Cholesterol in food is irrelevant
Most people don’t need to worry about their cholesterol levels
Cholesterol is a concern that often comes up when encouraging people to eat more healthy, natural fats. So the dietary myth to bust is that we need to worry about our cholesterol levels in the foods we are eating.
Dr Malcolm Kendrick is the best person to explain how we got into this cholesterol shaming situation, that has lead to statins being the biggest selling drugs in the world and handed out at the drop of a hat, when the benefits of them is surprisingly tiny. His book is a great read or you can find his blogs and/or sign up for his newsletter here: https://drmalcolmkendrick.org/
Cholesterol isn’t good or bad
Cholesterol is vital for our cells and is a compound we make loads of every day. A compound with a fixed chemical structure, that doesn’t change. If it did it wouldn’t be cholesterol! So there is no good or bad cholesterol, it just exists in our bodies as essential to help us make hormones and vitamin D amongst other functions.
Cholesterol is made via a very complicated pathway in the liver, not from the fat we eat, and is so vital for our bodies that there is a special transportation system in our blood (lipoproteins) to ferry it around to where it is needed. Lipids is a technical, general, term for all types of fats that include cholesterol and they don’t dissolve in blood – as we all know from salad dressings where we can see oil and water don’t mix.
‘Cholesterol tests’ actually measure the lipoproteins in our blood and there are varying proportions of cholesterol in each of the different types, as illustrated in this visual below. It quickly becomes complicated!
The key take out is that talking about our total cholesterol level is a pretty meaningless concept and interestingly what our doctors consider to be a healthy level has been falling relentlessly over the years. Without a good, justifiable reason, apart from to sell more statins.
Cholesterol in our food is irrelevant
We generally can’t eat enough cholesterol to meet our daily needs so the liver makes up the shortfall, making far more than we eat. A typical human would need to eat 6-8 egg yolks every day to cover their cholesterol needs.
And if we do manage to eat enough, the liver simply produces less! Another great example of how amazing our bodies are at self-regulating if we let them.
Despite the fact there is no association between the cholesterol in our food and the amount in our blood, the cholesterol demonisation continues in the media – with what feels like daily soundbite headlines, a lot of bad science and vested interests. I found this headline saying eggs increase your cholesterol as an example, after a few second google search, from last December...
What about cholesterol test results?
So if there is no good or bad cholesterol, and total cholesterol levels aren’t helpful, should we care at all about the lipoprotein profile in our blood when we have blood tests? There are a couple of things to look at in our blood tests, that are helpful indicators of metabolic health.
Our triglycerides levels are important, as high levels are associated with insulin resistance and too much fat in the body in general. Although you can also tell this from my favourite, simple, measurement of waist size!
Triglycerides are the VLDL (very low density lipoprotein) in the picture above and our fasting levels should be below 1.7 mmol/l. Mine was 0.6 when measured in April 👍
We also need good levels of HDL (high density lipoprotein) as low levels can be a marker of poor metabolic health. People with high HDL levels tend to have lower levels of heart disease and higher levels are good as you get older (over 50 😉).
HDL should be at least 1.0 mmol/l and higher is good. Mine has been 2.9 for the last few years which I am happy about, as the older you get the more dangerous it is to have a low cholesterol level.
The rest of the numbers in your blood lipid profile, unless they are staggeringly out of the ‘normal’ range can generally be ignored.
A word on statins
Statins reduce synthesis of cholesterol in the liver and via a convoluted pathway reduce levels of LDL (low density lipoprotein) in the blood. Malcolm Kendrick explains how the impact they have on heart disease is coincidental and not related to lowering LDL levels.
Their benefits on life expectancy are also not as great as you may think and there are side effects. Statins only reduce mortality in men who have previously had a heart attack and do not increase the life expectancy of women. To put it simply and bluntly they have absolutely minimal health benefit for the vast majority of the population. Have a look at the work of Dr Aseem Malhotra for more on this, such as his book ‘A Statin Free Life’.
So go ahead and enjoy plenty of eggs, one of the most nutritious and convenient foods, make plenty of mayonnaise, eat plenty of butter and relax about cholesterol!
Do get in touch if you would like to discuss this topic or how I could help you improve your diet.
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