Cholesterinum Anhängsel
[Linda Fischer]
Dass Cholesterin unsere Gefäße
verstopfen kann, wissen die meisten. Doch dabei ist es wichtig, verschiedene
Formen dieses Stoffes zu unterscheiden. Lange dachte man, das Cholesterin aus
dem Essen selbst erhöhe das Krankheitsrisiko. Seit wenigen Jahren ist bekannt:
Der Übeltäter ist ein an die Cholesterinmoleküle gebundenes Protein namens LDL
(auf Englisch: low density lipoprotein). Es dient als Transportmittel, das das
Cholesterin, auch Cholesterol, zu seinem Wirkungsort befördert – etwa zur einer
Zellmembran.
Daneben gibt es in unserem Blut
aber auch das HDL-Cholesterin (high density lipoprotein). Diese Verbindung gilt
das Gegenstück zum LDL-Cholesterin: Es senkt vermeintlich das Risiko von
Herzkrankheiten.
Lange gingen Ernährungswissenschaftler davon aus, dass LDL- und HDL-Cholesterin als Gegenspieler gleichwertig zu betrachten seien und das Risiko für Herz-Kreislauf-Erkrankungen entweder erhöhen oder eben verringern. Neuere Studien liefern jedoch Hinweise, dass das so nicht stimmt. Eine davon ist im Journal of Clinical Endocrinology & Metabolism erschienen (Haase et al., 2012). Ein Team rund um die Forscherin Christiane Haase untersuchte 54.500 Menschen. Die Forscher verglichen, wie viele derjenigen einen Herzinfarkt erlitten hatten, die erblich bedingt natürlicherweise einen hohen HDL-Cholesterinspiegel im Vergleich zu den anderen aufwiesen. Das Ergebnis:
Der natürlich erhöhte HDL-Spiegel bescherte nicht gleich ein geringeres Herzinfarktrisiko. Dies könne darauf hindeuten, "dass der HDL-Cholesterinspiegel nicht kausal
mit dem Risiko" zusammenhänge, schrieben die Autorinnen und Autoren. Eine weitere Studie an knapp 70.000 Männern und Frauen bestätigte das (The Lancet: Voight & Kathiresan 2012).
‡ Folgendes hat anthroposofische Einschlüße ‡
[Martin Errenst, M.D.]
Concentration of Chol. (in blood/food), is a recurrent topic in the
scientific and the popular press.
The image presented is that of a harmful substance that causes disease
and shortens life.
Yet others will say that the Chol. discussion is the invention of an
industrial lobby to boost the sale of Chol.-free margarine and plasma Chol.
level-reducing agents.
Chol. is at the heart of the egotistical interests of industrialists on
the one hand and consumers on the other.
Chol. holds a central position in the evolution of chemistry and the
physiology that has developed from it since the 18th century.
Chol. is considered in relation to fats as polar opposites among the
lipids (i.e. fat-soluble substances). Fats and Chol. are related not only
because they have lipid character
but also because of many physiological relationships; some of this will
be considered below. On the other hand it will be shown that they are also
polar opposites.
2. Triglycerides
Everyone knows fats and oils, for instance in the kitchen, where
vegetable fats play a major role. A vast variety of fats and oils with
different qualities may be described.
Even the widely used sunflower oil, olive oil and palm oil offer a broad
spectrum of qualities.
Palm oil is solid at room temperature, insensitive to heat and therefore
used for (deep) frying.
Olive oil has its own taste and odor; it is liquid at room temperature
but solidifies in the refrigerator or when the room temperature is lower in
winter.
Sunflower oil also has its own aroma and only solidifies at temperatures
below 0° C.
Linseed oil may be added to the range. It only solidifies if the
temperature is markedly below 0° C and is sensitive, easily going rancid and
needing protection from heat and light.
Fatty oils have to be distinguished from the volatile oils (identified
by the fact that drops applied to filter paper evaporate completely, whilst
fatty oils leave a fat stain).
