There is so much talk about cholesterol, but very little being said about how necessary it is for our body. So why has it become so critical to lower levels to the point to where they are talking about adding statin drugs to our water supply?

What is cholesterol?

First of all, there is no such thing as good cholesterol or bad cholesterol. Cholesterol is just cholesterol, a waxy, fat-like substance that’s found in all cells of the body. Some cholesterol comes from our diet but the majority, anywhere from 75-95%, is made by our liver.

Besides being a precursor to our hormones, when unoxidized it has free radical scavenging properties. It is a vital part of our cell membranes, a precursor to vitamin D, a component of bile salts to help us digest dietary fat, and important for proper neurological function by playing a key role in the formation of memory and the uptake of compounds in the brain (including serotonin, the body’s feel-good chemical) just to name a few key functions.

Some interesting facts about cholesterol

• Cholesterol can be made from fatty acids, amino acids, and even glucose. No other chemical in the body has so many avenues for formation.
• Your body makes about 75% of all the cholesterol you need. It increases production when you eat small amounts, and decreases when you eat large amounts.

Studies have shown that…

• People with low cholesterol get as many plaques in their blood vessels as those with high levels.
• The root cause of cardiovascular disease is not elevated cholesterol, but the vascular damage that came before signs of high cholesterol.
• High cholesterol is a response to some injurious agent and is not a cause of the injury and is part of a protective mechanism by the body.

In he American Heart Association 2015 report, Heart Disease and Stroke Statistics, five large randomized controlled trials demonstrated that total fat consumption does not affect rates of coronary heart disease or stroke. Additionally, for each 5 percent of saturated fat that you replace with carbohydrate in your diet, is associated with a 7 percent higher risk of coronary heart disease.

Why the controversy over cholesterol?

There are many studies sited that lead to cholesterol and fat becoming enemy #1. Let’s grossly oversimplify a few of the most popular ones…

6 Countries

Ansel Keys, father of the “K- ration” (1940), published a study about 6 different countries that made it look like heart disease was associated with fat intake. But the truth was that he started out with 22 countries but he only included selected countries in his findings. When other researchers analyzed his data using all the original countries, the link between fat and heart disease was not supported. By 1955, he had started to voice his concerns over his own studies findings.

Cholesterol Heart Hypothesis

Inkolai Nikolajewitsh Anitschkkow (1913) fed animal foods to rabbits (to achieve a blood level of 1000mg/dl) and found the production of intimal proliferation which he attributed to dietary cholesterol. The issue is that rabbits are vegetarians and are not normally exposed to dietary cholesterol and therefore, cannot process it. A parallel study with dogs and cats did not show indications of coronary disease.

Framingham Heart Study

Started in the late 1940s and still ongoing. Under the direction of the National Heart Institute, residents of Framingham, MA are being monitored to identify the common factors or characteristics that contribute to CVD by following its development in those who had not yet developed overt symptoms of CVD or suffered a heart attack or stroke. As to dietary cholesterol? There is no indication of a relationship between dietary cholesterol and serum cholesterol level. If the intake on animal fat is held constant there is still no relation of cholesterol intake to serum cholesterol level.

Check out the Salt on NPR

An interesting article on NPR blames politics for the whole debacle.

Let’s stop there as we all can find studies to support our own interests. But I do want to state this last thing. Critics of “cholesterol causing heart disease” offer this analogy:  So, if firemen are always present at a fire, then it must be the fireman who are the cause of the fire?

So why is LDL bad and HDL good, or is it?

Fat can’t be carried in blood, so transport proteins are used to get it to where it needs to go. These “buses” are called lipoproteins. LDL or low-density lipoprotein, gets cholesterol to all the places in the body it needs to be, whereas HDL or high-density lipoprotein, returns cholesterol back to the liver so it can be either recycled for reuse or removed from the body.

When levels of cholesterol and LDL start to rise, doctors feel the need to take out the prescription pad. But let’s put the pen down for a minute and consider this. The body is constantly making new cells to repair ones that have either become damaged or worn out. Since cholesterol is vital to making new cell membranes, the body needs to send LDL for the new cells. That being said, is it possible that elevated cholesterol and/or LDL levels might just be showing us that the body is experiencing inflammation, systemic dysfunction or plain out assault?

