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1 Lesson Handbook1 WHAT ISCHOLESTEROL? MODULE 11 Lesson HandbookCOPYRIGHT ADAPT YOUR LIFE ACADEMY LESSON 1 Cholesterol is essential for human performs numerous critical roles in the body:Required to build cell membranes and mitochondrial membranes. Major component of myelin a substance that insulates and protects neurons and facilitatesneurotransmission (signals sent between neurons in the brain, central nervous system, and alsomuscle cells). Building block for steroid hormones such as testosterone, estrogen, progesterone, and cortisol. Raw material for the body s internal synthesis of vitamin D. Component of bile salts (which facilitate digestion of dietary fats). Important part of the immune system. Most of the body s cholesterol is made in the liver but almost every cell in the body canmake its own does not cross the blood-brain barrier, so the brain makes its blood cholesterol level fluctuates from day to day and even within a single day; it isnot a fixed, static is not well-known among many is cholesterol and what does it do?

2 Key TakeawaysNotes2 Lesson HandbookCOPYRIGHT ADAPT YOUR LIFE ACADEMY Cholesterol comes from two sources: your diet (the foods you eat), and from your ownbody making it:Where does cholesterol come from?Cholesterol is found only in foods of animal origin; there is no cholesterol in there is no cholesterol in foods that come from plants, plant oils (such as olive oil orcoconut oil) and high-fat plant foods ( , avocado, nuts & seeds) contain no is not the same thing as fat; some very low-fat foods (such as shrimp) arerich in in food contributes very little to the amount of cholesterol in your a diet high in cholesterol-rich foods does not automatically increase your bloodcholesterol a diet with very little or even no cholesterol does not always lower your bloodcholesterol the amount of cholesterol in your diet typically has a small effect on your bloodcholesterol the amount or type of fat in your diet may influence your blood cholesterol blood cholesterol level can change within just a few days of changing your diet.

3 It doesnot take several US dietary guidelines place no restriction on the amount of cholesterol that should beconsumed per dietary cholesterol has little influence on blood cholesterol, those who follow avegetarian or vegan diet do not always have low blood cholesterol CHOLESTEROL:3 Lesson HandbookCOPYRIGHT ADAPT YOUR LIFE ACADEMY LESSON 2 Key TakeawaysThis is the cholesterol your body makes on its own internally--from within. Endogenous means from inside. Synthesis means creation. The cholesterol synthesis process called the mevalonate pathway has important molecules are produced in the same process not just HMG CoA reductase enzyme is the main control point of this process:Things that increase activity of this enzyme will increase cholesterol that decrease activity of this enzyme will decrease cholesterol drugs target this enzyme: they decrease cholesterol synthesis by inhibiting (decreasing)activity of HMG CoA activity of this enzyme also decreases synthesis of the other molecules produced inthe same molecules produced in the mevalonate pathway:Coenzyme Q10 ( CoQ10 or ubiquinone): needed for synthesizing ATP energy in almostevery cell in the A: a component of many metabolic : needed for protein formation and healthy brain & neurological proteins: specialized proteins needed for immune function, cellular signaling, insulinsecretion, vitamin K2 synthesis and CHOLESTEROL.

4 4 Lesson HandbookCOPYRIGHT ADAPT YOUR LIFE ACADEMY Cholesterol excretion/recycling:Cholesterol is recycled in the that is not recycled is eliminated in the liver secretes cholesterol into the biliary fluid (bile).~50% is reabsorbed in the small intestine; the rest is cholesterol is harmful, why does your body reabsorb any?5 Lesson HandbookCOPYRIGHT ADAPT YOUR LIFE ACADEMY Notes6 Lesson HandbookCOPYRIGHT ADAPT YOUR LIFE ACADEMY Cholesterol is not water-soluble, but your blood is mostly water. This means that inorder to travel in your bloodstream, cholesterol needs to be packaged inside specialtransport transport molecules are called lipoproteins:High-density lipoprotein (HDL)Low-density lipoprotein (LDL)Very-low-density lipoprotein (VLDL)Intermediate-density lipoprotein (IDL)The cholesterol inside all of these lipoproteins is the same:There is no such thing as good or bad is cholesterol; it s the same molecule whether it s being transported in an HDL,LDL, VLDL, or IDL nomenclature is misleading: LDL and HDL are not cholesterol they are the particles that transport refers to the cholesterol inside an LDL refers to the cholesterol inside an HDL of it like passengers traveling in cars: the transport particles are the cars.