Volatile oils are thus more inclined to evaporate, intensely addressing
themselves to the sense of smell. Combustibility, a characteristic also of
fatty oils, has here reached explosive and spontaneous combustion level.
Volatile oils are not nutrients, like fats, but have pharmaceutical actions.
At the other end of the scale, waxes, also not nutrients, are solid
lipids that only melt at temperatures higher than fats do and are chemically
more inert.
Volatile oils tend towards the gaseous and waxes to the solid state,
natural vegetable fats are generally fluid.
Both waxes and fats do not melt or solidify at a sharply defined
temperature but in a fusion interval. In the case of fats this covers a range
from -15 to 40°C, which is the temperature range in which higher organisms are
able to live.
Some of the many different qualities of fatty oils are evident in the
different fatty acids that can be liberated and isolated from fats by
saponification. Every natural fat contains a large number of different fatty
acids. One is usually dominant and this usually owes its name to the fat
concerned - oleic acid from olive oil, linolic and linolenic acid from linseed
oil. Saponification also liberates hygroscopic sweet-tasting glycerin, a
constituent found in all fats, which chemically distinguishes them from waxes.
The fatty acid composition of fats is primarily determined by the plant
species that produced them. Environmental conditions (temperature) have a
marked effect on the fatty acid composition.
Vegetable fatty oils are an important part of our diet, which means that
we are all the time taking in this rich variety of substance qualities with
natural foods.
Two fatty acids (linolic and linolenic acid) are only produced by plants
and essential to humans, for whilst the human organism is unable to produce
them it does need them. Fats of animal origin are clearly also important for
nutrition. (Milk fats have a great variety of fatty acids).
Apart from carbohydrates fats are the main basis of energy metabolism.
They go through physiological "combustion" in the organism, so that
their substance quality is destroyed.
Fatty oils are thus characterized as substances available in great
variety in nature that offer differentiated qualities perceptible to the
senses. We have distinguished them from the volatile oils and waxes,
identifying them as nutrient lipids that are nonvolatile, with their melting
point in the -15 to 40° C range.
3. Chol.
Fats have been known to man from early times. Fats and flour (cereals)
are the staple foods of settled people and part of their culture and religion.
The Mediterranean landscape is given its character by the olive tree which was
sacred to the Greeks. The founding of Athens involved the goddess Athena giving
the people an olive tree.
Chol. on the other hand had to be discovered by scientific means in more
recent times. The history of its discovery begins in the second half of the
18th century (1769-1789) when French chemists investigated and described the
waxy consistency of gall stones. This history of Chol. is essentially based on
the paper by Neuhausen. At the beginning of the 19th century (1815-1816)
Chevreui described the Chol. he had isolated from gall stones as a substance in
its own right. He distinguished it from waxes and fats because of its high
melting point (147.5°C) and because it could not be saponified by boiling in
lye to produce soap, a fatty acid salt. Chevreui gave Chol. its name from Greek
chole = bile and stereos = solid.
In 1932, a century later, Windaus established the molecular structure;
Woodward synthesized it in 1951. Chol. thus followed the whole evolution of our
modern chemistry
in which matter is weighed, a chemistry given its original foundation by
Lavoisier at the end of the 18th century, exactly at the time, therefore, when
Chol. was first discovered. The names of many renowned scientists are connected
with it,and few substances have seen so much eager effort as Chol. M. Brown and
J. Goldstein who received the Nobel Prize for physiological studies connected
with the substance in 1985, referred to the role of Chol. in the history of
science in their Nobel lecture, saying that Chol. was the most distinguished
small molecule. 13 Nobel Prizes were given to scientists who devoted a great
part of their life's work to Chol. The physiology of Chol. began to be studied
in the mid 19th century, when simple color reactions had been developed to
detect it/ Chol. found in most human tissues/secretions/pathological growths.
Two opposing views:
A. developing tissue was found rich in Chol., the conclusion being that
Chol. was important for "formative" processes. On the one hand it was
found that Chol. counteracted action of saponins and the venom of bees, spiders
or snakes, thus being medicinal.
