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Arterial Acne

Atherosclerotic plaques in coronary arteries may be more aptly described as pimples, initiated by the infiltration of cholesterol into the lining of our arteries. The ending, should blood flow to our heart muscle be cut off by a clot formed by the rupture of one of these inflamed pockets of pus in our arterial lining, is a heart attack.

June 21, 2012 |
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Arterial Acne, 4.8 out of 5 based on 5 ratings

Sources Cited

Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med. 2005 Apr 21; 352(16):1685-95.

Acknowledgements

Image thanks to the Center for Disease Control/Dr. Edwin P. Ewing, Jr.

Transcript

The plaques in our coronary arteries which can eventually burst, shut off our hearts’ blood supply, and kill us are more aptly described as pimples… not plaques. They are inflamed pockets of pus, and it all starts with cholesterol.
 This is a diagram of the wall of the coronary arteries crowning our heart. And here comes the villain of the story, LDL—the bad cholesterol—infiltrating the lining of our artery. It gets oxidized and triggers an inflammatory response. Your artery hangs a white towel out the window into the bloodstream asking for help. The lining of your artery actually produces adhesion molecules to stick white blood cells called monocytes zooming past and suck them into wall to try to repair some of the havok cholesterol is wreaking. We never evolved to have so cholesterol in our blood stream and causes damage and inflammation inside the walls of our arteries.
 Other inflammatory cells are called into action and it gets pussier, and more inflamed, and turns into a big whitehead sticking out like a zit into the blood flow inside our arteries. The blood's pulsating past, can rip off the cap and you get a big squirt of pus straight into the artery. Blood rushes into the hole and says, hey we know how to plug holes, forms a blood clot (also known as a thrombus) that can close off the whole rest of artery. And then we have the opportunity to visualize a cross-section like this of an artery on autopsy ‘cause you’re dead.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by Serena

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger

Doctor's Note

Cholesterol-induced zits in the lining of our coronary arteries can also occur in other blood vessels. In our head they can cause a stroke (videos about stroke), in our back they can cause degenerative disk disease (Cholesterol and Lower Back Pain), in our abdomen they can cause an aneurysm (Abdominal Aortic Aneurysms: Ticking Time Balloons), and in our pelvis they can cause sexual dysfunction in both men (Atkins Diet: Trouble Keeping It Up) and women (Cholesterol and Female Sexual Dysfunction). Thankfully, Avoiding Cholesterol Is A No Brainer. It's Purely a Question Of Diet. Trans fat, saturated fat, and cholesterol should be kept to a minimum. There are more than 80 videos on heart disease and also hundreds of other videos on more than a thousand subjects.

Also, be sure to check out my associated blog posts for more context: The Most Anti-Inflammatory Mushroom, Stool Size and Breast Cancer Risk, and Plant-Based Diets for Rheumatoid Arthritis

  • Michael Greger M.D.

    Cholesterol-induced zits in the lining of our coronary arteries can also occur in other blood vessels. In our head they can cause a stroke, in our back they can cause degenerative disk disease (see Cholesterol and Lower Back Pain), in our abdomen they can cause an aneurysm (Abdominal Aortic Aneurysms: Ticking Time Balloons), and in our pelvis they can cause sexual dysfunction in both men (Atkins Diet: Trouble Keeping It Up) and women (Cholesterol and Female Sexual Dysfunction). Thankfully, Avoiding Cholesterol Is A No Brainer. It’s Purely a Question Of Diet. Trans fat, saturated fat, and cholesterol should be kept to a minimum. There are more than 80 videos on heart disease and also hundreds of other videos on more than a thousand subjects.

    • HemoDynamic, M.D.

      Another article proving that meat and dairy cause acne!!!  Love it!

    • Stefan Juhl M.D.

      Imagine: Getting killed by a big, giant zit – what a way to go !

      Avoid this humiliation: Go plant strong…….

  • Superh1994

    Hey Doc this really interests me and worries me at the same time. I’ve eat 2 eggs a day for years now, so I’m worried about cholesterol. however, i have read many times that dietary cholesterol really inst very harmful, as once thought.

    Can i have your verdict please?

