High Cholesterol

Good nutrition plays a key role in healthy cholesterol

According to information published in 2007 in Scientific American, it is actually the carbohydrates we eat that cause complications. This is primarily because carbohydrates along with most vegetable oils cause oxidative stress which leads to elevated levels a of dangerous kinds of a lipoprotein called small or dense LDL. LDL or low-density lipoprotein is a molecule that is a combination of lipid (fat) and protein. Lipoproteins are the form in which lipids are transported in the blood.

LDL transports cholesterol from the liver to the tissues of the body. This is why we are often told that LDL cholesterol is the "bad" cholesterol. These lipoproteins are responsible for the formation of atherosclerotic plaques which are commonly considered to be the cause of coronary artery disease. Coronary artery disease appears to be the number one cause of heart attacks. You can determine your risk for coronary heart disease and other diseases of atherosclerosis such as peripheral vascular disease by looking at your lipid profile or blood lab profile which can be ordered by your doctor. But don’t focus only on the cholesterol level, look at the HDL and triglyceride levels, they will tell you if you have dangerous levels of dense LDL.

High cholesterol is often considered to be synonymous to heart disease. But to understand how this came about you must understand the role carbohydrates play. All the excess carbohydrates we consume are converted to fatty acids by insulin and stored as fat in our bodies. (see the section on Hypoglycemia on this website) Insulin does this because glucose is our primary fuel source. Our body wants to make sure that we always have a fuel source so it stores it in the form of glycogen in the liver and fat in adipose tissue. Fatty acids are formed primarily by the metabolism of glucose and fats that we eat. However, these fatty acids will only be stored as fat in our body if insulin is present. If insulin is not present, fatty acids will be used as building blocks much like protein is and fuel. While some insulin is released in response to any type of food intake, it is only released in large amounts when carbohydrates enter the body and are converted into glucose. Therefore, even if you have a lot of fatty acids around from a high fat meal, you will not store them as fat unless you ate a large amount of carbohydrates as well. Instead the fatty acids will be used as fuel and building blocks for tissue repair.

If you have higher levels of high-density lipoprotein (HDL), "good" cholesterol you have a lower risk of heart attack.

A recent study revealed that eating fat alone will not make you fat and that it is not conclusively the cause of coronary heart disease, stroke or diabetes. An article on the Johns Hopkins Medicine website goes into more detail on the subject. Unfortunately the advice provided on how to lower your risk given in the John Hopkin’s link is out dated, and erroneously advises you to avoid saturated fats. Other research has shown that they are not responsible - carbohydrates are. If your lab work shows that you do have elevated levels of dense LDL’s you can lower the level by reducing your refined, excess carbohydrate intake as this will lower your triglyceride levels. Add some saturated fats to your diet as this will raise your HDL levels. Keeping an eye on your total cholesterol to make sure it is not too low is important as well. (See links below under resources) Research has indicated that low cholesterol may be linked to increased risk of death from cancer, violence and suicide. Low cholesterol and risk of colon cancer. Low cholesterol and violence. Low cholesterol and risk of suicide.) For years patients who had never had a heart attack were placed on cholesterol lowering medications in an attempt to lower risk for heart disease. These medications were FDA approved for prevention of a second heart attack (after a person already had one. The assumption was that since these medications lower cholesterol levels that they also lower risk for heart disease. However, as noted in links below to various studies showing a link between heart disease and cholesterol have been controversial from the beginning.

All of the cholesterol lowering medications proved that they could effectively lower cholesterol but could never prove that they lowered risk for heart disease, until the JUPITER study 2006. This study showed that a certain class of cholesterol lowering medications called statins did lower the risk for heart disease, but not because they lowered cholesterol levels but rather because they lowered certain markers of inflammation called C-reactive protein. C-reactive protein is a marker of the inflammation in the lining of arteries which contributes to atherosclerotic plaque formation. Then in June 2010 a study published in the Archives of Internal Medicine showed that the JUPITER study was so flawed that it never should have been used to as proof that statins can be used as primary prevention for heart disease. The studies cited seem to say that the risk of atherosclerosis can be better reduced by reducing carbohydrates and unhealthy vegetable oils. But how many grams of carbohydrates should we consume? Since carbohydrates are fuel for the body the answer depends on how active you are. If you are sedentary, you may only need 70 grams of carbohydrates per day whereas if you work out a lot or are training to run a marathon you may need 300 grams. Most people fall somewhere between the two. If you want to lose fat you can burn it by keeping your insulin levels low by eating less than 70 grams of carbohydrates and engaging in moderate exercise. A good plan is to take a look at the amount of carbohydrates you are currently eating. Gradually reduce your carbohydrate consumption over time for best results.