One of the most confusing topics for many people with regard to their health is cholesterol – and justifiably so – there have been so many contrasting views in the media and medical world for so many years, it can be hard to separate fact from fiction. 

Firstly – some functions of cholesterol include

• Maintaining the structure of every cell in our body
• Contributing to the health of the gut wall, key in autoimmune disease
• Building block for many hormones such as oestrogen, progesterone, testosterone, and the stress hormone cortisol
• Precursor to Vitamin D – we can’t convert sunlight to vitamin D without cholesterol
• Health of serotonin receptors in the brain – so key in mental health
• Brain health and function – 25% of our cholesterol is needed in our brain
• Digestion of fats from bile acids

So, although cholesterol is often portrayed as the bad guy, and damaging to our health, it is in fact one of the most important molecules in our body and we depend on it for many vital functions.

Our body makes around 80% of our cholesterol in our liver. So if it wasn’t necessary and good for us, then why would our body make so much of it? Only 20% therefore of our cholesterol comes from our diet, so the foods that we have worried about for so long such as eggs, butter, meat, actually have a negligible effect on our circulating levels of cholesterol* . It’s the body that creates much larger amounts of cholesterol. In fact, by eating less cholesterol we are actually sending a message to our liver to produce more of it!

“There is basically no link between the cholesterol that we eat, and the levels of cholesterol circulating in our blood.”

So, the majority of our cholesterol is made by our body – does that mean it’s good for us? Well yes and no. We need cholesterol for the many functions listed above. However, the cholesterol that we create in our body CAN be related to disease – if we don’t keep that cholesterol healthy. So the key is to not allow this cholesterol to either become oxidised, or glycated as these processes are what cause the cholesterol to become damaged and thus harmful to our health. 

LDL cholesterol

When the body creates cholesterol, most of it gets shuttled through the body  by lipoproteins (combination of fat and protein). LDL stands for Low Density Lipoprotein and is often referred to as the “bad” type of cholesterol – the one we need to reduce. So, to start with at least, these LDL carriers are not bad. They are simply carrying the cholesterol from the liver to where it is needed in the body (25% to the brain but then to all other cells that need it for structure etc).

It’s when these particles become damaged that they become harmful to our health. Oxidation is one way they are damaged, and oxidation is a normal by product of time spent in the blood and oxidative stress. So our aim is to reduce the amount of time the particles spend in our blood, and we can do this by supporting our liver function and blood flow – see below.

Another way that these particles become damaged is through the process of glycation (the adding of sugar molecules to the carriers). 

This is why reducing our sugar rather than our fat is what is key to having healthy cholesterol. 

Once these formerly healthy LDL particles get damaged, the places in the body that the are being sent to no longer recognise them and so they get stuck in circulation and accumulate, perhaps eventually settling in an artery wall. 

Another circumstance where the LDL particles can’t get into places in the body where they are needed is when the liver is undergoing oxidative stress and overload, due to the over consumption of refined carbohydrates, sugars, alcohol or other toxins. When the liver is so busy dealing with these toxins, it isn’t able to prioritise the recycling of lipoproteins, again increasing the amount of time the particles spend in the blood, exposed to oxidising by products.

Ways to increase our LDL recycling capacity by caring for our liver:

• Regain insulin sensitivity by eating a balanced diet of carbs, fat, protein
• Increase intake of fibrous vegetables – the fibre slows down the absorption of carbs and fats, so gives the liver more time to process a meal
• Reduce alcohol consumption – heavy on the liver and breaks down in to sugar
• Reduce intake of processed foods – containing toxins and sugar which the liver then has to deal with
• Exercise and good sleep will also help increase the liver’s capacity to recycle LDL proteins and increase blood flow.

LDL also has 2 sub types – type A is the small and tight particles that can get in to small arteries and cause blockages, whereas type B are large and fluffy and so less likely to cause damage. There are new blood tests that can show levels of these sub types – called the full NMR lipid profile.

HDL Cholesterol

Often termed the “good” cholesterol, the main function of HDL (High density lipoprotein) is to sweep up the LDL particles floating in the bloodstream and carry them back to the liver for recycling. So as well as increasing our liver’s capacity to recycle the LDL, we need to have healthy levels of HDL cholesterol to deliver the LDL particles back to the liver as quickly as possible to prevent them doing damage in circulation.

Conventional blood tests look at your levels off HDL and LDL and the ratio between them. There are also newer tests that can look at the efficiency of the HDL particles – so that it’s not just a matter of how much HDL you have in your blood, but also how good they are at doing their job (called the Efflux Capacity). 

Finally, the functions of HDL are still being discovered all the time. For example it can be anti-inflammatory and an antioxidant – which is why it’s often referred to as the good cholesterol. It promotes levels of nitric acid in the blood that keeps the the blood vessels open and dilated. As it is anti-inflammatory – and a healing agent – it is sent to heal and repair. So for example when there are plaques and damage in the arteries, the cholesterol is sent to heal and repair. Because the cholesterol is found at the scene of the crime – it was for many years assumed to be the criminal. We now can see this is not the case, and it was never as simple as that!

HDL may also be sensitive to glycation and oxidation so it is another reason to keep sugar and processed foods in the diet to a minimum if this is something you are worried about.

Stress

Finally we need to address our stress. When we are stressed, and living in fight or flight mode, as most of us are throughout the day, our body produces the stress hormone Cortisol. This is made from cholesterol. So when we are stressed, our body needs to create even more cholesterol in order to produce cortisol. So if we have high levels of cholesterol it is worth asking why? Since this is less likely to be from diet than our body’s production of cholesterol, it could be because we are stressed. This can be physical stress (such as a highly processed diet as discussed, an underlying infection, virus, imbalance in gut bacteria), or mental and emotional stress such as work/home environment, relationships etc. So addressing our stress is another way we can address our cholesterol.

This is why I take a holistic approach when seeing my clients, as there is rarely a simple answer, a magic pill, that can address everything. We are connected, mind and body, and the magic happens when we listen to both. 

Please be in touch to make an appointment or discuss further with me.

*Credit Suisse Publishers Report on Evolving Consumer Perceptions about Fat