4 ms·

I fail to see what this has to do with my comment. The hardening in atherosclerosis is caused directly and exclusively by atheroma.

cageface 7y ago
Atherosclerosis refers to the buildup of fats, cholesterol and other substances in and on your artery walls (plaque), which can restrict blood flow. https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/symptoms-causes/syc-20350569 https://www.mayoclinic.org/diseases-conditions/arteriosclero... An atheroma, or atheromatous plaque ("plaque"), is an abnormal accumulation of material in the inner layer of the wall of an artery; it is present in the arteries of most adults.[1] The material consists of mostly macrophage cells,[2][3] or debris, containing lipids, calcium and a variable amount of fibrous connective tissue. https://en.wikipedia.org/wiki/Atheroma https://en.wikipedia.org/wiki/Atheroma
- glastra 7y ago
  Pardon my confusion: is this comment for or against the parent? "Plaque" and "atheroma" are synonyms in the context of cardiovascular health. Also, both quotes together go to show the ongoing misconception. Nowhere in the first quote are macrophages and other WBCs mentioned (but they are in the second, luckily). I guess this is what happens when you use quotes from different sources, too.
sambe 7y ago
Everything I've ever read says fatty deposits. The NHS website calls fatty deposits "atheroma". You can find multiple definitions of atherosclerosis/atheroma in other places describing them the same way. Wikipedia says: "While the early stages, based on gross appearance, have traditionally been termed fatty streaks by pathologists, they are not composed of fat cells but of accumulations of white blood cells, especially macrophages, that have taken up oxidized low-density lipoprotein (LDL)." So whilst it may be more accurate to say they are white blood cells that fed on LDL (and presumably contain fatty substances as a result) there is a long tradition of calling them fatty substances, and there is at minimum a connection to fat. It seems misleading to try to discount the role of the fat to me. They don't sound like they are just normal white blood cells. Is there any doubt that the fat plays a causative role? I know a couple of cardiologists who say it is clear. Do you have some references for the idea that fat is not relevant?
- contravariant 7y ago
  I see. Yeah calling stuff wrapped in macrophages 'white blood cells' is a bit confusing, given that macrophages will wrap around just about any substance that your immune system tries to remove.
- glastra 7y ago
  What do those cardiologists say? That fat in the blood (triglycerides) causes atherosclerosis? Or dietary fat? Very different things. Regarding the mechanism of atheroma formation, I don't have a list of references handy, but maybe this is a good start: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152836/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152836/ Also of interest would be the role of high insulin and/or glucose and the damage they can cause to the arterial walls (inflammation is a necessary condition in the formation of atheroma).
  - sambe 7y ago
    The conventional wisdom: fat in the blood is the main thing to worry about (along with genetics) and that lifestyle factors have a big influence on that. So both, really. Which part of that paper disputes the importance of fat?
- vijay_nair 7y ago
  I want to call attention to the "oxidized" part of "oxidized LDL" as that's what makes LDL so dangerous. While pathologies of LDL and fat hog the limelight, it's important to keep a close eye on the third villain in the fight against AS and that is immune system pathologies mainly chronic inflammation. Immune cells kill using peroxides, superoxides and other free radicals. Anyone with an over-active immune system that's triggered easily — allergies, chronic stress, sub-optimal sleep, genetics, exposure to pollutants, metal ions etc¹ — you're better off reducing immune system activity. So yes, eat less fat but also focus on the immune system. A study found 29% of Japanese babies less than 1 year old had fatty streaks and they were not spending the first 11 months chugging slurpies and McDs.⁴ TL;DR: Dietary fat and adipose tissue/adipocytes involved in AS are two different things⁵, and try not to get oxidized to death by a glitchy immune system while busy chasing fats or the latest fad diet. Fats are just one piece of the puzzle. --- ¹Mechanisms of LDL oxidation: http://sci-hub.tw/10.1016/j.cca.2010.08.038 http://sci-hub.tw/10.1016/j.cca.2010.08.038 ²This means sleeping better, reducing stress, taking anti-oxidants, reduce insulin triggers i.e., reduce food with IF/ADF/CR³ and reduce carbs ³Intermittent Fasting/Alternate-Day Fasting/Calorie Restriction. This study finds ADF to be superior to CR; if you can stick to it, that is: Differential Effects of Alternate-Day Fasting Versus Daily Calorie Restriction on Insulin Resistance — http://sci-hub.tw/10.1002/oby.22564 http://sci-hub.tw/10.1002/oby.22564 ⁴https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812791/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812791/ - conjecture is the mothers were smokers, see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2644569/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2644569/ for more info. Pollution should be focused more strongly when it comes to heart health, the evidence is clear. ⁵Any excess energy gets stored as fat, so reduce fat intake but increase protein or carb intake to compensate? No dice, the body will generate fat for you in the form of adipose tissue which will lead to AS in the presence of an unregulated immune system.

