Is Cholesterol Really the Villain We Make it Out to Be?

We have been indoctrinated for years to avoid cholesterol, but what if we have been taught wrong? Cholesterol is, in fact, an essential building block for the body and is key to good health. What it all boils down to is what we include, or leave out, of our diets.

Is Cholesterol a FRIEND or FOE? 

We need cholesterol to function properly. Like saturated and poly-unsaturated fats, it is part of the lipid family and is an essential building block in the body. Cholesterol isn't an essential nutrient (good news for vegans) meaning our body is capable of making it without any need for it to be found in our diet.

Cholesterol is used for many functions. Every single cell in our body uses cholesterol as part of the cell membrane (along with other lipids), our skin uses sunlight and cholesterol in the formation of vitamin D, sex hormones like estrogen, progesterone and testosterone use cholesterol as a building block, and our adrenal glands use cholesterol in the formation of stress hormones like cortisol. We also need cholesterol for the formation of bile salts, which are used to breakdown fats in digestion.

Cholesterol, being a lipid, can't just move about around blood stream freely, it needs to be packaged up neatly by proteins, forming complexes called lipoproteins. In this form, cholesterol gets a ride from the liver to the tissues where it is needed. There are three major types of lipoproteins:

* vLDL Cholesterol (very low lipid lipoprotein): This transports both cholesterol and triglycerides to the cells. The triglycerides, another member of the lipid family, are dropped off to be used as energy, and what isn't needed for energy is stored a body fat. vLDL are the most dangerous in that they are more likely to set off inflammation and cause narrowing of the blood vessels. It's important to remember that triglycerides found in vLDL complexes are not just created from fats in our diet, but also from carbohydrates and simple sugars. That's right – excess carbohydrates and simple sugars (including alcohol) are turned into triglycerides – or fat, which are then packaged into vLDL molecules.

* LDL cholesterol (low lipid density lipoprotein): An LDL complex is cholesterol packaged into protein, like vLDL molecules, delivering cholesterol to cells that need it. The issue is, if there's too much, it can build up in the blood. And if there is any damage to arterial walls, then this is where a buildup of fatty deposits, including cholesterol, can begin and arterial narrowing plaques can form, leading to atherosclerosis.

* HDL cholesterol (high density lipoprotein): This bundle is more protein and very little cholesterol or triglycerides. This is an excellent little complex that swims around like a little ray of sunshine removing excess cholesterol from the cells, and also from plaque in the blood vessels.

So, how can we end up with too much vLDL or LDL cholesterol in the blood? Tick off any which may apply to you to test your risk: 

Excess in the daily diet: 

Excess consumption of refined and simple carbohydrates, alcohol, excessive dietary cholesterol consumption (in the form of excess poor quality animal protein and fats).

Lack of nutrients: 

Unlike carbohydrates and protein, cholesterol is the only building block that can't be broken down and removed, it needs to be flushed. If you haven't got enough fibre in your diet and are occasionally or constantly constipated, know that the excess cholesterol that is being deposited into your bowel is being reabsorbed. Other nutrients that are linked to helping remove excess cholesterol include niacin (B3), chromium, selenium, zinc, antioxidants like A, C and E, essential fatty acids (EFAs) and phytosterols.

Being in a chronic stressed state: 

Cholesterol is a building block to the stress hormones. If you are chronically stressed, a supply of cholesterol is needed to build cortisol, which is an essential hormone for sustaining life.

Having a hormonal imbalance: 

Cholesterol is also a building block for many of the sex hormones including estrogen, progesterone and testosterone. As you can see, there are a few ways that you could end up with high serum cholesterol, and the huge focus on dietary cholesterol and saturated fats have allowed many other major risk factors to fly under the radar for decades.

Saturated fat consumption found not to be linked to more heart disease 

Research published in 2014, which drew upon 80 studies covering over half a million people, found that people who ate higher levels of saturated fat did not have more heart disease than those who ate less. However, when looking at individual fatty acids, it was found that omega 3s found in fatty fish are protective, while too much omega 6 could pose a risk. The researchers stated that the benefit of omega 3s probably lie in preventing heart disease, rather than treating it. 

Yes, saturated fat increases LDL cholesterol in the blood. But what the medical associations and marketing companies failed to tell us while they were screaming bloody murder, was that these fats also increase HDL cholesterol – the good stuff! So it could be that the consumption of saturated fat in moderation may be entirely neutral. This doesn't mean you have a free pass to eat animal protein at every meal (this wouldn't be classed as moderation!). And saturated fat isn't the only concern; hormones, antibiotics, cholesterol, endotoxins, the environment and animal welfare are also things to be careful about.

Fundamentally, if you have high serum cholesterol levels, there is so much more going on than just your saturated fat intake that needs addressing, and we're going to get into that now.

What is a true heart healthy approach?

If you could do five things for your heart it would be the following:

1. Avoid overly refined and processed foods, especially carbohydrates. This will automatically limit your intake of artificially produced trans-fats.

2. Increase your intake of whole-foods, and begin to experiment with plant-based meals. This includes all fruit and vegetables, raw nuts and seeds, wild fish, organic and grass-fed animal products and lentils and beans. This will ensure you are receiving a natural source of fibre, vitamins and nutrients. Not to mention a natural source of plant sterols which have been shown to limit the amount of dietary cholesterol entering your blood stream from the gut.

3. Move more! A healthy heart is linked to a healthy circulation. As well as fitting in a cardio workout or two, why not try out yoga, hiking or brisk walking. You don't have to get yourself into a sweaty, flustered state in order to work the heart, gentle exercise is massively beneficial.

4. Ask yourself whether any of the factors contributing to high cholesterol apply to you. Add in smoking cigarettes too, although this isn't linked to an increases in serum LDL cholesterol, it certainly is linked to the formation of atherosclerosis and lowering of the good HDL cholesterol.

References

i. James E. Dalen, MD, MPHcorrespondenceemail, Joseph S. Alpert, MD, Robert J. Goldberg, MD, Ronald S. Weinstein, MD. "The Epidemic of the 20th Century: Coronary Heart Disease" The American Journal of Medicine: September 2014 Volume 127, Issue 9, Pages 807–812

https://www.amjmed.com/article/S0002-9343(14)00354-4/fulltext

ii. Chowdhury, Rajiv, Samantha Warnakula, Setor Kunutsor, Francesca Crowe, Heather A. Ward, Laura Johnson, Oscar H. Franco et al. "Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis." Annals of internal medicine 160, no. 6 (2014): 398-406.

https://annals.org/article.aspx?articleid=1846638

iii. Demonty, Isabelle, Rouyanne T. Ras, Henk CM van der Knaap, Guus SMJE Duchateau, Linsie Meijer, Peter L. Zock, Johanna M. Geleijnse, and Elke A. Trautwein. "Continuous dose-response relationship of the LDL-cholesterol–lowering effect of phytosterol intake." The Journal of nutrition (2008): jn-108.

https://jn.nutrition.org/content/139/2/271.full.pdf+html