    • HemoDynamic, M.D.

      Your body makes all the cholesterol you will ever need so why would you want to add more?

      Well if you are the Poultry and Egg business I can think of a lot of rea$on$ to get you to BUY and eat more egg$  >> Here are a few–$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$.

      Eggs are the highest food source of Cholesterol AND are also the second highest in Arachidonic acid (which causes inflammation and PAIN in your body) and your body, as well, makes all the arachidonic acid you would ever need.  So if you are looking to increase the pain in your body and like the Arterial Acne promoting promise of added cholesterol then by all means chomp your chicken and eat your egg$.

      But it is clear you do not want to do this, so. . .

      Plants don’t make cholesterol they make Fiber for their cell walls, but you, me and every other animal makes cholesterol for their cell walls.  So if we stop eating each other and start eating more plants, our cholesterol will go down to normal, we will experience less pain, and our bowels will be ‘bubbling’ over with joy!!
      Eat Plants!!!!!

    • Stefan Juhl M.D.

      I think it was Rip Esselstyn who said: There are only 2 problems with eggs – the yolk and the egg white. Too much cholesterol and too much protein (that you dont need).

      Milk is for baby cows and the yolk and the egg white is for baby chicken.

    • http://www.facebook.com/profile.php?id=1353508408 Michael Pfiffner

      The idea that dietary cholesterol isn’t harmful is a dangerous little piece of misinformation that is frequently parroted by people seeking to justify eating certain foods.  Nothing could be further from the truth, and dietary cholesterol being completely unnecessary and dangerous is as established in science as the earth is being round.

    • http://www.DonForresterMD.com/ Don Forrester MD

      I can’t think of any reason to eat two eggs per day. You get adequate protein by the consumption of a whole plant based diet(see Dr. McDougall’s three newsletters on protein(12/03.4/07,1/04); you run a higher risk of food borne illness see… tp://nutritionfacts.org/video/total-recall/, and you ingest more chemicals such as dioxin see… http://nutritionfacts.org/video/food-sources-of-pcb-chemical-pollutants/. Additionally The Harvard Physicians study show a correlation that eating just one day a day was shown to be harmful see… http://nutritionfacts.org/video/is-one-egg-a-day-too-much/.

  • http://poxacuatl.wordpress.com/ Strix

    Great video! I don’t know how you get so much info into so little time in such easy-to-understand language. Awesome ;^) !!

    It’s scary what we do to our poor body. I’m surprised we last as long as we do. It’s such a beautiful, efficient machine.

    • Stefan Juhl M.D.

      The human body is very resistant - the human body can even tolerate to eat a little meat once in a while – easter and christmas – even meat containing feces! That is impressing…….

      Yes – we last a long time, but many people suffer a lot the last 20-30 years of their lives, because of the SAD (and european!).

      Solution: Go vegan (also in holidays!)

  • AlexanderBerenyi

    Curveball challengers! (and general food for thought):

    Health implications of high dietary ω−6 Fatty acids.
    http://www.ncbi.nlm.nih.gov/pubmed/22570770

    The importance of the ω−6/ω−3 fatty acid ratio in cardiovascular disease and other chronic diseases.
    http://www.ncbi.nlm.nih.gov/pubmed/18408140

    Association of plasma omega-3 to omega-6 polyunsaturated fatty acid ratio with complexity of coronary artery lesion.
    http://www.ncbi.nlm.nih.gov/pubmed/22576378

    Current intakes of EPA and DHA in European populations and the potential of animal-derived foods to increase them.
    http://www.ncbi.nlm.nih.gov/pubmed/18498671

    New insights into the health effects of dietary sat/ω−6/ω−3 fatty acids.
    http://www.ncbi.nlm.nih.gov/pubmed/22613931

    Beef in an Optimal Lean Diet Study
    http://www.ncbi.nlm.nih.gov/pubmed/22170364

    Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes
    http://www.ncbi.nlm.nih.gov/pubmed/19604407

    • AlexanderBerenyi

      Impact of ω−3 fatty acids on coronary plaque instability
      http://www.ncbi.nlm.nih.gov/pubmed/21684546

      Relationship between coronary plaque vulnerability and serum ω-3/ω-6 fatty acid ratio.
      http://www.ncbi.nlm.nih.gov/pubmed/21778590

      Fish oil, but not flaxseed oil, decreases inflammation and prevents pressure overload-induced cardiac dysfunction.
      http://www.ncbi.nlm.nih.gov/pubmed/19015135

    • Paulc

       So, what’s your point?