cageface 7y ago

Atherosclerosis refers to the buildup of fats, cholesterol and other substances in and on your artery walls (plaque), which can restrict blood flow. https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/symptoms-causes/syc-20350569 https://www.mayoclinic.org/diseases-conditions/arteriosclero... An atheroma, or atheromatous plaque ("plaque"), is an abnormal accumulation of material in the inner layer of the wall of an artery; it is present in the arteries of most adults.[1] The material consists of mostly macrophage cells,[2][3] or debris, containing lipids, calcium and a variable amount of fibrous connective tissue. https://en.wikipedia.org/wiki/Atheroma https://en.wikipedia.org/wiki/Atheroma

glastra 7y ago
Pardon my confusion: is this comment for or against the parent? "Plaque" and "atheroma" are synonyms in the context of cardiovascular health. Also, both quotes together go to show the ongoing misconception. Nowhere in the first quote are macrophages and other WBCs mentioned (but they are in the second, luckily). I guess this is what happens when you use quotes from different sources, too.

sambe 7y ago

Everything I've ever read says fatty deposits. The NHS website calls fatty deposits "atheroma". You can find multiple definitions of atherosclerosis/atheroma in other places describing them the same way. Wikipedia says: "While the early stages, based on gross appearance, have traditionally been termed fatty streaks by pathologists, they are not composed of fat cells but of accumulations of white blood cells, especially macrophages, that have taken up oxidized low-density lipoprotein (LDL)." So whilst it may be more accurate to say they are white blood cells that fed on LDL (and presumably contain fatty substances as a result) there is a long tradition of calling them fatty substances, and there is at minimum a connection to fat. It seems misleading to try to discount the role of the fat to me. They don't sound like they are just normal white blood cells. Is there any doubt that the fat plays a causative role? I know a couple of cardiologists who say it is clear. Do you have some references for the idea that fat is not relevant?

contravariant 7y ago
I see. Yeah calling stuff wrapped in macrophages 'white blood cells' is a bit confusing, given that macrophages will wrap around just about any substance that your immune system tries to remove.
glastra 7y ago
What do those cardiologists say? That fat in the blood (triglycerides) causes atherosclerosis? Or dietary fat? Very different things. Regarding the mechanism of atheroma formation, I don't have a list of references handy, but maybe this is a good start: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152836/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152836/ Also of interest would be the role of high insulin and/or glucose and the damage they can cause to the arterial walls (inflammation is a necessary condition in the formation of atheroma).
- sambe 7y ago
  The conventional wisdom: fat in the blood is the main thing to worry about (along with genetics) and that lifestyle factors have a big influence on that. So both, really. Which part of that paper disputes the importance of fat?
vijay_nair 7y ago
I want to call attention to the "oxidized" part of "oxidized LDL" as that's what makes LDL so dangerous. While pathologies of LDL and fat hog the limelight, it's important to keep a close eye on the third villain in the fight against AS and that is immune system pathologies mainly chronic inflammation. Immune cells kill using peroxides, superoxides and other free radicals. Anyone with an over-active immune system that's triggered easily — allergies, chronic stress, sub-optimal sleep, genetics, exposure to pollutants, metal ions etc¹ — you're better off reducing immune system activity. So yes, eat less fat but also focus on the immune system. A study found 29% of Japanese babies less than 1 year old had fatty streaks and they were not spending the first 11 months chugging slurpies and McDs.⁴ TL;DR: Dietary fat and adipose tissue/adipocytes involved in AS are two different things⁵, and try not to get oxidized to death by a glitchy immune system while busy chasing fats or the latest fad diet. Fats are just one piece of the puzzle. --- ¹Mechanisms of LDL oxidation: http://sci-hub.tw/10.1016/j.cca.2010.08.038 http://sci-hub.tw/10.1016/j.cca.2010.08.038 ²This means sleeping better, reducing stress, taking anti-oxidants, reduce insulin triggers i.e., reduce food with IF/ADF/CR³ and reduce carbs ³Intermittent Fasting/Alternate-Day Fasting/Calorie Restriction. This study finds ADF to be superior to CR; if you can stick to it, that is: Differential Effects of Alternate-Day Fasting Versus Daily Calorie Restriction on Insulin Resistance — http://sci-hub.tw/10.1002/oby.22564 http://sci-hub.tw/10.1002/oby.22564 ⁴https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812791/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812791/ - conjecture is the mothers were smokers, see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2644569/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2644569/ for more info. Pollution should be focused more strongly when it comes to heart health, the evidence is clear. ⁵Any excess energy gets stored as fat, so reduce fat intake but increase protein or carb intake to compensate? No dice, the body will generate fat for you in the form of adipose tissue which will lead to AS in the presence of an unregulated immune system.