5 The cholesterolmolecules inside the particles are the particles carry more than just cholesterol:They transport other important molecules that are not water-soluble, such as vitamins A, D, E& K, and triglycerides (an energy/fuel source).How is cholesterol transported in the body?7 Lesson HandbookCOPYRIGHT ADAPT YOUR LIFE ACADEMY LESSON 3 Key TakeawaysThe liver manufactures cholesterol that needs to be delivered to various cellsthroughout your body:As the lipoprotein particles deliver their cargo (cholesterol, fat-soluble nutrients, triglycerides),their density changes, and their names they start out full of cholesterol and triglycerides (fat), they have a low density. (Fat isbuoyant.) So, most particles originating in your liver are low-density lipoproteins, or the LDL particles drop off their cholesterol and triglycerides to various cells, they containless of these buoyant materials, so they become more dense: they go from LDL to IDL (low-density to intermediate-density lipoproteins).

6 IDL particles become small LDL role of triglycerides:If your liver is manufacturing triglycerides, it will package them inside contain fat; fat is buoyant and has a low density, so the more triglycerides aparticle carries, the lower its density will be. (Hence, very-low-density lipoprotein.)Triglycerides made in the liver come from excess dietary VLDLs deliver their triglycerides to cells for fuel or storage, they become smaller andbecome LDL these LDL particles continue delivering more cargo; they become IDL and then small your blood level of triglyceride or small LDL is elevated, it may be a sign you are consumingmore carbohydrate than your body can liver is the central processing site or warehouse for main site of shipping and receiving producing and secreting cholesterol and lipoproteins and taking these back up for reuse/recycling or to be excreted in the feces (via bile).Your liver manufactures most of your body s cholesterol and sends it out inside lipoproteinparticles, but even the particles that carry cholesterol from your food will end their transportjourney at the particles that originate in your liver (manufactured by your body) and theparticles that originate in your intestine (to transport cholesterol from your food) havedifferent fingerprints.

7 These fingerprints are called from the intestine (dietary origin) carry an apolipoprotein B-48 (apoB-48) from the liver carry an apolipoprotein B-100 (apoB-100) HandbookCOPYRIGHT ADAPT YOUR LIFE ACADEMY How cholesterol gets back to the liver:This process is called reverse cholesteroltransport. The particle that takes cholesterol back tothe liver is an HDL. (Because most of thebuoyant fats which have a low density have been dropped off, the particle is moredense, hence high-density lipoprotein.)HDL particles carry an apolipoprotein A1fingerprint: apoA-1 means particle isreturning to the liver. HDL particles start out small and get largeras they pick up cholesterol from yourtissues to bring back to the liver HandbookCOPYRIGHT ADAPT YOUR LIFE ACADEMY Journey of dietary cholesterol:Cholesterol from food is absorbed in the intestine, then packaged into chylomicrons andsecreted into the lymphatic system. (Most dietary fats follow the same path.)The lymphatic system empties directly into the blood circulation (veins).

8 Chylomicrons drop off their cargo to tissues that need it, then become chylomicron remnants,which travel to the liver for two journeys:Dietary cholesterol: foods you consume intestine lymphatic system bloodstream cells manufactured in the liver: liver bloodstream cells HandbookCOPYRIGHT ADAPT YOUR LIFE ACADEMY Remember, there is no good or bad cholesterol:Cholesterol is cholesterol, regardless of the type of particle it is transported particles do much more than transport cholesterol:Carriers for fat-soluble vitamins & other important moleculesEnergy/fuel delivery (triglycerides)Modulate inflammationContribute to cellular repairImmune surveillanceReducing cholesterol (LDL-C, specifically) would reduce the raw material needed for:All cell membranes and mitochondrial membranesMyelin sheathsEstrogen, testosterone, progesterone, cortisol & other hormonesVitamin D synthesisBile saltsImmune system componentsSpotlight on LDL: not really bad cholesterolIf you are still looking at LDL as "bad" cholesterol,then you're about thirty years out of date.

9 Ken Sikaris, MD (Quoted in Cholesterol Clarity)11 Lesson HandbookCOPYRIGHT ADAPT YOUR LIFE ACADEMY LESSON 4 Key TakeawaysThere is more than one kind of LDL: LDL or LDL-C is too are small and large LDL is currently believed that small LDL particles may indicate increased cardiovascular LDL comes from VLDL (not from LDL), and VLDL comes from the liver liver makes triglycerides from excess sugars and starches (carbohydrates) in the situations can raise LDL-C:FastingWeight lossHigh levels of physical activity (ultra-marathoners and elite athletes sometimes have highLDL-C)12 Lesson HandbookCOPYRIGHT ADAPT YOUR LIFE ACADEMY Notes13 Lesson HandbookCOPYRIGHT ADAPT YOUR LIFE ACADEMY