The Most Important Part of Your Cholesterol Test You May Be Missing by Kathi Bratberg RN, MS Holistic Nutrition

The cholesterol / lipid panel is a test that has become an integral part of the American health care system. Many of us have heard the diagnosis from our Primary Care docs - "your cholesterol level is too high"; however, what is considered "too high" is an arbitrary number at best and changed numerous times to reflect current trends. After that comes the standard advice- cut back on your fat intake, lose weight, exercise, and maybe even take the latest and greatest statin drug- because we all know that cholesterol is a bad substance that causes heart disease. Or does it?

Many have tried to follow this advice, but at what cost. The statin drugs are not without side effects- muscle pain, weakness and tingling, fatigue, memory loss, increased cancer risk, depression and sexual dysfunction. And don't even get me started on low fat diets. Low fat = high carb = weight gain= metabolic syndrome = type 2 diabetes. Well, that went well. Healthy fat IS NOT a problem with cholesterol levels and IT NEVER WAS. Trans fats are a different story.  

Exercise is important, but not many people really follow this advice, though I whole-heartedly indorse regular exercise.

What if I told you Cholesterol is a very important body substance, and there is a lot of new theory to back this up. "The Great Cholesterol Myth" - by Dr. Stephen Sinatra MD, cardiologist and Dr. Johnny Bowden PHD Nutrition, provides plenty of evidence.

So what do the numbers on the cholesterol/lipid panel actually reflect? Let's review. A typical lipid panel will show Cholesterol, Triglyceride, HDL, LDL, and VLDL levels. 

Cholesterol is a waxy substance, an important part of ALL of our 50 trillion cell membranes. Most of it is made in our liver, a little is absorbed from the diet. Cholesterol is the basic building substance for all of our Estrogen, Progesterone, Testosterone, DHEA, and Adrenal hormones. It is a major component of bile - responsible for fat digestion and the extraction of Vitamins A, D, E and K from our dietary fats. It is a super antioxidant and super protector for all of our cells. Current recommendations are to keep your number under 200;  but if your number is under 150 you are at increased risk for cancer. If your number is higher than 200 it could be a marker of infection or inflammation in the body. In some people there is a genetic component to this number.

Cholesterol travels to all parts of the body in the form of lipoproteins- namely HDL (high density lipoprotein) and LDL (low density lipoprotein).  

HDL is considered the good cholesterol. A HDL of 60 or higher is considered optimal for health. But some new evidence states that there are subgroups of HDL and what subgroup you are in is also important. This is not commonly tested. Also HDL is more controlled by genetics then LDL.  

LDL is considered the "bad cholesterol" (though why we think nature would put a bad substance in our body is beyond me). The lab normal for LDL is a result under 100. But again it is not that simple. There are also subgroups of LDL. This is the most important information for you if your LDL is elevated. There is a test called "Lipoprotein particle size or VAP ". Large fluffy, buoyant LDL-A is the preferred result. Small, hard, dense BB size LDL -B molecules are a different story. There is also some genetic predisposition for some with high LDL levels.  

TRIGLYCERIDES are another type of fat in the body. These are the storage form for excessive carbohydrates (note I did not say fats). If triglycerides are high, it is a tip off that you need to radically reduce the amount of simple sugars and alcohol in your diet. Eating low carb is also one of the ways to change those small BB size LDL particles to the large buoyant ones, along with exercise. Intermittent fasting is also helpful.

VLDL (very low density lipoprotein) is the carrier form of triglyceride. So if both VLDL and triglyceride are elevated, it's time to rethink your diet.

Chronic stress and lack of sleep, which is viewed by the body as stress, will also affect these numbers because of the cortisol connection.  

So to quote Dr. Sinatra, "Inflammation, NOT CHOLESTEROL, is at the "the heart" of heart disease. It's worth pointing out that the metabolic effects of sugar and all processed foods are highly inflammatory to your artery walls."

So relax and enjoy healthy fats!