Is cholesterol really the bad guy? The answer is yes-and-no: it depends. In this article, we will discuss the myths and facts of cholesterol.
The Cholesterol Myth: What Really Clogs Our Arteries (YouTube link)
Is Cholesterol Really the Bad Guy?
In [1], Dr. Dwight Lundell said:
As a heart surgeon with 25 years experience, having performed over 5,000 open-heart surgeries,today is my day to right the wrong with medical and scientific fact.In a nutshell, here are his statements:
| What Was Wrong? | Heart disease resulted from the simple fact of elevated blood cholesterol. The only accepted therapy was prescribing medications to lower cholesterol (hint: statins) and a diet that severely restricted fat intake. |
| What Is the Answer? | Inflammation in the artery wall is the real cause of heart disease.[1,16,22,25] Without inflammation being present in the body, there is no way that cholesterol would accumulate in the wall of the blood vessel and cause heart disease and strokes. |
If cholesterol alone were the bad guy, then the pill named evacetrapib would be the miracle cures for most heart diseases because evacetrapib can:
- Substantially raises the high-density lipoprotein (HDL) cholesterol level, reduces the low-density lipoprotein (LDL) cholesterol level, and enhances cellular cholesterol efflux capacity
Treatment with evacetrapib did not result in a lower rate of cardiovascular events than placebo among patients with high-risk vascular disease and the trial was terminated early because of a lack of efficacy.
 |
| Figure 1. Healthy Heart for all |
What is Cholesterol?
Cholesterol[3,6] is a lipidic (or fatty), waxy steroid found in the cell membranes and transported in the blood plasma. Here are the facts of cholesterol:
- Body needs cholesterol
- For its structural role in the cell membrane—to maintain membrane permeability and fluidity
- As a precursor for the biosynthesis of steroid hormones, bile acids, vitamin D, and the adrenal gland hormones cortisol and aldosterone[4]
- No cholesterol, no sex
- As a precursor for synthesizing the sex hormones progesterone, estrogens, and testosterone and their derivatives.[4]
- For muscle mass buildup
- The research at TAMU revealed that following relatively vigorous workouts, individuals who had the most muscle mass gain also had the highest LDL cholesterol levels.[20]
- For skin protection
- In the skin, cholesterol is secreted by glands just below the surface to protect against dehydration and the wear and tear of sun, wind, and water.[3]
- For healing wounds and protecting against infections.[5]
- Almost every cell in the body manufactures cholesterol
- In vertebrates, the liver typically produces greater amounts than other cells.
- Even you eat foods with little cholesterol ingredients, your body will still manufacture at least 1,000 mg of pure cholesterol each day.
 |
| Figure 2. Main target organs of oxysterols during ageing and aged-related diseases |
- Cholesterol may act as an antioxidant[7]
- It can stand in to perform an antioxidant function when certain vitamins and minerals are in low supply.
- However, cholesterol is damaged in the process, and oxidized cholesterol is bad for the body.[29]
- The accumulation of oxysterols can be cytotoxic, mutagenic, atherogenic, and possibly carcinogenic—in other words, toxic to cells, toxic to DNA, and contributing to heart disease and maybe cancer.
- That's why getting antioxidants in a steady supply throughout the day is important. Let your vitamins and minerals protect you from free radicals so they can allow your cholesterol to play all of its other life-saving roles.
Video 1. Oxidized Cholesterol as a Cause of Alzheimer's Disease (YouTube link)
What is Inflammation?
By itself, cholesterol does not cause heart disease and stroke. Atherosclerosis is an inflammatory disease. It's what inflammation does to cholesterol that causes arterial plaques.[11]
Inflammation is simply our body’s natural defense to a foreign intruder (i.e., bacteria, toxin or virus).[1] The cycle of inflammation is perfect in how it protects our body from these bacterial and viral intruders. However, if we chronically expose the body to injury by toxins or western diets the human body was never designed to process, a condition occurs called chronic inflammation.
Connection between Inflammation and Plasma Fibrinogen Level
There's a strong and well-established connection between inflammation and plasma fibrinogen level.
Here's a breakdown of their relationship:[35-39]
Inflammation: When your body encounters a threat, like an infection or injury, the immune system triggers inflammation. This process involves releasing various chemicals, including cytokines, that signal the body to heal and defend itself.
