All the ways Step One helps lower cholesterol

If you’re a regular reader of this blog, you might already know that there are three big reasons why circulating levels of LDL (bad) cholesterol levels can be high:

1. We make too much of it in the liver
2. We get rid of too little of it through the biliary system
3. We remove too little of it from the bloodstream

Of the three mechanisms, Mechanism 2 - involving the biliary system - is where Step One Foods probably has the greatest impact in most people.  We all have an elimination pathway for LDL that is driven by bile production.  Bile, a substance essential for digesting food, is made from LDL cholesterol.  So you can think of a funnel taking LDL from the blood stream, directing it to the liver where it gets turned into bile, is next dumped into the small intestine, and is eventually excreted out of our body as part of stool. 

But not all bile gets eliminated.  Some of us are quite frugal and reabsorb any bile not used up in the digestive process.  Recovering unused bile reduces the amount of LDL needed to make bile for the next meal, effectively shrinking the LDL funnel and helping to keep circulating levels of LDL high.  Step One Foods helps prevent bile reabsorption in the intestinal tract through the actions of fiber (which traps bile in the digestive system) and plant sterols (which effectively lower bile reabsorption rates).

As an aside, this is the same mechanism that was leveraged by the original cholesterol lowering drugs.  They were called bile acid resins or bile acid sequestrants (some of you might remember Questran® and Welchol®) and they literally bound bile in the digestive system so it could not be reabsorbed.  And these drugs worked!  LDL levels fell.  The problem was they were messy powders or you had to take 6-8 pills per day, and many people got digestive upset.  So when statins came along, these medications really fell out of favor.  But their underlying mechanism of action was valid and can be mimicked by Step One Foods.

However, Step One’s effects don’t end there.  HMGCo-A reductase, the enzyme that drives cholesterol production in the liver (Mechanism 1, above), might be the enzyme that statin drugs inhibit, but this enzyme’s activity is also influenced by insulin levels.  When insulin levels are high, HMGCo-A reductase activity revs up and the liver spits out more LDL into the bloodstream.  Because Step One delivers complex carbohydrates in a high fiber package, it tamps down insulin production, leading to less HMGCo-A reductase activity, helping to drive LDL levels down.

Mechanism 3, related to LDL receptor activity, is also influenced by Step One.  Before LDL can be removed from the bloodstream it has to bind to an LDL receptor.  LDL receptors are upregulated (meaning they are made more active) by unsaturated fats, especially those healthy omega-3 fatty acids.  Given that Step One Foods are a rich source of those means that our products can also aid removal of LDL from the bloodstream by positively affecting LDL receptor function. By the way, injectable drugs like Repatha® and Lequvio®, the latest cholesterol lowering medications, work through upregulating LDL receptors.

So you can use Lipitor® to impact HMGCoA reductase, Welchol® to block bile reabsorption, and Repatha® to improve LDL receptor function – and then add even more drugs to optimize blood pressure, lower blood sugar and lose weight.  Or you can just eat food – a complex bioactive that has multiple effects. 

You likely won’t get to the spectacularly low LDL levels that are achievable with cholesterol lowering pharmaceuticals.  But you will get to much better LDL numbers – while at the same time achieving much better overall health including lower blood pressure, improved blood sugar, and better weight.