Does just saying the word cholesterol make your airwaves feel smothered?
I know, I used to be scared of the stuff too! It was on my list of the top 3 words followed by "free” to look for on a package:
"Sugar-Free", "Fat-Free" and "Cholesterol-Free" equaled Dieters Gold!
I’d gleefully munch on a box of "free from everything", while pondering "what the heck is in here if it’s void of all the stuff I’m trying to get it to mimic??? Oh well".
I understood so little about health and nutrition at the time, that my biggest concern was ensuring that what I was scarfing down wouldn't break the calorie budget for the day.
Since I’m suddenly on the topic of calories - and trying to get you to not be offended by cholesterol... would it make you feel better if I told you cholesterol has zero calories? -I’m not making that up! Cholesterol really has zero calories!
I want to share with you some other cool things about cholesterol, not so you start making yolk-scrambles to make-up for all those egg-white omelettes, but just so you can understand cholesterol and not fear it like I mistakenly did.
6+ Things everyone should know about cholesterol:
1. Cholesterol is not a fat!
- Cholesterol is not a fat! I know I know, what is it then? It’s a steroid and alcohol molecule - called a sterol. It’s basically wax.
- Since cholesterol is a sterol and not one of the three types of macronutrients (macronutrients are fats, carbs and proteins), it has zero caloric value like I mentioned before. Basically our bodies can’t metabolize cholesterol and use it as energy, but it has lots of other important roles!
2. You need cholesterol to survive
- It’s just one of many things your body can’t live without. Cholesterol is so important, your liver makes most of your body’s need for it.
- Cholesterol is vital to the life of each cell because it helps protect the cell membrane by providing a waterproof barrier that allows for a completely different environment to exist on the outside of the cells, than on the inside.
- Your brain needs cholesterol to protect the nerve endings in the myelin sheaths which allows communication to occur. Higher levels of cholesterol have been associated with better memory in the elderly.
3. It aids in digestion
- Cholesterol helps manufacture bile salts that are necessary to digest fats from your food.
4. It helps in the synthesis of Vitamin D
- When your skin is exposed to UV-rays, cholesterol is needed to synthesize Vitamin D, otherwise your body can't utilize the vitamin D.
5. Cholesterol is necessary for healthy hormones
- Steroid hormones require cholesterol for production and transportation throughout the body. So if your cholesterol is too low, you could also have a lower than ideal amount of steroid hormones:
- Androgens and estrogens (your sex hormones!) which affect sexual development and function in both men and women.
- Progestins that help with pregnancy and the regulation of the menstrual cycle in women.
- Mineralocorticoids help regulate minerals, especially salt regulation by the kidneys.
- Glucocorticoids (like cortisol) affect inflammation and stress response as well as the metabolism of food.
6. HDL and LDL are not types of cholesterol
- There is only one type of cholesterol in your body and it’s called... wait for it… cholesterol! So then, what are HDL and LDL if not cholesterol??? They are types of lipoproteins which transport cholesterol and other molecules in the blood. Lipoproteins are made up of fats and proteins and are the carriers or vehicles that move cholesterol, triglycerides, other proteins throughout the body.
- LDL (low density lipoprotein) carry cholesterol to the cells from the liver.
- HDL (high density lipoprotein) are the debris collectors that collect extra LDLs that are not being used and brings them back to the liver. When it returns to the liver the collected cholesterol can be recycled and used again.
- You may have recently heard of VLDLs (very low density lipoprotein). They’re not newly discovered, it’s just that now there is a way to measure VLDL where there wasn’t before. The new test for VLDLs is called the particle size test. It differentiates the LDLs from the VLDLs. Typically, when you have your cholesterol levels checked, the VLDLs are included in the number of LDLs. But now they can be separated and measured.
- There are other types of lipoproteins too (carriers of cholesterol and fats) but there are no proper ways to measure these carriers yet.
SO NOW YOU'RE SAYING, THAT'S NICE BUT WHAT ABOUT...
Heart Attacks, Cardiovascular Disease, Triglycerides, SAturated Fats and the role of statin?
Heart Attacks & Cardiovascular Disease
Would you be shocked to know that 75% of people who have a heart attack do not have high cholesterol levels that would put them in the 'at-risk' category!?
