By Paul Garcia DC
I have spent the last 20 years studying and learning all I could about health and how our bodies function. This journey was initially motivated by my desire to overcome my own health challenges and now my motivation comes from helping others overcome theirs. Along the way, it became increasingly clear to me that misinformation and fear are two huge limitations that hold us back from living healthier, more energetic and more productive lives. Nowhere is this more apparent than in the current views regarding cholesterol and heart disease. In this series I will attempt to clear up some of the confusion and fear surrounding the dreaded diagnosis of “high cholesterol”. I will cover 1) why cholesterol is critically important for your health 2) what can make cholesterol turn to “the dark side” in some people 3) what’s the best heart-healthy diet according to the medical literature and 4) who (if anyone) may benefit from taking cholesterol lowering drugs.
Cholesterol Is Not The Enemy
Most people I talk with believe that cholesterol is bad and we should attempt to get our numbers as low as possible. The reason this view is so prevalent is that we’ve believed for years that heart attacks are the result of too much cholesterol “clogging up” our arteries. If this were true, it would seem reasonable to see cholesterol as the villain and low cholesterol would be desirable. However, current studies show this to be a very poor model explaining the connection between cholesterol and heart disease. In truth, cholesterol plays a vital role in keeping you healthy.
Cholesterol is synthesized by your body and is essential for life. Of all the cholesterol in your blood, 75-85% is made by your own cells and only 15-25% comes from the foods you eat. Cholesterol is required for heathy cell membranes, to make many important hormones like estrogen, testosterone and Vitamin D, for a proper brain and nervous system function and for growth and development of our bodies. Recently, cholesterol has even been shown to have a very important role in our immune system, where it is protective against bacterial invasion. Simply put, without cholesterol you would be dead!
As the cholesterol story unfolds, it’s becoming increasingly clear that elevated cholesterol levels are not the death sentence many of us once thought. Recent studies suggests that in many patient groups elevated cholesterol may even be protective. The results of one study following 52,000 people found that women with total cholesterol levels below 195 mg/dL had a higher risk of death than women with cholesterol levels above that level. Another study published in the American Journal of Medicine found that people over 70 years of age with total cholesterol levels below 160 mg/dL had twice the risk of death than those with cholesterol levels between 160-199 mg/dL. If high cholesterol levels do cause heart disease then we should see this hold true in both men and women, and in all age groups, but this is just not the case. Additionally, many observational studies have shown a correlation between low cholesterol levels and increased risk of other degenerative diseases. Consider the following examples:
▪ The Journal of Psychiatric Research found that men with low total cholesterol levels were 7 times more likely to die prematurely from suicide and accidents than other men in the study.
▪ The Lancet found that depression was 3 times more likely in men over 70 with low cholesterol verses those with normal or high cholesterol.
▪ A study in the journal Neurology showed that low cholesterol is associated with increased risk of dementia.
▪ The European Journal of Internal Medicine found low cholesterol levels associated with Alzheimer’s disease.
So if cholesterol is so good for us, then why are we so concerned about it? The answer mostly stems from studies looking at people with familial hypercholesterolemia, a genetic disorder that results in much higher blood cholesterol levels and much higher rates of heart disease. This correlation between high cholesterol and heart disease was (and still is) seen as proof that high blood cholesterol levels directly cause heart disease. There is, however, a major problem with this line of reasoning. Correlation does not prove causation. Just because there is an association between two occurrences does not mean that one caused the other. Consider the correlation between fires and firefighters. When you see a fire, chances are you will also see firefighters. So does this prove that firefighters are the cause of fires? Obviously it does not. And now we are beginning to understand that high blood cholesterol alone is not the cause of heart disease.
I hope this post gives you more appreciation for cholesterol’s vital role in your health. In part 2 of this series I will cover why there is an association between cholesterol and heart disease in some people and what can make this important molecule turn bad. Let me hear your questions or concerns by commenting below.