Are you on the list of people who worry about their health because of high
cholesterol? Have you cut out eggs, shrimp and other high cholesterol
foods including saturated fats? Perhaps you’re one of the 56 million adults
in the US for whom statin use is indicated?(1)
Where ever you are on the cholesterol spectrum, there are some facts you
may not be aware of that could be important for your health.
What is Cholesterol and why do we need it?
Cholesterol is a waxy, fat like substance produced by your body. In fact
80% of all cholesterol is made by the body while 20% comes from the food
we eat. Cholesterol is found in every cell of your body as a building block of
cell membranes, providing flexibility and allowing lipids to actually pass
through the membrane. Cholesterol is needed to make Vitamin D,
hormones and fat dissolving bile acids. These all have a direct effect on
immune function, detoxification, blood sugar regulation, mineral absorption,
metabolism and reproduction.
Because cholesterol cannot cross the blood brain barrier, 25% of the
body’s total cholesterol is found and produced in the brain. It protects the
axons of nerve cells facilitating quick transmission of electrical impulses.
This has a big impact on thought, movement, and sensation.
Types of Cholesterol
If you wondered why HDL is “good” cholesterol and LDL is “bad”
cholesterol, it all boils down to delivery! Cholesterol is a fat that does not
mix well with blood, similar to oil and water. In order to carry cholesterol
and other fats to various cells they must be packaged with protein carriers
known as lipoproteins. There of 5 different lipoproteins that vary in shape
and form depending on the task at hand.
- Chylomicrons are made in the intestines. They mainly carry
triglycerides or fatty acids from the break down of your food to cells for
absorption.
- Very-low-density lipoproteins (VLDL) also carry triglycerides but they
are produced in the liver. As they give up their triglycerides to cells they
become IDL’s and eventually LDL particles.
- Intermediate-density lipoproteins (IDL) are intermediates between
VLDL’s and LDL’s. Some IDL’s are removed by the liver for excretion
and others are converted to LDL’s.
- Low-density lipoproteins (LDL) are high cholesterol containing particles
because they have very little triglycerides left. They continue to travel
through blood to deliver cholesterol to cells.
- High-density lipoproteins (HDL) remove cholesterol from the blood and
artery walls and return it to the liver so it can be excreted.
It is thought that HDL is “good” because it takes cholesterol out of the
circulatory system while LDL is “bad” because it delivers cholesterol to the
body and is associated with the buildup of arterial plaque.
The Nitty Gritty
While many healthcare practitioners plant red flags on high LDL and total
cholesterol lab values, it has been shown that cholesterol is not correlated
with hardening arteries (atherosclerosis) and the build up of arterial
clogging plaque.(2) In 1936, researchers Landé and Sperry concluded that
the degree of aortic atherosclerosis at autopsy of healthy individuals who
had died violently, was independent of their blood cholesterol concentration
analyzed immediately after death. This lack of correlation between LDL
cholesterol and total cholesterol and the degree of atherosclerosis has
been repeatedly confirmed by recent additional studies.
Unfortunately, the conclusion from the “Seven Countries” study by Ancel
Keys in 1970 finding a significant association between fat and saturated fat
intake and heart disease mortality fueled the campaign against saturated
fat and cholesterol.(3) Additionally the 1984 statement ’The more LDL there
is in the blood, the more rapidly atherosclerosis develops,’ by Nobel Award
winners Michael Brown and Joseph Goldstein, thereafter dominated
research on atherosclerosis.(4) These events lead to recommendations in
1961 by the American Heart Association to decrease intake of saturated fat
and high cholesterol foods and in 1987 the FDA approval of statins, a
cholesterol lowering drug.(5)
Since 1987 tens of millions of individuals use statins to control cholesterol.
Yet our population continues to suffer from heart disease. Perhaps the
conclusions of Lande and Sperry in 1936 should be more highly
considered. Although the use of statin drugs does help decrease the
incidence of heart attacks, it is likely not due to it’s cholesterol lowering
effects, rather some other effect that is not absolutely understood.
Inflammation and irritation of the artery wall trigger the build up of
cholesterol and calcium plaques, similar to a scab, that harden arteries.
It has been theorized that smoking, lack of exercise, stress and obesity are
the culprits and statins have some anti inflammatory effects.(6)
This completely changes the way we view cholesterol, treatment for high
cholesterol, and high cholesterol foods and saturated fats in the diet! In fact
the campaign against cholesterol has effectively stifled knowledge of how
extremely beneficial cholesterol really is for the body! With this in mind
consider these 5 key factors concerning cholesterol:
- Statins have side effects that are downplayed due to the apparent
“benefit” of the drug in lowering cholesterol. These side effects include
headaches, difficulty sleeping, gastrointestinal issues, muscle pain,
severe confusion or memory impairment, fatigue and new onset of Type
2 Diabetes. (7)
- The USDA (United States Department of Agriculture) recently published
new dietary guidelines indicating “cholesterol is not considered a
nutrient of concern for over-consumption.”(8) Clearly cholesterol is
produced in the body and needed for critical biological functions.
- Focus on a healthy diet to decrease heart disease. Avoid processed
foods and sugar, eat more fiber and choose healthy fats. Remember to
drink plenty of water.
- Get more exercise. This is one of the best things you can do to increase
HDL and decrease LDL. It also helps control blood sugar, manage
stress and excrete toxins, all of which contribute to better heart health.
- Eat more vegetables. These are high in antioxidants which help
decrease inflammation, high in fiber to help excrete toxins and
cholesterol, and they feed your gut bacteria which play a role in
cholesterol balance and metabolism.
In conclusion, cholesterol is vital to our bodies to the extent that we make
80% of all our cholesterol. Statins may help decrease heart attacks but
have little correlation to lowering cholesterol while their side effects are
dramatic. Diet, exercise and managing stress are important and effective
alternatives to controlling heart disease. Understanding these nitty gritty
details can direct you on a path to better health and optimal heart health!
References:
- https://jamanetwork.com/journals/jamacardiology/fullarticle/2583425
- https://academic.oup.com/qjmed/article/95/6/397/1559536
- https://academic.oup.com/jn/article/128/2/449S/4724049
- Brown M, Goldstein JL. How LDL receptors influence cholesterol and
atherosclerosis. Sci Am1984; 251:58–66. - https://www.clinicalcorrelations.org/2019/01/11/on-the-history-of-statins/
- https://jamanetwork.com/journals/jamacardiology/fullarticle/2583424
- https://www.drugs.com/medical-answers/side-effects-statins-3439483/
- https://www.dietaryguidelines.gov/sites/default/files/2020-12/
Dietary_Guidelines_for_Americans_2020-2025.pdf
