calcium – Nicole Holovach | Dietitian Nutritionist

Did you hear? The latest version of the U.S. Dietary Guidelines, released earlier this year, has removed the recommended limit on cholesterol in the diet. Cholesterol is no longer a nutrient of concern. While most of us in the nutrition world have known for a long time that cholesterol in the diet does not affect risk for heart disease, we also know that it sometimes takes a while for policy to catch up with science.

So if cholesterol in food doesn’t cause high cholesterol, what does? While some might blame saturated fat and fructose (the latest fad), I’m going to dive in and explain to you a more in-depth, big picture view of cholesterol labs and your health.

The most important thing to know is that is that cholesterol isn’t this bad-for-you-you substance that it’s made out to be. Most people think, the lower your cholesterol, the better. If you could just get it down to zero you’d be in great shape! However, cholesterol is absolutely vital to the proper function of the human body. Your body makes cholesterol, regardless of your dietary intake, for good reason. If you had no cholesterol in your body, you would be dead! It plays an important role in digestion, Vitamin D status, hormone production and balance, and many other human body processes.

You also need to know that high cholesterol isn’t a diagnosis. It’s a symptom. Just because you have high cholesterol, doesn’t mean anything bad will happen! The words ‘high cholesterol’ inspire a feeling of dread as something akin to a death sentence. The mainstream narrative on cholesterol is that arteries are like pipes and cholesterol is like gunk. The pipes get clogged up with cholesterol, and then you have a heart attack. This is a powerful image, but it’s not accurate at all. First of all, at least half of all people who suffer a heart attack have normal cholesterol levels (1, 2). Second of all, after age 65, high cholesterol is associated with health and longevity (3). Third, plaques that “clog” arteries are actually made up of calcium and oxidized LDL particles (think rancid – more on that later), and they form under the artery wall (4). So get that vision of “clogged arteries” out of your head, and if you are a health professional, quit using those test tubes full of fat to scare people at health fairs!

Instead of looking at your high cholesterol labs with a sense of doom, let’s look at how cholesterol levels in the blood rise and when it becomes a problem.

One of the basic functions of cholesterol is to stabilize the mitochondria (the energy powerhouse of the cell), preventing their destruction by stress. Anytime you’re under a stressful situation, cholesterol rises as a protective response to the stressor. Yes, you read that right: cholesterol is a protective substance! Stress also lowers intracellular magnesium, which also causes cholesterol production to increase, since magnesium regulates the enzyme that makes cholesterol (5). Stress can be anything from psychological stress like that from jobs, family, money, etc., to physiological stress like skipping meals, not getting enough sleep, and eating poorly.

In youth and those with high metabolisms (good thyroid output AND uptake of thyroid hormone by cells), cholesterol is converted inside cells into pregnenolone, DHEA, testosterone, progesterone, and other important protective hormones. You cannot make these hormones without cholesterol!

Cells need two things to make the conversion: Vitamin A in its active form and thyroid hormone. As humans get older, their ability to convert beta carotene into active Vitamin A decreases, most Americans don’t eat much active Vitamin A in their diet, and metabolism decreases. In fact, up until about 40 years ago, high cholesterol was diagnostic of hypothyroidism, and routinely treated with supplemental thyroid hormones.

So high cholesterol is a problem because you’re not making youthful, protective hormones. But it’s also a problem because cholesterol oxidizes if it hangs around in the blood stream long enough, losing its protective functions. The cholesterol — or more accurately, the lipoproteins like LDL that are carrying cholesterol — get damaged by oxidation, and then the immune system’s response to that oxidative process is what causes the buildup of plaque and then ultimately the rupture of plaque and heart attack.

So the real question everyone should be asking when it comes to atherosclerosis and heart disease is: “what causes LDL to oxidize?”