B. On the other hand North American
scientists in particular draw a picture of Chol. where the emphasis is on its
occurrence in conjunction with pathological phenomena such as gall stones.
Flint referred to Chol. as a
"sinful" substance in 1862. Chol. promoted tumor growth in
experiments on animals and the fatty tissue of cancer patients was found to
have elevated Chol.
levels. Experiments were also done
from which it was wrongly concluded that Chol. cannot be produced inhuman or
animal organisms but has to be taken in with the food.
The idea of Chol. as a harmful substance had so been born. On the basis
of it, attempts were made to explore the connection between food Chol. and
atherosclerotic changes. It had been known for some time that atherosclerotic
changes relate to high Chol. levels. Rabbits were thus given Chol. suspended in
oil in addition to their vegetable diet which, of course, contained practically
no Chol. After 4 - 8 weeks all tissues had been infiltrated with Chol. Rabbits,
being completely herbivorous, are not used to foods containing Chol. The same
experiment gave negative results with rats, naturally carnivorous and therefore
used to foods containing Chol. This raises the question how far the experiment
done with rabbits applies to humans who eat a mixed diet. In spite of this, the
concept of Chol. in foods being harmful dominated the discussion for a long
time. It was only in the 1970s that experiments on human subjects showed that
the Chol. level of foods has only a limited effect on Chol. levels.
On the other hand Chol. was also considered and used medicinally as a
general roborant (= Kräftigungs-/Stärkungsmittel) for anemia and infectious
diseases. These uses never gained real significance, however.
It is remarkable how long it took for the idea that Chol. is produced in
the human organism to be accepted. Systematic investigations of the Chol.
balance in 1920 - 1923 showed that the body eliminates more Chol. than it takes
in with the food, so that Chol. is not really a food. With a purely vegetarian
and therefore practically Chol.-free diet, the organism is able to produce all
the Chol.
it needs. On the other hand Chol. is continually eliminated as the
organism is not able to break it down. If the diet contains high levels of
Chol. (= high proportion of foods of animal origin) the body's own synthesis is
reduced, though it never ceases completely. The Chol. balance thus varies
depending on the diet.
Daily dietary intake is 500 mg, but only 200 mg are absorbed, compared
to more than 95% of fats. 700 - 900 mg are produced in the body, and in accord
with this about 1.000 mg = 1 g is eliminated as Chol. or bile salt in a ratio
of approx. 1:1 and as steroid hormone (about 50 mg).
Chol. is thus the complete opposite of the fats as characterized above.
The latter are needed as foods. They are taken up from the outside world and
metabolized in the organism. With Chol., the opposite is the case. It is mainly
produced in the organism itself and eliminated. In human metabolism, fats and
Chol. are polar opposites in one major aspect.
4. Polarity of Chol. and dietary
fats.
Fats = substances human beings have used as foods taken from the natural
world around them from early times.
Vegetable fats have ripened in the light and in the heat of the sun;
they have numerous qualities that relate to the particular plant and reflect
the conditions under which the fat was produced in the plant.
They go through a physiological combustion process in the human organism
that destroys their qualities.
Chol. on the other hand is produced in the organism and does not
immediately show itself. It needed to be discovered. Compared to the
qualitative variety of fats which is reflected in the wide variety of fatty
acids, Chol. is a single substance. It does not go through combustion in the
organism but is excreted into the outside world, into the light.
Fats and Chol. also differ in their qualities as substances. Both are
completely insoluble in water, but fats are saponifiable and may thus be
converted to fatty acids and glycerin, whereas Chol. is not saponifiable. The
melting temperatures of fats have been considered above; Chol. does not melt at
temperatures in the range of life, as they do, but only at a high temperature,
having a clearly defined melting point. The substances also differ in density.
Fats are lighter than water - "fat floats on top" - whereas Chol. has
a density of 1.046 g/ml (Beilstein), which makes it heavier than water.
Compared to the wide variety of fats that are produced in the light and
show a wide range of qualities, Chol. is thus a heavy, monotonous substance
produced in the dark.