When is LDL and HDL bad?

Now, don’t get me wrong. I am not saying that LDL is all good and in fact, increased levels can be dangerous. LDL is designed to be large and fluffy. What if instead, it is small and dense? Instead of doing their job and going on their merry way, tough little LDL particles may get lodged into the small gaps in the artery walls. Therefore, instead of being flushed away by the bloodstream, they may easily stick and start to oxidize. This in turn generates inflammation causing the body to mount an immune system attack. Guess what? The body sends more cholesterol via LDL to the site to help! WBCs and cholesterol start to build up and form scar tissue over time, plaque, which can affect blood flow and lead to CV risk.

Now HDL on the other hand, is supposed to be great. The higher the HDL, the better, right? Unfortunately, high HDL levels have been correlated with inflammation in the body as well. 

What about statin drugs?

One in four adults is taking a statin drug. Statin drugs block enzymes in the liver that are used to make cholesterol. They have also been shown to help reduce inflammation but unfortunately, do nothing to affect particle size. But what else might they affect? They have been shown to cause cellular and muscle damage, muscle cramps, exercise intolerance, sexual dysfunction, liver and nerve damage, and other detrimental effects in about 10-15% of folks who take them.

Statins are made from mycotoxins that are extracted from pathogenic fungi. They work by blocking an enzyme called reductase that is used for metabolism, replication, and cell membrane integrity. Without these vital functions, cells may die, leading to tissue damage and loss of function. And we wonder why there are so many side affects?

There are hundreds of studies showing these adverse affects as well as documenting the fact that high cholesterol levels alone do not increase cardiovascular risk for instance:

• The Honolulu Heart Study, refers to an increase the risk of death in older patients with low cholesterol levels. 
• The JUPITER5 trial that showed that lowering LDL without a reduction in inflammation didn’t prevent heart attacks or death.
• The ENHANCE trial documented that cholesterol treatment with two medications (Zocor and Zetia) were effective at lowering cholesterol much more than one drug alone, but also caused an increase arterial plaque while not decreasing the incidence of heart attacks.

In fact, 50-75 percent of people who have heart attacks have normal cholesterol! The only subgroup that appear to have benefited from these drugs are those born with a genetic defect called familial hypercholesterolemia.

So what is the risk for heart issues?

What we should be concerned with is anything that causes inflammation. There are many causes, but the one that we need to address is something we expose our bodies to everyday, sugar. Sugar undergoes something called glycation which form something called AGES (yes, it does indeed age you) which lead to inflammation and damage to the arterial walls. Fructose is even more prone to this.

In addition, a poorly controlled diet too rich in unopposed carbohydrates may cause insulin surges, which over time, lead to insulin resistance and increases the amount of cholesterol produced by the body. If you think about it, there is a catch 22 here. Damaged cell membranes (caused by bad fat and inflammation) may lead to insulin resistance, which in turn, degrades cell membranes. Systemic dysfunction like infection, adrenal and thyroid dysfunction, etc. may also lead to issues with insulin regulation and inflammation.

The good news is that a balanced good diet consisting of whole, nutritious foods has been shown to increase particle size and reduce insulin resistance and inflammation, which is a win-win-win situation.

What should we test besides cholesterol?

A lipid panel is both easy and inexpensive. But since issues with increased cholesterol may be systemic, a full blood chemistry panel analyzed from a functional perspective should be run to determine cause. If there are high levels of blood lipids encountered, a VAP panel can be ordered to determine particle size and CV risk. A Bioimpedance Analysis can help determine cell membrane health.

How do I improve my cardiovascular health?

A balanced diet with good sources of fat (as bad ones tend to replace good fats in the membranes) and reduction of sources of inflammation are key whether these source are caused by food intolerances, subclinical infection, stress, dehydration, etc. 

In addition, essential fatty acids improve cell membrane quality as well as reduce inflammation. Optimized vitamin D levels help reduce inflammation and improve insulin response. Antioxidants and magnesium are essential, as is CoQ10 especially for those who are taking a statin drug. 

Exercise and anything that makes you happy can’t hurt either!