Cholesterol

For a number of decades cholesterol has been labelled as the route cause of heart disease.  Eggs and red meat have been demonised because they are said to contain high levels of cholesterol and will make your heart explode.  But I feel sorry for cholesterol, and so should you.  It’s been falsely accused for long enough!

What is cholesterol?
Cholesterol is essential and present in every cell of your body, without it cells could not form.  It has a variety of functions from hormone production to neurological function.  Dietary intake of cholesterol actually has very little impact on your bodies overall level of cholesterol – your body produces over 75% of it with no input required!  This should be the first clue that some of the advice you may have heard about dietary cholesterol could well be questionable.

75% of people will experience little to no rise in blood cholesterol after being exposed to a high amount of dietary cholesterol.  The other 25% (called hyper-responders) do experience a rise in TOTAL blood cholesterol, but this has been shown to have little to no effect on the build up of plaques in arteries (Fernandez, 2010).

Who started this cholesterol bashing?  
Way back in the 1850’s  Rudolf Virchow came up with what’s now known as ‘the Lipid Hypothesis’, which suggested that cholesterol in the blood leads to the development of plaques and blockages in your arteries.  Since then large population studies such as the Seven Countries Study and the Framingham Study have been misinterpreted when some correlation between the consumption of dietary cholesterol and heart disease was seen, BUT CORRELATION DOES NOT IMPLY CAUSATION!

Cholesterol levels seems to be the ‘go to’ test for every doctor, so are cholesterol levels a good indicator of heart disease?
No.  Total cholesterol is NOT a good indicator of heart disease – less than 50% of people who have heart attacks have a ‘high’ total cholesterol level (Fonarow, 2008 ) (Kwiterovich, 2002).  The idea that cholesterol can be simply separated into ‘good’ (high density lipoproteins or HDL) and ‘bad’ (low density lipoproteins or LDL) is gradually being phased out in the scientific community.

So which bit of cholesterol is ACTUALLY causing harm?
LDL cholesterol is now being further separated into different particles, each of which vary in the amount of damage they cause to blood vessels.  The two subtypes of LDL which have been identified as causing the most damage are small, dense low density lipoproteins (SDLDL) and very low density lipoproteins (VLDL).  And the quickest way to increase these two types of LDL?  A diet high in sugars and refined carbohydrates (Nesto, 2005).

People tell me I shouldn’t eat so many eggs…Should I listen?!
No.  Please do not.  Eggs are cheap, nutrient dense and damn tasty (I am THE self proclaimed Omelette King).  It’s been proven time and time again that eggs are safe, even for cholesterol ‘hyper-responders’.  Here’s some evidence to back that up:

Fernandez, 2010 – “We need to acknowledge that diverse healthy populations experience no risk in developing coronary heart disease by increasing their intake of cholesterol but in contrast, they may have multiple beneficial effects by the inclusion of eggs in their regular diet”

Herron et al. 2003 – “These data suggest that additional dietary cholesterol does not increase the risk of developing an atherogenic lipoprotein profile in healthy men, regardless of their response classification. ”

Mutungi et al. 2008 – “These results suggest that including eggs in a carbohydrate restricted diet results in increased HDL-C while decreasing the risk factors associated with Metabolic Syndrome.”

McNmara. 2010 – “These data help explain the epidemiological studies showing that dietary cholesterol is not related to coronary heart disease incidence or mortality across or within populations”

I could go on…but you get the idea.  Eat whole eggs.

To Summarise…

Cholesterol is not the devil.  The lamentable truth is that by focusing all of our attention on cholesterol we are missing the REAL causes of heart disease – sugar, stress, inactivity and inflammation.