Chol. became the subject of research as a substance that has dropped out
of life. This determined its image for a long time, although it was noted that
Chol. was a necessary part of many organisms and was produced especially in the
course of growth processes. In the above-mentioned feeding experiments Chol.
was added artificially, thus teaching us nothing about the substance in a
healthy organism. People were blinded by the material substance, failing to see
where the activity really lay, in this case in themselves. In a living context,
the organism itself is active. Views on Chol. are now turning in this
direction, and people now concentrate less on influencing plasma Chol. levels
by the amount of Chol. in the diet, which is only possible to a limited extent.
Instead, attention focuses on the way the diet influences plasma Chol. levels,
quite apart from the Chol. it contains, and the effects of people's behavior
and life style. Chol. is seen as a substance that is really passive in itself.
What are fats, and what is Chol. to
the human being?
When the human organism is given nourishment in form of fats, qualities
from the outside world enter into the human being. These qualities are
"burned" to destroy them. This generates heat and the potential for
movement in the human being, i.e. he brings his will impulses into the world.
It is thus immediately apparent that dietary fats relate to the human will
pole.
Compared to this, what is the
significance of a substance the human being produces himself, and which he then
makes into something alien and eliminates?
In Extending Practical Medicine, Rudolf Steiner and Ita Wegman describe
substances that are eliminated to the inside or the outside and provide the
material basis for conscious human experience
in contrast to substances taken into the body which are connected with
unconscious processes. The examples given are uric acid for elimination and protein
as a substance taken in. Does something like this also apply to Chol. and
dietary fats in the sphere of lipids?
5. Chol. in the natural world outside
man and as the starting material for substances with hormone-type actions
Chol. is found in the membranes of all eukaryotic (nucleated =
Keimbildende) cells in animals. But whereas in humans only a few % of other
sterols occur associated with Chol., a large number of these occur with Chol.,
with the Chol. itself going more into the background. So one substance is
replaced by many. Terrestrial vertebrates have almost only Chol., like humans.
Marine fish have up to a 1/3 of sterols other than Chol. Plants may also
synthesize Chol. and usually contain small amounts of it, but they mostly
produce special phytosterols. In evolutional terms, sterol production is thus
progressively simplified both as regard variety and method of synthesis.
Bacterial membranes hold a special position, being sterol free. The
anthropods, incl. insects, are unable to synthesize new sterols themselves,
though these are found in their membranes. They take in sterols with their food
or from symbiotic micro-organisms and modify them. Sterols are thus essential
food constituents for arthropods, just as fatty acids (e.g.linolic acid) are
for us, with the organism able to modify but not produce them. Insects thus
relate in the opposite way to Chol. or to the sterols that take the place of
Chol. than humans do.
Conversion of Chol. to substances with homone-like actions. As already
mentioned, part of Chol. is eliminated in form of bile salt, calciferol
(vitamin D) or steroid hormones. About 0.5 g of bile salts and 50 mg of steroid hormones on
average are produced daily and eliminated by the human organism. Bile salts
emulsify Chol. in the bile fluids and play an important role in breaking down
dietary fats. This is the point where Chol. and fat aspects come together.
Calciferol production from Chol. is remarkable if one considers the
character of Chol. as it has been presented so far. 7-dehydroChol. is converted
to cholecalciferol under the influence of light in the skin. Calling
cholecalciferol vitamin D is therefore misleading. It is not an essential
vitamin; the light is essential. Deficiency of this can be corrected by giving
cholecalciferol as "vitamin D". The substances needed above all to
regulate bone development and hence the human form are produced from
cholecalciferol in the liver and kidneys. Thus Chol., produced in the darkness
of the organism, is under the influence of light converted to a substance with
hormone-like action.
Steroid hormones are produced from Chol. in certain organs of the
adrenal cortex and gonads and regulate growth and metabolic processes. The
effect is always on the whole organism. The steroid hormones produced in the
adrenal cortex or gonadal cells are distributed throughout the organism by the
blood. These processes take hours at their shortest, more often days
(reproductive cycle) and even longer in growth processes.