Fibrinogen: This is a plasma protein essential for blood clotting. It helps form a fibrin mesh that traps blood cells and platelets, stopping bleeding.
The Link: During inflammation, cytokines also stimulate the liver to produce more fibrinogen. This increased production elevates plasma fibrinogen levels, contributing to several outcomes:
Blood clotting plays a crucial role in both heart attacks and strokes, but the specific causal links differ slightly.
Key Points:
In this article, we have shown you that cholesterol is an essential nutrient. Driving your cholesterol levels down too far can cause serious health problems.
To recap, atherosclerosis is an inflammatory disease. Inflammation in general are almost never the presence of too much cholesterol alone—rather they are too little of many other compounds: antioxidants, vitamins, minerals, omega-3 fatty acids, etc.
Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped. As noted in previous section, chronic inflammation is harmful while acute inflammation is beneficial. To become healthy is to avoid chronic inflammation. As Dr. Dwight Lundell pointed out, the culprits of chronic inflammation is our western diets:[1,8]
Fibrinogen: This is a plasma protein essential for blood clotting. It helps form a fibrin mesh that traps blood cells and platelets, stopping bleeding.
The Link: During inflammation, cytokines also stimulate the liver to produce more fibrinogen. This increased production elevates plasma fibrinogen levels, contributing to several outcomes:
- Acute Phase Response: This refers to the body's overall response to inflammation, and elevated fibrinogen is a hallmark feature.
- Blood Clotting: Higher fibrinogen levels increase the blood's clotting potential, potentially leading to risks like thrombosis (blood clot formation) if not regulated properly.
- Chronic Inflammation: In conditions with long-term inflammation, like autoimmune diseases or rheumatoid arthritis, chronically elevated fibrinogen levels are often observed. This might contribute to tissue damage and disease progression.
Important Points:
- Not everyone with elevated fibrinogen levels will experience complications. Other factors like genetics, lifestyle, and underlying health conditions play a role.
- Treatment for high fibrinogen typically focuses on addressing the underlying inflammatory cause, not directly lowering fibrinogen itself.
- Consulting a healthcare professional is crucial if you have concerns about your fibrinogen levels or inflammatory status.
Video 2. High Cholesterol is Healthy! [with David Diamond, PhD] (YouTube link)
Causal Effect of Blood Clotting on Heart Attack and Stroke
Blood clotting plays a crucial role in both heart attacks and strokes, but the specific causal links differ slightly.
Key Points:
- Blood clots themselves don't directly cause heart attacks or strokes. However, they worsen pre-existing conditions and trigger the events.
- Different types of arteries and specific causes of clot formation contribute to each scenario.
- Prevention focuses on managing risk factors for plaque buildup, blood clotting, and heart/brain health.
Summary
In a first study that explores the independent risk factors of long-term all-cause mortality in coronary artery disease patients with well-controlled LDL-C levels, authors have found that:[32]
The relative risk was highest for severe malnutrition. Considering the prevalence of identified risk factors, the highest population attributable risk was found for mild malnutrition, followed by chronic kidney disease, moderate malnutrition, age ≥75 years, congestive heart failure, severe malnutrition and atrial fibrillation.
To recap, atherosclerosis is an inflammatory disease. Inflammation in general are almost never the presence of too much cholesterol alone—rather they are too little of many other compounds: antioxidants, vitamins, minerals, omega-3 fatty acids, etc.
Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped. As noted in previous section, chronic inflammation is harmful while acute inflammation is beneficial. To become healthy is to avoid chronic inflammation. As Dr. Dwight Lundell pointed out, the culprits of chronic inflammation is our western diets:[1,8]
What are the biggest culprits of chronic inflammation? Quite simply, they are the overload of simple, highly processed carbohydrates (sugar, flour and all the products made from them) and the excess consumption of omega-6 vegetable oils like soybean, corn and sunflower that are found in many processed foods.Without much ado, I would refer you to watch [1] for the causation of heart diseases:
Western diets -> High blood sugar -> Glycation -> Chronic inflammation -> Heart diseases
Remember this: Avoiding heart disease begins and ends with following a healthy lifestyle, not with pharmaceuticals. Poisoning your cells' ability to make cholesterol isn't the best way to avoid heart disease.
