Do your cholesterol numbers concern you? Has your doctor put you on a statin? Do you really understand what cholesterol is, where it comes from, why it’s in our body, and what it really does?
Cholesterol is a deeply misunderstood element within our body. This is a topic that required a lot of research, study, and time. My goal is to clear up some of the fears of a low carb diet and cholesterol, and if you should worry or not.
I’ve been interested in this topic for a while now, but I was compelled to write about this topic for a good friend of mine. He stopped doing low carb because his doctor told him his cholesterol was too high, and I think that doctor did him an injustice.
Tony … I dedicate this one to you buddy. At the very least, I hope this will arm you with some knowledge to make your own health decisions.
Please remember, I’m not a doctor or anything like that. I’m just a regular guy living the low carb life, so don’t interpret this as medical advice. I’m just passing on what I’ve learned, and I urge you to do your own research.
What’s the big deal about Cholesterol?
Due to years of bad and deceitful epidemiological science, which is basically not science, and an onslaught of propaganda derived from that “science”, cholesterol has become one of the most misunderstood elements in the human body.
For decades the consensus has been, and in many cases continues to be, that high cholesterol is indicative of impending heart attacks, strokes, and a myriad of other health problems. Cholesterol has a bad reputation, and is generally misunderstood, due to the widespread use of epidemiological studies being interpreted as causation. This is just plain WRONG!
Epidemiological studies can only show a loose association/relationship/correlation between two data sets. Think back to the Nicholas Cage movies and swimming pool drownings example I referenced in this previous article.
All of this “cholesterol is bad because fat clogs your arteries” nonsense started back in 1953 when a guy named Ansel Keys performed an epidemiological study, cherry picked the data, then published the results. Our government got behind his findings and published recommendations to cut fat from the diet, and the low fat scam was born … and coincidentally, or maybe not, so was the obesity epidemic.
What is Cholesterol Anyway?
Cholesterol is a type of fat. It is mostly created within the body by the liver, but can also be introduced through eating foods like meats, fish, eggs, butter, and cheese. But, eating foods high in cholesterol has virtually no impact on the amount of cholesterol in your body.
Your body is well-designed, intelligent system. Most of the cholesterol in the body is made by the body. If you eat foods higher in cholesterol, the body just makes less. If you don’t eat foods high in cholesterol, the body makes more. The body will adjust as needed to keep everything at the correct levels. This is known as homeostasis. Homeostasis is the bodies way of maintaining a stable internal environment.
The Bio-Speak …
When we hear people talk about cholesterol, the terms we hear about most often are, LDL, HDL, and triglycerides. I’m sure your doctor has brought these to your attention at one time or another. Let’s break the topic down a bit so it makes a little more sense to those of us without medical degrees as we move forward … and just because we don’t have a medical degree doesn’t mean we can’t understand this stuff and allow ourselves to make informed decisions regarding our health. Knowledge is power!
I find the best place to start when trying to learn something new, is with the terminology regularly used in any discussion of that subject. Here are some terms we need to be familiar with when discussing cholesterol. If you need to, you can reference back to this section moving forward.
LDL – low density lipoprotein
HDL – high density lipoprotein
VLDL – very low density lipoproteins.
Density – The protein-to-lipid ratio. (Generally, the smaller the particle, the denser it is. It has less lipid cargo and a greater proportion of proteins.)
Particle – Small bit of matter
Apolipoproteins – Proteins that bind with the lipids, such as fat and cholesterol, to form lipoproteins.
Lipoprotein – A group of soluble proteins that combine with, and transport, fat or other lipids around the body in the blood plasma.
Soluble – Able to be dissolved, especially in water
Lipids – The biology term for fats
Plasma – Part of the fluids in the bloodstream
Metabolism – The process by which your body converts what you eat and drink into energy
Glycerol – This one is kind of hard to define in a few words … check out the link
Triglyceride – an ester formed from glycerol and three fatty acids
Phospholipid – a phosphorus containing complex lipids derived from glycerol
Ester – a chemical compound derived from acid (organic or inorganic)
Let’s put that all together an example using our little glossary. LDL is a Lipoprotein particle with a smaller ratio of fat to proteins. Proteins, that can be dissolved in water, and fat, that as anybody that has ever washed a frying pan after cooking bacon knows, cannot be dissolved in water. Make sense? Good!