Arachidonic acid cascade results in active compounds such as
prostaglandins being produced from essential fatty acids. Unlike the steroid hormones, these compounds,
collectively called eikosanoids, act within very short time span (seconds) and
only locally. The mode and direction of their action depends on the site in
which they occur and may even be the opposite for one and the same substance in
another site.We note that substances with hormone-like actions are produced
from both fatty acids and Chol. The steroid hormones produced from Chol. act
for relatively long periods and within the whole organism; eikosanoids produced
from fatty acids act locally and short term.
It is also worth looking at the sulfuric acid compound of Chol. which is
Chol. sulfate, a substance found mainly in the epidermis. The two play a role
in regulating comification and the desquamation of corneal cells. A most
illustrative example is the horse's hoof (Keratinum equi w = Pferdhuf/contains 27% of cholesterol. and 20% of cholesterol sulfate Tierisches Gewebe.). Its lipid part contains 27% of
Chol. and 20% of Chol. sulfate. In this extreme case the character of Chol.
emerges as a substance that shows up where firmness, structure and external
pressure are found. No up-to-date literature could be found on Chol-sulfate in
human cornified matter.
6. Physiology of Chol.
Describing the human physiology of Chol. we have to consider 3 aspects:
I. Inquiring into the
genesis of Chol. produced by all nucleate (= keimbildend in Phasenübergang)
cells (liver/intestine produce excess to serve other organs/pass it on to other
organs via the blood).
Elimination of Chol. via the bile and intestine also starts from the
liver. Chol. - emulsified by phospholipids and bile salts produced from Chol. -
gets into the intestine in the bile and there encounters food substances, above
all fats. Part of this Chol. is eliminated through the intestine, another part
is absorbed together with dietary lipids and reaches the liver via the blood
circulation; it is therefore involved in the biliary cycle.
Three processes
connected with Chol. in the liver and intestinal tract
a. synthesis, b. elimination, c.
biliary cycle.
The metabolic processes relating to
fats go in the opposite direction.
Chol. synthesis has its opposite in fat degradation (Fatty acids = fats
may also be synthesized in the liver). With a balanced diet the amounts
involved are negligible. What both have in common is that substance - Chol. or
fat - is moved and transformed.(In the sphere of the metabolic organs, bile
acids and cholecalciferol are also produced in the liver and steroid hormones
in the adrenal cortex and gonads.
II. Bigger
concentration - as a substance in the brain = ¼ of the total Chol. in the body
(about 140 mg) = up to 10% of the dry matter.
The question as to the site of major Chol. synthesis and conversion took
us to the metabolic sphere of intestine and liver. The highest concentrations
of Chol. may be found in the brain. If we consider that Chol. goes through the
biliary cycle several times a day (half life in the CNS is much longer/up to
several years) we can appreciate the opposite nature of the situation in the
latter. In the brain, Chol. is found above all in the myelin sheaths, extreme
forms of cell membranes with the emphasis on the insulating, separating
function. Cell membranes in the metabolic sphere, in liver cells, for instance,
have the emphasis on a mediating as well as a limiting function, permitting the
catalysis of processes and exchange of substances. The functional difference
correlates with the higher protein levels in liver cell membranes and higher
lipid levels in myelin sheaths. Myelin sheaths with their high lipids and Chol.
levels form an insulating layer around nerve cells; they are persistent
structures with closed-off surfaces.
The lipids in all cell membranes in the human and mammalian organism are
made up of Chol. on the one hand and polar lipids that give mediation towards the
watery element on the other (e.g. phospholipids orsphingolipids). These derive
from triglycerides in so far as they are saponifiable and fatty acids are
liberated in the process. The polar lipid and Chol. composition results in the
liquid-crystalline state of the membranes as a new quality that cannot be
derived in a linear way from the properties of the individual components.
Thus the melting point of the membrane is not a intersection (=
Durchschnitt) of the high melting point of Chol. (147.5°C) and the low melting
point of the lipids.
The liquid-crystalline state is a synthesis of the properties of liquid
and solid bodies. A higher proportion of Chol. gives the membrane greater
solidity and impermeability, a property seen above in all myelin sheaths.