Warning: If you have concerns about your cholesterol levels, always consult a qualified healthcare professional for personalized advice based on your individual risk factors and medical history.
Photo Credit
- 2healthcare.net
References
- The Truth About Heart Disease & Cholesterol — Dwight Lundell
- The Healthy Home by Dave Wentz and Dr. Myron Wentz
- Every patient is different, and every case of heart disease involves a multitude of factors, from diet to activity level to lifestyle, as well as the genetic diversity of the human race.
- U. Erasmus, Fats That Heal, Fats That Kill (Burnaby BC, Canada: Alive Books, 1993).
- Hanukoglu I (Dec 1992). "Steroidogenic enzymes: structure, function, and role in regulation of steroid hormone biosynthesis.". J Steroid Biochem Mol Biol 43 (8): 779–804.
- U. Ravnskov, "High Cholesterol May Protect Against Infections and Atherosclerosis," QJM Internaltional Journal of Medicine 96 (2003): 927-34.
- Cholesterol (Wikipedia)
- Smith LL (1991). "Another cholesterol hypothesis: cholesterol as antioxidant". Free Radic. Biol. Med. 11 (1): 47–61.
- Western Diets and Western Diseases (Travel and Health)
- Omega-3 Fatty Acids (Travel and Health)
- 10 Things You Didn't Know About Cholesterol (Everyday Health)
- Check out "Pathology of Atherosclerotic Plaque" of this article
- David Seaman: Inflammation From Our Diet Is Killing Us Slowly (a must-watch video)
- Statin Drugs and Diabetes
- Statin drugs can increase women's risk of diabetes by 48%
- The Little-Known Vitamin Essential to Your Health
- Vitamin K2 deficiency can cause calcium-buildup, which can increase the risk of calcification of the arteries and hence the heart disease.
- High Cholesterol Tied to Prostate Cancer's Return in Study
- But expert doesn't recommend taking statins to prevent recurrence
- The Real Cause of Heart Disease
- The Overlooked Health Risks of Very Low Cholesterol
- New Scientific Analysis Confirms Saturated Fats Have No Link to Heart Disease
- The incredible cholesterol-lowering benefits of the Avocado
- Bad Cholesterol Not As Bad As People Think, Study Shows (TAMU)
- Flaxseed dietary fibers lower cholesterol and increase fecal fat excretion, but magnitude of effect depend on food type
- Research has shown that consuming flaxseed daily can help to reduce bad cholesterol.
- Deep Vein Thrombosis (DVT)
- Anything that damages the inner lining of a vein may cause DVT -- surgery, an injury, or your immune system.
- People who have certain genetic disorders or more estrogen in their system are more likely to have blood clots, too.
- Higher levels of estrogen during pregnancy may make blood clot more easily
- Evacetrapib and Cardiovascular Outcomes in High-Risk Vascular Disease
- Heart attack symptoms: Know what's a medical emergency
- Novartis Drug Becomes First To Prevent Heart Attacks And Strokes By Targeting Inflammation
- The Cholesterol Myth Has Been Busted — Yet Again
- Rethinking good cholesterol — A high HDL cholesterol level may not be as beneficial as once believed.
- The best food for high cholesterol (Dr Michael Greger)
- Oxidized Cholesterol as a Cause of Alzheimer’s Disease
- Low Fat Diet Associated With Reduced Testosterone Levels
- Chest Pain: 3 Signs It’s Not a Heart Attack and Possible Causes
- Wang B, Liu J, Chen S, Ying M, Chen G, Liu L, et al. Malnutrition affects cholesterol paradox in coronary artery disease: a 41,229 chinese cohort study. Lipids Health Dis. (2021) 20:36.
- Can High Cholesterol Cause Headaches?
- Is It Better to Drink Little Alcohol Than None? Do Any Benefits of Alcohol Outweigh the Risks?
- Acute phase reaction and acute phase proteins
- C-Reactive Protein: A Simple Test to Help Predict Risk of Heart Attack and Stroke
- What are blood clots and what causes them?
- Association Between γ′ Fibrinogen Levels and Inflammation
- Fibrinogen, Fibrin, and Fibrin Degradation Products in COVID-19
- Weighing the Risks and Benefits of Statins (Michael Greger, M.D.)
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