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The Surprising Truth About Cholesterol
Why we worry about cholesterol…
The seeds of ‘cholesterol anxiety’ are something we all carry with us in our minds, either consciously or unconsciously. You may not be worried about your cholesterol levels right now but if you had a blood test and it came back ‘high’, suddenly you would be worried about it. Why is that?
It all began in the 1950‘s with the ‘Lipid Hypothesis’ – the growing opinion that the consumption of meat and dairy products was responsible for rising rates of heart disease in the U.S. This hypothesis was put forward by epidemiologists who observed that rates of heart disease plummeted during WWII. They guessed this was perhaps due to the rationing of meat and dairy products. Actual proof of the hypothesis was very thin even by 1977 when the U.S. Senate Select Committee on Nutrition and Human Needs endeavoured to change the diet of a whole population for the first time in history. They issued a set of dietary guidelines encouraging Americans to ‘cut down on their consumption of red meat and dairy products’. This statement prompted enormous criticism from the powerful meat and dairy industries, huge political fall out and, as a result, a permanent shift in dietary announcements.(1)
You may notice today that foods are still never mentioned in food marketing unless the announcement is to ‘eat more of something’. The ‘eat less of something’ announcements only ever relate to nutrients, not wholefoods. This is problematic because the science of nutrition is usually carried out on whole foods, not single nutrients and when it isn’t, it should be! And so, the tenuous connection between saturated fats and cholesterol contributing to heart disease and other chronic diseases came about and has changed the way we eat for the last 30 years. It has changed what our GPs have told us, and what pharmaceutical and food companies have sold us…. But is it all true??
Has eating ‘low fat’ made us any healthier?
In a word, no. Since the 1970s, Americans (and Australian’s) haven’t been eating less meat and dairy products but we have been eating less saturated fat and cholesterol. At the same time, we have also been eating more low-fat, highly-processed, well-marketed foods produced by the food industry! And… more polyunsaturated fats, transfats, refined carbohydrates and high-fructose foods. As a result of our new diets, we are fatter than we’ve ever been, obesity and diabetes have become epidemic and heart disease rates have actually increased.
What does the science say?
In his book, “In Defence of Food”, Michael Pollan reports on a recent study by a group of prominent nutrition scientists at the Harvard School of Public Health titled, “Types of Dietary Fat and Risk of Coronary Heart Disease: A Critical Review”. He writes, “Only two studies have ever found a ‘significant positive association between saturated fat intake and risk of coronary heart disease [CHD]’; many more have failed to find an association. Only one study has ever found ‘a significant inverse association between poly-unsaturated fat intake and CHD’. Let me translate: The amount of saturated fat in the diet may have little, if any bearing on the risk of heart disease, and evidence that increasing polyunsaturated fats in the diet will reduce the risk is slim to nil.(1)
As for the dangers of dietary cholesterol, the review found ‘a weak and non-significant positive association between dietary cholesterol and risk of CHD.’ [Also,] although ‘a major purported benefit of a low-fat diet is weight loss,’ a review of the literature failed to turn up any convincing evidence of this proposition. To the contrary, it found ‘some evidence’ that replacing fats in the diet with carbohydrates will lead to weight gain!”(1)
Science has confirmed a link between high rates of cholesterol in the blood and the likelihood of heart disease. What it has not confirmed is whether high serum cholesterol is a cause of heart disease or a symptom of it. One of the major roles of cholesterol in the body is the repair of damaged cells. Doesn’t it make sense that a damaged heart or damaged arteries might lead to the presence of more cholesterol in the blood? This idea, called the ‘Response to Injury Hypothesis’, was first proposed in 1858 by Rudolf Virchow but not researched again until 1993! (2) Perhaps because noone stood to make any money out of such an idea?
Some more interesting science…
So much attention is given to the tenuous link between cholesterol and heart disease that its role in other diseases, like cancer, is overlooked. In the book, “Fats Are Good For You and Other Secrets”, Jon Kabara PhD writes, ‘people with especially low levels of cholesterol have higher rather than lower risks of disease’.
He describes a 17-year study at the University of Basel in Switzerland that found ‘men with the lowest levels of cholesterol have a 70% greater risk of stomach cancer after the age of 60, a 100% greater risk of lung cancer, a 307% greater risk of colon cancer and a 770% greater risk of prostate cancer by the age of 60!!
Cholesterol’s role in the body…
Jon Kabara writes, “from an evolutionary point of view, cholesterol is the most sophisticated molecule in our biological world, [is] not found in lower forms of life such as bacteria [and is] an essential component of more complex living beings.” He argues, “all evolutionary changes occur for a definite protective purpose or to gain biological advantage [and from a] teleological argument of evolution, biological systems would not make or require a substance that would be toxic or harmful to it.” Cholesterol plays a critical role in the body. It is the precursor of many substances essential to life including every sex and steroid hormone in the body as well as certain stress hormones; bile acids for digesting fats; cortisol for regulating blood sugar levels; and Vitamin D which is essential for calcium absorption and bone strength. It is also part of the structure of every cell membrane and the highest concentration of cholesterol is found in the brain.
Cholesterol is predominantly created in our livers, from amino acids, carbohydrates and fatty acids. In fact, only about 15% of the cholesterol in our bodies comes from our diets (!) while some 85% is produced by the body. And, when in balance, our super clever bodies are capable of regulating their own cholesterol levels. When we eat foods high in cholesterol, we produce a little less of it and when we eat less, we produces a little more. If we are consuming excess cholesterol through our diets, the body should technically be able to excrete the excesses. If it isn’t, it is likely our digestion is hampered in some way…. or our diets are genuinely terrible… or most likely both.
