Cholesterol is transported to and from the cells by special carriers proteins called lipoproteins.The two main types are low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
Resident Medical Authority: J. E. Williams, OMD, FAAIM
First, the good news: since the 1980s there has been an overall decrease in total Cholesterol levels among Americans. Now, the bad news: as a nation, our average cholesterol is still too high.
And now, the information cholesterol drug companies don’t want you to know: A national study reveals that 75 percent of patients hospitalized for a heart attack had cholesterol levels that were within current national cholesterol guidelines.
What’s Cholesterol Good For?
Cholesterol is a soft, waxy lipid (fat) found in the bloodstream and in all your body’s cells. It is transported to and from the cells by special carriers proteins called lipoproteins. The two main types of lipoproteins are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL is the major cholesterol carrier in the blood. If too much LDL cholesterol circulates in the blood, it can clog your arteries. About one-third of blood cholesterol is carried by HDL, and is referred to as “good cholesterol” (and LDL as “bad cholesterol”) because high HDL levels seem to protect against a heart attack.
We need cholesterol in every part of our body for brain and nerve cells, Vitamin D and steroid hormone synthesis, for healthy cell membranes, and many other structures and functions in the body. Too little cholesterol over time can lead to hearing and vision loss, and is associated with chronic constipation and megacolon, liver failure, and spontaneous miscarriages.
Are There Really “Good” and “Bad” Fats?
Not really. But it’s a convenient way of labeling HDL and LDL. The fact is that it’s much more complicated involving particle size and relationships between different types of fats. Lipid health includes partners within your body like liver function and enzymes that support fat digestion and assimilation. And heart disease is beginning to be understood as a stress, inflammation, and metabolic disease rather than the simple bucket theory of high and low total cholesterol.
Is There an Optimal Cholesterol Level?
According to the American Heart Association, the ideal cholesterol to HDL ratio is about 3.5:1. From the optimal wellness viewpoint, integrative medicine practitioners want better. Since LDL is associated with cardiovascular disease, LDL/HDL, you want strong HDL and low LDL. Triglycerides are an independent associated factor in insulin resistance, so you want to know you TG/HDL ratio. All three ratios are easy to calculate by yourself: simply divide total cholesterol (TC) by HDL for your TC/HDL ratio, and LDL and TG by HDL for the other ratios.
Dr. Williams’ Cholesterol Ratios
Diet is considered the primary culprit for too much or too little cholesterol, but other influences are just as important. Vigorous exercise will help your body process lipids and raise your HDL. Managing your blood sugar (glucose) level to avoid insulin resistance is also important. Nutritional supplements can help, and non-flushing forms of niacin have been shown to increase HDL.
Basic Dietary Fat Tips:
- Use plant oils for cooking and baking. Olive, canola, coconut and other plant-based oils are rich in heart-healthy unsaturated fats.
- Eliminate trans fats. Steer clear of fried foods, biscuits, and other baked goods. Question: How many grams of trans fats are good for you. Answer: None.
- Eat at least one good source of omega-3 fats each day. Fatty fish, walnuts, and canola oil all provide omega-3 fatty acids.
- Cut way back on meat, butter, and milk. Beef, pork, lamb, and dairy products are high in saturated fat. For non-vegetarians, choose low-fat milk and yogurts, go moderate on the eggs, and savor old world cheeses in small amounts.
Advanced Dietary Fat Tips:
- Use less cooking oils, even from plants. Steam your vegetables. Make your own salad dressings.
- Increase omega-3 fatty acids and include plant-based omega-6 and omega-9 from sources like organic flax oil and Sacha Inchi oil from the Peruvian Amazon.
- Drastically reduce or eliminate meat, poultry, and dairy fat. Use moderate amounts of cold-processed whey and go light on cheese keeping to low fat types like parmesan.
The Importance of HDL
The clinical evidence and research strongly suggests that levels of HDL need to be to be at least 55 mg/dL. Though still listed on standard laboratory reference ranges, previous acceptable values of HDL started at 35 mg/dL. That’s too low for optimal lipid health.
Bottom Line on Lipids: To prevent cardiovascular disease life long, raise your HDL and lower LDL. Improve liver health, lower serum glucose, exercise regularly, and follow a plant-based diet that includes healthy fats and oils from seeds and nuts.
I want to know your thoughts: Do you think the cholesterol paradigm needs to change?
(i) Arnet, DK, et al. Twenty-Year Trends in Serum Cholesterol, Hypercholesterolemia, and Cholesterol Medication Use, The Minnesota Heart Survey, 1980–1982 to 2000–2002. Circulation. 2005;112:3884-3891.
(ii) Science Daily (Jan. 13, 2009): http://www.sciencedaily.com/releases/2009/01/090112130653.htm
(iii) There is no medical consensus yet on TG/HDL ratio, but the research is clear that high levels are associated with insulin resistance and increased risk for coronary heart disease: http://care.diabetesjournals.org/content/27/4/936.full
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