University of California Los Angeles Heart Disease Discussion

This week we covered the cardiovascular system. Heart disease is the leading cause of death in the US and many other countries. Atherosclerosis is a major problem that can lead to multiple types of cardiovascular diseases. We discussed that the accumulation of cholesterol (LDLs) under the vascular endothelial layer recruits macrophages that will fill themselves with cholesterol-loaded LDLs (a.k.a. foam cells), but then end up accumulating locally themselves and promoting plaque formation. Naturally, there has been much interest in the role of cholesterol in the development of atherosclerosis and consequent cardiovascular diseases. The notion of ‘good’ vs ‘bad’ cholesterol may simplify the context for the general public, but is technically incorrect because cholesterol is just cholesterol. Instead, the cholesterol transport mechanisms (e.g. lipoproteins) are important in understanding the pathophysiology of atherosclerosis.

That said, the contribution of diet in the development and progression of atherosclerosis in unclear. Please share your thoughts on the effect of diet on the etiology and progression of atherosclerosis. Please avoid personal experiences, anecdotes and speculations that are not based on “rigorous scientific studies”.

Some things to consider when analyzing papers: focus on the what they mean by increased nutrient uptake (e.g. how much more than average, what form of cholesterol, what tpye of lipid, etc), other confounding effects (e.g. genetics, pre-existing conditions, etc), and the degree of altered CVD risk (e.g. statistically significant but modest, etc). Lastly, does the paper provide correlation or cause-effect relationship between diet and CVD?