Cholesterol & Heart Disease

For decades, cholesterol has been demonized as bad, and the main cause of heart disease.  

This idea might have been understandable given the available science 50 years ago, but recently, evidence DOES NOT support this argument. 

 

So WHAT exactly is cholesterol?

Cholesterol is a fat-like substance that occurs naturally in your body.

Many people think that cholesterol is harmful, but the truth is that it's essential for your body to function.

Cholesterol contributes to the membrane structure of every cell in your body.

Your body also needs it to make hormones and vitamin D, as well as perform various other important functions. Simply put, you COULD NOT survive without it.

Your body makes all the cholesterol it needs, but it also absorbs a relatively small amount of cholesterol from certain foods, such as eggs, meat, and full-fat dairy products.

 

Lipoproteins

Lipoproteins are made of fat (lipid) on the inside & protein on the outside.

The two most relevant lipoproteins that relate to heart health are low-density lipoproteins (LDL) & high-density lipoproteins (HDL).

 

Low-density lipoprotein (LDL)

LDL comprises 60–70% of total blood lipoproteins and is responsible for carrying cholesterol particles throughout your body.

It’s often referred to as "bad" cholesterol, as it has been linked to atherosclerosis or the buildup of plaque in arteries.

Having a lot of cholesterol carried by LDL lipoproteins is associated with an increased risk of heart disease. In fact, the higher the level, the greater the risk.

There are different types of LDL, mainly broken down by size. They are often classified as either small, dense LDL or large LDL.

Studies show that people who have mostly small particles are at a greater risk of developing heart disease than those with mostly large particles.

Still, the size of LDL particles is not the most important risk factor — it's the number of them. This measurement is called LDL particle number, or LDL-P.

Generally, the higher the number of LDL particles you have, the greater your risk of developing heart disease.

High-density lipoprotein (HDL)

HDL picks up excess cholesterol throughout your body and takes it back to your liver, where it can be used or excreted.

Some evidence indicates that HDL protects against the buildup of plaque inside your arteries.

It’s often referred to as "good" cholesterol, as having cholesterol carried by HDL particles is associated with a decreased risk of heart disease.

 

How does dietary cholesterol affect blood cholesterol?

The amount of cholesterol in your diet and the amount of cholesterol in your blood are very different things.

Although it may seem logical that eating cholesterol would raise blood cholesterol levels, it usually doesn't work that way.

Your body is very good at regulating the amount of cholesterol in your blood by controlling its production of cholesterol.

When your dietary intake of cholesterol goes down, your body makes more. When you eat greater amounts of cholesterol, your body makes less. Because of this, foods high in dietary cholesterol have very little impact on blood cholesterol levels in most people.

However, in some people, high-cholesterol foods raise blood cholesterol levels. These people makeup about 35% of the population and are often referred to as "hyper responders." This tends to be genetic.

Even though dietary cholesterol can slightly increase LDL in these individuals, it does not seem to increase their risk of heart disease.

 

This could be due to the fact that hyper responders also experience an increase in HDL particles, which offsets the increase in LDL by transporting excess cholesterol back to the liver for elimination from the body.

Because of this, these individuals may see an increase in cholesterol levels but the ratio of good cholesterol vs bad cholesterol stays the same. So their risk for heart disease doesn't seem to go up.

Of course, there are always exceptions in nutrition, and some individuals may see adverse effects from eating more cholesterol-rich foods.

 

Dietary cholesterol and heart disease

Contrary to popular belief, heart disease is not only caused by cholesterol.

Many factors are involved in the disease, including inflammation, oxidative stress, high blood pressure, and smoking.

While heart disease is often driven by the lipoproteins that carry cholesterol around, dietary cholesterol has very little to no effect on this.

However, high-heat cooking of cholesterol-rich foods can cause the formation of oxysterols.

Some studies have shown that a high level of oxysterols may contribute to heart disease, but further evidence is needed before this can be finalized. 

 

High-quality research finds no link to heart disease

A vast number of studies have shown that dietary cholesterol is not associated with an increased risk of heart disease.

A lot of studies have been done on eggs specifically. Eggs are a great source of dietary cholesterol but studies have shown that eating eggs has zero effect when it comes to developing heart disease.

The type of dietary cholesterol found in eggs can help improve lipoprotein profile, actually lower your risk for heart disease.

One study that compared whole eggs vs egg whites showed that the people who consumed whole eggs had a greater increase in HDL particles & a decrease in LDL particles.

The people who consume egg whites only had the opposite outcome.

It's important to note that content matters. and individuals consuming the SAD diet (standard American diet) would probably not benefit as much from consuming eggs on a regular bases

 

So... Should you really avoid high-cholesterol foods?

For years, People have been told that high cholesterol foods are bad and that you should avoid them. But new studies have now come to the conclusion that this simply isn't the case.

Many high-cholesterol foods are also among the most nutrient-dense foods on the planet.

Some of these foods are:

  • Grass-fed beef
  • whole eggs
  • full-fat dairy
  • fish oil
  • shellfish
  • sardines
  • & liver 

Ways to lower high blood cholesterol

High cholesterol can be lower though very simple lifestyle changes. Things like;

  • exercising regular
  • eating a balanced diet of whole natural, unprocessed foods
  • making sure you are getting in plenty of fruits and veggies
  • reducing sugar consumption
  • reducing stress
  • weight loss

 

The bottom line

High blood cholesterol levels can raise your risk of developing heart disease. BUT, dietary cholesterol has little effect on your blood cholesterol in the majority of people. 

Top that of with that there is no significant link between the cholesterol you eat and your risk for developing heart disease. 

 

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