      • AlexanderBerenyi

        Part of the problem might be caused or exacerbated by our staunch avoidance of ω-3-rich (EPA/DHA) foods like oily fish (because it’s animal protein! with animal fat! and cholesterol!) and replacing them with increasingly ω-6-rich vegetable fats, which can trigger chronic inflammation, which can end up having…arterial consequences.

        The point is the perpetrator is inflammation, and that’s a predicament not inherently solved by clinging to the vegetable blanket.

        • Paulc

           Thanks for replying, AlexanderBerenyi. Vegans do get quite a bit of short-chained omega-3′s and whether this is sufficient is an area of active research which we should have the answers to soon but the initial indications are very hopeful: See http://newsletter.vitalchoice.com /e_article001932826.cfm?x=b11,0,w
          Meanwhile there is vegan algae oil sources of long-chained omega 3′s and other sources of inflammation-lowering plant foods. Some I’m aware of are turmeric, garlic, onions, and ginger. Whatever I’m doing seems to work for me; my CRP test came back with barely detectable levels. I tend to eat mostly vegetables and fruit and avoid a lot of grains and most seeds for the reason you mentioned, because of their unfavorable omega 6/3 ratio. Meanwhile I make sure to get enough flax seed in my diet to tilt the ratio in favor of omega 3′s..

        • Paulc

          Just read a new article on Omega-3′s and Inflammation. Seems that omega-3′s are most helpful for the obese. It may even be that those with normal height-to-weight proportions may not particularly benefit from omega-3′s inflammation reducing power since the causes of inflammation may be excess corpulence along with a lack of exercise and other healthy plant-strong habits:
          http://www.medicalnewstoday.com/releases/246893.php

          • AlexanderBerenyi

            “Seems that omega-3′s are most helpful for the obese.”
            Yes, agreed.

            “…Those with normal height-to-weight proportions may not particularly benefit from omega-3′s inflammation reducing power since the causes of inflammation may be
            excess corpulence along with a lack of exercise and other healthy
            plant-strong habits”
            No, I don’t think the article implied that. Obesity is often brought on by inflammation—yes—and exercise is anti-inflammatory—yes—but, again, just because a food is plant matter doesn’t mean it can’t contribute to inflammation. In fact, one of the major factors in our great ω-3/ω-6 ratio imbalance is the widespread predominance of ω-6-rich vegetable fats.

            Omega-3 fats in the diets of non-obese individuals who exercise don’t all of a sudden switch from anti-inflammatory to inflammatory. They still play all of the same roles.

          • Richard Arppe

            “The point is the perpetrator is inflammation, and that’s a predicament not inherently solved by clinging to the vegetable blanket”.

            Incase you watched the video Dr Greger posted you ought to know that both inflamation and high blood lipids are the partners in crime, not inflamation alone.

            High LDL and HDL are pro-inflamatory by their own.

            1) ‘Good’ HDL Cholesterol Can Also Be ‘Bad’ (2012)
             
            “the HDL amplified inflammatory reactions several times over and could explain the latent chronic inflammation that is associated with high cardiovascular risk,”
             
            “Lowering the LDL level is therefore still even more important than raising the HDL level.”
            http://www.sciencedaily.com/releases/2012/01/120113210207.htm 

            2) Rethinking the Links Between Inflamation and Chronic Disease.
             
            http://www.northwestern.edu/newscenter/stories/2012/05/inflammation-chronic-disease.html

            3) Inflammation and Infection Do Not Promote Arterial Aging and Cardiovascular Disease Risk Factors among Lean Horticulturalists
            http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722089/

            besides, even if you were into the “inflamation as the root for all evil” -theory then why would you push these fad diets based o the appeal-to-nature fallacy (paleo-diet)