There are three main ways oxidized cholesterol builds up in your bloodstream (6):

eating commercially fried foods, such as fried chicken and French fries
eating excess polyunsaturated fatty acids, which are found in vegetable oils, packaged food and restaurant food
cigarette smoking

Your doctor, and most dietitians for that matter, will tell you that polyunsaturated fats from refined vegetable oils, margarine, nuts, seeds, and other plant foods lower your cholesterol. And they’re right! But given what you just learned about cholesterol, do you really think lowering your body’s protective production of cholesterol is a good idea?! Within this framework, the effect of polyunsaturated fats is the same as the effect from statins, which come along with nasty side effects. I hope after reading this, you’ll start to understand physiologically why statins have the side effects they do, and why they’re not very helpful for most people (7).

A note about Paleo diets and fructose. Paleo bloggers and gurus have been pretty hard on fructose recently, blaming carbs and sugar for raising cholesterol. “Quit sugar and watch your cholesterol plummet!” Yup, also watch your libido and energy tank from lack of fuel for the liver and brain. Don’t fall for the low-carb trap when trying to lower your cholesterol. Fructose has pretty much been absolved of any wrongdoing in my book (8, 9).

If you have high cholesterol and your doctor is concerned, here is what I would advise:

Ask your doctor for a cholesterol particle size test (LDL-P). Small LDL particles are more likely to oxidize and form plaques under the artery walls (10).
Know your calcium status. One of my favorite things about Mineral Analysis, is the crucial information on tissue calcium it gives me. Coronary calcium scans will also give you good information about your tissue calcium buildup (4).
Have your thyroid status checked. This involves more than a TSH test! Blood lab work, including TSH, will tell you if your thyroid gland is producing enough thyroid hormone, but tells you nothing about your cells’ ability to use it. Broda Barnes was an American physician who was able to reduce heart disease incidence in his almost 2,000 patients by 90 percent. He used basal body temperature first thing in the morning as an indicator for thyroid uptake. Anything less than 97.8 degrees was considered functionally hypothyroid (11).

If you want to lower your cholesterol in a physiologically-sound way, that ensures proper body function for years to come:

Make sure your diet has plenty of sources of active Vitamin A. Eggs, liver, and grass-fed dairy are examples. Hmmm, imagine that….all potent sources of cholesterol! It’s like nature has a plan or something…
Make sure your diet has plenty of Vitamin K2, active Vitamin K. K2 is a calcium director and can remove calcium buildup from the arteries (12). It’s found in, again, eggs, liver, and grass-fed dairy. This is sounding more and more like a French diet. It’s not genes or the wine protecting them from heart disease (13).
Eat plenty of potassium-rich foods, like fruits and vegetables (14). You are likely not eating enough.
Eat more magnesium and supplement if needed. Cooked dark leafy greens and organic dark chocolate are good sources. Magnesium is also absorbed topically through the skin.
Destress!
Focus on all the things that improve thyroid uptake by cells: get enough calories, protein, carbohydrates, potassium and other minerals, good estrogen metabolism, and good liver function – AKA all the things I work on with clients!

I’ve been thinking a lot about calcium lately. Our bodies need this mineral to build and maintain bones and teeth. Calcium also helps with blood clotting, muscle function, and regulation of the heart’s rhythm.

We’ve had it hammered home since we were in grade school that increasing calcium intake will prevent osteoporosis, the weakening of bones. We’ve been told to take calcium supplements if we don’t get enough calcium in our diet.

Yet, we have a very high calcium intake in the U.S. and also high osteoporosis rates, plus, calcium supplements are linked to heart disease (1). What gives?

It has to do with calcification, calcium buildup in the body’s tissues. Along with reduced metabolic rate, calcification is a hallmark sign of aging.

Examples of calcification:

Atherosclerosis: calcification of blood vessels
Osteoarthritis: calcification of joints
Tartar: calcification on the teeth
Gallstones/kidney stones: caused by calcium deposits
Infertility: sometimes caused by endometrial calcification
Alzheimer’s: evidence is mounting brain calcification contributes
And so many more!

When you consume calcium, regardless of if through food or supplements, you hope it will be deposited in the bones and teeth, right? Well without a critical vitamin in your diet to direct calcium, it often winds up in the body’s tissues instead. So you could conceivably have a high dietary calcium intake or take calcium supplements, and still wind up with osteoporosis and heart disease to boot. Sucks, right?

