesn't it goes nuttin have any effect on vld or LDL just travels