It seems everyone is at odds about cholesterol. What’s good one day, is bad the next.
Let me bust some common cholesterol myths right now, starting with the myth that “cholesterol is cholesterol” because it's not. Cholesterol has various forms and functions.
In fact, most cholesterol is essential to good health.
Myth #1: All cholesterol is the same
Cholesterol is an androgen (a sex hormone that is lipid based). It’s an actual molecule that buddies-up with other molecules as it floats through your blood. What it is bound to is more important than the amount of cholesterol you have floating around.
What does that mean? Cholesterol is just one component of compounds that float around in your blood. These compounds contain cholesterol, as well as fats and special proteins called “lipoproteins”.
They are grouped into two main categories:
HDL: High Density Lipoprotein (AKA “good” cholesterol) that “cleans up” some of those infamous “arterial plaques” and transports cholesterol back to the liver.
LDL: Low Density Lipoprotein (AKA “bad” cholesterol) that takes cholesterol from the liver (where it is made) and transports it around the body. This is the kind found to accumulate in arteries. It is easily oxidized and contributes to heart disease.
Each of these categories are further broken down into subcategories which can also be measured in a blood test.
So “cholesterol” isn't simply “cholesterol” because it has very different effects on your body depending on which other molecules it's bound to and what it is actually doing.
Myth #2: Cholesterol is bad
Cholesterol is absolutely necessary for your body to produce vitamin D when your skin is exposed to the sun. It is a key component of your sex hormones (e.g. estrogen and testosterone) and it plays an important role in bile formation to help you absorb dietary fats. Cholesterol is also part of your cell membranes - it helps form the lipid (fatty) “skin” around each and every cell in your body. It also acts like a bandaid when there is internal damage to the circulatory system.
The overall amount of cholesterol in your blood (a.k.a. “total cholesterol”) isn't nearly as important as how much of each kind you have in your blood. Too much LDL cholesterol in comparison with HDL (the LDL:HDL ratio) may be associated with an increased risk of heart disease. But it is absolutely not the only thing to consider for heart health.
Myth #3: Eating cholesterol increases your bad cholesterol
Most of the cholesterol in your blood is made by your liver and not from the cholesterol you eat. This is why cholesterol medications block an enzyme in your liver (HMG Co-A reductase, to be exact). This is often the case for those who have genetically inherited familial cholesterol (when the liver produces too much cholesterol).
However, what you eat still can affect how much cholesterol your liver produces. After a cholesterol-rich meal, your liver doesn't need to make as much.
For people with genetically inherited cholesterol issues, you have to be more mindful as your liver isn't cooperating. Here, doctors normally recommend keeping dietary intake to 15 - 20% of total calories.
More tips below on what you should eat instead.
Myth #4: Your cholesterol should be as low as possible
As with almost everything in health and wellness, there's a balance that needs to be maintained. There are very few extremes that are going to serve you well.
We all know that eating a diet high in saturated fat is not good for our hearts. There are many contributors to this situation. For instance, not enough dietary fibre, too much sugar, refined foods, processed foods, transfats, rancid oils and too few antioxidants all lead to eleveated triglycerides and arterial damage. Cholesterol is not the only component.
People with extremely low levels of cholesterol also have increased risk of death from other non-heart-related issues, like certain types of cancers, as well as suicide.
Myth #5: Drugs are the only way to achieve cholesterol balance
Don't start or stop any medications without talking with your doctor.
Sometimes they are essential, but they are not the only thing you can do to protect your heart health. And while drugs can certainly lower the “bad” LDL cholesterol, they don't seem to be able to raise the “good” HDL cholesterol all that well.
Guess what does all of the above? Good nutrition and exercise.
If you have high LDL, eat at least 10 servings a day of fruit and vegetables – it is one of the most impactful ways to lower your levels. A higher fibre diet will help lower LDL cholesterol because cholesterol needs to be “pooped out” to remove it from your system. When I’ve worked with clients with high cholesterol, I encourage one vegetarian meal a day if not more (with legumes) because it provides extra fibre.
Other factors that will help balance your cholesterol?
Try to exercise regularly
Lose some weight
Eat better quality fats (fatty fish, hemp seeds, avocado, flax oil and olive oil).
Ditch those over-processed hydrogenated “trans” fats (deli meats)
Drink a glass of fresh carrot juice a few times a week - it helps flush bile and lower cholesterol levels (blend of ginger, beet, apple, carrot is also good for gallbladder)
Chia is good for lowering LDL and raising HDL (also high in fibre - chia pudding?)
Peaches, apples, oranges, grapefruit and apricot are the highest in pectin (to help lower LDL)
Eat oats a few times a week - it reduces absorption of dietary cholesterol
Chlorella and spirulina help lower LDL and increase HDL (spirulina is excellent to use in a fast)
Coffee elevates cholesterol
Braise foods instead of frying
The science of cholesterol and heart health is complicated and we're learning more every day. You may not need to be as afraid of it as you are. And there is a lot you can do from a nutrition and lifestyle perspective to improve your cholesterol level.