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Good cholesterol, bad cholesterol...
Another important dietary fat is cholesterol. It's been given the reputation of a bad fat but, in fact, it has many important health supporting functions, from being structural part of cellular membranes to synthesis of vitamin D and steroid hormones. The body can synthesize cholesterol, so it does not depend on its food sources - which are animal fats in general. Vegetable oils and fats do not contain cholesterol.
Food cholesterol intake affects its blood levels in about 1 in 3 individuals. With the rest, the body adjusts its cholesterol production to its dietary intake, maintaining adequate cholesterol levels5. The fact that cholesterol consumption hasn't changed in the last 100 years, while the incidence of cardiovascular disease skyrocketed, suggests that dietary cholesterol intake - except in extreme cases - is not to be considered one of the major risk factors.
Let's say a bit more about all the good things that cholesterol does in our bodies. For some reason - one could be a high-priority goal of selling as much of cholesterol-lowering drugs as possible - we can hear very few words on the importance of cholesterol for preserving health. Your body needs cholesterol to:
∙ regulate fluidity of cellular membranes, which has to be kept in narrow range for optimum cellular function; most of body's cholesterol is in its cellular membranes
∙ synthesize steroid hormones, including estrogen, progesterone and testosterone
∙ synthesize corticosteroid hormones, like aldosterone, controlling salt/water balance, and cortisone, regulating inflammatory/allergic response
∙ synthesize vitamin D
∙ protect the skin from dehydration and erosion
Body cholesterol levels are indicated by the level of lipoproteins transporting it through the bloodstream: low-density- (LDL) and high-density-lipoproteins (HDL). The former are taking cholesterol from the liver to the bloodstream to supply the body with it, while the latter are taking it to the liver to be disposed of. This is how the body balances out its cholesterol use.
Thus, the level of LDL-cholesterol - also called "bad cholesterol" - relative to "good" cholesterol levels, indicates the actual body cholesterol usage. Till recently, both, elevated total and "bad" cholesterol levels were considered to be major cardiovascular disease risk factors.
Serum cholesterol levels were - and often still are - used as an indicator of the health risk. The official standard places normal (healthy) total cholesterol level at below 200mg/dl; borderline at 200mg/dl-239mg/dl, and high-risk at above 240mg/dl.
Average (healthy) levels of good cholesterol (HDL) are 40mg/dl-50mg/dl for men, and 50mg/dl-60mg/dl for woman. Lower levels are officially considered to be increasing the risk from cardiovascular disease.
Optimum levels of "bad" cholesterol (LDL) are considered to be below 100mg/dl, with 100mg/dl-129mg/dl being good range, 130mg/dl-159mg/dl borderline, 160mg/dl-189mg/dl high, and over 190mg/dl excessively high.
Note that the official medical cholesterol measure is now millimoles per liter, where the level expressed in mmol/l is numerically about 38.8 times smaller than when expressed in mg/dl (the mole is a complicated measure expressing a number of grams of cholesterol for which the corresponding number of cholesterol molecules equals Avogadro's constant, 6.022x1023).
Gradually, nominal cholesterol levels alone - either for the total, "good" or "bad" cholesterol - have been dropped as a major cardiovascular disease risk factor. Instead, the new hypothesis was that it is the ratio of total to "good" cholesterol, which primarily indicates the increased risk, if over 3.5.
In other words, if your total cholesterol is elevated while "good" and "bad" cholesterol remain in healthy proportion, there is no significant increase in the risk of cardiovascular disease. On the other hand, if your total cholesterol is in the safe range, but with disproportionately high "bad" cholesterol, your risk does increase more significantly.
However, the story doesn't end here; it turned out that there is
little evidence supporting this cholesterol level/cardiovascular disease concept as well,
in this simplified form. About as many people with healthy cholesterol levels still suffer heart attacks and strokes, as those with unhealthy levels; also, new drugs that do lower cholesterol usually don't also lower the risk of cardiovascular disease. There must be something more to it.
And there is. While the relation between cholesterol and cardiovascular disease is certain, it is more complex, and involves other factors and mechanisms that actually determine not only how high is your cholesterol production, but also whether cholesterol is significant danger to your health, or not. For one, it has been found that it is
only free-radical oxidized "bad" (LDL) cholesterol that
In this mechanism, the actual risk factor is low level of antioxidants in your body. Elevated cholesterol becomes the risk factor only after you fail to supply the body with needed antioxidant nutrients. And more so if it is also plagued with hidden inflammation inside the blood vessels, arising from free radical damage, hidden bacterial infection, actions of your own immune system or high oxidative exposure, alone or combined.
Not only that lack of antioxidants results in more of oxidized cholesterol (which the body may be using as free-radical shield in the absence of antioxidants), it also leads to increased cholesterol production by the body, as threatened and damaged cells are trying to reinforce their walls with more cholesterol.
Next, the apparent harmful effect of "bad" cholesterol was partly due to elevated lipoprotein(a), which is chemically very similar to LDL ("bad") cholesterol, and erroneously merged with it in measurements. This lipoprotein carries sticky protein which enables it it to patch spots on blood vessel lining damaged by free radicals. Otherwise, it is practically identical to LDL cholesterol, which is not inherently sticky.
Again, the more free radical damage, the more of lipoprotein(a) on and around blood vessel walls, as well as more of oxidized cholesterol, repair proteins, and everything that gets caught in the mix. And again, all it takes to control this dangerous process is a sufficient level of antioxidants, in particular vitamin C, one of the main water-soluble antioxidants used by the body.
Another very important factor is your homocysteine level. Homocysteine is an intermediary compound (amino-acid) in methionine-to-cysteine conversion, normally quickly converted back to methionine.. However, under some circumstances it can accumulate, causing damage, inflammation, and ultimately thickening and narrowing of blood vessel walls as a result of deposition of repair proteins and other substances involved. Homocysteine level below 13μmol/l is considered normal, moderately elevated if between 13μmol/l and 30μmol/l, and high thereafter.
Correcting high homocysteine levels (unlike correcting high total cholesterol, where the effect is insignificant)
reduces your risk of heart death by 50%,
and also halves the risk of dying from a host of other diseases (Alzheimer's, stroke, diabetes, Parkinson's, etc., including 26% lower risk from cancer death)12.
What causes elevated homocysteine? It can be genetic mutation resulting in the absence, or inefficiency of the MTHFR (Methylene-Tetra-Hydro-Folate-Reductase) enzyme, which metabolizes homocysteine (this particular enzyme deficiency doesn't necessarily result in elevated homocysteine, since sometimes the body apparently can use some alternative mechanism to keep it under control).
Often times elevated homocysteine results directly from deficiency of B9 (folic) and/or B12 vitamins and, less frequently, also vitamin B6 deficiency. It can also be caused by thyroid deficiency, renal failure, lead toxicity, or excessive stress.
Summing it all up, cholesterol is far from being that evil fat making people sick. It has a number of vital functions in the body, and only becomes part of the problem if you allow unhealthy diet and lifestyle to damage your body, including cardiovascular system. In fact,
cholesterol imbalance is
much more a signal
The highest risk for developing cardiovascular disease comes not from elevated cholesterol itself, but
And it all goes back to the quality of nutrition and lifestyle. These factors are much more to blame for the rapid rise in incidence of cardiovascular diseases, than cholesterol. There is little benefit and many serious side effects from the use of cholesterol lowering drugs, which interfere with body's own production and use of this important substance, necessary to maintain health.
Better and safer option is to use natural alternatives to cholesterol-lowering drugs. As usual, the only long-term solution if such treatment is combined with helping your body to regain and preserve health by following health recipe.