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May 17, 2017
Remember when eggs and butter were deemed to be bad for you because they could raise your cholesterol levels? Now you hear they may be OK to eat after all, and maybe high cholesterol isn’t really the issue we once thought it was. With all this flip-flopping back and forth, how do you know what to believe? Is cholesterol really an issue or not?
In the same way that all fats were once thought to be bad for you, and now we know that some fats are important for good health, new evidence indicates that cholesterol may not actually be the demon it’s been made out to be.
Cholesterol is “a waxy, fat-like substance that’s found in all cells of the body,” according to the National Heart, Lung, and Blood Institute. The body produces the cholesterol it needs and the liver uses it to make vitamin D, some hormones, and bile acid to help digest fatty foods. Cholesterol is needed to build and maintain cell membranes and is an important component of the brain. In fact, cholesterol is vital to brain neuron function, according to Dr. David Perlmutter, M.D., a neurologist and author of the book Brain Maker. Cholesterol is also used by the immune system’s white blood cells to help fight off bacteria.
Cholesterol occurs naturally in all animals, including humans, and is found in animal foods like eggs, butter and animal fats, shrimp, crab, lobster, and other shellfish.
Cholesterol became a household term in the 1960s when the American Heart Association first introduced cholesterol guidelines, and labeled one type of cholesterol (high-density lipoprotein or HDL cholesterol) as “good” and another type (low-density lipoprotein or LDL cholesterol) as “bad”. But what exactly is good or bad about it? Is it really good or bad at all?
HDL has traditionally been considered “good” because this type of cholesterol travels through your blood collecting excess LDL cholesterol and returning it to the liver where it can be broken down rather than adding to plaque buildup in your arteries.
LDL has traditionally been considered “bad” because this type of cholesterol has the potential to accumulate in your arteries as plaque and eventually clog your arteries.
When it comes to cholesterol in food, the cholesterol you eat may have been wrongly implicated all along. It now appears that dietary cholesterol has little to no effect on cholesterol levels in the body. One study evaluating the association of saturated fat with cardiovascular disease, by Ronald M. Krauss, M.D., senior scientist and director of atherosclerosis research at Children’s Hospital Oakland Research Institute, indicated that dietary fat does not increase cardiovascular disease mortality.
Dr. Krauss also found that there are actually multiple types of LDL cholesterol, not just one type. These different types of LDL cholesterol contain different sizes and densities of particles, ranging from very dense to fluffy, and from extra small to large. The smaller the cholesterol particle, the denser it is. The larger the particle, the fluffier it is. The large, fluffy types seem to pass right through the arteries and pose no medical problems. On the contrary, the small, dense types have a correlation with heart disease. As it turns out, Dr. Krauss and other researchers determined that a diet high in carbohydrates is linked to the small, dense type of cholesterol, and diets higher in saturated fats and animal fats are linked to the larger, fluffy type of cholesterol.
This study by Dr. Krauss is one of the reasons that eggs and other saturated fats are now being given a second look for correlation between cholesterol and heart disease.
Recent studies have shown that high cholesterol levels may not increase risk for heart disease or morbidity after all, and one study byDepartment of Internal Medicine at Yale University School of Medicine even showed those with lower overall cholesterol had a higher morbidity rate than those with higher overall cholesterol. Again, this may have more to do with the actual type of cholesterol—small and dense, compared to large and fluffy. So far, the standard cholesterol tests your doctor may prescribe do not generally distinguish among the different types of LDL cholesterol. You may have high LDL but it may all be large and fluffy, or you may have low LDL but it may be predominately small and dense. More advanced tests are available that can show these differences.
When arteries are damaged by a lifestyle event such as stress, high blood pressure, nicotine, or other toxins, cholesterol is the body’s first response to help repair the artery, according to Dr. Alejandro Junger, M.D.., cardiologist and author of Clean Gut. Similar to forming a scab on a wound, the body sends cholesterol plaque to help repair the damage. This is the small, high-density type of cholesterol. In a healthy body, healthy cells would then continue to repair the artery, and the cholesterol plaque would be reabsorbed back into the body and not accumulate and become a health issue.
However, in a chronic situation like ongoing stress, high blood pressure, or exposure to toxins (all inflammation producers), the signal to stop sending cholesterol to that damaged area never gets turned off and the cholesterol plaque continues to build up. Chronic inflammation can exacerbate this process and keep the plaque building until the affected artery is clogged.
Living a healthy, low-stress lifestyle, including mindfulness practices like meditation and yoga, can help turn off the conveyer belt of plaque being sent to a damaged artery.
The U.S. federal government is slated to publish updated dietary guidelines later in 2015 and indications are that they will revise their recommendations for cholesterol levels to be more in line with new research findings. In the meantime, keep in mind that diets high in carbohydrates may actually be linked to increased risk of heart disease, and diets high in healthy fats—with some animal fats—may be healthier than they were once thought to be. If you’re currently on statin drugs or being treated for high cholesterol, talk to your doctor before making any changes to your diet or medications.
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January 15, 2021