Welcome to the plant-based wellness kickstarter!

Today we are going to talk about cholesterol and heart disease. How does cholesterol, mainly found in our diet, affect arterial blockage and arterial health? I'll go into that in some depth today.

Week two is going to be about saturated fat and how that affects insulin resistance and eventually diabetes. Week three we're going to talk about protein--how much protein do you really need? Our protein needs are not quite as big as most people believe. Week four will be topics in diet and aging, skin health, internal aging, external aging, even the aging of our DNA. It's not as scary as it sounds, you'll see!

So today we're going to go through an introduction. I will give you a few disclaimers, then we'll get into the topic, and then we will go over this week's action plan!

About me. I'm going to make this short because if you've signed up for this course you have most likely read my bio. There are two important things you need to know: I've been vegan for 15 years, and I recently went through the plant-based nutrition program, a six-week certificate program at Cornell. And that taught me so much. I've modeled this course loosely on that as well as a lot of the other research I've done over my 15 years being plant-based.

What you can expect from all of these sessions is a lot of information that you probably don't know because who really researches this stuff, unless you're you want to make a career out of nutrition? I want to bring the knowledge that I've learned to my friends, to my family, to anyone who wants to hear it because it's that important. It's important for human health. It's important for the world, the animals.

Disclaimers: I am not a registered dietician. I am not a medical doctor, I'm not here to give you medical advice. I am here to share my research, to share what I know, to share my knowledge, and to help you transition to a plant-based diet. You're not required to go plant-based in this program. It would be great if you did, but I'm here to help you make that transition as far as you want to take it.

Before we get into today's topic, let's cover some fast facts. Most deaths in the US are related to nutrition. What we eat is the number one determining factor of how long and how well we live. It outpaces even smoking. Most people think smoking is a huge risk factor, which obviously it is, yet our diet is a bigger risk factor than smoking at this point in time. That may have been different in the past when many more people were smoking, but as things stand now in society, smoking is number two as a risk factor for death.

Second, doctors, don't get a lot of education in nutrition in medical school. They get about one semester. So I probably know more about a plant-based diet than most medical doctors, which is very sad to say. It should not be that way, but that's the way it is right now until medical education changes.

Third, consuming more whole foods, vegetables, whole grains, and fewer animal products, I should say, not just less meat translates directly to reducing your risk of chronic disease. For sources I am using in putting these and all of the information in this course together, check out the Resources section at the end of the course.

Now, let's talk about atherosclerosis, which is the beginning stage of heart disease. This actually begins in childhood, believe it or not. By the time we are about 10 years old, most children raised on the Standard American Diet, which I call "sad" because it is very sad that this is the state of affairs here in the west. Most children have fatty streaks in their arteries, and I'm not even necessarily talking about children who go to McDonald's for lunch and dinner every day. That is bad, but the Standard American Diet--meat, potatoes, some vegetables on the side--our children are getting fatty streaks in their arteries from this diet. We know this because of autopsies that have been done on children who have died of other causes. They find these fatty streaks in them, which is very concerning. By the time we reach our twenties and thirties plaques begin to form, and by our four forties and beyond hardening of the arteries sets in and it starts to kill us in the form of heart disease and stroke.

There's good news though. There's light at the end of the tunnel patients who switched from a Standard American Diet to a whole food plant-based diet (not to be confused with a junk food vegan diet, because that exists!) saw improvement in artery function and a reversal of the heart disease that they already had started developing. So does this make sense so far? Does anyone have any questions at this point?

AMANDA: That's sad. I didn't know that about the kids and 10 years old. That's crazy.

PAMELA: Yeah. It is scary. You know, because we feed our children meals that we think are wholesome and good for them and going to build muscle and build bone and all of that. And yes, we are doing those things, but we're also giving them fatty streaks.

How does this translate into what goes on inside our bodies? We're going to dive a little deeper now. This is where I get all science geeky, so bear with me!

If you have any questions at all please put them in the comments section

There is a process to how cholesterol affects our arteries. We've probably all heard of "good cholesterol" versus "bad cholesterol." LDL stands for low-density lipoprotein. It's a lower density fat that causes inflammation in our heart and our blood vessels. This is the "bad" cholesterol, and the inflammation it causes happens continually. If we're on a S.A.D, it happens pretty much every time we eat a meal. Inflammation over time can lead to sudden arterial blockage. We're also going to cover how to prevent the plaques that we have already built up in our arteries from rupturing. And then we can do some Q & A.

What we're looking at is the bloodstream and I've got everything labeled here. Normally you'd look at a picture of an artery and it would be a tube but for the purposes of this lesson, I've created a flattened representation of an artery. This represents any in our body--it could be a coronary artery, a blood vessel in your lungs, a blood vessel in your arm, etc. All of our blood vessels basically look like this. There's the blood, the artery wall and then there is a thin layer in between the artery wall and the blood called the endothelium. The endothelium is a thin layer of specialized cells that does things like regulating blood vessel dilation, regulating contraction, regulating the action of our platelets, how sticky our platelets become in the case of wound healing, which will become important in a few minutes.

