What it is:
Cholesterol gets a bad rap, but it is a vital lipid that forms every cell membrane in our bodies. This lipid is needed to synthesize items like Vitamin D, bile salts and form the backbone to many hormones synthesized by the liver.
Lipoproteins transport items like cholesterol that are water-insoluble throughout the body. Lipoproteins consist of varying amounts of triglyceride, cholesterol, phospholipid, and protein. The variation in these components' composition determines the lipoproteins' density. This density is the ratio of protein to fat. Those with higher levels of protein are High-Density Lipoproteins (HDL), and the particles with lower levels of protein are Low-Density Lipoproteins (LDL). You may have heard them classified as good (HDL) fats and bad (LDL) fats.
The partition as good and bad is down to HDL and LDL’s primary roles, which are to carry cholesterol. However, HDL picks up excess cholesterol and clears it to be disposed of by the liver. On the other hand, LDL picks up cholesterol from the liver and deposits it all over the body, including in arteries.
LDL and saturated fats are different molecules, but people tend to get the two confused. LDL is composed of multiple particles including lipoproteins and cholesterol. Saturated fats are formed of fatty acids and exist in foods such as red meat, cheese, and butter. When we eat foods that contain high amounts of saturated fat, it can raise our LDL blood cholesterol.
Dietary cholesterol is found in foods such as eggs, seafood, and liver. However, this type of cholesterol is not the same as the cholesterol in our blood because our body has checkpoints for absorption. Our body is very clever at checking whether we have enough from our diet and only allowing a certain amount to be absorbed. The cholesterol you eat is not the same as your blood cholesterol.
Blood (or serum) cholesterol increases when foods that contain saturated fat, such as red meat, cheese, and butter, are consumed. But ~75% (Silva, 2013) of the cholesterol in our blood is made and recycled by our body, not absorbed from our food.
Plant sterols and stanols: These have a similar chemical structure to cholesterol, therefore, can inhibit dietary cholesterol absorption through replacement. Consuming high amounts of these plant foods may consequently assist in the reduction of blood cholesterol LDL levels.
Purported claims:
Saturated and Trans fats increase LDL cholesterol
Plant sterols reduce LDL cholesterol
Viscous (soluble fiber) reduce total and LDL cholesterol
What the science says:
When LDL is in excess, the immune system sends a response to help clear the build-up. However, the longer the LDL deposition occurs, the different stages of oxidation it goes through, and the greater the inflammatory response from the immune system. The inflammatory response and therefore build up of plaque snowballs over time, clogging the walls, increasing inflammation, stiffening the arteries, blood flow, and so on. We want our blood vessels to remain malleable and unclogged to efficiently pump blood and avoid health complications.
The inflammatory response differs in each person due to a combination of factors. Your susceptibility depends upon genetics, other stressors such as smoking, and many other aspects. But combining a multi-tiered approach to reduce the inflammatory response, such as anti-inflammatory foods, exercise, and sleep can help mitigate any health issues.
Some nutritional areas to improve cholesterol health include:
Increase phytosterols found in whole plant foods.
Legumes
Unrefined vegetable oils
Whole grains
Nuts and seeds
Increase healthy unsaturated fats:
Monounsaturated Fats
Olive oil, Olives
Avocado
Nuts
Polyunsaturated
Omega-3 Fatty Acids - Salmon, Flax seeds, Chia seeds
Nuts and Seeds
Increase viscous (soluble) fiber found in whole plant foods.
Legumes
Whole grains
Vegetables and fruits
Nuts and seeds
Avoid foods containing trans fat, such as fried foods or high amounts of saturated fats.
The buildup of deposits in the artery walls (atherosclerosis) can occur for a plethora of reasons. Some of the risk factors are uncontrollable, from genetics to aging, but others are lifestyle dependent, such as smoking, obesity, a high saturated fat diet, or inactivity.
It’s therefore essential to alter other areas of health, such as increasing physical activity and lowering stress.
Our take:
Whilst it is good to understand the difference in wording when it comes to health terminology, also recognizing the overall health patterns is important. For example, note that foods high in dietary cholesterol also tend to be high in saturated fats. It is crucial to strive for eating habits that consider a food's overall composition.
A balanced diet, sleep schedule, and workout routine will always benefit you and help to keep your health numbers, such as cholesterol, in check.
So remember, blood cholesterol is not the same as dietary cholesterol. But, as long as you're consuming a balanced diet of fruits, vegetables, healthy fats, and lean proteins, you don't need to focus too hard on the terminology.
Will this benefit you?
Yes, increasing your intake of “good” fats and lowering your intake of “bad” fats can improve many areas of your health. However, check with your Client Advocate as to the correct ratio of fats for your particular needs.
Still curious to try it? If you do, here’s what to keep an eye on:
Optimal Levels according to the American Diabetes Association (Krause 2017) and current research:
LDL - Below 100 mg/dL.
HDL - Above 60 mg/dL.
Total Cholesterol <200 mg/dL
References and additional reading:
Mahan, L K, and Raymond, J L. Krause's Food & the Nutrition Care Process. Elsevier Inc, 2017. Print.
American Diabetes Association: Cardiovascular disease and risk management: Standards of medical care in diabetes—2018, Diabetes Care 41(S1):S86-104, 2018.
Silva, Regis A. Biographies of Disease - Heart Disease. American Heart Association. p.212. 2013. Print.
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