Triglycerides are of no significance in the sphere of the brain and nerves, not
as a substrate for energy metabolism nor as a structuring agent. Only the polar
membrane lipids derived from them play a role. Compared to the fat stored in
fatty tissues, where the composition of fats reflects that of the diet in a
remarkable degree, the fatty acid composition of these polar membrane lipids is
largely controlled by the organism. Brain lipids do, however, have particularly
high essential fatty acid levels. Again Chol. is the polar opposite. Chol.
supply to the brain is independent and does not depend on plasma Chol., whereas
Chol. synthesis in the liver balances the organism's needs against the dietary
supply in a flexible way. We thus see a tendency in the brain for processes to
be determined by the organism and not be open to the triglycerides, which are
greatly influenced by the environment; here the character of the organism's own
Chol. production emerges clearly.
Chol. is tied in with opposing functional complexes in the neurosensory
and metabolic spheres. The two spheres interpenetrate in space, with Chol.
synthesis taking place throughout the organism and Chol. a membrane constituent
in all tissues. Liver and intestine are nevertheless major sites for Chol.
synthesis; Chol. elimination is via the bile only, and the role Chol. plays in
the membranes is at its highest level in the myelin sheaths with their high
lipid levels.
III From the point of view of health
and sickness, attention focuses on blood plasma Chol. levels, as the body is
particularly sensitive to Chol. - in this area, so that there is considerable
potential for pathology.
The three aspects -Chol. in the metabolic sphere, in the nervous system
and in the blood circulation- will be considered below.
3. Circulation
The dynamics in the metabolic sphere and the static state of matter in
the neural sphere are balanced out in the blood circulation. The movement of
lipids in the blood mediates between the two. Water-insoluble substances are
kept in the liquid, watery state in the blood by lipoproteins. How are these
processes, where changes of a high order are continually occurring, approached
in experimental research?
The first observations were made on dogs in 1622. Their lymph vessels
contain a milky white fluid after feeding. Blood samples taken after a fatty
meal are also milky and turbid. This points to the presence of lipoproteins as
vehicles for lipophilic substances in the blood. They appear as spherical or
drop-shaped structures under the microscope, certainly comparable to fat
droplets in milk, but should not be thought of as static but in continuous
motion and transformation.
A first experimental differentiation of lipoprotein according to density
gives the generally used terms VLDL (very low density lipoprotein), LDL(low
density lipoprotein, and HDL (high density lipoprotein). These tell us nothing
of their physiological significance. Chemical analysis of the selipoproteins
according to fat, Chol. and protein content shows that VLDL have the highest
fat content (which correlates with their low density, fat being light), LDL the
highest Chol. and HDL the highest protein content.
What is their physiological role? Lipoproteins with high fat content have
nutrient function, supplying organs (not brain) with triglycerides. Considering
the site of synthesis, distinction must be made between VLDL that are largely
produced in the liver and "chylomicrons" which are produced in the
intestinal wall. Dietary fats digested in the intestine and absorbed into the
intestinal wall are incorporated in the organism as chylomicrons. This is the
reason for the milky, turbid lymph. The chemical composition of chylomicrons
shows that they are nutrients by nature. The fat composition is the same as in
the food, and compared to VLDL, chylomicrons contain retinol (vitamin A =
essential nutrient element) and compared to the dietary Chol. level less of the
non-nutrient Chol. Chylomicrons convey the lipids taken in from outside via the
intestine into the organism; VLDL convey lipids produced or transformed by the
liver within the organism.
In the organs, triglycerides are released from the lipoproteins whilst
still within the blood capillaries. Chol.-rich residues remain. If one considers
that the fats of lipoproteins also go through a physiological form of
combustion, the high-Chol. residues may also be called "ashes" to
give us a picture. The "ashes" of chylomicrons are taken up into the
liver and digested; those of VLDL partly remain in the blood and are converted
into high-Chol. LDLs. These may be taken up both into the liver and into other
cells in the organism, thus complementing tissue Chol. metabolism. (LDLs are
taken up entire into the cell (endocytosis) and digested within it.
