75% of people who have heart attacks have normal cholesterol. Slowly, but surely, the medical community is coming to grips with the realization that inflammation is the true culprit for heart attacks and stroke (Unforunately this will not stop them from putting you on a statin medication!) The truth about cholesterol (even LDL, the “bad guy”) is that it is all good.
The laying down of cholesterol in your arteries is your body’s way of dealing with damaged artery walls that get roughed up by inflammation. Inflammation can be caused by sress, bad diet, an overactive immune system, toxins, etc. The majority of your cholesterol, however, is made by your liver. And while it usually only makes a gram of cholesterol per day; it could produce 400 times more cholesterol that what you get from 3.5 ounces of butter. Thus, poor cholesterol levels really reflect imbalances in your liver’s cholesterol production and absorption (i.e. your diet/GI Health and not your cardiovascular health!)
So, what do we want our cholesterol levels to be? Well, unfortunately the true relationship between cholesterol and heart disease has not been studied much, compared to the multitide of efforts to connect Statin use to reduced cardiovascular risks. The studies we do have suggest that either there is no link, or that the link is much more complicated and even showing that higher cholesterol levels are linked to benefits.
A Norwegian study following 52,087 people (men and women) found a much more complex relationship suggesting that for women the most protective levels of cholesterol actually increased with age such that women past age 65 whose total cholesterol level was over 270 (compared to those with total cholesterol under 193) enjoyed a 28% reduction in death (all causes) and 26% reduction of heart disease. Men also enjoyed an 11% reduction in death and a 20% reduction in heart disease with total cholesterol up to 228 mg/dL (compared to a total cholesterol of less than 193). Patients ranged from ages 20 - 74 at the start and were followed for ten years. The results were adjusted for other co-morbidities known to influence heart disease, such as hypertension and smoking. When these (inflammation-based) factors were present, the protective effect of high cholesterol was less apparent consistent with the idea that inflammation drives plaque formation. I wish that they had also looked at the specific lipoprotein subtypes (LDL, HDL, etc) so that we might draw some conclusions about these markers, but it is clear to me that if you want to lower your cardiovascular risks then you want to focus on an anti-inflammatory diet to support both gut health and cardivascular health. And you also want to test your blood for markers of inflammation…which is the topic of my next feature article. Stay tuned!