I come from a South African Indian family and community where poor nutrition and therefore poor health is unfortunately a way of life. My family has fortunately managed to, in general, make progressively better food choices over the years. But the broader community is riddled with lifestyle diseases such as diabetes and cardiovascular disease. Central to the cardiovascular conditions is elevated cholesterol. And it’s a topic that always comes up, at the dinner table, that has all the high glycemic goodness you can think of!
Cholesterol is also one of the primary concerns raised when suggesting a paleo/primal/whole-food approach due to the greater fat intake. People still don’t seem to understand the connection between diet and cholesterol, and that’s partly because they don’t understand cholesterol.
I wrote the article below for a local online health and fitness mag, Rise To It. The information should hopefully dispel some of the concerns and misconceptions regarding cholesterol and food. Before you read it remember that natural fats (animal, dairy, nut and seed oils), including saturated fats, aren’t the cause of high cholesterol or artherosclerosis. Processed foods, sugar and pro-inflammatory foods are. (Note to the Indian community: It’s not the prawns that “give you high cholesterol,” it’s the bread you’re eating it with along with all the desert that follows.)
If you have any questions about the topic, ask them in the comments section below and I’ll respond within the next day.
Understanding cholesterol is essential, especially with all the misinformation out there. Cholesterol is a waxy steroid of fat found in all cell membranes and in our blood plasma. Among its many jobs, cholesterol is responsible for insulating neurons (nerve cells), building and maintaining cellular membranes (the security walls of cells), metabolising vitamins, producing bile, and initiating the synthesis of many hormones. Cholesterol is vital for life. No cholesterol = death.
Given all the important work that cholesterol is responsible for, its production in the live is self-regulated. That means that the liver will always ensure that there is enough. What’s especially important is that our livers regulate cholesterol production in response to our nutrition. When we eat less, it makes more, and vice-versa.
Contrary to ‘conventional wisdom,’ there is only one “type” of cholesterol, and it’s called just that, cholesterol. However, we don’t just have cholesterol floating about. Cholesterol can only be transported in the blood by lipoproteins. Lipoproteins deliver cholesterol to sites in the body.
When referring to cholesterol nowadays, we mistakenly refer to cholesterol as HDL and LDL. High density lipoproteins (HDL) and low density lipoproteins (LDL) do not give us a measure of cholesterol. They are simply vehicles transporting cholesterol.
HDL has the renowned job of getting rid of excess cholesterol. It transfers cholesterol from the body’s tissues back to the liver, and the liver excretes it through bile. LDL, in contrast, transports cholesterol from the liver production line to wherever it’s needed in the body. Remember, cholesterol has a lengthy to-do list!
Naturally, HDL became known as “good” cholesterol and LDL as “bad” cholesterol. LDL became really bad in the fifties when research found an association between early death by heart disease and fat deposits along artery walls. Cholesterol was found in the fat deposits. Therefore, researchers concluded that it was the culprit. However, one of cholesterol’s roles is to act as a plaster. In an inflammatory situation, cholesterol (transported by LDL) forms a temporary cover over lesions in the arterial wall. When the inflammation is resolved, cholesterol is removed (by HDL). Unfortunately in most heart disease cases, the inflammation doesn’t subside.
What causes inflammation? A diet high in simple and processed carbs, including grains and starches, does. However, given that meat, eggs and dairy are the primary sources of dietary cholesterol, the message sent home was to eat less of those and more carbs. All you need to do is look at the general state of health to see where that advice has left us – fat and riddled with cardiovascular and metabolic disease.
What compounds the good vs. bad cholesterol frenzy further is that it’s not the cholesterol part of LDL that is bad, but the lipoprotein itself. Some smaller forms of LDL are the ones involved in the process of inflammation in arterial walls. And again, these types of LDL do not increase with the amount of saturated fats you eat, but instead with elevated levels of inflammation caused by simple carbs and hydrogenated fats.
So, a high level of blood cholesterol, low HDL or high LDL does not necessarily indicate a risk of heart disease. While those measurements can tell you that something is not right, the problem is unlikely to be cholesterol itself. Cholesterol might just be the symptom, the decoy, of the larger concern.
Maintaining a healthy heart is achieved by minimising inflammation. That means eating loads of vegies, fruits, good quality meats, and healthy fats and proteins. Top that off with a good dose of omega-3 fatty acids, especially from fish oils.
If a blood test has been recommended, then speak to your doctor about what the numbers mean in the big picture of your health.