When we hear about high cholesterol, most of us think about it causing heart attacks or strokes. And it scares us. According to the National Health Library, high cholesterol itself does not cause symptoms, so many people are unaware of their cholesterol levels. They suggest that everyone age 20 and older should have their blood cholesterol levels checked every 5 years. But is that true, is cholesterol really bad? Should we all start using statins, the cholesterol lowering drugs, like most doctors and drugs companies tell us to?
When I first asked myself these questions, I started to research as much I could. And it was really not easy to find independent studies — most studies seem to be funded by the drug companies. Of course anyone should be able to do a study, but should the leading studies really be funded by the same drug companies that sell the drugs that they are studying? That’s just my personal opinion! Although I’m not alone, for example the cardiologist Dr. Aseem Malhotra, who is the known as one of the most influential cardiologists in Britain, is trying intensely to get attention on how the pharmaceutical companies support research, and perhaps mislead the results.
What is cholesterol?
Cholesterol is a fat-like substance that is found in every cell in our body. It’s one of the primary structural components of the membrane of a cell. Although we like to think that having too much cholesterol can increase the risk of adverse health effects, the human body actually needs cholesterol. It is essential in making hormones and other substances — all of the steroidal hormones of the body are synthesized from cholesterol, including cortisol and corticosteroids, DHEA, the estrogens, testosterone, progesterone, and aldosterone. Cholesterol is the precursor to all of these hormones. Vitamin D is synthesized from cholesterol in the skin upon exposure to sunlight. Bile acids, which help the body digest fats, are also produced by cholesterol. So using cholesterol lowering medication, without at the same time making the necessary lifestyle changes, can have significant side effects including fatigue and muscle loss. The liver already naturally produces all of the cholesterol that the body needs. So if we stop ingesting cholesterol through food, or take cholesterol reducing drugs, then the liver needs to work harder to maintain homeostasis.
Cholesterol is among the most vital lipids inside of the human body. There are no such things as “good” and “bad” cholesterol. Both LDL (which is commonly known as bad) and HDL (commonly known as good) are actually not even cholesterol, they are lipoproteins, transport mechanisms that deliver cholesterol to and from the tissues. LDL carries cholesterol out to the different parts of the body, and HDL removes cholesterol from the tissues and brings it back to the liver. So they are neither good nor bad, they are both essential and normal biological processes that the body needs in order to maintain homeostasis.
However, you have likely heard that high levels of LDL cholesterol can lead to fatty deposits building up on the walls of arteries, which increases a person’s risk of heart disease, heart attack, and stroke? Actually, HDL cholesterol does a pretty good job at collecting the LDL cholesterol and other fats from the arteries and transporting them back to the liver. The liver then disposes of excess cholesterol by converting it into a digestive fluid called bile. And LDL actually also does much more than just transport cholesterol. It also transports essential antioxidants, such as the vitamins A, E, D, K, coenzyme Q10, alpha lipoic acid (ALA), as well as phospholipids and various fatty acids.
Current attention in medical research has shifted away from just cholesterol, and instead is focusing more on “oxidized” LDL particles. The increase in oxidation of certain molecules, caused by oxidative stress and free radical formation, appears to be the cause for inflammation and degradation in the tissues. The critical point here is that oxidizing LDL particles are not being caused by cholesterol. Moreover, reducing the amount of LDL and cholesterol via a statin drug will not prevent oxidative stress — in fact it will most likely increase oxidative stress, because cholesterol is a potent anti-inflammatory.
Emerging evidence suggests that the quality of the LDL particles is more important than the quantity of them. It’s the quality of an LDL particle that will largely prevent the molecule itself from oxidizing, and instead remain more resilient and stable. The quality of the LDL molecules is largely related to diet and whole food nutrition. So, for example, an increased consumption of certain oxidative-prone, unsaturated vegetable oils and trans fatty acids will be a major cause of degradation and decreased quality of LDL particles.
So with this in mind, what should you eat, or not eat? I am not saying that you can eat whatever you want! I am saying that we should stop blaming cholesterol. Maybe we have been blaming the wrong substance for problems like cardiovascular disease…
You need to look at your lifestyle, and especially look closely at how much added sugar you consume each day. How many excess carbohydrates or trans-fats are you consuming without even realizing? And how are you living your life — for example, are you meditating, and living with gratitude, and even doing physical activity on a daily basis? If you do all of them, you really won’t need to worry about your cholesterol.
In part 2, I will explain which cholesterol tests you may need to ask your physician about, when you might need to worry about your results, and what you can do to improve your health naturally.
Ayda Ersoy is a nutrition and fitness director at The Diet Doc Hawaii. She can be reached at DietDocHawaii.com, Ayda@DietDocHawaii.com or (808) 276-6892.