We have all heard people talking about how we should avoid egg yolks because they are full of cholesterol, and when we shop for groceries each weekend, we are bombarded with products that are labeled “low cholesterol” or “cholesterol free”. Many of us (including myself) have bought into the great cholesterol con and worked hard to decrease our lipid profile by eating a more vegetable based diet, even to the point of dumping the meat all together. And many of us have done so without knowing a single fact about cholesterol. For this reason, I decided to do some reading on Mother Nature’s “big mistake” and came up with some interesting information. In fact, I was so interested in the molecule that I came home to talk to my wife about how cool cholesterol really is…she wasn’t interested so I talked to my colleagues…they weren’t interested, so I decided to write a post about one of nature’s most interesting molecules for you!
So basically, cholesterol, which has been demonized by every arm chair doctor in the world as something that we should avoid at all costs, is essential for life. Yes, that’s right, we need cholesterol or we will die!
This essential molecule is basically a waxy solid alcohol (it is not a fat) that is soapy to the touch, of which 7% is located in the blood, while the other 93% is located in every cell in the body…yes every cell!
Cholesterol provides structural integrity to the cell membranes and regulates the flow of nutrients into the cells, while it sends waste products out of the cells. Not only is cholesterol important for cellular maintenance, it is the building block from which our body can make hormones; such as alderstone for blood pressure control, hydrocortisone which is the body’s natural steroid, estrogen and testosterone which are the sex hormones, and numerous other hormones that play integral roles within the body on a daily basis.
Cholesterol is also the main component of our bile acids which aid in digestion of the food we eat, especially fatty foods such as animal fat. Did you know that if it weren’t for cholesterol, we would not be able to digest fat soluble vitamins A, D, E, and K!
Cholesterol is also necessary for normal growth and development of our brain and nervous system. Without cholesterol, we would have a difficult time organizing things, and regular movements would be very difficult. Our emotions would be out of control and so would our intimate bodily functions! The good thing is that cholesterol will work for us by coating our nerves and assist in making transmissions of nerve impulses possible. All this while giving the skin the ability to shed water, otherwise we would drown in the shower!
Cholesterol is also a precursor of Vitamin D in the skin, meaning that without cholesterol, we would not be able to turn those beautiful sun rays into vitamin d and we would end up with all kinds of ailments such as rickets, and even the common cold would happen much more frequently.
Did I mention that cholesterol is responsible for normal growth and repair of our body’s tissues, while playing a major role in transportation of triglycerides throughout our circulatory system? This is why when we eat a high carbohydrate diet that our cholesterol will increase. Basically when we eat sugar, our liver turns the sugar into triglycerides and the cholesterol takes it away.
Now that we know some of what that ‘nasty’ molecule cholesterol actually does in the body, let’s look at what would happen if we did not have any cholesterol through diet or through our body’s own cholesterol producing plant in our cells…
Well, first of all, we would die. Plain and simple.
On our way to death, we will lose strength, and stability of our cells which will lead to infection and malignancy. In fact, one of the indications that we have something seriously wrong with us is a cholesterol level that is dropping like a Mike Tyson opponent.
Although conventional wisdom has you worried to death about the eggs you are eating for breakfast, and while just about every food item we buy is labeled low or cholesterol free so that you will buy the product, only a small fraction comes from our diet. In fact, about 80% of our cholesterol is produced by the body itself as every cell in the body is equipped with the ability to create its own cholesterol.
The liver, intestines and skin are responsible for creating most of the cholesterol, and what I find most interesting is that the body has it’s own feedback loop which increases cholesterol synthesis when dietary cholesterol is low, while doing the opposite when we eat loads of cholesterol rich foods.
Most people can consume plenty of cholesterol without significantly increasing their risk of high serum (blood) cholesterol levels, yet there are people who have some issue with high blood cholesterol levels. This is most likely caused by their body’s inability to regulate cholesterol internally.
Generally, people who are at risk for elevated blood cholesterol levels are told to limit their intake of dietary cholesterol. This usually means that they should stay away from the wonderful tasting egg, beef, and other fatty foods which have a higher level of cholesterol and saturated fat, however, there is a theory that in order to decrease such high levels of blood cholesterol, one should work to gain control of the internal cholesterol regulatory system.
Here’s the scoop…
Johnny has elevated blood cholesterol. Remember that cholesterol is regulated within the cell (via the feedback loop), so if he has elevated blood cholesterol, then there must be a problem with the regulatory mechanism of the cells. We know this because there is no feedback loop available within the blood, so his cholesterol continues to add up in his blood stream.
