Cholesterol Truths You Should Know

Cholesterol remains one of the most incomprehensible health topics in the 21st century. Myths surrounding cholesterol exist since the early 1900s when Rudolf Virchow theorized that excessive lipids in the blood, a condition known as Hyperlipidemia, can trigger heart problems.^{8, 9} Pharma giants capitalized this and rolled out a range of cholesterol-controlling drugs. However, health advisors now say that reducing fatty foods and burning calories serves the purpose better than medications do.^{8, 9, 10, 11} This baffles patients as they’re led to question why if they’re taking meds, it’s not sufficient? The truth, unfortunately, took as long as the last decade to unfold,^{6 11, 12} but helped to figure out the most effective ways to manage cholesterol.

The liver and gut cells work together to regulate cellular cholesterol levels.^{1, 2} The liver usually converts cholesterol to bile and when there’s an excess, the colon produces bile acid from it. Storage of cholesterol happens in the gut cells,^{1, 2} which can be reabsorbed again and recirculates between the liver and gut cells as needed.

The body needs cholesterol

Hormones, vitamins, bile juices, nerve sheaths, and cell membrane, all contain cholesterol in high quantities. In fact, every cell makes cholesterol to form cell membranes, which is known as cellular cholesterol.

Cellular cholesterol doesn’t equal blood cholesterol

Cellular cholesterol resides in all cells of humans as cellular components. ^{1, 2} Whereas, blood cholesterol is cholesterol bound with lipoproteins and triglycerides moving through the bloodstream as cholesterol-lipoprotein complexes. The liver produces 75% of the cholesterol.^{1, 2} When a person does not eat cholesterol-containing foods, more and more cholesterol production occurs internally(>85%).

Reducing cholesterol doesn’t reduce CVD risks

Cholesterol’s links with heart disease were recently put to rest when a study concluded that 92% of people with higher cholesterol levels led longer lives. ^{9, 11, 12} Experts even question now whether lipid-plaques in the bloodstream cause heart attacks. ^{11, 12}

Total cholesterol numbers don’t matter

The following fats make up blood cholesterol:

Lipids - heavy molecules that don’t mix in water; cholesterol is also a lipid.

Triglycerides - special fats that move along with lipids in a cholesterol-lipoprotein complex.

Low-density lipoproteins (LDL) - lipids in which the protein content is low and is large enough to obstruct blood flow.

High-density lipoproteins (HDL) - lipids with more protein content and of small sizes (5-15 nm).

HDL and LDL concentrations cumulate to Total Cholesterol. ^{8, 10, 12}

This parameter, although, highlighted in the cholesterol test reports, doesn’t indicate anything. LDL particle size and frequency, along with ratio between Total Cholesterol and HDL cholesterol drive the cardiovascular health of a person. Physicians note that small, heavy LDL particles tend to stick to the arterial borders. If they stay in the bloodstream for longer periods, they can form plaques.^{8, 10, 12}

Statins act on liver’s cholesterol production

By and large, statins target lowering LDL cholesterol. ^{2, 4, 8, 9} Statins do so by interfering with liver’s metabolic pathways. These drugs inhibit production of useful enzymes and antioxidants. This eventually affects brain function as cranial nerves contain thicker sheaths.^{4, 8, 9, 11, 12} In addition, side-effects of statins’ have been implicated in increasing heart disease.^{4, 8, 9, 11, 12}

Diet and Exercise Influence Blood Cholesterol

Fat-burning exercises help in controlling cholesterol numbers better than statins do.^{3, 8} Burning excess fats lowers the fat load on the liver and gut cells; this benefits the pancreas too. A good mix of fibre, proteins and antioxidant-rich foods lets the liver break fats down easily. ^{1, 2, 8, 12} Fibre prevents triglyceride buildup. Antioxidants enhance cholesterol utilization rates and moves cholesterol to the cranial nerves faster. Proteins play a role in forming fat-reducing enzymes like HMG-CoA reductase, pancreatic lipases and intestinal esterases. ^{6, 9, 12}

Having said that, it’s important to realize that not all cholesterol is good.

Nutritionists call omega-3 and omega-6 fatty acids “essential” fats for good reason. The human body needs them for many functions, from building healthy cells to maintaining brain and nerve function. Our bodies can’t produce them. The only source is food.

Omega-6 mostly comes as linoleic acid from plant oils such as corn oil, soybean oil, and sunflower oil, as well as from nuts and seeds. The American Heart Association recommends that at least 5% to 10% of food calories come from omega-6 fatty acids.

Omega-3s come primarily from fatty fish such as salmon, mackerel, and tuna, as well as from walnuts and flaxseed in lesser amounts.

a) PUFAs Produce Useful Cholesterol

The most effective step is to consume unsaturated fats (mono- and polyunsaturated fats) as they can be easily broken down to derive cholesterol without side-chains. Omega-3 and omega-6 fats fall in this category.

Omega-3 fats boost heart health by

reducing the chances of developing clots,

preventing slowing down of heartbeats, and

promoting the growth of new blood vessels.^{2, 6, 7, 12}

Secondly, omega-3s reduce triglyceride and low-density lipoprotein production in the liver. ^{6, 7} In fact, they do it better than statins. ^{6, 7, 10}

Thirdly, omega-3 fats readily break down to form cell-membrane components. ⁷

They’re present in high quantities in fish, fish oil, krill oil, and few plant sources like flaxseed oil, canola, walnuts, soya bean and tofu. ^{5, 7} Both plant-based and animal-based omega-3s can be taken, although krill-oil based omega-3 fats work the best.^{1, 2, 6, 7}

Omega-6 fats play important roles in brain cell functions, ^{6, 9, 12} bone health and stimulate skin and hair growth. Eggs and canola, corn and sunflower oils contain omega-6 fats. The trick here is to keep the omega-6 to omega-3 ratio as 1:1 because if this ratio increases, it disrupts omega-3 absorption. ^{6, 9, 12}

b) Cholesterol from fatty foods differs from the one produced internally

Depending on the source, cholesterol has 2 forms -- one with a side chain and one without. ^{1, 2} Contrary to popular belief, cholesterol from creamy, lip-smacking foods contains bulky side-chains. ^{1, 2, 5, 12} Gut cells and the pancreas cleave off these side chains for metabolic processes. ^{1, 2} 25% of the cholesterol in the body comes through this method.1, 2 On the other hand, the body readily utilizes the other form produced by the liver that doesn’t contain bulky side-chains.

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