Cholesterol Guidelines – Low Cholesterol Diets and the Cholesterol Myth

In 1950, doctors told their patients to try to keep their cholesterol levels below 300 mg/dl.

In 1975, doctors told their patients to try to keep their cholesterol levels below 250 mg/dl.

And in 2011, doctors tell their healthy patients to keep their total cholesterol levels to 200 mg/dl or lower, and some high-risk patients are told they even need to keep their total cholesterol levels as low as 120 by a combination of statin medications and severe blood-cholesterol diets. Why do the cholesterol guidelines keep recommending lower and lower levels of cholesterol, so that more and more people-nearly 90 per cent of all people-qualify for cholesterol drugs.

The obvious answer would be that the cholesterol drug manufacturers also make the cholesterol treatment guidelines, but conspiracy theories don’t make anyone healthy. Instead, it is far more helpful to understand the one and only cholesterol test that really predicts risk of cardiovascular disease.

What doctors don’t tell you about cholesterol. Every cell in the human body makes cholesterol. Some such as the liver, the linings of the intestines, the adrenal glands, and the ovaries in women and testes in men, make relatively more. Human beings are not the only producers of cholesterol. Every animal cell makes cholesterol, and it can appear in some plants. Corn oil, cottonseed oil, canola oil, and coconut oil contain tiny amounts of cholesterol-but less than 0.1% as much as is found in meat.

About 85 per cent of the cholesterol in the human body is made from triglycerides, and about 60 per cent of the triglycerides in the body are made from excess sugar. The amount of carbohydrate you eat usually has more influence over your cholesterol levels than the amount of cholesterol you eat. And there are at least three major kinds of cholesterol, only one of which is harmful.

VLDL, LDL, and HDL. The bloodstream is mostly water, and cholesterol is a fat. The bloodstream could not transport cholesterol except that it is enclosed in a “balloon” of protein called lipoprotein. The bigger the balloon, the lighter its contents.

When the liver makes cholesterol to provide the rest of the body-especially the immune system-a fuel source, it starts by making “big balloons” of very low-density lipoprotein or LDL cholesterol. As the cholesterol inside these traveling “balloons” is used up, the protein changes to accommodate the changes in the cholesterol inside. VLDL cholesterol becomes low-density or LDL cholesterol, and eventually the LDL cholesterol shrinks to tiny packets of high-density or HDL cholesterol.

We often hear about HDL being the “good” cholesterol. Actually, HDL is not so much a protective substance as it is what is left over after a protective process. If your body is using cholesterol for fuel, shrinking VLDL down to HDL, less cholesterol is going to be left to “clog” your arteries. But actually only one kind of cholesterol is harmful.

Apo-A and apo-B. LDL cholesterol is usually termed the “bad” cholesterol, but many LDL molecules are harmless. When LDL cholesterol is still relatively large and fluffy, it’s attached to a transporter protein known as apo-A. When it begins to shrink, it goes through a phase during which it is just the right size to be food for a kind of white blood cell known as a macrophage.

Macrophages are big, clumsy “germ eating” cells that tend to get stuck in small blood vessels. They fuel themselves by swallowing cholesterol whole. Apo-B cholesterol is the kind of cholesterol on which the feed, and when they feed, they can get stuck. Both the macrophage and the cholesterol inside it, plus more macrophages that come along trying to consume the first macrophage, actually form “clogs.”

The lab measurement that really tells you your cardiovascular risk is apo-B. If you have high levels of this kind of cholesterol, then you need to lower your cholesterol, and statin drugs may actually help.

So what do you need to do? You may have to spend some effort finding a doctor who will actually run a test of apo-B, or, more likely (and just as helpfully) as test of your ratio of apo-B to apo-A. (The specific proteins identified in this test are known more precisely as ApoB100 and apo-A1.) Then, if your ratio of apo-B to apo-A is too high, you will likely get the best results if you take cholesterol-lowering medication and you also take at least 360 mg of the omega-3 essential fatty acid DHA and 480 mg of the omega-3 essential fatty acid EPA, what you can get in one capsule of a high-quality fish oil such as Xtend Life.