The cells in the body require a continuous supply of cholesterol which is used for maintenance of the cells, and to carry out all other functions discussed earlier such as coating nerve fibers and so on. This maintenance is what makes life possible from the cellular level all the way to Johnny’s ability to stay alive and vibrant.
In order for the cells to get its continuous supply of cholesterol, Johnny’s body has two pathways…
The cool think about Johnny’s cells is that the interior of the cell requires plenty of cholesterol, and interestingly enough, this is where the sensors are located. When his cholesterol levels fall, this stimulates the sensors to send messages for more production. When the body receives these messages, it will either make its own cholesterol, or it will send out receptors to steal it from the bloodstream. Generally, this feedback loop has a pretty good handle on maintaining adequate levels of cholesterol within the body which is sometimes known as the “optimal level”. As mentioned earlier, most of the cholesterol sensors inside the cells are located in the liver.
Cholesterol’s artery clogging generally occurs in the arteries that supply the heart, the brain and the body, but not in the cells with cholesterol sensors. Think of the feedback loop with this analogy…
It is a hot summer, and Johnny wants t keep his house cool by using an air conditioner so he buys one from Home Depot and installs the new house cooling machine. Johnny makes a mistake and installs the thermostat in the hottest, driest room in his house, which happens to be an enclosed closet. This closet is always hot, and requires the air conditioner to be running constantly, eventually causing the remainder of the house (except the closet) to form icicles throughout the rooms. These icicles are like cholesterol plaques that choke the arteries.
The deposits of cholesterol fill the arteries (icicles in the room) but the sensors are in the cells (hot closet) which will never really know that there is clogging occurring downstream (icicles in the adjacent rooms) because all they are concerned with are the levels within the cells (hot closet).
Cholesterol doesn’t make its own way around the body, so it is transported throughout the body via lipoproteins. You may have heard of them before, or you may at least have heard of their short hand names such as LDL (Low Density Lipoprotein), HDL (High Density Lipoprotein) and even VLDL (Very Low Density Lipoprotein).
You can think of these lipoproteins as envelopes that will enclose the cholesterol (waxy, fatty solid) and triglycerides (storage form of fat) making them soluble in the blood so that they can be transported to the tissues. In fact, this is the only way that cholesterol and triglycerides can be transported, sort of like how most adults make their way from their house to the corner store…in their SUV, otherwise they would never get there!
The names for LDL, HDL and VLDL are only representative of their density, not their duties throughout the body. Triglycerides are the lightest of all blood fats, in fact they are so light, they would float to the top in a mix of blood fats. Next on the scale is the VLDL which carries some triglycerides and a little bit of cholesterol.
High Density Lipoproteins (HDL) are the heaviest of the blood fats, hence the name. VLDL are created and released into the blood stream via the liver cells and are mainly made of triglycerides but with very little cholesterol. They then travel through the blood and mature by acquiring more cholesterol and takes triglycerides to the body tissues to be burned for energy or stored.
After the majority of the triglyceride is burned, the chemical rich remnants that remain then become LDL (low density lipoprotein) that is practically a cholesterol. LDL travels throughout the bloodstream and is the primary means for the body uses to transport cholesterol to the tissues. There are basically 3 things that happen to LDL as they travel through the blood…
It is the LDL, not dietary fat that is the main culprit of coronary artery disease, in fact, high sugar (generally from high refined carbohydrate diets) causes the triglyceride levels to increase because the liver turns the sugar into triglycerides, and then the cells send out the lipoproteins to take away the triglycerides in the blood. So understanding how the body uses LDL and how to manipulate the cells to remove as much LDL from the bloodstream as possible should be the key to maintaining optimal levels of cholesterol in the blood.
I talked earlier about the feedback loop that sends LDL receptors from the interior to the exterior of the cell in order to grab the cholesterol filled LDL particles. The more LDL receptors that steal cholesterol from the blood, the better off we will be because this will ultimately please the sensors in the interior of the cell, and decrease the amount of cholesterol in the blood, which is what we want to decrease.
Think of this feedback loop as though the cholesterol were Salmon in the river, and the receptors are bears who travel from the interior of the forest into the rivers to catch the fish (cholesterol) and bring them back into the forest to deposit after eating what they want. The result is that there is less fish in the river, and more nutrition for the forest to grow because of the bears that travel from the forest to the river and back again.
