The Great Cholesterol Debate

25 Jan

The Great Cholesterol Debate

by Tim Skwiat, MEd, CSCS, Pn1

I have frequently been asked by folks who are serious about their health, fitness, and vitality on how they can improve their cholesterol. While I hesitate to call it a myth, it does seem that we have been deluded in our understanding of cholesterol and what causes “high” cholesterol. The aim of this article is to offer a clarification on what may lead to these high blood levels of cholesterol, as well as strategies to improve this marker of health.

In a nutshell, I would say that we have been misinformed as consumers by the media and health experts alike when it comes to cholesterol. That’s not to say that their intentions aren’t good, not at all. However, research really tells us that high cholesterol and high-fat diets are really NOT the cause of heart disease.

As a matter of fact, well-respected nutritionist and health advocate Dr. Jonny Bowden recently named the following four factors as far greater causes of heart disease that he labeled “The Four Horsemen of Aging.” They are: Inflammation, Oxidative Stress, Sugar, and Stress. In addition, Dr. Bowden recently co-authored a book recently titled, “The Great Cholesterol Myth.” May be worth looking into.

Did you that the high-cholesterol/heart disease “connection” began more than 100 years ago when a German pathologist theorized that cholesterol led to the development of plaques in your arteries? Did you know that his theory was later supported by a Russian scientist who fed cholesterol to rabbits and determined that it led to atherosclerotic changes?

Unfortunately, not too many people questioned the fact that rabbits are herbivores and do not naturally consume cholesterol:) Anyway, that breakthrough information started the notion that eating cholesterol leads to plaque deposits in your arteries, and at that time, it was believed that all cholesterol in your blood was due to dietary sources. But…

Did you know that your liver actually produces about 75% of your body’s cholesterol? That is indeed correct. So, even if you didn’t eat a single drop of cholesterol in your diet, you’d still have cholesterol in your body. And, that’s actually a good thing because cholesterol is needed by your cells to produce the cell membranes

My intention is to help you realize how little of an impact that dietary cholesterol has on blood levels of cholesterol. There are, arguably, studies that do connect cholesterol levels to cardiovascular disease — although we could pick those apart.

It seems that there are several reasons why health professionals would want to look at cholesterol in such detail. One, it’s relative easy to measure and monitor. Two, the cholesterol-lowering drug industry is highly profitable. And, three, it’s been imbedded in our heads.

Interestingly, while the goal of statin administration is to lower LDL, or “bad” cholesterol, a task at which it is markedly effective, research suggests that one’s risk of a cardiovascular event is only improved 25%:

Despite aggressive statin treatment to achieve target LDL-C levels, a residual risk for cardiovascular events of 65% to 75% is reported in statin studies. Factors contributing to residual risk other than LDL-C levels include components of non–HDL, such as very-low-density lipoprotein (VLDL), chylomicrons, VLDL remnants, and lipoprotein (a).

Going back then, what are the factors that really impact our cholesterol and how can we best manage our blood levels?

Metaphorically speaking, cholesterol accumulation on the walls of arteries can be compared to firefighters battling a blazing fire. Along those lines, we don’t accuse those brave men of arson because they’re at the scene of a fire. Rather, they are responding to a problem.

Cholesterol actually acts in the same way, as it is sent to repair damaged arterial walls. Cholesterol is sent in to “patch up” the damage induced by factors like smoking, chronic inflammation, metabolic disease, high blood pressure, etc. In a sense, elevated cholesterol may be “guilty by association,” as the body is simply responding to damage induced by these other factors.

Nutrition and lifestyle factors are the biggest, controllable factors in the battle against cholesterol. Wait, didn’t I say that dietary cholesterol has very little impact on blood cholesterol? I did indeed. But, that doesn’t mean that other food choices and nutrition habits don’t have an impact.

Dietary fiber has significant cholesterol-lowering properties. Fiber can interfere with the amount of bile — which is necessary for the breakdown of dietary fats — that is reabsorbed in the intestines. To make up for this loss, the liver must produce new bile salts, which are composed of cholesterol. So, increasing your fiber intake through vegetables, fruits, beans, legumes, etc., can have a cholesterol-lowering effect.

Omega-3 fatty acids have been shown to improve HDL cholesterol levels and reduce triglycerides. Omega-3 fatty acids have been shown to reduce levels Tumor Necrosis Factor-alpha, which is a marker of inflammation. What’s more, low levels of Omega-3 fatty acids have been shown to be closely related to high levels of C-Reactive Protein (CRP), a marker of chronic inflammation, which implies that increasing Omega-3 fatty acid intake may reduce CPR (and systemic inflammation).

Not surprisingly, supplementation with Omega-3 fatty acids has been shown to reduce C-Reactive Protein and improve insulin sensitivity. This latter improvement also seems to be important to managing cholesterol. Thus supplementing with a high-quality fish oil may have significant cardiovascular health benefits. (Recommendation: BioTrust’s OmegaKrill 5X.)

Certain herbs and spices like garlic, cumin, and ginger can have a cholesterol-lowering effect by blocking cholesterol uptake in the gut. Further, dark chocolate that’s high in cocoa (70% or more) has been shown to lower LDL while increasing HDL cholesterol.

Exercise and lifestyle (i.e., stress management) also play a significant role in lowering cholesterol.

The last point I want to come back to is that the liver is the predominant producer of blood cholesterol and nutritional factors — outside of dietary cholesterol — play a huge role.

One of the most-overlooked factors is actually blood sugar management and insulin control. That’s right, the hormone insulin actually plays a significant role in the liver’s production of cholesterol — that’s one reason why we actually see BETTER cholesterol numbers in low-carbohydrate studies. It’s also why we see increased risk for heart disease in low-fat, high-carbohydrate diets. Shocker!

Insulin resistance is actually an underlying cause of heart disease and cholesterol manufacturing (especially of the LDL variety). Insulin resistance results, ironically, from a diet high in carbohydrates — especially processed carbohydrates, sugars, and fructose.

Ironically, I say, because most people are prescribed a low-fat diet when they are diagnosed with high cholesterol. When you can’t eat fat, you are told to eat more carbohydrates. More carbohydrates result in chronically high levels of both blood sugar and insulin, which result in insulin resistance and high cholesterol.

Hmmm, interesting. Here is one of many studies that implicate insulin sensitivity as governing factor over cholesterol production:

Insulin sensitivity regulates cholesterol metabolism to a greater extent than obesity: lessons from the METSIM Study.

So, it’s likely that the very foods that you’ve been told NOT to eat are actually better for you — and your cholesterol levels — than the foods that you have been told to consume.

Food for thought =)

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