Your doctor sends you for a lipid profile and when it comes back, your doctor tells you your cholesterol is high and you need to go on a statin or you will have a heart attack. Trick question – do you go on the statin or do you investigate for yourself what all the numbers mean?
It’s been ingrained in the American consciousness that cholesterol is bad. I’ve written some previous articles on why cholesterol is good for you, why cholesterol is needed in the body and how statins are harmful.
However, I’m also of the opinion that it never hurts to get the most comprehensive tests available in order to fully ascertain your risk.
It has been shown clearly that cholesterol is not the only issue in the development of heart disease. Just look at the Framingham Heart Study, which shows that 50% of the people who suffered myocardial infarction (MI) had normal, or near normal, cholesterol.
While I am confident that switching to real food and/or Paleo and consuming more meat and saturated fats is healthy, some folks and may want to monitor their numbers to be sure it is right for them.
I’m all for that as long as you understand the numbers.
The Lipid Profile
The lipid profile gives you just a few numbers – total cholesterol, LDL (also known as LDL-C), HDL, VLDL and triglycerides. That’s it.
With better technology, there are more sophisticated tests that are available through traditional labs that give much more important information.
There really is no good cholesterol or bad cholesterol. There is only one cholesterol. LDL and HDL refer to the lipoprotein cholesterol carriers and they are both equally necessary for health and wellness.
Cholesterol particles are not soluble in a watery environment (the environment of the tissues and cells), therefore they need a vehicle to cart them around in. Lipoproteins are the carrier proteins for cholesterol – they are sort of like taxi cabs for cholesterol.
LDL carries cholesterol from the liver to the cells. Once the lipoprotein reaches the cell, the cell attaches to it and extracts the fat and cholesterol it needs.
However, we do know that the small dense LDL particles are dangerous. These are the ones to test for and watch, because they can easily penetrate and injure the arterial wall and this leads to inflammation and heart disease.
The Cholesterol Numbers
Total cholesterol is nothing more than the total amount of LDL-C (also know as simply LDL), HDL and VLDL. HDL is the healthy cholesterol and when it is high – which it should be – this will bring up the total cholesterol. When conventional doctors see total cholesterol over a mere 200 they jump on the statin bandwagon and frighten misinformed people with this totally fake number.
Recent research in the development of atherosclerosis and the role oxidation and inflammation play, has indicated that cholesterol in itself does not cause atherosclerosis. It is only when cholesterol bound to atherogenic lipoproteins becomes trapped within the arterial wall, that it becomes a part of the atherosclerotic process. It does this by causing an inflammatory response within the arterial wall and this damages the artery.
HDL cholesterol is thought to be the good cholesterol because it carries cholesterol particles away from heart, to the liver. In fact, it is merely recycling cholesterol, but is also thought to clean the walls of the arteries. You do want the HDL to be higher than 60 mg/dL and certainly not lower than 40 mg/dL.
HDL cholesterol can be raised with exercise.
LDL-C is a calculated number using an equation – so it is not a direct count of the particles. LDL is considered to be the bad cholesterol, but as explained above, it is really just a lipoprotein carrier molecule.
They have lowered the levels of optimal LDL cholesterol to 100 mg/dL. This puts many people as candidates for statin use.
What is important is the number of small LDL particles. This is called LDL-P and this is the test that is most important. We know that the more LDL-P particles, the greater the risk.
The test called the NMR LipoProfile Test, which will give an exact measure of the types of particles of LDL, but it is not typically performed.
This test is available at Labcorp and Quest (it may be under a different name at Quest).
Ask your doctor for this test.
LDL particles also carry molecules other than cholesterol. LDL particles also carry triglycerides. Furthermore, there is an association between serum triglycerides and the risk of cardiovascular disease.
Triglyceride molecules are larger in size than cholesterol molecules. If the number of triglyceride molecules in an LDL particle is high, there will be less space for cholesterol molecules. It has been speculated that if triglycerides are high, it may take many more LDL particles to carry a given amount of cholesterol. Therefore high LDL particle count may be associated with small, cholesterol depleted, triglyceride rich particles.
This study published in Arteriosclerosis and Thrombosis in 1992, shows that high levels of triglycerides are associated with small LDL particle size. Therefore, triglyceride count IS important.
What’s Most Important in Cholesterol Testing?
Right now, the thinking is that LDL-P or particle number is the most important aspect of the Lipid Profile (NMR).
Triglycerides are also important. They are a telltale marker of carbohydrate intake. If they are under 100 (below 70 optimal) you are eating the right amount of carbs. This will be different between people, because some people can eat more carbs and still stay below 70.
According to Dr. William Davis in Wheat Belly, grains are one of the most inflammatory foods – which results in a higher blood sugar response than even when eating sugar.
There are lots of health claims about healthy whole grains – but grains were not part of the food culture until the last 10 thousand years. Our Paleolithic ancestors did not consume grains as we know them today.
What Can You Do?
You want to increase the large fluffy LDL particles and you can do this by eating saturated fat from healthy sources.
You want to remove the threat of oxidizing the large fluffy LDL cholesterol particles you have and turning them into dangerous small particles. You can do this by removing all the industrial vegetable oils from your diet immediately! These rancid vegetable oils (the very same ones we have been told are healthy) are, in fact, majors drivers of heart disease and atherosclerosis.
You want to have an HDL above 50 and optimally above 70. The way to raise HDL is to eat saturated fats (from clean animals and tropical plants) – also exercising consistently will raise HDL.
Two Foods to Avoid
Cereal is NOT a health food for many reasons, but the American Heart Association puts their stamp of approval on these foods simply because they were able to show that they lower the LDL number and the total cholesterol number, which are basically meaningless.
Vegetable oils highly processed and loaded with omega 6 fats which are highly inflammatory. Toxic Oil is a book written by David Gillespie and in it, he explains how these oils batter the large fluffy LDL particles and leave behind the oxidized small dense LDL particles.
These two food items are the critical products that many people consume on a daily basis and this is the source of the heart disease problem we have today.
What are the Good Fats?
Coconut oil will raise HDL and improve ketone production for fat burning as energy.
Butter and lard are real foods and have been eaten for ages. When they are sourced from pasture raised animals they contain healthy saturated fats. Do not use the lard from the conventional grocery.
Saturated fats from pasture feed animals contain loads of CLA and this is a fat that actually helps you lose weight.
You must be careful with olive oil because some olive oils can legally be mixed with up to 40% omega 6 vegetable oils like soy and corn (these are also genetically modified). Most olive oil in the conventional grocery in not 100%.
Cod Liver Oil
Cod liver oil provides omega 3 fats that the heart needs to function well — as well as essential vitamins A, D, and K.
What If Cholesterol Goes Way Up With Real Food Diet?
There are many other factors, aside from cholesterol that lead to the development of disease. Importantly an underlying cause is inflammation.
As you age, the cholesterol goes up naturally – remember that historically, the groups with high levels of cholesterol lived the longest.
Statins will lower cholesterol and will cause lots of side effects that include, neurodegenerative effects like Alzheimer’s and dementia, global transient amnesia, muscle pain, diabetes and cancer.
Of course you should speak with your health care provider when making changes to diet or medication. See my disclaimer.
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