Cholesterol: Good? Bad? Should I worry? - Blog # 44
Hello Everyone! Welcome to another Friday blog. Today I wanted to address the ever concerning questions about cholesterol. Cholesterol has a bad rap. The focus seems to be on getting it lowered, usually through avoiding a fatty diet and medications, like statin drugs. So, what is all the fuss really about. What IS cholesterol anyway?
Cholesterol is a lipid (fat) molecule that is an essential component of animal cell membranes. It is in every cell membrane and many organelles of cells. It is only found in animal products. It is a precursor for steroid hormones, bile salts and vitamin D. We all know the importance of our hormones, but if we can’t make bile salts we can’t absorb vitamins (A,E,K, and omega 3) and break down food appropriately. Cholesterol is also required to make vitamin D. Vitamin D is synthesized in our skin when exposed to sunlight. It is essential for our immune response, absorption of calcium and phosphorus to keep bones, teeth and muscles strong and many other important functions.
Cholesterol composes roughly 30% of all animal cell membranes. Just this tells us how important it is to our survival. Our body normally makes all the cholesterol it needs through an intricate 37-step process! It is responsible for maintaining fluidity of cell membranes, intracellular transport, signaling and nerve conduction. It helps facilitate speed of transmission along nerve tissue by providing insulation for more efficient conduction (myelin sheath). Obviously, loss of this layer results in decreased nerve conduction speed and is thought to be the cause of multiple sclerosis.
Wow! Sounds like it is pretty important. I can only imagine the horrible side-effects of statin drugs…you can’t really make new cells appropriately. That explains a lot, as we look at the side-effects of statin drugs in a minute. So, why the bad rap? Let’s take a closer look. Cholesterol is a lipid, so not very soluble in water. It gets packaged in lipoproteins to allow emulsification in the blood.
“Lipoproteins are critical for absorbing and transporting dietary lipids (fats) by the small intestine and moving lipids from the liver to peripheral tissues and back from peripheral tissues to the liver and intestine. They are also crucial for transporting toxic foreign hydrophobic and amphiathic compounds, including bacterial endotoxins from areas of invasion and infection.” Lipoproteins have varying densities. “In order of increasing density, they are chylomicrons, very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Lower protein/lipid ratios make for less dense lipoproteins.” HDL is considered the good cholesterol, whereas LDL (esp. VLDL) is considered bad, but it also has a super important job. Let’s take a closer look at function.
Chylomicrons - primarily made up of triglycerides and a small amount of protein. They are the least dense of the lipoproteins. Responsible for transporting lipids from the intestinal tract to cells in the body. They “carry fats from the intestine to muscle and other tissues in need of fatty acids for energy or fat production. Unused cholesterol remains in more cholesterol-rich chylomicron remnants, and taken up from here to the bloodstream by the liver.”
VLDL - consists primarily of triglycerides, some cholesterol and low in protein. “made in the liver and is responsible for delivering triglycerides to cells in the body, which is needed for cellular processes. As triglycerides get delivered to cells, VLDL is made up less of fat and more of protein, leaving cholesterol on the molecule. As this process occurs, VLDL will eventually become an LDL molecule.” These are “molecules produced by the liver from triacylglycerol and cholesterol which was not used in the synthesis of bile acids.”
LDL - consists of more cholesterol than triglycerides and protein. It is responsible for carrying cholesterol to cells that require it. LDL receptor function is vital to the processing of cholesterol. “LDL receptors are used up during cholesterol absorption.” LDL receptors are found in the liver and throughout other tissues in the body. Cholesterol levels regulate the formation of receptors! This can be a problem with too many planes and nowhere to land scenario. “Oxidized LDL are not recognized by the LDL-receptor Apo (B/E) but are taken up by macrophages in a nonregulated manner through the scavenger-receptor pathway, which leads to the formation of foam cells, the hallmark of arteriosclerotic lesions.”
“The presence of large lipid-laden foam cells in intimal lesions is one of the most prominent and consistently found features of the atherosclerotic lesion both in humans and in experimental animals.”
HDL - consists of a larger amount of protein (more dense), made in the liver and intestines. These “particles are thought to transport cholesterol back to the liver, either for excretion or for other tissues that synthesize hormones, in a process known as reverse cholesterol transport (RCT).” **super important!!
Cholesterol is very susceptible to oxidation. In the liver, cholesterol is oxidized into bile acids. About 95% of these bile acids are resorbed in the intestine, the rest is excreted in feces. This actually speaks to how important cholesterol is if your body tries to recycle 95%!!!
The problem lies when you eat a nutritionally poor high fat diet, likely high in cholesterol (remember your body makes all you need) and it begins to stick to the blood vessels, creating atherosclerosis, or hardening of the arteries. Normally, your blood vessels are smooth and slick and nothing sticks. However, when you have inflammation, lesions can occur on your blood vessels making them slightly sticky. This is where the formation of foam cells starts. Now, this becomes an area that is rough and sticky. Many things floating by can stick to this area. Not only cholesterol, but calcium, fibrin, fatty substances and even cellular waste products.