During this process however, the cell is also beginning to make its own cholesterol and this continues until the sensors decide that there is enough cholesterol within the cells. If we can slow down the rate at which the cells make their own cholesterol, they would have to increase the number of LDL receptors they send to the surface of the cell to pull more LDL from the blood stream.
What is interesting about this is that in a healthy human, this is exactly what happens. In fact, Lovostatin (Mecavor) works on this principle to lower cholesterol in people who have elevated levels and who have difficulty decreasing their levels assuming they have exhausted all avenues of diet and lifestyle change first. Well, in a perfect world that is what would happen but many people skip the dietary and lifestyle changes and opt for the expensive drugs which is unfortunate because Mother Nature didn’t create this feedback loop so that people can spend their money on drugs.
The cholesterol synthesis pathway in the cells acts like a production line in a factory. The raw materials are brought in to assemble the end product, and then they are sent out. There is one step in this process which is known as the ‘rate limiting step’ that determines speed and controls the volume produced.
It is during this step that the enzyme HMG-CoA is intervened by Mecavor as it slows down the step and decreases the amount of cholesterol production. Less cholesterol in the cell indirectly increases the production of LDL receptors to pick out the LDL cholesterol from the blood. This causes a significant lowering of LDL in the blood. The problem with relying on the drug to lower cholesterol in the blood is in the side effects such as liver problems, muscular disorders, gall bladder issues, rashes, and even psychiatric disturbances. All of this with a hefty cost as well. In fact, when used in high dosages pocket books can be hit for upwards of $200/month for many years, even indefinitely!
Now, there is a way to achieve this cholesterol lowering effect without taking the statin drugs…
We have all heard of the hormone insulin, yet not many people know of its many roles in the body. Just the same, another hormone, Glucagon, also involves itself in this process by affecting the activity of the enzyme HMG-CoA reductase. Insulin stimulates the enzyme while glucagon inhibits the enzyme activity.
This is why it can make sense that people who have insulin resistance (diabetics) can also have elevated levels of cholesterol, which eventually leads to an abundance in the cells. Remember that when there is enough cholesterol within the walls of the cells, there is no reason to send out the LDL receptors to the surface to steal the cholesterol from the blood, and this results in elevated LDL in the blood which continues to rise or at least remains elevated.
Glucagon, on the other hand, does the opposite by inhibiting the activity of the enzyme HMG-CoA in much the same way that the drug lovostatin works. As glucagon slows production of cholesterol in the cells, supply inside runs low. When there is low cholesterol in the cells, they send the LDL receptors to the surface so that they can grab LDL molecules, which are carrying plenty of cholesterol, to supply the cell with the much needed cholesterol.
With a diet that works to balance insulin and glucagon, blood cholesterol will be reduced in the same manner as the drug without the side effects and the cost.
What about HDL and VLDL?
Well, cholesterol from the tissues (including the linings of the arteries) that is scavenged by the HDL carries it through the blood and passed it off to the VLDL particles that hand out in the blood stream, kind of like the “floater” that hangs out at the other team’s blue line waiting for an opportunity for a breakaway in a hockey game. This is eventually converted down to LDL and is carried toward the tissues to be deposited.
HDL then gathers it from the tissues ad takes it back the other way to the cells of the liver where it is disposed of. The amount of cholesterol in the tissues is dependant on the relative amounts of HDL and LDL in the blood. Much like a freeway leading into and out of a city, one lane will be busy with traffic while the other is quiet. The increase in population (because of people from the suburbs travelling in to the city for work) is the SUM of the people entering, minus those leaving.
If there is lots of LDL and very little HDL this means that most of the traffic is heading into the tissues.
If there is lots of HDL and very little LDL, the flow is going in the opposite direction (from the city to the suburbs).
This information helps health car professionals in determining health risks for their patients and is measured via ratios of HDL/LDL and other lipoproteins.
If you are interested in knowing your lipid profile, talk to your doctor and ask for some blood tests that will show you where you stand in terms of:
These numbers on their own only show a portion of the puzzle, so also remember to ask your doctor to discuss with you what the ratios mean as this is often a more meaningful explanation of your lipid profile. There are many websites that offer great information regarding the ratios and I suggest that you educate yourself in the process.
