The cholesterol conundrum

The cholesterol conundrum

By
Dale Pinnock
Contains
0 recipes
Published by
Quadrille Publishing
ISBN
978 184949 542 4

I don’t think there is any greater area of misunderstanding, confusion, contradiction and outright panic than the area of cholesterol and heart health. So many clients that I have worked with over the years have been almost fixated on their cholesterol levels… and terrified by the numbers.

Massive health campaigns that cross continents and span generations have been among the public health front runners. There have been TV campaigns, funny little drinks, you name it. And there have been many efforts to get us all to reduce our cholesterol and, of course, many a commercial opportunity, too. But how many of us actually understand our cholesterol, know what it is, or even know what half the terminology means?

Let’s get one thing perfectly clear from the off: cholesterol is a vital substance. The fact that our body produces up to one gram of it per day, regardless of what our diet looks like, is a pretty good indicator that it may actually need to be there and may not be the murderous villain that we are led to believe it is. Mechanisms that lead to that scale of production inside all our bodies cannot be some unfortunate physical flaw; they exist because the substance is vital to our health. Cholesterol is needed for the manufacture and maintenance of cell membranes.

Each cell in our body consists of hundreds of different pieces of machinery and a host of biochemical signalling and relaying systems. These substances are held in place by a double-layered fatty bubble called the membrane. The membrane also helps our cells to function, as it actively gets involved in carrying messages from outside the cell to the inside, and moving things in and out. So, all in all, pretty important! Cholesterol helps strengthen the bonds within this structure, so it is more resilient. It also helps to secure specific proteins found within cell membrane walls that are involved in relaying signals between the inside and outside of cells.

Cholesterol plays an incredibly important role in digestion, too, as it is also used to create the bile acids that are released from the liver during digestion. Specifically they are involved in the breakdown of fats into smaller, more manageable particles, ready for absorption. Cholesterol has another vital role to play. It is the metabolic precursor (the chemical building block) for some vital substances in the body. One of the most important is vitamin D.

As you may be aware, vitamin D is the latest nutritional darling and the centre of a huge amount of research. What we are discovering about it is truly remarkable. We all know that it is important for maintaining healthy bones, because it helps the body to use calcium properly. But its benefits don’t stop there. It has been shown to affect both mind and mood and it also regulates immunological responses.

Where does it come from? Well, a certain amount can come from our diet, from foods such as oily fish and offal. But the primary source of vitamin D for humans is the conversion of cholesterol into vitamin D when our skin is exposed to ultraviolet radiation (the sun)! Here in good old England, the sun is little more than a rumour for most of the year, so if the benefits of what little we do get are stifled by having very low levels of vitamin D precursors, we are in a bit of trouble.

Cholesterol is also the precursor for our main sex hormones: oestrogen and testosterone. The body needs cholesterol to make these. I don’t know about you, but I for one don’t want to see my levels of testosterone plummet any time soon! So, with all this in mind, I think it is clear that cholesterol isn’t the demonic destroyer of health that we automatically suppose.

LDL and HDL

I guess you might have heard the terms LDL cholesterol and HDL cholesterol. These are sometimes also called ‘bad’ and ‘good’ cholesterol. What do they mean? Well, to start with, there is only one type of cholesterol. Cholesterol = cholesterol. It is a thick waxy substance. As such, it doesn’t mix well with our blood (oil and water just won’t mix) so, left to its own devices, it wouldn’t get very far or fare very well just bobbing around fattily in our bloodstreams.

To this end, the body has its own transport system to shuttle cholesterol around the body. These are like two different bus routes and the bus is called a lipoprotein, a protein that can give fatty substances a piggy back. LDL = Low Density Lipoprotein, HDL = High Density Lipoprotein. LDL carries cholesterol out into our bodies’ tissues via the bloodstream. HDL returns cholesterol from the blood to the liver for recycling and breakdown.

So, the theory goes that if your LDL (bad) cholesterol is high, then you are at greater risk of heart disease, but if your HDL is high, then it’s good news. The basic proposition was – for a very long time – that an excess of cholesterol in the blood would begin to deposit itself in the walls of the blood vessels and cause a plaque. It was as simple as that. The more there was, it was thought, the greater your risk of developing heart disease, as more cholesterol would be getting deposited out into your tissues. The resulting medical treatment protocol for the prevention of cardiovascular disease focused upon getting levels of cholesterol down.

For a couple of decades, the medical profession were happily able to target a specific biochemical marker (cholesterol) in an attempt to decrease cardiovascular disease. Very soon there was a multi-billion dollar market in pharmaceuticals such as statins, while the functional foods market (those funky little cholesterol-lowering drinks) was also beginning to boom.

But, as the years went by and research moved forward, this clear picture and perfect theory began to fall apart. Did you know that almost 75 per cent of people who have a heart attack have clinically ‘normal’ cholesterol levels? Normal, as in at healthy levels… now there’s a conundrum! Recent studies have even shown that a large proportion of patients with heart disease have a lower-than-average level of cholesterol. If it were purely a numbers game, then this simply would not be the case. Something else must be going on.

Perhaps we have missed the trick! There are populations on the Earth, such as the Inuit people, that have been shown to have staggeringly high cholesterol levels, yet heart disease in their communities is as good as non-existent. Is there something else in their environment, diet or even their genes that offers them protection? If cholesterol were the single pathogenic factor that we have been looking for, then this lack of clarity as well as the seemingly outright contradiction would simply not exist.

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