Triglycerideson the other hand are released from lipoproteins with high fat
concentrations in the plasma and only then absorbed into the cells).
Compared to the rest of the organism, Chol. exists largely - about 76% -
as a fatty acid ester combined with essential linolic acid in the blood. Here,
in the middle, rhythmic sphere of human physiology, the two sides which we have
been considering as polar opposites in this paper (essential fatty acid taken
in with the food and Chol.) combined in a kind of neutralized storage form of
Chol. (a small proportion of Chol. in cells is fatty acid ester, and in that
case mainly esterified with oleic acid; in the brain it exists only as
non-esterified Chol.). Binding of fatty acid to Chol. is possible because Chol.
has an "alcohol function". This reveals a side of Chol. that is not
immediately obvious. Though practically water-insoluble, it has an affinity to
the watery element. It therefore crystallizes with water and is used as an
emulsifier in ointments. The olending relates to this aspect, whilst the term
Chol., which was chosen by Chevreui, puts the emphasis on the waxy appearance
(as in paraffin, stearin).
Protein-rich lipoproteins (HDL) play a major role in Chol.
esterification in the blood plasma, for they contain the enzyme which catalyzes
the esterification (LCAT = lecithin-cholesteryl-acyl-transferase).
These high-protein lipoproteins are not uniform but changing. Even the
appearance under the microscope of lipoproteins newly produced by the liver or
the interstitium differs from that of others. They do not yet have the
spherical form shown by the others but are said to be discoidal.
They change in the plasma, assuming the spherical form, growing larger,
with a lower specific weight, and have higher lipid and above all Chol. levels.
They take up Chol. from the organs and combine it with linolic acid, thus
withdrawing it from the organism, for this esterified Chol. is above all
eliminated via the liver and bile, with the lipoproteins taken up into the
liver and digested. Chol. esterification in the blood plasma is thus an
important stage in "reverse Chol. transport", i.e. its transport back
to the liver for elimination.
Distinction is therefore made today between LDL and HDL Chol. and high
HDL Chol. levels are rated positive, unlike high LDL Chol. levels.
Lipoproteins with their nutrient function support metabolic and limb
activity; the eliminatory function, "reverse Chol. transport",
relieves the organism of Chol. Pathological changes threaten if the right balance
is not maintained.
The Chol. discussion shows that the potential for disease is
particularly great in the circulation. In the region of the brain and nerves,
the composition of the membranes, Chol. levels, etc. are largely subject to
laws and not greatly variable. As a rule they cannot be changed to any major
extent by nutrition (except in cases of extreme malnutrition) nor by behavior,
moods or stress situations. This is different in the metabolic sphere.
Digestive functions, the secretion of digestive juices, production and
composition of bile depend to a considerable degree on psychological factors,
though the deviations are tolerable to a relatively high degree. Thus
intestinal Chol. absorption differs markedly between individuals. In the sphere
of the circulation, the influence of the psyche on physiological processes is
again considerable, but the limits are narrower and too great a deviation may
lead to disease. A common example is a high plasma triglyceride level, usually
in conjunction with a high LDL Chol. level. In that case nutrient processes are
too powerful compared to activity in limbs and metabolism, and there is a
danger that processes which can only be healthily dominant in the head region
become too powerful here, resulting in lipid and cell substance deposition
(atheroslerotic plaques). Suggested preventive measures in that case are
physical movement and a diet rich in ballast and fats with high oleic acid
content (olive oil). This will increase metabolic and limb activity.
Little well-founded knowledge is available today on the significance of
the reverse situation, i.e. a low Chol. plasma level. Correlation between this
and with neoplasia, hemorrhagic cerebral accident and increased death rate
involving violence is controversial. Extremely low plasma Chol. levels are seen
in patients where the immune system is reduced to an extreme degree (advanced
AIDS). In that case the low Chol. level reflects a weakness in the powers to
maintain oneself against the outside world, with the organism flooded by that
outside world.