This type of damage or alteration in the permeability of the endothelial lining of the blood vessel is considered the initiation of atherosclerosis. “Endothelial dysfunction in both coronary and peripheral arteries is a consequence of prolonged and/or repeated exposure to cardiovascular risk factors that induce oxidative stress.” This can lead to narrowing of the blood vessel, increasing pressure and preventing normal blood flow. Think of a water hose when you put your thumb over a portion of the water. Hmm…not good. The outcome can lead to occlusion of the artery or blood vessel, or possibly a “clot” getting dislodged and causing a stroke or heart attack.
When your cholesterol is high, most MDs will prescribe statin drugs. These drugs directly interfere with your body’s ability to make cholesterol…even when it’s really needed. I’ve seen the effects of long-term use of statin drugs in many of my patients. I’ve seen significant functional decline in muscle strength and function. Patients have gone from being completely independent, able to mow their own yard, to being unable to get up from a chair without assistance = profound muscle weakness. Why? It interferes with with many normal functions in the body, including blocking Co-Q-10. It causes myopathy…necrosis, muscle cell apoptosis (death), inflammatory, stiffness, pain and significant muscle wasting. The weakness can be irreversible after years. Guess what? YOUR HEART IS A MUSCLE. It can cause heart failure!
Common statin side effects include:
Less common side effects you may have with statins are:
- Hair loss
- Pins and needles sensations, such as pricking, numbness, or tingling on your skin
- Liver inflammation, which can make you feel like you have the flu
- Pancreas inflammation, which can cause stomach pain
- Skin problems such as rashes or acne
- Sexual problems, such as erectile dyfunction or a low sex drive
The focus has always been and continues to be on lowering cholesterol, (primarily through medication) when the focus really should be on the health of our blood vessels and keeping them smooth and elastic. If you have a lot of inflammation in your body, damage is occurring all over, not just in your blood vessels. Interestingly, foods that are high in saturated fats are typically high in cholesterol as well. So, how can we keep our blood vessels smooth, elastic and super healthy?
What we eat has a huge impact on our vascular health. Following the Mediterranean diet and consuming high polyphenol EVOO is one of the best ways to prevent atherosclerosis.“Studies have shown that EVOO reduces blood pressure, improves the lipid profile by increasing HDL-cholesterol and reducing LDL-cholesterol and triglyceride levels, reduces oxidative stress, and inhibits human lipoprotein oxidation, making LDL, for instance, less atherogenic.”
“Numerous epidemiological, clinical and experimental studies suggested that the consistent intake of olive oil can limit oxidative damage and inflammation, thereby restoring endothelial function and slowing atherogenic development as well as aiding in the control of cardiovascular risk factors.”
So, EVOO can naturally lower your cholesterol to your body’s requirement to maintain homeostasis, both protecting cells and creating new cells! Several recent studies have demonstrated reversal of damage to blood vessels when oleic acid is the choice fat. How does it do this? Oleic Acid (OA) to the rescue! Studies show OA interferes directly with the inflammatory response that leads to atherosclerosis, resulting in more pliable, smooth artery allowing unimpeded blood flow. The polyphenols in EVOO are anti-inflammatory and also play a role in lowering cholesterol. However, The combination of OA + antioxidants accomplished the most cholesterol lowering activity without affecting cell viability.
Studies show EVOO inhibits the oxidation of LDLs, enhances HDLs ability for RCT (reverse cholesterol transfer) in a concentration-dependent manner!! So, the higher the polyphenol concentration, the more cholesterol is removed from where it should not be. Furthermore, the shape of Oleic Acid in EVOO enhances cell membrane fluidity, enhancing membrane health and function. “Phenolic compounds, especially hydroxytyrosol and oleuropein, dose-dependently inhibit LDL and HDL oxidation in vitro and in vivo, repress superoxide-driven reactions, and break the chain-like propagation of lipid peroxides.” “Consuming EVOO increases the postprandial concentration of phenolic compounds in the plasma and in LDL and HDL, which may explain the protective effect of phenolic compounds.”
“Olive oil bioactive compounds exhibited a potent capability to attenuate oxidative stress and improve endothelial function through their anti-inflammatory, anti-oxidant, and anti-thrombotic properties, therefore reducing the risk and progression of atherosclerosis.
In addition to high polyphenol EVOO, there are other functional foods that help to protect our blood vessels. Omega 3’s from fatty fish, turmeric, garlic and many others. Eating a variety of colorful fruits and veggies, dark leafy greens, high fiber foods, drinking enough water and getting plenty of exercise all contribute to the health of our blood vessels. Fiber is important because it is the food for you microbiome. Fiber also binds to excess cholesterol for excretion.
So, until next time my friends, Drink, drizzle, digest high polyphenol EVOO, eat foods rich in phytonutrients, eat fatty fish rich in Omega 3s, eat foods high in lutein, drink lots of water, brush and floss your teeth, increase your fiber, get a good pre/probiotic to balance your gut microbiome, exercise your body and mind, monitor your blood pressure, get plenty of sleep…and turn off the light! Stay healthy my friends #EVOO