Would you shoot the firemen?

In relation to cholesterol there are more fallacies than facts in the mainstream media.

Today I’d like to address some of these head on.

1) Excess cholesterol, a symptom not a cause

 

2) There is only 1 type of cholesterol

 

3) Cholesterol travels in the blood in two lipoproteins

 

4) LDL and HDL refer to cholesterol carriers that transport it from point A to -point B, LDL transport endogenous fats and cholesterol from liver to tissues and HDL transport endogenous cholesterol from tissues to liver.

 

5) Excess cholesterol in the diet shouldn’t affect serum (blood) cholesterol levels

 

6) You get about 20% of your cholesterol from diet and the remaining 80% is synthesized by your liver

 

7) Cholesterol is essential for life!

 

8) Also carriers for fat soluble vitamins, constituent of cell membranes and play a vital role in production of steroid hormones.

 

 

So let’s get into the nitty-gritty:

Low density lipo-proteins (LDL) is supposed to be the ‘bad’ cholesterol but we need certain amounts of LDL as it not only carries cholesterol to the cells that need it but it also carries a lot of the fat soluble vitamins to the cells, for example Vitamin K, so that you can have healthy bones, blood clotting, reduce risk of calcification of arteries and protect against heart disease and you NEED LDL to carry it to the cells!

The liver packages the cholesterol and fat soluble vitamins into very low density lipo-protein (VLDL) and as cells metabolise it they extract all the nutrients they need and with that the cell starts to shrink and it becomes the LDL particle.  Ideally, when metabolic function is up to scratch, the LDL receptors will bring the LDL into the cells.  BUT when the LDL receptor does not work very well the LDL will not get into the cell where it is needed. There are three main reasons for this, one is genetic – a very small proportion of population, secondly metabolic efficiency, ie good thyroid status as adequate levels of thyroid hormone are imperative to make the LDL receptor work. And thirdly oxidative damage to the particles so that the LDL receptor does not recognise it and take up. This is dangerous, because if the LDL stays in the blood it starts to oxidise and this is where the issues begin.

Therefore the relationship between blood lipids and heart disease is twofold – keeping metabolism high AND using everything within the blood efficiently and preventing oxidative damage.

Where did all this misinformation and demonising of cholesterol begin?

Back in the 50’s and 60’s they thought high cholesterol in the blood caused heart disease, they didn’t realise that it was actually caused by the fatty acids becoming oxidised and going bad.

They did experiments where they gave people corn oil instead of butter and their cholesterol went down and so they were recommended as the heart healthy oils to reduce risk of heart disease.  The problem is that these are the very fatty acids that are most susceptible to oxidation. And remember it is the oxidised LDL and not the LDL itself that is bad for you! So these oils are actually contributing to atherosclerosis – misguided information!!

But even in the light of conflicting information, (for example the 1965 study where researchers gave people corn oil, olive oil and butter, people on corn oil had 4 times the cardiac mortality as the people on butter, people on olive oil were in between) they still recommended synthetic and vegetable oils as heart healthy.  The aftermath of this is easy to see just look around your supermarket!

There are two important markers for heart disease risk:

1. Total LDL to HDL ratio 7:1 (4:1 – good)

We need a certain amount of LDL and its serum content will always be greater that the ‘good’ HDL, but it’s the ratio that actually gives an indication of cardiac risk factors.  A ratio of 4 LDL : 1 HDL is considered optimum, but anything up to 7 LDL : 1 HDL is considered normal.

2.The TYPE of LDL- i.e. small dense LDL versus large, buoyant, (pattern a or pattern b ldl particle size) can significantly indicate cardiac risk factors.

Small dense LDL particles are much more vulnerable to oxidation, the blood vessel walls have small spaces that the lipoproteins can slip through, (spaces which can close up with exercise!) therefore they are not just more likely to oxidise (which is when the trouble starts remember!) but also more likely to slip behind arterial wall and start building up into plaque.  The longer the LDL is in the blood the smaller it will become (due to enzymatic action), the LDL will ‘steal’ cholesterol from HDL (therefore tipping the balance between them and enzymes responsible for this also), and finally its going to run out of anti-oxidants and start oxidising.

 

I hope this helps to explain why fighting cholesterol is fighting the symptom of something else. Excess LDL cholesterol is a vital warning sign from the body that SOMETHING else up or downstream is not functioning properly.

*Some measures you can take to reduce elevated LDL or simply protect against rising levels:

1) Get lots of antioxidant nutrients:

A good quality Vitamin C tablet with Zinc can help to reduce oxidation of LDL within the blood.  As with all supplements some is good but more is not better as too much Vitamin C has been shown to actually act as a pro-oxidant, and you don’t want that! Stick too 600mg-1000mg per day.

 

2) Avoid polyunsaturated fatty acids:

Avoiding the polyunsaturated fatty acids in vegetable oils, as these are the main components susceptible to oxidation in our bodies, is another way to mitigate the risk of high LDL. Substitute for coconut oil which is very low in polyunsaturated fatty acids, if you leave it out and at room temp for a year a good coconut oil will last and not go bad whereas vegetable oils will turn rancid after a short period of time.

 

3) Exercise:

The benefits of exercise are too myriad to get into here but remember – exercise plays a vital role in lipid metabolism, exercise can close up the small holes in the arterial wall that allow oxidised LDL particles to slip through and commence plaque build up.  Exercise makes you feel good and is excellent for all round cardiovascular health!

 

When cholesterol levels in the blood are raised there is an immediate reaction in the medical profession to put a patient on statins or other cholesterol lowering drugs, but consider this for a moment:

**Do firemen cause fires?

If you were to pass the burnt out shell of a house and saw lots of men in yellow coats hopping into a red bus – you may assume that they started and caused the fire. Of course we know that is not true.  The firemen are there as a protective, safety and compensatory measure.

The same is true of cholesterol.

Cholesterol is a symptom not a cause, cholesterol points to inflammation within the body and an issue with some other bodily function up or downstream, prescribing statins as a solution is like shooting the firemen when they are on their way to a burning house.  It does not solve the problem, it masks the problem.

Naomi McArdle MSc

PTI Tutor

*I am not advising for a moment that if you are currently on statins that you simply stop taking them, never cease medication use without consulting your doctor.  However, I am saying that you should educate yourself on the risks and ask for a lipid profile breakdown the next time you get your bloods done so you can get a better view of the overall picture.  AND I am also saying that if you have high LDL cholesterol then you need to look at other areas of your health and life and see what is causing the problem.  From the article above you can see that it could be something as simple as not enough antioxidants in your diet to something more sinister such as thyroid or liver problems.

**Dr Graeme Close of the ISSN first used the firemen analogy to discuss the presence of free radicals but it is equally applicable in the instance of cholesterol.