We have characterized three functional spheres in the human organism
that interpenetrate in space but may be clearly differentiated by their
functions. In so far as food uptake is dominant in the intestine, the food must
be broken down, mixed up, made chaotic. At the other pole we have the
neuro-sensory sphere which is connected with the development of conscious
awareness and powers of memory. For this, we need stable structures in the
brain where substances come to rest. This only applies to substances that give
structure, the brain itself having a very high energy metabolism,
of course.The opposite pole to the homogenizing, chaos-creating,
form-dissolving processes in the intestine is the structure at rest and the
generation of surfaces in the brain. The circulation holds
a middle position. There we have the spherical droplet form of
lipoproteins continually changing and in motion in a highly ordered fashion.
The function of Chol. may be seen most clearly in the neurosensory system,
in the brain's myelin sheaths with their high lipid and hence Chol. content,
persistence, with the brain always creating its own Chol.s and triglycerides of
no significance. In the middle sphere of the circulation there can be no
persistence; the processes that are dominant in the head have to be overcome
here, with Chol. brought to elimination in the intestine.There it meets the
nutrient stream (dietary fats).
7. Connection between processes
relating to substance and those relating to the psyche
Chol. research is simply vast. In so far as it is not merely
descriptive, defining substance properties, molecular structures, occurrence in
the organism and biosynthesis, it has initially concentrated on the connection
between plasma Chol. levels and cardiovascular disease as well as the factors
that influence plasma Chol. levels. The focus has been on Chol. in relation to
pathological changes. Relatively little is known, however, about the actual
significance of Chol. in the organism. Apart from the role it plays as a
precursor in steroid hormone, cholecalciferol and bile acid synthesis, research
has for a long time concentrated mainly on physical membrane properties in
relation to their Chol. levels. To date, the influence of membrane Chol. on a
number of biochemical parameters has been investigated. From the above we may
deduce Chol. to have a function which is the opposite of that of lipophilic
anesthetics. With the latter one sees increased fluidity/with Chol. increased
solidity and impenetrability of membranes. This is in accord with the image we
have evolved from total Chol. metabolism of a substance that shows its
character in the neurosensory sphere. A connection exists between the substance
character of lipids in particular in the central nervous system and the
potential for conscious awareness. In the past, the power of anesthetics was
estimated by determining their solubility in olive oil. Today more detailed
insight into the connection is the subject of intense research.
The phenomenon of human conscious awareness cannot be explained from
substance processes like these, nor the human will in terms of energy released
in the combustion of fats. Physiological processes do, however, go hand in hand
with every act of will, and the creation and condensation of matter in some
form is the precondition for human waking consciousness.The way the balance
between solidification and dissolution is found in the circulation ultimately
depends on how the human being relates to the world in his inner experience,
thus reflecting his feelings.
A similar quality of gesture was described by Rudolf Steiner in his
lectures on occult physiology in 1911. He spoke of processes originating in the
blood that accompany thinking, feeling and acts of will with crystallization,
flocculation and warmth processes, and of processes in the development of the
human body where bone development, gelatin and physiological combustion provide
the physical basis for human thinking, feeling and doing.
As we have seen, Chol. has significance in all spheres of the human
organism. Considering the characteristic role it plays in the physiology one
sees it to be the polar opposite to fats in every sphere. It is possible to
establish, even at substance level, that the synthesis and function of Chol. is
above all under the influence of forces dominant in the neurosensory sphere.
A signature may also be seen at the social level if one considers the
scientific and cultural role of Chol. With pathological changes it drops out of
the organism as a whole, becomes a single substance, and is then easily
detectable using color reactions. Here it makes us aware of it as
substance,becoming the object of egotism and anxieties. The changing views on
Chol. reflect a turning away from focusing mainly on the substance.Gradual
realization that the organism is responsible for the control of matter, under
the influence of soul and spirit, is putting an end to fixation on matter,with
growing awareness of personal responsibility for the way one lives one's life.
A stage in the evolution of conscious awareness thus crystallizes out from the
cultural history of Chol.
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