Health Minute: Cholesterol Confusion
Is Cholesterol really the bad guy?
Health Minute Audio Summary:
Few subjects contain more nonsense per square inch than that of cholesterol. For thirty years America has been on an anti-fat, anti-cholesterol fanatical crusade — the definition of a “fanatic” being one who redoubles his effort after he’s lost sight of his goal. Lest I be misunderstood, let me say that high cholesterol is a problem, but there’s a lot more to it than just avoiding cholesterol in the diet. On the other hand, low cholesterol is also a problem, a subject totally foreign to most medical doctors. And, above all, you need to learn that fat is not your enemy — not categorically at least.
WHAT IS CHOLESTEROL?
Cholesterol is an odorless, soft, waxy substance present throughout the body, including the nervous system, muscle, skin, liver, intestines, and heart. It is essential for the manufacture of hormones, bile acid, and vitamin D. There are two kinds of cholesterol: blood and dietary. Blood cholesterol is manufactured in the liver, and to a lesser extent, absorbed from the food you eat. About 80% of the cholesterol in your body was manufactured in your own liver — not from dietary sources. Dietary cholesterol is present only in foods of animal origin.
CHOLESTEROL GUIDELINES
The National Heart, Lung and Blood Institute has established the following guidelines for diagnosing high blood cholesterol in individuals 20 years of age or older:
Desirable Cholesterol Less than 200
Borderline-High Cholesterol 200 – 239
High Cholesterol 240 or higher
HIGH CHOLESTEROL AND HEART DISEASE
As most people know, high cholesterol is regarded as the primary cause of heart disease. Excess cholesterol results in clogging arteries with plaque. High cholesterol may also be a cause of gallstones, impotence, mental impairment, high blood pressure, colon polyps, and colon cancer. If your blood cholesterol is 240 or greater, you have twice the risk of heart disease as someone with a cholesterol of 200. If in addition to high cholesterol you also have high blood pressure or smoke, the risk of heart disease goes even higher.
HDL & LDL LIPOPROTEINS
Cholesterol travels in the blood in packages called liporoteins, which are basically “transporting detergents” that are formed in the liver. The Low Density Lipoproteins (LDL) take the cholesterol from the liver to where it is needed in the body, while the High Density Lipoproteins (HDL) bring the cholesterol back to the liver for processing and removal from the body. When LDL is not effectively removed from the blood, it can build up atherosclerosis deposits in the arteries. Thus, it’s often called the “bad cholesterol.” Conversely, since the HDL does the removing of excess cholesterol, it’s often called the “good cholesterol.”
The amount of HDL is far more significant than the amount of Total Cholesterol in the blood. LDL should be less than 130. Borderline high is 130 – 159, and high is above 160. HDL less than 35 is too low. Ideally HDL should be in the low 50’s.
You can have normal Total Cholesterol and still have a problem because the HDL is too low. A Johns Hopkins study of people with coronary artery disease who all had Total Cholesterol less than 200 found a great difference between those with high HDL and those with low HDL. Of the low HDL group, 75% died from a heart attack or experienced new cardiovascular problems. Less than half the high HDL group had problems.
In short, cholesterol is not that important, while HDL is extremely important.