            4) Red meat intake is associated with metabolic syndrome and the plasma C-reactive protein concentration in women.
            http://www.ncbi.nlm.nih.gov/pubmed/190742

            5) Comparative effects of three popular diets on lipids endothelial function and c-reactive protein during weight maintenance

            “These data suggest that during weight maintenance, less favorable biological effects are observed during a simulated, high-fat Atkins diet when compared to the South Beach and Ornish diet. The findings support additional study in subjects with visceral obesity and the metabolic syndrome, in whom an increased risk of coronary disease at baseline may be accentuated with chronic consumption of a diet that exhibits unfavorable effects on lipids and endothelial function”.

            http://www.ncbi.nlm.nih.gov/pubmed/19328268

            6) Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study
            http://arthritis-research.com/content/10/2/R34

            7) Consumption of saturated fat impairs the anti-inflammatory properties of high-density lipoproteins and endothelial function

            “Consumption of a saturated fat reduces the anti-inflammatory potential of HDL and impairs arterial endothelial function. In contrast, the anti-inflammatory activity of HDL improves after consumption of polyunsaturated fat. These findings highlight novel mechanisms by which different dietary fatty acids may influence key atherogenic processes”.
            http://www.ncbi.nlm.nih.gov/pubmed/16904539

            8) The effects of diet on inflammation emphasis on the metabolic syndrome
             
            “Jenkins et al. (86) found a reduction of CRP levels (28% vs. baseline) in hyperlipidemic patients following a whole diet approach, which was comparable to statin therapy (33% reduction of CRP levels) and independent of changes in body weight. The diet, which was low in saturated fat and included viscous fibers, almonds, soy protein, and plant sterols, also induced reduction in lipids that was comparable to lovastatin therapy”.
            http://content.onlinejacc.org/cgi/reprint/48/4/677.pdf

          • AlexanderBerenyi

            With the exclusion of some “but / maybe / in this circumstance only” scenarios, this is all quite thorough and well put together. I’ll definitely save some of these finds.

        • Jola

          It seems to me that the vast amount or current research and “the balance of scientific evidence suggests that the healthiest way to eat is a vitamin B12-fortified diet of whole plant foods.” 
          (Not to mention that plant-based eating is also the most ethical and moral way to eat. 
          http://www.youtube.com/watch?v=es6U00LMmC4 )
          Dr. Greger also states that “[a]ttention should also be paid to specific nutrients listed here:http://nutritionfacts.org/2011/09/12/dr-greger%E2%80%99s-2011-optimum-nutrition-recommendations/. Among, them he recommends omega 3 fatty acids. Specifically, “250 to 500 mg daily of yeast- or algae-derived DHA and/or EPA”.  

        • Toxins

          Whole foods plant based diets actually have ratios of omega 6 : Omega 3 in the 4:1 range or better. Omega 3 is not absent from a plant based diet. If you wish to expose your body to an abundance of Toxins then go ahead and eat fish. There are much cleaner ways to obtain omega 3.

  • b00mer

    A question: So as I understand it, we can skip the fish as a source for DHA and EPA, and go straight to their source, the algae. But this is always referred to in terms of taking supplements. Are these algal sources ones that we can just eat, similar to the way we can eat kelp for the iodine?

    • b00mer

      I realize now this may be a misplaced comment- it’s more in reference to the course the comment thread has taken than the video itself.

  • http://twitter.com/ztaylorwell Zachary Taylor

    I thought this was interesting – “we never evolved to have so much cholesterol in our arteries.”
    I’ve seen some charts on all-cause mortality rates and they’ve all shown that people with total cholesterol from 200 – 240 have the lowest rates of death from a variety of diseases, including heart disease.

    What I wonder, and I’m not a nutritionist (yet), is if we actually did evolve to have cholesterol around 200-240, but that we had a lot more anti-oxidants (and far fewer environmental toxins) so that we could keep the LDLs from oxidizing — since really, it’s “oxidized” LDL that is the problem.

    It’s equally as plausible that we did evolve to have this much cholesterol, but that today we have far fewer anti-oxidants from our processed diets and far more toxins and stressors that deplete our anti-oxidants even more.

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