Cholesterol

All too often patients bring in blood work from their medical doctors with their cholesterol numbers underlined circled and highlighted, with instructions to lower that cholesterol number. It happens so often that it is becoming one of my most frustrating moments in practice. It has become a cultural meme that cholesterol causes heart disease. That red meat, eggs, and saturated fats are horrible for you because they cause heart attacks and cardiovascular disease.

The simple fact is that this just isn’t true. American’s have lowered their cholesterol, and increased their activity, but the rate of heart disease has significantly increased. In fact 1 million, Americans have heart attacks every year. Cardiovascular disease affects about 65 million Americans every year and about one person every 39 seconds dies from cardiovascular diseases. I would say that this war on cholesterol has not accomplished any of the goals of decreasing heart disease.

The discouraging part to me is the overall cost of cardiovascular disease is approximately $300 billion in 2008. To put that in perspective, it is estimated to cost only $195 billion to end world hunger.

This war on cholesterol is based on the diet-heart hypothesis, which says that the consumption of cholesterol and saturated fat will increase your blood cholesterol. This theory is based on research that is more than half a century old. Normally, I find older research much more interesting, but not in this case. This research and theory should be thrown out  just like all of the research from the same time that said ‘smoking was good for you .

One of the major flaws with the diet-heart myth is that only about 20% of your blood cholesterol comes from your diet and that your body (liver) makes up the rest of the 80% circulating in your blood. This means that no matter how little or how much cholesterol you eat you will only be able to change your blood cholesterol levels a few points. In fact, the originator of the diet-heart myth the New England Journal of Medicine has said, “Adding cholesterol to a cholesterol-free diet raises the blood level in humans, but when added to an unrestricted diet, it has a minimal effect.”

If that wasn’t enough when you look at the research studies on low-carb diets, they show over and again that having high intakes of saturated fat and cholesterol do not increase blood cholesterol but, in fact, it can help change other risk factors associated with heart disease.

The decrease in risk factors includes decreases in body weight, triglycerides, glucose, blood pressure, abdominal circumference and C-reactive protein. It is amazing that just decrease in body weight may be the most beneficial for your cardiovascular system because every pound of fat requires approximately 7 miles of capillaries and veins. This means that the simple act of gaining 10 lbs. of fat requires your heart to pump blood through 70 extra miles of arteries. The only good part is that if you lose that fat, your body reabsorbs those arteries. This has lead one of its most staunch proponents, Dr. Sylvan Lee Weinberg to say:

“The low-fat, high-carbohydrate diet may well have played an unintended role in the current epidemics of obesity, lipid abnormalities, type 2 diabetes, and metabolic syndromes. This diet can no longer be defended by appeal to the authority of prestigious medical organizations.”

I believe that it is these risk factors that play much more into cardiovascular disease than cholesterol or saturated fats do. Cholesterol is not even the primary cause of atherosclerosis. The lining of your arteries is very thin, only one cell wide in fact. If the lining is damaged or inflamed and there is a lot of LDL particles floating in your blood, then they will get "stuck" in these damaged spots, causing the placing.

While the cholesterol does play a role in the thickening and hardening of the arteries in atherosclerosis, the main culprit is the inflammation that damaged the arterial wall in the first place. This damage is usually accomplished by a chemical compound called homocysteine.

Homocysteine is the breakdown product of two amino acids and is increased in the blood if you consume too many grains and have reduced elimination pathways.

The problem with excess homocysteine is that it is very inflammatory to the arterial walls and is the leading culprit of the damage that leads to plaque in the arteries. So if a high cholesterol number does not mean that you have an increased risk of heart disease what does it mean?

There have been numerous studies that show an increase in cholesterol, in the blood is related to potential hypothyroidism, infection, gut dysbiosis, and potentially leaky gut to name just a few. All of these things are significantly increased on a diet low in fat and high in refined grains.

Okay, so we now know cholesterol is not as bad as the drug companies want us to believe it is, but doesn't lower cholesterol number lead to a better life? Absolutely not, low cholesterol numbers have been shown to increase depression, libido, fertility, and overall energy and vitality.

Hopefully these side effects and the fact that cholesterol does not cause heart disease help you to rethink the dogma that eating cholesterol will cause heart disease.