We are told to reduce red meat consumption and that eggs are bad, and still the rate of heart disease is rising, well could it be the advice is wrong? Seems likely. We all know there is good and bad cholesterol, right? Wrong. Well, you’re half right. The good-bad cholesterol notion is often followed with HDL as good and LDL as bad, and therefore we should do everything we can to get our LDL numbers down. HDL (High Density Lipoprotein) and LDL (Low Density Lipoprotein) are transporters of cholesterol and triglycerides (fat cells) to muscles for energy and cells for synthesis. The statement that HDL is “good” is correct. Reason being that HDL takes cholesterol to the liver where it can be synthesised or expelled from the body. Not much goes wrong there. HDL gets the thumbs up.
The statement that LDL is “bad” is false. LDL is the primary transporter of cholesterol and triglycerides (fats) to cells that need it. LDL also travels through the arteries and this is why it can get stuck there. At this point I’m sure you’re thinking eat less fat, less triglycerides, less LDL to go through my arteries and voila! reduced risk of heart disease. I’m afraid that’s not quite the full story.
Firstly, total LDL is not the issue but rather the number of particles in our blood is. Doctors measure total LDL (also known as LDL-C) and not LDL particles (LDL-P). Why do we care about the particles and total amount? Think of it like this, is the total amount of metal on our roads or the number of cars on our roads the concern for road traffic accidents? The more cars we have the more likely one is to lose control and collide into the barriers. It’s the same process in our arteries, the more particles we have the more chances of them getting stuck in our arteries, even when you keep the total LDL the same.
Another important distinction to make here is that the issue is not really the LDL particles getting stuck in our blood, but rather what occurs afterwards. Once a particle gets stuck in our arterial walls the bodies defence system (the immune system) sends its clean-up-crew (white cells) to go and deal with the issue. The white cells whilst doing their job of clearing out the stuck LDL particle actually end up creating a bit more damage. That damage creates more opportunity for other LDL particles to get stuck, and this results in more white cells being sent, so on and so forth.
This starts to occur in our bodies at a very early age and continues ever since. And with each instance the blood vessel gets narrower (please note – this is a very simplified explanation of the process). If you’re thinking then that the older you are there will be more instances of these particles being stuck in your blood then you are right. Age is the best indicator of coronary heart disease. This does not mean young people are free of this disease, it just means the older you are the more likely your chances.
Most cholesterol tests will not measure the number of LDL particles but instead the total number of LDL cholesterol. And this too is not an accurate measure it’s a guess based on a formula. You could be reading this article and be concerned about your cholesterol because of a test but in reality there is nothing to worry about. You might argue that it’s better to manage LDL cholesterol even if in reality its not a problem, and I would likely agree with you, except for that the way you are managing your LDL numbers is likely increasing your risk.
As I mentioned earlier, most tests only show LDL-C numbers not LDL-P. The common approach in reducing LDL-C is to cut down on cholesterol consumption, reduce fat intake, and avoid fattier cuts of meat. This reduction in fat calories is often balanced by an increase in carbohydrate calories; bread, sugar, pasta, wheat, cereals etc… After all people don’t just go hungry because they have high LDL-C numbers. The problem with this is that increased carbohydrate consumption results in increased triglycerides and increased LDL-P. Let me reiterate, the most common approach to lower your cholesterol and that recommended by “experts” is having the complete opposite effect on the one measure (LDL-P) that to date is the most accurate measure of heart disease.
Recall in my last article I finished off by stating that we have been told for many decades now to reduce our cholesterol and fat consumption – particularly saturated fat. We are told to reduce red meat consumption and that eggs are bad, and still the rate of heart disease is rising, well could it be the advice is wrong? Seems likely. In the next and final instalment of this three-part article I will discuss the nutritional and training protocols we can follow that will help reduce our risk of being found in the back of an ambulance.
By Hanan Burki