Total Cholesterol – the sum of all of the lipoproteins that carry cholesterol in the blood (HDL, LDL, VLDL, and a few more that don’t get much attention because for the most part, the three listed are those that are of most concern)
Total cholesterol, however, isn’t a number that you should stop at because for the most part, about 70% of your cholesterol in the blood is carried by the LDL molecules. If your total cholesterol is high, chances are that you will also have a high LDL count, but there are some exceptions. This is why ratios are more important. Studies suggest that higher levels of LDL = Increased risk of heart disease and with higher levels of HDL, the risk decreases.
The following two examples may help with understanding how the ratios work…
Total cholesterol:HDL ratio should be below 4
LDL:HDL ratio should be below 3
Take for example, an individual who has a Total Cholesterol of 240. Without any further ratios, most people would look at that number and worry. If that individual’s HDL is 60, then their score (based on Total:HDL) would be 4, which is listed as ok. (240/60 = 4)
If their HDL increases to 70, their score would be 3.43 (240/70 = 3.43). This score would be even better.
Here is another example…
This person has a total cholesterol score of 180. They may go to their family and co workers to brag about their stellar cardiovascular health, but let’s say that their HDL is 30, then the story changes because their Total:HDL ratio is now 6. (180/30=6). Remember that a score of 4 or les is preferred. This person would most likely be at a greater risk than the first example.
Let’s look at another example, this time using the LDL:HDL ratio…
LDL = 120 and HDL = 30 (120/30=4) this would be above the LDL:HDL benchmark number of 3 as stated earlier. This person, even though they seemingly have low cholesterol, would most likely be at a higher risk for heart disease than the person who has a total of 240 and a score of 4.
Now that you know way too much information with regards to cholesterol, you are probably wondering how you can make changes to the lipid profile (Total, LDL, HDL, etc). There are a few ways, one which can cost plenty and cause side effects, but we would like to stay away from drugs as much as possible, considering the fact that Nature has an effective way that doesn’t cost as much in the long run and has more positive side effects such as increased energy, looking better, and feeling better each and every day.
Basically, the diet that will increase LDL while simultaneously decreasing HDL, is the diet that is being recommended by most governments. Our food guide promotes an eating strategy which is termed the LFHC diet (Low Fat High Carbohydrate), and oddly enough, it is what most doctors will prescribe. Such a diet may lower total cholesterol and LDL slightly, however it will also significantly lower HDL which will result in a negative effect on the ratios, which are more important than the individual measurements themselves.
What may end up happening with an overall decrease in cholesterol is an increase in death through other means such as cerebral hemorrhage, gall bladder disease, and many types of cancer – remember earlier where I said that falling levels of cholesterol are often markers of cancer.
However, when we flip the food pyramid around and take the carbohydrates (especially high glycemic, refined, processed and grains) from the bottom and move them closer to the top of the triangle, we then replace the servings of carbohydrates( pasta, rice, bread, cereal, granola, etc) with protein and fat in the form of animal foods (fish, beef, chicken, turkey, eggs, cheese, etc), and other rich sources of nutrients (nuts, seeds, leafy greens, etc) alongside the more positive sources of carbohydrates in the form of vegetables, and fruit. Doing so will increase the HDL which as you may know now, works to get rid of cholesterol.
While this happens, we will also decrease LDL to a certain extent because of the decreased triglycerides in the blood – high carbohydrate loads increases blood sugar, which is turned into triglycerides in the liver, and then sent out to the blood, which is picked up by the LDL. So, an increase of HDL with a decrease of LDL will help to bring out ratios into the good books and ultimately decrease our risk of heart disease and other diet related ailments.
My lipid profile is a perfect example of this theory…
I just had my labs done, and technically my total cholesterol is high, however when you look at the ratios, they tell a much different story…
Tri : 43
Tri/HDL = 0.52 (Should be below 2)
Having a high HDL number is certainly helping me to dispose of the cholesterol that is trying to hang out in the tissues, and eating a diet higher in protein and fat, while lower in carbohydrates (especially processed junk) decreases the level of triglycerides in my blood stream, thus decreasing the LDL. There is more to the LDL story, but that can be another post! Basically what research knows now is that there are 2 LDL particles to look for, Pattern A, and Pattern B. This is based on their density, and Pattern A would be the desired type to have. Based on my ratios, it is safe to say that I have mostly Pattern A, and having a higher LDL count, most of which are Pattern A, is certainly not something to worry about; in fact, it is something to be happy about as this is considered to decrease the risk of heart disease and other ailments.
Having said all that, I appreciate the fact that there is more to learn about cholesterol, so may I suggest that you check out the following links for further reading…
Until Next time,