Busting the low-fat myth: Cholesterol is good for you

534 cholesterol good for you copy

If you’re one of the many people with high cholesterol, you may have been prescribed statin drugs and told to eat a low-fat diet — the standard advice for decades. However, experts have now reviewed the research and found there is no link between heart disease and total fat, saturated fat, or dietary cholesterol.

Statins made me forget where I parked the car

Cholesterol-lowering statins are among the most commonly prescribed and profitable medications in the world, taken by 25 percent of people over age 45. Touted to keep heart disease at bay, statin drugs are now known to be a cause of serious memory loss  fuzzy thinking, learning difficulties, fatigue, muscle damage, and even diabetes.

Why do statins cause memory loss? The human brain is made up of 60 percent fat, much of that cholesterol. The brain uses cholesterol to build brain chemicals that allow neurons to communicate with one another. Without cholesterol, the brain’s cells eventually die from inactivity. Over time, this results in memory loss and other brain disorders. In studies of the elderly  those with high total cholesterol actually have reduced risk of dementia – likely due to their body’s plentiful supply of this brain-supporting substance.

Cholesterol and heart attack risk

In a review of 72 studies  researchers found that most heart attack patients’ cholesterol levels did not indicate cardiac risk; in fact, 75 percent of them had normal, not high LDL (“bad”) cholesterol. Even more surprising, 90 percent of them had HDL (“good”) cholesterol levels under 60. Additionally, low HDL is a warning sign for pre-diabetes, and most of these patients had pre-diabetes, or “metabolic syndrome.” We now know that low HDL, not high LDL, is the real driver behind most heart attacks and heart disease, which changes the game on cholesterol management.

What about dietary fat?

Consider the following regarding low-fat diets. (Keep in mind this refers to intake of healthy fats):

  • High-fat diets lower triglycerides  normalize LDL (bad cholesterol), and increase LDL particle size. LDL cholesterol comes in two sizes; large particles that move freely, causing no harm, and small particles that embed in artery walls, causing inflammation the buildup of plaque. You want fluffy large particles.
  • The National Institutes of Health reported that increasing fat intake to 50 percent of calories improved the nutritional status of heart study participants, and didn’t negatively affect heart disease risk factors.
  • The 2015 U.S. Dietary Guidelines Advisory Committee reviewed all the research over 40 years and told us to stop worrying about dietary cholesterol, arguing it is “not a nutrient of concern for overconsumption.”
  • People who consume low-fat diets are at increased risk for depression and suicide (remember how the brain is made from 60 percent fat).
  • And here’s the clincher: Harvard School of Public Health recently admitted that when it comes to disease prevention, low-fat diets don’t appear to offer any special benefits. It’s sugar and refined carbohydrates that contribute to obesity, pre-diabetes, heart disease, and many other health issues.

If not fat, what causes heart disease?

Here are five important factors in heart disease risk:

  • Inflammation in the body.
  • Free radicals that attack LDL and turn it from large (unharmful) into small (harmful) particles.
  • Trans fats that increase inflammation and raise triglycerides.
  • Sugar, which is inflammatory, promotes plaque formation in arteries, and raises stress hormones.
  • Stress, which increases blood pressure and causes other heath issues.

Ask my office how to have better heart health.

Cholesterol often wrong target in heart disease risk

cholesterol and heart disease

Everyone has heard that high cholesterol is bad for heart health. But as it turns out, the association between cholesterol and cardiovascular disease has been somewhat misrepresented. Doctors are starting to accept that cholesterol levels do not necessarily predict risk for heart disease as much as we thought. Consider the following:

  • 75 percent of people who have heart attacks have normal cholesterol.
  • Older patients with lower cholesterol have a higher risk of death than those with higher cholesterol.
  • Countries with higher average cholesterol than Americans such as the Swiss or Spanish have less heart disease.
  • Recent evidence shows that it is likely statins’ ability to lower inflammation that accounts for the benefits of statins, not their ability to lower cholesterol.

We need cholesterol!

Cholesterol is a fat-like substance found in every cell in the human body. The liver makes 75 percent of cholesterol. Cholesterol helps produce cell membranes, vitamin D, and vital hormones, and is needed for neurological function. Put bluntly, we would die without it.

The cholesterol players

When we measure cholesterol levels, we are actually measuring the lipoproteins LDL and HDL. We refer to them as cholesterol, but they are actually small packages of fat and protein that help move cholesterol throughout the body.

High-density lipoprotein — HDL

This is considered “good” cholesterol. It helps keep cholesterol away from your arteries and removes excess arterial plaque.

Low-density lipoprotein — LDL

This is considered “bad” cholesterol. It can build up in the arteries, forming plaque that narrows the arteries and makes them less flexible (atherosclerosis).

Also important are:

Triglycerides

Elevated levels of this dangerous fat have been linked to heart disease and diabetes. Levels rise from eating too many sugars and grains, smoking, being physically inactive, excessive drinking and being overweight.

Lipoprotein (a) or Lp(a)

Lp(a) is made up of an LDL part plus a protein (apoprotein a). Elevated Lp(a) levels are a very strong risk for heart disease.

When testing cholesterol, total cholesterol is not as important as:

  • Levels of HDL “good” cholesterol versus LDL “bad” cholesterol
  • Triglyceride levels
  • The ratio of triglycerides to HDL
  • The ratio of total cholesterol to HDL

In order for cholesterol to cause disease, it has to damage the arterial walls. There are small and large particles of LDL, HDL, and triglycerides. Large particles are practically harmless, while small, dense particles are the dangerous ones, lodging in the arterial walls, causing damage and inflammation. The resulting “scar” is called plaque. Repeated trauma causes a buildup of plaque and chronic inflammation while your risk of high blood pressure and heart attack increases.

The biggest culprits in high cholesterol? Sugar and bad fats!

Although we’ve been taught that a high-fat diet causes problems with cholesterol, the type of fat you eat is more important than the quantity. Trans fats, or hydrogenated and saturated fats, promote abnormal cholesterol, while omega-3 fats and monounsaturated fats actually improve the type of cholesterol in our bodies. Eat your good fats, your body needs them!

The surprise: the biggest source of abnormal cholesterol isn’t dietary fat, but sugar. Sugar (and refined carbs, including processed white foods), drives good cholesterol down and triglycerides up. It causes those small particles, encouraging dangerous plaque buildup, and can lead to heart disease and metabolic syndrome or “pre-diabetes.” Doctors are starting to admit that sugar, not dietary fat, is the bigger cause of most heart attacks.

So, the real concern isn’t really the amount of total cholesterol you have, but the type of fats, sugar, and refined carbohydrates in your diet that lead to abnormal cholesterol production.

Inflammation promotes heart disease

Systemic inflammation plays a key role in heart disease and, in fact, most all chronic illnesses. Systemic inflammation can arise from poor diet, a sedentary lifestyle, stress, allergies, and more. Research at Harvard has shown that people with high levels of systemic inflammation (measured by a test called C-reactive protein, or CRP) had higher risk for heart disease than those with high cholesterol, while normal cholesterol was not protective to those with high CRP.

Clearly, multiple factors come together to determine your risk for heart disease, including diet, lifestyle, and environment. If you are concerned about your heart health, contact my office for a comprehensive evaluation to help reveal the factors that may increase your risk for heart disease.