The endothelium has other functions as well, but for the purposes of this talk, those are the important things you need to know about the endothelium. They regulate blood vessel dilation contraction, and how freely the blood flows in our arteries. When the endothelium is unable to allow the blood vessel to dilate properly, we run into problems! Next, we have some angry-looking LDL cholesterol in our bloodstream. Hopefully, you'll find these animations amusing because I had fun doing them. LDL cholesterol comes predominantly from our diet. Where is cholesterol found? Mostly animal foods. I can think of one plant food off the top of my head that would contain cholesterol but by and large, cholesterol is found in animal foods.

These LDL cholesterol molecules circulate through our bloodstream and they bump up against the endothelium, entering the artery wall. Inside the artery wall, many of the LDL molecules become oxidized. LDL cholesterol gets oxidized this way because we've all got free radicals floating around in our system. Free radicals are the natural byproducts of cellular metabolism. Just by existing, by breathing, eating, just by being a human being, we create free radicals all the time. We take in what we need to survive and we create waste. These free radicals are what cause LDL to become oxidized.

As a consequence of oxidation, the LDL molecules become very hard, and this sets off an inflammatory response within the artery wall. In response to the inflammation, our bloodstream sends in white blood cells to take care of the LDL cholesterol. The white blood cells ingest all of the cholesterol in the artery wall in order to lower the inflammation that's happening there. When a white blood cell ingests enough of this LDL cholesterol, it becomes engorged. And if you look at it under a microscope, it looks foamy. So now after it's done its job and has become engorged with cholesterol, it's now known as a foam cell.

This is a very dangerous state to be in, as foam cells do a lot of bad things. I'm going to show you some of those bad things in the next slide. So in this slide, we see a bunch of foam cells. They have already gone through and ingested all the LDL that they can. Meanwhile, in the middle of our bloodstream is a plaque on the artery wall that has been building up for 10, 20, 30 years or longer. This is the type of fatty streak and plaque that I'm talking about when I say at 10 years old, it's just starting out. By the time we reach 40 or so years old, this is what the plaque is going to look like. And the really sneaky thing about these plaques is that you could have a plaque that blocks about 40% of the artery, blocking your blood flow and not know it at all. There are no symptoms with a plaque like this because you're still getting enough blood flow that you're not going to feel any symptoms.]

Back to the foam cells: once they're formed, they emit enzymes into the bloodstream. I want you to pay attention to what's happening here with the plaque. As the foam cells are emitting this enzyme into the bloodstream, the enzyme is actually eating away at the covering of the plaque in the bloodstream. And when that happens for long enough, the contents of the plaque can spill out into the bloodstream. This in itself can cause a clot, but there's another step in this process. The blood platelets realize, oh my God, there's a wound inside. We've gotta take care of that wound. We've gotta take care of all this mess that was just spilled into the bloodstream. And so your bloodstream sends in the troops, red blood cells, platelets that are trying to contain the contents of the plaque that have gone into the bloodstream. This is how a clot forms. The contents of the plaque are fat and crystallized cholesterol, among other things. When cholesterol gets into the plaque it actually crystallizes into sharp shards--that's what they look like under a microscope. So even from inside the plaque, crystallized cholesterol, that's poking up trying to get out. So between the bloodstream and what's inside the plaque, it's very dangerous.

And this is how a sudden heart attack happens. I'm sure we've all heard those stories, usually about men in their middle age, but it can happen to other people as well. Other demographic demographics, where they'll be fine and then one day they have a stroke suddenly, or a heart attack. This process accounts for about 90% of heart incidents and strokes. Old plaques that have been around forever, if left alone, by themselves only account for about 10% of heart attacks. This is because these plaques can grow to a point where they're obstructing 90 or more percent of the artery wall, but much more common is that the plaque grows to a certain level, and then it ruptures. And that's why cholesterol is really so dangerous over time. So before I move on, are there any questions about the geeky sciencey part or comments?

AMANDA: One of my fiance's friends, he got gout and I was like, wow, I have not heard of that disease in so long. But the doctor prescribed him all this medication made it sound like it had nothing to do with what he ate. But I remember growing up like hearing, it was like a red meat disease or something.

JULIE: Yeah, it's acidity. It's an acidity that comes from an accumulation of some acidity from a lot of times from meat.

AMANDA: Yeah. So I asked him, I said, don't you eat a lot of red meat? Growing up, I heard that's what caused it. I think my grandmother said that because someone know that she knew had it or something. And he was like, no, that's not what the doctor said. You know, I'm just gonna take this prescription medication as nothing to do with the meat. And I was like, oh no, if I were you, I'd like not. I was like, I'm not a nutritionist or anything, but... So I was just wondering if you knew Pamela

PAMELA: I've, I've watched and read some things about gout. But, I'd like you to put all your questions here or in the Facebook group. Anything that I'm not sure of off the top of my head, I will do some research for you and I'll put it in the Facebook group. I'll try always to get it in there within 24 hours or, or less. So tonight after we get off, I'll do some research for you. That sounds right, what Julie said. I haven't personally researched it, so I'll put some resources in the Facebook group for you. That is my commitment to you all, as we go through this: if there is anything that you have questions about and I need to find out, I'll get the answer to you within a day. Thank you. You're welcome.

Remember to download this lesson's bonuses!

• Quick start guide
• Week 1 Meal Plan for two people
• Food journal
• Quick shopping list
• Berry Power Smoothie recipe