The only difference between HDL, LDL, and VLDL is the ratio of proteins to fat, what they do in the body, and how they do it.
Does Cholesterol have a purpose?
The short answer is yes, of course cholesterol has a purpose. Virtually everything that happens in the human body has a purpose. The body uses cholesterol for things like building the structure of cell membranes, making hormones, helping your metabolism work efficiently, our immune cells require cholesterol, our brains require cholesterol, and cholesterol is essential for your body to produce vitamin D.
There are studies currently in progress that are indicating cholesterol is very important for brain health and low cholesterol may be a determinant for Alzheimer’s disease.
It appears that cholesterol may not be the villain we’ve been led to believe. On the contrary, it’s got some very important jobs, and maybe we don’t really want less of it in our body.
How does low carb affect cholesterol numbers?
To effectively answer this question, we need to understand a little bit about metabolism, energy transport, and why we have VLDL, LDL, and HDL in the first place.
Every living thing is made up of cells. All cells need energy. Our cells get that energy from the things we eat (or from fat stored in and on our body). The process of breaking down the things we eat, or our fat storage, into usable energy for our cells, is known as metabolism. The majority of our cells get their energy from the bloodstream.
The most common source of energy is glucose (sugar). When high levels of glucose are present in the bloodstream insulin is produced to help the cells receive the glucose. Glucose is mainly derived from what we eat in the form of carbs.
A secondary source of energy our cells can use is fat, in the form of fatty acids (this is the primary fuel source for us low carbers). Our cells also get this energy from the bloodstream. The fat can come from what we eat, or from our fat storage when we have low levels of blood glucose.
The big difference between glucose and fat is that glucose can swim around in the bloodstream and fat cannot. Fat has to be helped to get to where it needs to go. In order to get fat, or the energy from fatty acids, to the cells that need it, our bodies do a couple of pretty cool things.
First, it bundles three fatty acids together with glycerol, into a molecule called a triglyceride. Triglycerides are produced by the small intestine (from the food we eat) and by the liver. Since this molecule is mainly fat, it needs help to move around in the bloodstream, so the body creates a particle to carry the triglycerides to where they’re needed. This particle is known as a lipoprotein.
You can think of lipoproteins as delivery trucks. They carry cargo that has to be delivered to various destinations. Their cargo is mainly triglycerides and cholesterol, but can also include fat soluble vitamins, phospholipids, and esters … all things needed for various purposes in the body.
There are five different lipoproteins. The ones we don’t hear about very often are Very Low Density Lipoproteins, or VLDLs, Intermediate Density Lipoproteins, or IDLs, and Chylomicrons. Let’s briefly discuss Chylomicrons, then move on to the more common ones we hear about most often.
Chylomicrons are created in the intestine. They’re main job is to shuttle around the fats and cholesterol that we eat. Chylomicrons are very large compared to other lipoproteins and their cargo is mostly triglycerides. If there is an abundance of glucose present in the bloodstream, most of the Chylomicrons triglycerides will be delivered to fat cells to be stored as energy for use later.
Chylomicrons generally remain in the bloodstream for about an hour after eating. When they’ve delivered their cargo, their work is done, so they head to the liver, drop of their remaining cargo, and get re-purposed for other functions.
Very low density lipoprotein (VLDL) is a lipoprotein particle created by the liver to deliver energy, in the form of fatty acids, to our cells. When VLDL’s cargo of fatty acids (triglycerides) has been mostly unloaded, the particle transforms to an IDL. Many of the IDL particles will return to the liver, but those that don’t will transform into low density lipoprotein (LDL).
As we just read, an LDL is a lipoprotein that is primarily made up of cholesterol. An LDL particle will contain over two times as much cholesterol as a VLDL particle. The VLDL cargo was primarily triglycerides, about 70%. But the LDL is only about 10% triglycerides. The remaining LDL cargo is cholesterol, about 25%, Protein, and some other fats.
High density lipoprotein is the busiest of all the lipoprotein particles, and the smallest. HDL has a lot more proteins and a lot less lipids. HDL is all over the place doing a variety of jobs like loaning out apolipoproteins, transferring cholesterol around, taking things back to the liver for processing, and generally cleaning things up. This is why HDL is considered the “healthy” lipoprotein. One of HDLs primary jobs is collecting cholesterol and returning it to the liver for re-purposing.
