Cholesterol is probably nutrition's most controversial molecule, often made out to be the bad guy in the modern medical world. While many people might be under the impression that cholesterol = bad, it is, in fact, an important molecule in the body that can work in our favor with the right diet and exercise routine.
What is High Cholesterol?
The liver naturally produces between 1-2 grams of cholesterol per day. We can eat cholesterol-rich foods, in which case the liver slows down production. Likewise, when we neglect to eat cholesterol-rich foods, the liver increases production.
Why?
Cholesterol is essential in the production of vitamin D, steroid hormones, and bile acids. It’s also a component of cell membranes (the protective walls of the cells, protecting the cell from its environment).
You may have heard of HDL and LDL when discussing good vs bad cholesterol, but HDL and LDL are a little more nuanced than ‘good’ or ‘bad’. As with most things in diet and nutrition, cholesterol is not so black and white!
What is HDL?
HDL and LDL are lipoproteins that are essentially wrappers that transport cholesterol over the body.
High-density lipoprotein is often referred to as ‘good cholesterol’. It essentially mops up the excess cholesterol, bringing it to the liver to be disposed of.
What is LDL?
Low-density lipoprotein is often referred to as ‘bad cholesterol’. It transports cholesterol and fat from the liver to the rest of the body. During this process, LDL can turn into the bad guy, as it leaves behind plaque in blood vessels during transportation. LDL is fragile and susceptible to oxidation, which overall is bad news.
What Does Cholesterol Do For Us?
Cholesterol has a few jobs in the human body, mainly helping the body to make cell membranes, hormones and vitamin D. Cholesterol...
- Assists in bile production
- Makes up a part of the cell’s outer layer
- Is the precursor to important anabolic hormones that are related to muscular growth and repair. This is why a higher cholesterol intake could be associated with greater muscle growth
- Is the basis for other reproductive hormones, such as androgens and estrogens. Essentially, no cholesterol = no sex hormones
- Is also linked to Vitamin D, as we need cholesterol in our skin cells in order to make vitamin D from sunlight the skin absorbs.
So What’s Wrong With High Cholesterol?
We can see from research and peer-reviewed studies that there is an association between elevated cholesterol levels and the risk of premature death from cardiovascular disease.
What Should We Aim For In Our Labs?
According to the Framingham study, no one has died of cardiovascular disease while maintaining a cholesterol level lower than 150mg/dl, while going from 200mg/dl to 260mg/dl increases the risk of death by 500%.
The Framingham study also found that 35% of heart attacks that occurred were in patients with ‘normal’ cholesterol of between 151mg/dl and 200mg/dl. Aiming for low cholesterol levels of less than 150mg/dl has been shown to protect us against cardiovascular disease.
According to Dr. Colin Campbell, “Heart disease is virtually unknown in regions where cholesterol is under 150.”
HOWEVER, as always in nutrition, the way our bodies respond to certain diets varies from person to person based on psychosociological factors.
In the Greek island of Crete, not a single heart attack was registered across half a million people during a 10-year study. This must mean that they have low cholesterol levels, right? Wrong.
The average citizen of Crete has a cholesterol level greater than 200mg/dl. So why aren’t they experiencing the same cardiovascular issues as others with high cholesterol? Some experts link this to the protective effects of unprocessed fats, which are very common in the Mediterranean diet, eaten by most Cretians. Many believe that this dietary anomaly is also related to inflammation, insulin resistance, and genetics.
Yes, cholesterol plays an important role in cardiovascular health, however, it’s worth noting that it is definitely not the only factor involved.
How Can We Lower/Increase Cholesterol?
The first step is understanding whether or not you’re at risk. When you see a functional medicine physician, they’ll likely look at an advanced lipid panel to assess this. Unlike the simple annual physical bloodwork that is usually offered to track cholesterol, these lipid panel tests provide a lot more information, offering an incredible guide to know how to address any abnormalities found.
The most effective way to manage cholesterol levels is through diet and exercise. However, millions of people use cholesterol-lowering drugs every day. Why? Because it takes work to control our cholesterol levels.
It’s speculated that the production and sale of statin drugs (often offered to manage cholesterol levels) is one of the most lucrative pharmaceutical markets, being one of the top two selling drugs in the USA.
Studies have shown that a 100% plant-based diet full of nutrient-dense foods can decrease LDL cholesterol, in some cases, moreso than statin drugs. It’s safe to assume that you’re not ready to go full vegan after reading that, and we don’t expect or want you to either. This simply illustrates the power our diet has on our body and cholesterol levels, and shows that even small shifts in diet can make a big difference to our overall health.
Please note any treatment approaches mentioned are not intended and should not be considered, or used as a substitute for, medical advice, diagnosis or treatment and have not been evaluated by the FDA.
So Cholesterol Can Be Good?
YES! Better than good, cholesterol is essential. Just like all things related to our diet and health, moderation is key, and tracking our progress through lab testing is fundamental when it comes to managing our cholesterol levels.
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