When your medical practitioner tells you that you have high cholesterol and are in danger of developing heart disease, this opinion is usually based on your total cholesterol and lipoproteins LDL and HDL levels. He/she would then prescribe some drugs to lower your cholesterol, in order to reduce your risk of heart disease. However, be aware, this conventional approach may not be the best course of action!
What is cholesterol?
Cholesterol is a soft white fatty substance that is found in the bloodstream and in every single cell in the human body. About 25% of the cholesterol in your body is found in the human brain. In fact, cholesterol is of vital importance for the body; has many functions and is decidedly not an enemy, but an essential friend.
Most of our cholesterol is made daily in our livers – if we have cholesterol in the food we eat, the liver makes less cholesterol. If we eat no foods that contain cholesterol, the liver simply makes the full amount of 2 g of cholesterol per day.
What is cholesterol’s function in the body?
Cholesterol forms an integral part of all cell membranes, including that of the skin, where its fatty substance contributes to the “waterproofing” that covers the whole body. Cholesterol is used to make all the steroid hormones, which includes estrogen, progesterone, testosterone, cortisol and aldosterone. Some vitamin D is formed in human skin from cholesterol in the presence of sunlight (UVB rays).
Not only is the liver responsible for making new cholesterol daily, but it is also responsible for breaking down and ridding the body of old cholesterol, which it releases in bile, as bile salts. Bile salts are vital for your body, as it emulsifies the fats in our food, which aids digestion. (Acting like your own Sunlight Liquid!) The body needs about 2 grams of cholesterol per day, with most of this being synthesized in the liver, while the diet supplies the balance – for example, meat and eggs are excellent sources of cholesterol.
Cholesterol’s journey in the body
Cholesterol and other fats we eat are not soluble in water. The body has a wonderful way of solving this problem. Fat from our food or the fat we produce in the body is transported in the blood stream, which is largely made up of water (water based), by packaging fat (lipid) into a special water soluble package called a lipoprotein. A lipoprotein consists of an inner core of fat, surrounded by a layer of protein.
Testing for cholesterol levels
There is actually only one type of cholesterol. Cholesterol is cholesterol. Thus, when a doctor sends off a blood sample to test cholesterol levels, he/she requests a “lipogram”, in which individual lipoprotein packages are investigated. The two lipoproteins that are routinely reported are LDL (low density lipoprotein) and HDL (high density lipoprotein).
LDL is the package that transports the most cholesterol, together with other types of fat, at any one moment in your blood stream from the liver to peripheral tissues – cholesterol that was made in your liver, plus the cholesterol from your food. Besides carrying the greatest quantity of cholesterol, it is also the package that circulates in the blood stream for the longest period – days instead of hours, thus the levels of these “lethal” LDL packages should ideally be regularly monitored. In obese patients LDL deposits cholesterol in fat cells for steroid hormone synthesis.
The LDL levels in the blood stream are determined by many factors such as diet, genetic factors, age, smoking and the amount of daily physical activity. Ideally the LDL levels should not be too low or too high.
The ratio of the “healthy” HDL lipoprotein package when measured against LDL is important. HDL is the vehicle that picks up and transports old, used cholesterol from body cells back to the liver for breakdown and conversion into bile acids and bile salts. Bile salts are the route of elimination of cholesterol from the human body.
Recent research has found that it is not as much the amount of LDL that causes heart disease, but rather the size and the number of the LDL particles. Large particles (think large fluffy beach balls) flow easily through blood vessels, but small, dense, particles (think small golf balls) are the dangerous ones. They can squeeze through the linings of the arteries, and with oxidation (turning rancid), can cause damage and inflammation in the arterial walls. Soft plaque forms in these areas of the blood vessel wall in an attempt to repair the blood vessel. Testing for LDL particle size and number is in reality the best measure of cholesterol levels and risk for heart disease.
A few years ago it was discovered that inflammation in the artery wall is the real cause of heart disease. Inflammation in the arterial wall allows the small dense LDL particles to move into the wall and be trapped.