Now that we know what all these lipoproteins are and what they do, we can answer the question … how does low carb affect cholesterol numbers?
On a low carb diet, especially combined with intermittent fasting, we shift the primary fuel source from glucose/sugar to fat/lipids. Naturally, we will need to move more fat around in the bloodstream to provide energy to our cells. Since fat can’t swim, the body has to produce more cholesterol (in the form of VLDL, which transforms to LDL) to provide fuel/energy to all the cells that need it. It only makes sense that total cholesterol numbers would increase, because of the fuel our body is using!
Should I worry about my cholesterol numbers
The body does everything for a specific reason. Do you think it would create a element to clog your arteries and make you drop dead just because it is present in your system? I don’t believe that for a second. The question we need to ask is, “If cholesterol is causing blockages in our arteries, why is it happening?”. It surely doesn’t happen just because of the presence of cholesterol in high volumes.
LDL is considered the “bad” cholesterol. It’s largely considered a waste product with no benefit to the body. This is the guy blamed for heart attacks and strokes, largely based on the Lipid Hypothesis. However, recent studies, and some great analysis and testing by engineers like Dave Feldman and Ivor Cummins, show this doesn’t necessarily appear to be the truth.
Perhaps cholesterol is actually performing a necessary function and LDL is the delivery truck responsible for getting the cholesterol to where it’s needed. Perhaps we should think of LDL particles as fire trucks, police cars, or ambulances. Perhaps LDL particles are responding to emergencies and/or providing protection within our body. This line of thinking is known as the Chronic Endothelial Injury Hypothesis.
If you eat a low carb/ketogenic diet, and have improved things like your blood pressure, fasting blood glucose, fasting insulin level, waist to hip ratio, raised your HDL cholesterol and lowered your triglycerides, should you be worried? Currently, evidence is pointing toward a firm, maybe not.
Sorry, but the jury is still out. At this point, I’ll quote @daveketo who says he is “cautiously optimistic” that in a scenario consisting of triglycerides less than 100 and HDL greater than 50, high LDL may not be a bad thing … and his current studies seem to indicate that it may contribute to longevity, and if not, it definitely doesn’t prevent it!
Personally, I have full trust that my body is doing exactly what it has been designed to do with the fuel that I put in my tank. I’ve cited many times before how much improved my health has become since drastically cutting my intake of carbs, processed foods, processed refined carbohydrates, fruits, and sugars.
I’m due for a blood test soon. I’m sure my total cholesterol will be what most doctors consider high … and I’m not worried about it at all, because all of my other health markers, like blood pressure, blood glucose, and almost everything else (I still have about 17 lbs to lose until my goal weight), are in the “normal” range.
I’m feeling great and I’m losing weight! Why worry?!?!
When it comes to cholesterol, this is what we are all aiming for …
If you happen to be eating the Standard American Diet (SAD), and you have any of the symptoms associated with pre-diabetes or insulin resistance, you may want to watch those cholesterol numbers. High levels of glucose, insulin spikes, and high LDL cholesterol are the trifecta for heart attacks and/or strokes.
Additionally, when you eat highly processed carbs and fats together, which raises your glucose and the amount of lipoproteins in the bloodstream, you’ve created the perfect environment for glycation.
Glycation is the process of sugar/glucose molecules binding with lipoproteins, thereby damaging the lipoprotein molecule . This leads to several health issues that will affect the length and quality of your life.
If you’re participating in a low carb lifestyle … congratulations! You are on the path to a much healthier you. The key thing for you to be concerned with in the area of cholesterol is keeping your triglycerides under 100 and your HDL over 50. It really looks like LDL is nothing to be concerned with at all.
I hope you found this article thought-provoking and helpful. I urge you to do your own research. Don’t take what your doctor says as absolute truth. They’re people just like you and me. They may not be current with the latest research and findings. Educate yourself and be informed. The information age is an awesome time to be alive, take advantage of it!
If this helps just one person, I’ve fulfilled my mission.
I hope that person was you!
If I can help in any way, please leave me a comment!
What you do today is who you’ll be tomorrow. You are capable of great things!
If I can do this … so can you!