Retrospective #246: “Sugar Substance Reduces HDL”

“Sugar Substance Reduces HDL,” Diabetes in Control reported on an August 2014 paper in Nutrition and Diabetes. Most people know LDL is the “bad” cholesterol and HDL the “good” cholesterol. That message has been pushed to promote the use of statins, which do lower LDL cholesterol (and thus Total Cholesterol). But how can you raise HDL?

The Diabetes in Control lede: “The substance, METHYLGLYOXAL (MG), was found to damage ‘good’ cholesterol, which removes excess levels of ‘bad’ cholesterol from the body.” MG is formed during glycolysis, the utilization of glucose to eventually make ATP, our cell’s energy furnaces. “Why methylglyoxal (MG) is produced remains unknown, but it may be involved in the formation of Advanced Glycation Endproducts,” per Wikipedia. “Due to increased blood glucose levels, methylglyoxal has higher concentrations in diabetics, and has been linked to arterial atherogenesis.”

“Low levels of High Density Lipoprotein (HDL) are closely linked to heart disease, with increased levels of MG being common in the elderly and those with diabetes or kidney problems.” “MG destabilizes HDL and causes it to lose the properties which protect against heart disease. HDL damaged by MG is rapidly cleared from the blood, reducing its HDL content, or remains in plasma having lost it beneficial function,” the researchers say. MG damage to HDL is a new and likely important cause of low and dysfunctional HDL…,” the researchers speculated.

To recap, when you eat carbohydrates, glucose (sugar) becomes energy (ATP) and along the way HG is produced. The HG damages the “good” cholesterol and prevents it from removing LDL, the “bad” cholesterol, from the blood stream. (Sounds a bit like sugar isn’t such a clean “fuel” for your body, doesn’t it?) Well, the researchers asked, what can be done about it? Not surprisingly, they had an answer: “By understanding how MG damages HDL, we can now focus on developing drugs that reduce the concentration of MG in the blood, but it won’t only be drugs that can help.” (That’s sounds promising, I’m thinking. Maybe they’ll mention a dietary intervention. Let’s see.)

“We could now develop new food supplements that decrease MG…” “This means that in future we will now have new drugs and new food supplements too that help prevent and correct low HDL, all through the control of MG.” To emphasize just how dangerous MG really is, and the importance of their “new” discovery, they add:

“MG is formed from glucose in the body. It is 40,000 times more reactive than glucose and damages arginine residue (an amino acid) in HDL at a functionally important site causing the particle to become unstable.”

Diabetes in Control “Practice Pearls” for the busy physician trying to keep up on the latest research in lipid chemistry:

●     Methylglyoxal (MG) was found to damage “good” HDL cholesterol.

●     There are currently no drugs that can reverse low levels of HDL.

So, what can a Type 2 diabetic or elderly person or a person with kidney problems or heart disease do now to raise HDL? Well, my answer is you don’t have to wait for a drug or a supplement to be developed. You don’t need a drug or a food supplement. You need to simply but substantially reduce the amount of “sugar” (carbohydrates) that you eat.

All carbohydrates, whether simple sugars or “complex” carbohydrates, become glucose in your blood. Carbs will raise your triglycerides, and there’s an inverse relationship between HDL and triglycerides. So, lower carbs = lower triglycerides →  increased HDL. The British Heart Foundation, which funded this study, should request a refund. 

My doctor, since deceased, first suggested that I eat very low-carb (to lose weight!) in 2002. It worked. I lost a lot of weight (170 pounds), my health improved and I felt much better. Then, when I started writing about my success, he read my blog regularly. Then, a while later, at my request, he emailed me suggestions for subjects to write about, and “Foods that Raise HDL” was first on his list. So, I did (Retrospective #34). Nine months later I wrote a sequel (Retrospective #67), HDL Cholesterol and the Very Low Carb Diet.” The table in #67 shows how before I changed my diet, my average HDL over 10 visits was 39. When I wrote that column the average of my most recent 10 HDLs was 81. After writing that column, the average of the next 7 HDLs was 78; median 77, range 58 to 91. Do you want to double your HDL? And reduce your triglycerides by 2/3rds (Retrospective #68)? You can do it by diet – a VERY Low Carb diet.