So what’s this critical vitamin? Vitamin K2, not to be confused with the Vitamin K1 that is found in dark leafy greens. K1’s main role is in blood clotting, while K2’s main role is calcium metabolism. K2 activates certain proteins that guide calcium into bones and teeth where it belongs. And even cooler? K2 will activate other proteins that sweep calcium OUT of other tissues where it is potentially harmful. So you could potentially REVERSE heart disease just by getting enough of this crucial vitamin (2).

Other potential benefits? Better teeth. Weston A. Price (3) was a dentist who embarked on an medical anthropology trip around the world in the 1930’s to study how diet and lifestyle affected dental health. He found cultures with straight, beautiful, healthy teeth and deduced what they had in common. He has been called the “Charles Darwin of Nutrition,” since much of what he discovered looks at how food and food quality affect health in general. If you haven’t read his 1939 book, “Nutrition and Physical Degeneration,” a nutrition classic in my opinion, pick it up for the photos alone! Anyways, Price is credited with discovering Vitamin K2, although at the time, he had no idea what it was. He called it Activator X.

He realized that humans are capable of thriving on very diverse diets. However, he did find one thing in common: they all ate some amount of animal-derived fat-soluble vitamins. Even the near-vegetarian groups ate insects or small animals that were rich in pre-formed Vitamin A, Vitamin D, and what we now know is Vitamin K2. And here’s the kicker for my fertility clients: many of the foods high in these nutrients were fed preferentially to pregnant or reproductive-age women in the groups he studied.

Depending upon your current understanding of fats and the causes of heart disease (see here and here), you either will be pleasantly surprised or horrified by the list of foods high in Vitamin K2:

Butter from grass-fed cows
Organ meats
Shellfish
Fish eggs
Cheese from grass-fed cows
Natto (a fermented soybean popular in Japan)

Butter from grass-fed cows vs butter from the grocery store

Now, think about the French Diet and the above list of foods. Health experts have been talking about the “French Paradox” for years – the confusion over France’s rich, fatty diet and their low heart disease rates. What if the French Paradox isn’t such a paradox after all? What if it’s not the red wine that’s protecting them, but all the foie gras, quality cheese, and butter?

Now think about the Japanese diet. What if it’s not the green tea that’s protecting them from cancer and heart disease, but all the fish eggs and natto?

Previous thinking on Vitamin K2 was that our gut bacteria can make what we need from Vitamin K1. Does the typical American’s damaged gut do this? Who knows. I’ve seen evidence for and against the claim that we get enough from eating dark leafy greens.

But logically, when I think about the modern American diet, our current rate of disease, and compare it to someplace like France that has loads of K2 in their diet, it makes sense to me to eat more foods with K2.

As a side note, my latest obsession in my nutrition practice is mineral analysis. I find it most useful for determining tissue calcification. I would say that about 80 percent of my clients have high calcium levels in their tissues and would benefit from more K2 in their diet, either from foods or supplements, to help “sweep” it out of tissues. For those few who actually do need more calcium, K2 would also be beneficial in guiding that extra calcium into bones and teeth.

I see lots of potential in Vitamin K2 and I think you’re going to be hearing a lot more about it in the future. Vitamin K2 has potential benefits for nearly every major health concern of our time. K2 might be the ‘missing link’ that explains many of our modern health woes.

So eat your pastured dairy, organs, fish eggs, and shellfish! And if you have arterial calcification, as determined by a heart scan, or tissue calcification as determined by mineral analysis, you may want to consider supplementing with additional K2 (also called menaquinone-4 and menatetrenone).

For more information on Vitamin K2, “Vitamin K2 and the Calcium Paradox,” by Kate Rheaume-Bleue, is a great place to start.

1. https://well.blogs.nytimes.com/2013/04/08/thinking-twice-about-calcium-supplements-2/

2. http://wholehealthsource.blogspot.com/2008/11/can-vitamin-k2-reverse-arterial.html

3. Trolls: I am not a lacky for the Weston A. Price Foundation. Stop trying to label me. I’m anti-dogma and support many different types of diets.

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