Monday, September 3, 2018

Cholesterol: the Good, the Bad and the Ugly


Welcome back to my blog! In my last article (An Eggcellent Idea, check it out!), I promised you all an article unveiling the facts about cholesterol. So let’s start with what I think you guys already know, and let me know if it sounds familiar:

There are two types of cholesterol: HDL and LDL. HDL is good cholesterol, so we want high levels (H-igh for HDL), while LDL is bad cholesterol, so we want low levels (L-ow for LDL). If our blood levels of cholesterol are high, then we need to cut out dietary sources of cholesterol.

Sounds about right?

Wrong.

First Things First, What Is Cholesterol?
Cholesterol is a molecule that makes up part of your cell membrane to ensure structural support and membrane fluidity for nutrient transport. It is also used for myelin synthesis (the protective sheath around your neurons), brain plasticity (your brain’s ability to change or reorganize it’s neural pathways according to the stimulation it receives), bile acid production (to digest fats), hormone synthesis (testosterone, estrogen, progesterone, cortisol, vitamin D), etc. Needless to say that cholesterol plays a very important role in your body.

But I didn’t mention LDL and HDL yet. Actually, they aren’t even cholesterol at all. They are low-density and high-density LIPOPROTEINS, which are protein-based carriers of cholesterol, triglycerides and other fat-soluble molecules, since fat-soluble molecules don’t mix in your blood. Think of it this way: oil and water don’t mix, but cholesterol is like oil and your blood is 92% water, so the oil needs a carrier to be transported across the water.


How Does LDL Get A Bad Rep?
For this next part, I will borrow an analogy from a book called Genius Foods, by Max Lugavere. I will cite it at the end of this article and I strongly recommend reading it.

Imagine two highways. Highway A has one hundred cars on the road, each with one passenger, while highway B has 5 buses with 20 passengers each. As you know, highway A will be more prone to accidents and traffic. Which highway would you choose to take to work? I would definitely choose highway B.


In our body, cholesterol passengers all start on highway B, in big buses. As the buses empty out, when the cholesterol passengers reach their destination, they shrink to be more like cars, making them “small and dense”, thus becoming like highway A. Now this isn’t an issue if the lipoproteins go back to the liver to be recycled, avoiding congestion. The issue arrives when the LDL particles become oxidized (oxygen sticks to them and changes the molecule, like a rusty car) or glycated (sugar sticks to them), damaging the molecules OR that there is an issue with your liver reabsorbing them altogether because it is too busy processing concentrated carbs, alcohol, toxins or oxidative stress. Then, the small dense LDL particles clog up your bloodstream, making it look more like highway A, leading to plaque formation.




How Do I Reduce My Cholesterol?
As I mentioned in my last article, your liver makes 80% of the cholesterol that you need. Studies have repeatedly shown that the cholesterol you eat doesn’t significantly change your blood cholesterol levels at all! For this reason, what we want is to avoid our LDL particles becoming damaged or our liver being too busy to recycle them. This involves eating plenty of antioxidants, which are in most fruits and vegetables, such as dark leafy greens and berries. You also want to keep your liver happy by reducing sources of toxins, alcohol, but also very high levels of carbohydrates that it would need to process. Eating good sources of fibre (also found in most fruits and vegetables) will also give your liver a chance to slowly process the food you eat instead of overloading it with work. And most of all, you’ll want to reduce the amount of processed foods that you eat. The more whole the food is, the better.



High-DL
As for HDL, they are like clean-up trucks that pick up excess cholesterol and bring it back to your liver to be converted into bile and sent away. There are a few ways to increase your HDL levels, including eating sources of monounsaturated fats (extra virgin olive oil being the best example, but also coconut oil, avocado oil, macadamia nuts, etc.), reducing alcohol intake and EXERCISE. EXERCISE. EXERCISE.


So it isn’t as much the level of LDL that is harmful, but the type of LDL particles that you have (small dense LDL being unwanted) and the ratio of LDL to HDL that is in your body (wanting as low a ratio as possible). And as a quick side note, saturated fats increase both your LDL and your HDL, but bending the ratio in your favor by increasing your HDL more.

When medical doctors ask to lower your LDL and raise your HDL, they are asking for you to move a mountain because HDL production is actually controlled by your amount of LDL. The more LDL you have, the more easily your body will produce HDL. You can’t do both. The important part is to have a lower LDL to HDL ratio. And if you increase your HDL, your total cholesterol will also increase, which your medical doctor might also ask you to reduce simultaneously. For a mathematical explanation on this topic, please read this very interesting article.

The next time your medical doctor talks about raising good and lowering bad cholesterol, do me a favor and reply that LDL and HDL are not cholesterol, but cholesterol carriers!



*** Disclaimer: As usual, recommendations made on this blog are for the general healthy population. If you have any doubts regarding your nutritional health, I strongly recommend that you consult a registered dietitian. Stay tuned, as I will be graduating from McGill university and be a registered dietitian recognized by the OPDQ in December 2018!


Sources:
Lugavere, Max. (2018). Genius Foods. Harper Wave. 388 p.


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