In my opinion as a full time clinician, cholesterol is easily the most misunderstood and poorly managed aspect of medicine today. Strong words, I know. Understanding cholesterol could save your life, just not the way you might initially think. The alternative to understanding cholesterol and health is the risk of being put on pharmaceutical drugs called statins. These are drugs that have some of the worst long term side effects in modern medicine.
So, what is Cholesterol? Cholesterol is a very large and essential molecule that your body uses to build cellular membranes, repair wounds and support brain health. Cholesterol is also the base nutrient that your body uses and to make all of your sex and stress hormones. This includes hormones like progesterone, testosterone and all of the adrenal hormones. It is also the molecule your body uses to make vitamin D with the help of the sun. So, cholesterol builds and repairs tissue and makes most of the hormones that run, regulate and repair all of your bodily functions, all day every day. Have I said essential yet?
Cholesterol is a unique nutrient in a some surprising ways. First, there is no way that you can eat enough cholesterol from a normal diet to meet your bodies daily need for cholesterol. You need so much cholesterol to maintain your health that your liver will always make up the difference. If you eat a lot of high cholesterol foods, your liver has a moderate chore, if you are a vegan and bring in almost no cholesterol into your body from your food, now your liver and other organs have a full time job just to make enough. Second, cholesterol brings no calories into your body. It is such an important and useful structure that your body will not even risk breaking it down as a source of energy. Third, contrary to popular belief, the foods that increase your blood cholesterol the most are lean meats, excessive carbohydrates and polyunsaturated fats – not saturated fats. Fourth, and finally, you can only absorb and use less that 50% of the cholesterol that you eat every day unless you are an infant drinking breast milk. Human breast milk contains a significant amount of cholesterol and an enzyme that ensures complete absorption of this molecule. If mother nature knows what she is doing then cholesterol is NOT something you need to be limiting from your diet.
When you go to see a medical doctor, they will check for LDL and HDL. LDL actually means “low density lipoprotein”; it is usually referred to as the bad cholesterol. And HDL means “high density lipoprotein”, and usually referred to as the good cholesterol. There are some problems with this. I need to say this another way. As a clinician this makes no sense at all. Lipoproteins are proteins that move lipids, or fat like molecules around your body. No one can test for the cholesterol in your blood because there is little or no actual cholesterol in your blood. This is because fatty substances like cholesterol float on water, or are insoluble in water, and your blood is about 50% water. So, again, when you go to see a doctor they are only testing for some proteins that carry cholesterol around your body. LDL carries cholesterol to support your bodies needs and HDL carries cholesterol from your cells to your liver to be recycled as bile or removed from your body when those needs are met.
For a reactive and poorly thought out reason LDL has been described as bad because it may increase your bodies tissue cholesterol. Again, actually responding to your bodies needs for more tissue repair, hormonal needs and adaptability to stress.
So, here is the reasoning most doctors are following. Two of the most consistent causes of hospitalization and death in modern societies in the last 50 years are cardio vascular disease (CVD) and coronary heart disease (CHD). Both of these chronic and degenerative diseases usually end in a heart attack or a stroke. In both of these tragic conditions the blood vessels become damaged by arteriosclerosis; which is the thickening, narrowing and clogging of the arteries. When researchers examine the plaque that clogs our arteries they find a lot of LDL. For some people that is enough. If medical research was a TV show about cops and lawyers, that bad LDL should be put away for crimes against humanity. Never mind the evidence.
So, here is what is really going on. When your diet is too high in sugars and starches, your blood insulin has to go up to control your blood sugar levels. This high blood insulin level can cause pitting wounds to the inner lining of your blood vessels. These wounds are obviously very dangerous, so your body “patches” the wound with some white blood cells and some cholesterol. The cholesterol, a healing and repair molecule, is delivered to the wound by LDL. Remember LDL takes cholesterol to the body and HDL removes it from the body. This is actually normal healthy function. What actually goes wrong, is when the cholesterol in your body is oxidized from over-cooking or over processing. Usually, your body can repair and recycle the cholesterol from these patches to your blood vessels. When the cholesterol is oxidized, it is profoundly harder to remove from your blood vessels. Now a short term patch turns into some long term plaque. It is Oxidized LDL that makes the plaques hard to re-absorb and a source of inflammation and free radicals.
We all know that excessive sugar and starch are related to obesity, heart disease and overall poor health, but there are some other culprits that need to be introduced. If you are under a lot of stress, your body tends to become more inflammatory, increasing the wound formation in the blood vessels and slowing the natural repair processes. A diet in highly acid forming foods also makes the body more pro-inflammatory. Excessive consumption of fried (grilled) red meats increases the amount of a substance called homocysteine, which is also a pro-inflammatory substance to the inner lining of your blood vessels. The overuse of alcohol and many pharmaceuticals are also destructive to your blood vessels. High amounts of LDL and HDL are a response to stress, wound healing and will be naturally higher when the blood stream and whole body are in a relatively pro-inflammatory state.
One of the worst substances that occur in your body, when you eat too much sugar and starch and eat too much deep fried and grilled meats are called Advanced Glycation End-products (AGE’s). These very inflammatory and destructive molecules are now understood to be very dangerous to your blood vessels, a significant factor in the development of Alzheimer’s, weight gain and premature aging. I know, AGE’s and aging – isn’t medical terminology fun?
So, what should you do about cholesterol? Enjoy your eggs, just keep the yolks soft. Braise your meats instead of grilling them. Eat more fish. And, of course, focus on a plant centered diet. If your doctor wants you to lower your cholesterol, follow an Ancestral Diet for three months. If things do not improve noticeably, seek professional help. Just try and avoid the statins if you can.