Chronic inflammation is driven by the regular, high intake of simple, processed carbohydrates, like sugar, white flour and all products made from them, as well as the high intake of omega-6 vegetable oils, like sunflower, corn and soya bean oil, found in most processed foods. The repeated intake of refined carbohydrates and/or sugar throughout the day results in regular spikes in your blood glucose level. Insulin is released with each spike, which allows cells to use some of this glucose for energy, while also storing some of this glucose away as fat. Blood glucose levels are normally controlled within a very narrow range. However, these regular spikes in the blood glucose level do allow some of these glucose molecules to attach to proteins in the blood vessel wall, and this causes injury to the vessel wall. Repeated injury to the delicate blood vessel wall in this way leads to inflammation and can be likened to using sand paper on the inside of the smooth blood vessel walls.
Whenever there is inflammation in blood vessel walls, this damage is followed by cell repair in this area of the wall, and for this cholesterol is needed in the making of new cell membranes. Thus the liver releases more cholesterol for this purpose. If there is chronic inflammation in your body (indicated by highly sensitive C-reactive protein (hsCRP) levels in your bloodstream) this adds to the increased cholesterol levels seen in your circulation, to help with repair and healing.
It is very important to determine what causes the chronic inflammation, rather than just trying to lower one’s cholesterol levels. When chronic inflammation is suspected, a highly sensitive C-reactive protein (hsCRP) blood test can be requested. With routine annual blood tests, it is wise to always determine the total level of inflammation in the body through the hsCRP levels.
Besides HDL and LDL fractions, two other blood measurements are also of importance:
Triglycerides – this refers to fat in the bloodstream, which was formed from excess glucose. Elevated levels of this type of fat have also been linked to heart disease and diabetes. Triglyceride levels are increased by eating too many refined carbohydrates and sugars, being physically inactive, smoking, excessive alcohol intake and being overweight or obese. The higher the triglyceride level in the bloodstream, the more likely your LDL particles are going to increase in number and decrease in size. There is a direct correlation between increasing triglyceride levels and more dangerous small dense LDL particles.
Lp(a) or lipoprotein (a) – is an extra protein around the LDL fraction in your bloodstream – a very strong risk factor for heart disease and or stroke.
As a result a detailed look and analysis of the lipogram is needed in order to assess risk, and then the most suitable treatment to reduce such risk must be decided.
The best remedy for your medical practitioner’s message about “high cholesterol”, is to start a regular exercise routine and eliminate inflammatory foods from your grocery cart. Buy more fresh, natural and unprocessed food. Choose complex carbohydrates, like colorful vegetables and fruit. Cut down or eliminate the use of oils, high in omega 6 – like sunflower, corn or soya bean oil, or any processed foods made with them. Animal fats contain much less omega 6, and are far less likely to cause inflammation, than the so called “healthy polyunsaturated oils”. Use extra virgin olive oil and butter instead.
Sources:
The cholesterol myth that is harming your health. Published 10 August 2010 in Dr. Mercola’s Natural Health Newsletter. (www.drmercola.com)
LDL Cholesterol, particle number and particle size made easy. Posted 20 October 2013 and last modified 27 December 2017. Doc’s Opinion. (www.docsopinion.com)
Cholesterol particle size. Posted 19 May 2011. Main Heart Clinic. (www.mainheartclinic.com)
Making sense of cholesterol tests. Updated online 4 December 2015. Harvard Medical School.
Non-HDL cholesterol explained. Published in January 2018 edition of Harvard Health Letter, Harvard Medical School.
Cholesterol and heart disease. Blog by Prof Nola Dippenaar. May 2016. Health Insight.
Cholesterol – understanding all about it! Blog by Prof Nola Dippenaar. June 2009. Health Insight.
What is cholesterol, do we need it? Article by Prof Nola Dippenaar. Published April 2010 edition of CEO Magazine.
Cholesterol levels. Article by Prof Nola Dippenaar. Published May 2010 edition of CEO Magazine.
HEALTH INSIGHT. APRIL 2018
