If there’s ever a much-maligned and misunderstood substance, it’s cholesterol. Painted as a villain as it wreaks havoc clogging up your arteries, you may believe it’s only possible to be healthy if your cholesterol is low.
To coincide with National Cholesterol Awareness Month, let’s become a little more familiar with cholesterol
Cholesterol is a fatty, wax-like substance travelling around your body in your bloodstream.
You might be surprised to learn you produce cholesterol for yourself – one of your liver’s many jobs is to make more than three-quarters of your body’s cholesterol. You may wonder why, if cholesterol is so damaging, your body bothers to make it at all.
In fact, cholesterol is very necessary, because it’s a component of the membranes surrounding your cells, the outer covering keeping their contents inside. It’s found in the fatty substance surrounding nerves, so they can communicate with one another. As if this wasn’t enough, cholesterol is needed to make hormones like testosterone, oestrogen and your stress hormones, as well as Vitamin D, and so you can produce bile, needed to digest fats. With all these roles, it’s no exaggeration to say you couldn’t live without cholesterol.
In some people, cholesterol is prone to collect on the inside of blood vessels, effectively narrowing their diameter, increasing blood pressure and putting extra strain on the heart. These collections of cholesterol, also containing calcium and waste products from cells, are called atherosclerotic plaques.
This has led to the idea that cholesterol levels should be reduced at all costs, and the development of statin drugs to discourage your body from making cholesterol. You may also be told to avoid cholesterol-containing foods such as eggs, cheese and shellfish. However, your body in its wisdom produces less cholesterol if you eat foods containing cholesterol.
Not only this, but research has discovered overall cholesterol levels aren’t connected with death from cardiovascular disease after all. In fact, the higher the cholesterol, the less likely people were to die from cardiovascular disease, with low cholesterol being linked with increased risk of death. To understand these findings we need to look a little closer at cholesterol and its different forms.
Cholesterol can’t travel around in your bloodstream on its own, because it’s not water-soluble, so it’s packaged alongside another fat called a triglyceride. Together they form a lipoprotein. Cholesterol tests record your lipoprotein levels so they’re a measure of this package of cholesterol and triglycerides together.
Otherwise known as LDL or ‘bad’ cholesterol, this carries cholesterol from your liver to the rest of your body, including to your artery walls. Low levels of LDL cholesterol have been linked to a reduced risk of heart disease.
HDL is known as ‘good’ cholesterol, and it carries cholesterol to your liver where it’s broken down and removed from circulation. High HDL appears to cut your risk of heart disease.
Despite the distinctions above, recent research suggests cardiovascular disease risk isn’t a simple case of good vs bad. When scientists looked at data from almost 70,000 elderly people, those with high LDL lived longer than those with low LDL – exactly the opposite of what would be expected
Lipoproteins are not created equal, and what seems to be important is their size and density. Lipoprotein can be made up of very small, dense particles or larger, more fluffy ones. The smaller particles have a greater likelihood of collecting in atherosclerotic plaques because they can enter tiny spaces very easily.
Even more closely related to heart disease risk is oxidated lipoprotein. Oxidation occurs when cells and tissues are damaged by free radicals, unstable molecules released in your body during the process of energy production. Free radicals are also formed because of toxins, pollutants and stress.
Oxidised lipoproteins can stick more easily to the inside of your arteries. This causes inflammation, putting your immune system on red alert. Inflammation can also increase the likelihood of atherosclerotic plaques rupturing, and cause blood to clot more easily.
Oxidative damage can make the inside of your arteries less smooth than they should be, providing an ideal opportunity for cholesterol deposits to latch on and form atherosclerotic plaques.
So although cholesterol alone doesn’t cause atherosclerotic plaques, it can be a marker for cardiovascular disease risk because other factors like oxidation, inflammation and immune system dysfunction form the building blocks for plaques to form.
Functional medicine is obsessed with finding the causes of your health issues. Testing can reveal your LDL particle size alongside other markers for cardiovascular disease risk.
Nutritional and lifestyle factors have a significant influence on oxidative stress, inflammation and the particle size of your LDL.
If you would like to start your journey to optimal cardiovascular health with functional medicine, contact me today.
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