3 Mistakes People Make About Cholesterol

September is National Cholesterol Education Month so I would like to talk about 3 myths/mistakes people have about cholesterol.  

Before I start, I will just say that cholesterol is a natural fat/lipid that we, and every other animal, make for a purpose.  The liver produces 85% of the cholesterol in your body and it is used to make vitamin D, hormones, and our body’s cells.  We need cholesterol.  

There are two forms of cholesterol: low density lipoproteins (LDL-C), which can cause issues with heart health when it piles up and forms plaque inside of a person’s arteries. Some have hypothesized that cholesterol gathering in the arteries is actually the body’s attempt to repair damage to the blood vessels caused by inflammation, which might occur in the presence of a bad diet (high amounts of animal fat and processed foods). 

The second part of what is included in a  Total Cholesterol test result are the high density lipoproteins (HDL-C), which act to remove cholesterol from the body. This is why health professionals recommend the goal of keeping LDL cholesterol levels low and HDL levels high. 

So here are the mistakes I’ve seen:

 Thinking that diet is the major cause of high cholesterol.  

In the 1980’s food packagers were promoting their products as “cholesterol free”,  Some were foods that never would contain cholesterol (i.e. They were from plants not animals). Other food products didn’t contain cholesterol, BUT they contained so many refined ingredients like white flour, white sugar and trans fats that people’s cholesterol actually worsened.  This myth has been largely dispelled in more recent years, though as a holdover from the ‘fear of cholesterol in food days’, I still see restaurants serving egg white omelets.  Yes, eggs contain cholesterol, but they also contain a lot of other really great nutrients! 

 LDL Cholesterol  and HDL Cholesterol are Always Bad or Good

As mentioned above, the LDL cholesterol deposits cholesterol in the arteries and HDL removes cholesterol, but is a high LDL always bad and a high HDL always good?   First, people will want to look at the HDL/LDL ratio on their lab results, which asks the question, “How much protective HDL is there in relation to the problematic LDL?”  

Secondly, health professionals are beginning to look at the sub-types of these lipid particles.  According to Quest Diagnostics Lab, “…testing, which include LDL subfractionation, can offer a more complete picture of a patients’ cardiovascular health when available with conventional cholesterol screening. The test separates, counts and measures the particles that make up LDL-C and HDL-C. Low-density lipoprotein particles (LDL-P) are a strong predictor of cardiovascular risk beyond a basic lipid panel. A high number of small and medium LDL particles indicate an increased risk for heart disease. A low number of large HDL particles indicate increased risk for heart disease.” 

To translate, specialized testing is available to look at the various types of LDL and HDL and this may be more predictive of who is at risk of developing cardiovascular disease than just our usual cholesterol panels.  Many people I talk with are concerned about their high LDL results, but their doctor has not offered further testing to look at the particle types.  

I have to feel bad on statins

Although many people can achieve good cholesterol levels by making healthy food choices and getting enough physical activity, some people may also need medicines called statins to lower their cholesterol levels. High cholesterol that runs in families due to genetic issues or diabetics would be among those where statins should be considered.  

Unfortunately, not all physicians acknowledge that statins can cause a deficiency of a nutrient called Coenzyme Q 10, which is a big part of our cell’s energy production mechanism.  I have had people who used to run marathons tell me that on statins they can’t even cross the street because of muscle pain and weakness.  CoQ10 is available as a supplement and can help this side effect.  Even the natural cholesterol-lowering supplement Red Rice Yeast acts on the same metabolic pathway as statins and may require CoQ10 supplementation.  

Let’s avoid myths and mistakes and stay informed!

Resources

“Is the Cholesterol in Your Food Really a Concern?”   https://www.pennmedicine.org/updates/blogs/heart-and-vascular-blog/2016/april/is-the-cholesterol-in-your-food-really-a-concern

“Why You Should No Longer Worry About Cholesterol in Food.”   https://health.clevelandclinic.org/why-you-should-no-longer-worry-about-cholesterol-in-food/