And according to two recent studies (1) (2), lowering your LDL ("bad") levels and increasing HDL ("good") levels doesn't always translate to reduced risk of cardiovascular disease.
When you combine these findings with the knowledge that cholesterol has a healthy and necessary purpose in the body, then it makes sense that there's more to the equation of heart disease than just high cholesterol levels:
LIKE INFLAMMATION!
According to Pamela Ouyang M.D. testing for cardiovascular inflammation can provide better insights to cardiovascular risk and a simple, but not as commonly used Highly Sensitive C-Reactive Protein blood test can help determine this.
It used to be thought that high cholesterol would block arteries and lead to a heart attack or stroke, so it was best to avoid it in foods and to try to get your cholesterol levels low. What seems to be the more likely culprit is actually inflammation.
We've all been told high cholesterol causes hardening of the arteries. However, what seems to be making more sense is that inflammation from a poor diet (high in sugars and rancid fats), high stress and other factors has the the potential to trap the cholesterol in inflamed (damaged) artery walls and start a build-up of cholesterol and plaque.
Triglycerides
Then there are the notorious triglycerides. Triglycerides are 3 fats and a sugar alcohol, which are transported by the previously mentioned VLDLs. But not all triglycerides are bad!
They are necessary to carry fats (energy) to the cells, BUT if those fats are harmful, rancid fats, they are causing inflammation as they travel through the bloodstream.
You can think of good triglycerides as excess energy that is waiting to be used. It’s normal to have some floating around especially after a meal when your body hasn’t been able to use or store all the energy from that meal just yet. The problem is when the triglycerides become so abundant before the body has a chance to use them. This can usually be attributed to inactivity and overeating, especially of refined carbs and sugar. Remember that refined carbs are easily broken down into sugar, and sugar is converted into fat. So having high triglycerides (fats) are not necessarily the result of eating too much fat but also from eating too many carbohydrates, especially refined carbs and sugar!
Saturated Fats
Saturated fats can be found in some of the same animal foods as cholesterol, like eggs, bacon and butter, and also in plants like nuts, coconut, cocoa, avocado and olives!
It's a diet high in saturated fats that have been blamed for contributing to high cholesterol and high triglyceride levels due to a flawed 1970s report from Ancel Keys', Seven Countries Study. In the study he cherry picked only 7 countries to report on, from the 22 countries that he actually studied. He concluded that those 7 countries had heart disease due to diets high in saturated fats. However, had all 22 countries been left in the report, no such causation could have been made.
The published findings from the Seven Countries Study is what propelled the anti-fat movement.
- If we look at the Inuit tribes living in northern Canada and Alaska. They don’t have cardiovascular disease and heart attacks yet they live on mainly meat, fish and even whales so they’re eating protein and lots and lots of fat. They can only forage for fruits and plants a couple months out of the year, and even in those times the amount of plants they're eating is limited.
As pointed out in this study published in the British Medical Journal and recapped here, sugar seems to be a much bigger culprit behind heart disease.
Finally, STATINS!
In 2008, 1 in 4 Americans over the age of 45 were taking statin drugs! That is a lot of people trying to lower their cholesterol. Unfortunately, a large global trial of more than 12,000 people shows that statins only benefit 1 of 100 people taking them according to Dr. Topol, a cardiologist and director for the Scripps Translational Science Institute. Yet, the drug company behind the study, AstraZeneca sees the data a little differently and uses it as confirmation for expanding the use of statin drugs to a wider population.
What's interesting about statin drugs is not only do they function to lower cholesterol but they are also known to have anti-inflammatory benefits which could explain their benefits rather than it's cholesterol lowering abilities.
You can read more about statins from Dr. Mark Hyman. He has a great article on statin drugs that is worth the read.
Conclusion
To sum this all up, cholesterol is not inherently bad for us. It's actually very good and serves many important and essential functions throughout the body. The bigger cardiovascular culprit seems to be pointed at sugar and inflammation (3)(4) and getting a better picture of your body's inflammation through a test such as a hs-CRP test can help you make a more informed decision about your cardiovascular health with your doctor.