You knew there was a bit of an over-emphasis (borderlining obsession) about cholesterol, right?
Don’t eat too many eggs! Avoid using butter! Reduce consumption of red meat!
We have heard it all and, thankfully, organizations such as the American Heart Association are now retracting their stance on cholesterol.
Before we jump into some myths let's make sure we're on the same page when it comes to what exactly cholesterol is. Cholesterol is an organic molecule, a sterol, which is a type of lipid (fat) molecule. It is biosynthesized by all animal cells, because it is an essential structural component of all animal cell membranes and is essential to maintain both membrane structural integrity and fluidity.
Myth #1: “Cholesterol” is cholesterol
While cholesterol is an actual molecule what it is bound to while it's floating through your blood is what's more important than just how much of it there is overall. In fact, depending on what it's combined with, cholesterol can have opposite effects on your arteries and heart. Yes, opposite!
So cholesterol is just one component of a compound that floats around in the blood. These compounds contain cholesterol as well as fats and special proteins called “lipoproteins”.
They're grouped into two main categories:
HDL: High Density Lipoprotein (AKA “good” cholesterol) that “cleans up” some of those infamous “arterial plaques” and transports cholesterol back to the liver.
LDL: Low Density Lipoprotein (AKA “bad” cholesterol) that transports cholesterol from the liver (and is the kind found to accumulate in arteries and become easily oxidized hence their “badness”).
And yes, it's even more complicated than this. Each of these categories is further broken down into subcategories which can also be measured in a blood test.
So “cholesterol” isn't simply cholesterol because it has very different effects on your body depending on which other molecules it's bound to in your blood and what it is actually doing there.
Myth #2: Cholesterol is bad
Cholesterol is absolutely necessary for your body to produce critical things like vitamin D when your skin is exposed to the sun, your sex hormones (e.g., estrogen and testosterone), as well as bile to help you absorb dietary fats. Not to mention that it's incorporated into the membranes of your cells.
Talk about an essential molecule!
The overall amount of cholesterol in your blood (AKA “total cholesterol”) isn't nearly as important as how much of each kind you have in your blood.
While way too much LDL cholesterol as compared with HDL (the LDL:HDL ratio) may be associated with an increased risk of heart disease it is absolutely not the only thing to consider for heart health.
Myth #3: Eating cholesterol increases your bad cholesterol
Most of the cholesterol in your blood is made by your liver. It's actually not from the cholesterol you eat. Why do you think cholesterol medications block an enzyme in your liver (HMG Co-A reductase, to be exact)? 'Cause that's where it's made!
What you eat still can affect how much cholesterol your liver produces. After a cholesterol-rich meal your liver doesn't need to make as much.
Myth #4: Your cholesterol should be as low as possible
As with almost everything in health and wellness there's a balance that needs to be maintained. There are very few extremes that are going to serve you well.
People with too-low levels of cholesterol have increased risk of death from other non-heart-related issues like certain types of cancers, as well as suicide.
Myth #5: Drugs are the only way to get a good cholesterol balance
First, I am NOT a medical doctor and therefore do NOT start or stop any medications without talking with your physician.
Now, while drugs can certainly lower the “bad” LDL cholesterol they don't seem to be able to raise the “good” HDL cholesterol all that well.
Guess what does?
Nutrition and exercise, baby!
One of the most impactful ways to lower your cholesterol with diet is to eat lots of fruits and veggies. I mean lots, like 5 (women) to 10 (men) fist-size servings each and every. Yes, that is today, tomorrow, and the next!
You can (should?) also exercise, lose weight, stop smoking, and eat better quality fats. That means fatty fish, avocados and olive oil. Ditch those over-processed hydrogenated “trans” fats. If you have not banned margarine from your kitchen, do so right away!
The science of cholesterol and heart health is complicated and we're learning more every day. You may not need to be as afraid of it as you are. And there is a lot you can do from a nutrition and lifestyle perspective to improve your cholesterol level.