LDL vs HDL and testing
You might have heard of LDL vs HDL cholesterol. Actually LDL and HDL refer to lipoproteins that transport cholesterol, rather than cholesterol itself. LDLs are low-density lipo-proteins that carry cholesterol (and other lipids) to the cells of the body while HDLs are high density lipoproteins that carry cholesterol and other lipids from the cells of the body towards the liver.
The theory is that HDLs are ‘good’ because they take cholesterol out of the blood to be eliminated. LDLs on the other hand are considered ‘bad’ because if large amounts of LDLs are circulating there is a higher chance of fatty substances (not just cholesterol) being deposited on the arterial walls. That is the theory that is yet to be proved by science, according to the Harvard School of Public Health. It is agreed that neither lipo-proteins are actually ‘good’ or ‘bad’ as they are both necessary…. but the ratio of the two is said to be significant.
But that is only part of the story. There are actually two types of LDLs. The first type are ‘Pattern A’ Large Buoyant LDLs which are harmless. The second type are ‘Pattern B’ Small Dense LDLs which are small, dense and do not float. These are the bad guys – the ones that cause plaque build up in the arteries. But when you have a cholesterol test, your LDLs are measured together. So how do you know whether you have the more harmful ones? The trick is in your triglyceride levels. If you have high LDLs and high triglycerides, you’re likely to have the bad LDLs whereas if you have high LDLs and low triglyerides, then you have the harmless type.(3)
Dietary fat only raises Pattern A Large Buoyant LDLs. The thing that raises Pattern B Small Dense LDLs is fructose.(3) This is interesting because sugar was rationed during WWII as well. I’m just saying…
The Ayurvedic view…
In Ayurveda, high LDL cholesterol is seen as a cellular intelligence disorder, or more specifically, a metabolic disorder. (5) It is believed to be a warning sign that your Agni (or digestive fire) is imbalanced. This imbalance is usually caused by eating too many difficult-to-digest foods including: excessively sweet food, excessively heavy, cold or dry foods; processed food and stale food; poor food combinations and from other factors that can hamper Agni – such as high stress, no exercise etc. When Agni is compromised, particularly in the liver, so too is the body’s ability to digest and eliminate excess cholesterol – leading to the build up of undigested or ‘bad’ cholesterol in the body. In this way, high LDL levels can be interpreted as a symptom of poor Agni and high Ama (i.e. toxins or undigested food wastes). Interestingly, the description of Pattern B Small Dense LDLs corresponds quite closely to the description of Ama.
If you have very high LDL levels and see an Ayurvedic practitioner, they may recommend decreasing your intake of certain fats (especially transfats), but also sugar (particularly processed sugar and fructose). At the same time, they will recommend dietary and lifestyle practices that will improve Agni, reduce Ama and balance your cellular intelligence. They may use specific herbs to aid the process and recommend certain spices in your cooking. Surprisingly, they may also recommend you use ghee (a saturated fat) as your cooking oil of choice. This is because ghee, of all the fats and oils available, is believed to be the lightest, most easily absorbed and metabolized, most Agni-promoting and most appropriate for all constitutions. There are also some scientific studies demonstrating that ghee actually reduces LDL levels.
In terms of Ayurvedic home remedies, fenugreek is great for reducing LDL cholesterol. Soak 1/2 tsp of fenugreek seeds in water overnight. In the morning add 1 tbsp of Aloe Juice and 1/4 tsp of turmeric and consume before breakfast.(6) Garlic is also good for reducing cholesterol so use it regularly in your cooking (cooked garlic is best).
The results are in….
When you next have your cholesterol tested, make sure it is a fasting-test (for better results) and includes a triglyceride test… and when you get the results, make sure you consider the ratio and the triglycerides, not just the individual numbers. Also, consider thinking about your cholesterol in a different way…. your body may be producing larger amounts of cholesterol as a response to stress or injury in the body.
If your LDLs are said to be a little high, but your ratio and triglycerides are fine, don’t freak out. If your LDL levels are high, your triglyceride levels are too and your ratio isn’t great, you need to explore ways to improve your digestion, reduce stress in your life and eliminate your intake of processed sugar.
You may feel pressured to take pharmaceutical medicines (especially if you have other risk factors for heart disease). By all means, follow your Doctor’s advice but don’t think of high cholesterol as a ‘life sentence’. There is always another way. Consider working with an Ayurvedic practitioner for specific dietary recommendations and herbal preparations to reduce ama and improve the cholesterol digestion and elimination capacity of your liver. In this way, you can bring your body back into balance and you may not need to rely on pharmaceutical medications indefinitely.
**Always consult your trusted healthcare practitioner before making any decisions about medication.**
1. “In Defence of Food” by Michael Pollan
2. “Fats Are Good For You and Other Secrets” by Jon Kabara PhD
3. Essential of Human Anatomy and Physiology” By Elaine Marieb
4. “The Bitter Truth” http://www.youtube.com/watch?v=dBnniua6-oM (from 0.30.10-0.39:09)
5. “The Complete Book of Ayurvedic Home Remedies” by Vasant Lad
6. “Ayurvedic Medicine: The Principles of Traditional Practice” by Sebastian Pole