We’ve all heard the same story:

Our first question around a blood test panel usually stems around our cholesterol level?

But Why? And what are the facts around cholesterols importance good or bad?

We need cholesterol to survive so much so our body, specifically the liver, makes it from the ingredients we give it. Our diet gives the liver all the necessary ingredients to make cholesterol. About 80% of our cholesterol comes from our bodies own production, whether from dietary cholesterol itself (20%) or sugars, fats and proteins (80%). Do you eat a lot of sugars and carbs?… Your body may make excess cholesterol LDL with it, you don’t need to eat cholesterol to make cholesterol; think on that for a bit.

The average person reasons that the cholesterol in scrambled eggs must surely end up in our arteries somehow, and this makes us do things like order egg-white omelets for breakfast. 

There is indeed a link between the cholesterol we eat and the cholesterol in our arteries. It’s just not the “more cholesterol we eat, the more we get” fear that’s been drummed into us for years. In fact, your body’s production and uptake of cholesterol is highly regulated; eat a multi whole egg omelet and your body simply produces less cholesterol because of the dietary onslaught. “There is a very weak connection between the LDL cholesterol we measure and dietary cholesterol, dietary cholesterol is not the same as blood cholesterol. 200 milligrams of cholesterol most people eat every day is nothing compared with the 800 milligrams or so our bodies produce.

A majority of the mass in the human brain and Central Nervous System (CNS) is made up of a substance called myelin, and myelin is made up of approximately 80% cholesterol. See Figure 1 below. The myelin sheath is a structure of layered cholesterol-rich membranes that extend from the plasma membrane of oligodendrocytes. Oligodendrocytes or (oligos) form and maintain the myelin that surrounds processes of CNS neurons. Myelin membranes wrap around and insulate neuronal axons to facilitate efficient fast communication. (1)

Figure 1: Myelin Sheath Composed of Cholesterol.

Let’s start with the 3 biggest reasons why we need cholesterol:

1) Hormonal Regulation

Cholesterol is the precursor for numerous important hormones like:

• Cortisol
• Estrogren
• Testosterone
• Progesterone

Without cholesterol, these systems don’t function properly.

2) Vitamin D Synthesis

Cholesterol is also the building block for vitamin D production.

Vitamin D is linked to cholesterol because we need cholesterol in our skins cells to make vitamin D from sunlight.

You can supplement Vitamin D and get all the sunlight you want, but without healthy amounts of cholesterol your body won’t produce as much Vitamin D as it could.

Fun Fact: When we take a Vitamin D supplement it needs the LDL cholesterol as a vehicle to transport it in our blood. On the other hand, natural body made vitamin D, can freely flow in our blood without carrier lipid particles like LDL. See Figure 2. If you supplement vitamin D your LDL levels can be skewed from the carrier lipid particles. Since you’ll likely have more LDL carriers to move the synthetic Vitamin D around.

Figure 2. LDL As A Carrier Lipid Particle.

3) Neurological Functioning

Cholesterol is very important in the brain.

The brain contains the highest level of cholesterol in the body; it contains approximately 20 – 25% of the whole body’s cholesterol. To put that in perspective, the brain has a cholesterol content of 15–30 mg/g tissue, whereas the average for other tissues in our body is 2–3 mg/g tissue.

It supports the formation of new nerve cells, and is essential for regulating the nervous system. (2)

It also maintains optimal healthy synapses between brain cells responsible for:

• Memory
• Learning
• Mood Regulation
• Overall cognition

Figure 3. Cholesterol In Our Brain.

Now you know why cholesterol is essential for survival.

But I’m sure you still have questions, like:

“Is there a difference between good and bad cholesterol?”

“What’s really causing heart attacks and stroke?”

“How can I lower my risk of heart or brain disease?”

Let’s dive into each:

1 ) “Is there a difference between good and bad cholesterol?”

We’ve been taught HDL is “good” and LDL is “bad.” 

It’s just not that simple.

Both play key roles in cholesterol regulation. HDL primarily carries cholesterol from tissues back to the liver for removal, while LDL transports cholesterol from the liver to tissues throughout the body.

So what are we missing?

The mainstream narrative is that excess LDL (bad cholesterol) can lead to the buildup of plaque in arteries.

It’s easy to then build a very lucrative pharmaceutical  industry on the fear of cholesterol. Cue in the statins introduced in 1987. These are drugs that can lower cholesterol. They work by blocking a substance that our body needs to make cholesterol (but don’t we need to make cholesterol for optimal brain health?).

Statins decrease cholesterol by blocking the HMG CoA reductase enzyme that your liver uses to make cholesterol. (3) 

In the adult mammalian brain, cholesterol is derived mainly from de novo synthesis in astrocytes. 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase constitutes the enzyme responsible for the rate-limiting step of cholesterol biosynthesis. (4)

A known side effect is mental fuzziness. I’ll leave it there for you to make your own opinion.

Ahh but this is leaving out one very important factor in the buildup…Oxidation.

LDL and HDL are simply vehicles.

They move cholesterol back and forth.  When they become oxidized they are slowly damaged or destroyed.

Now we have a “traffic jam”.  And to make matters worse, these vehicles are on fire and toxic, causing inflammation.

Our body responds by forming plaque.

2 ) So what’s really causing this oxidation, plaque formation, heart attacks, and strokes?

It’s not enough to say cholesterol is the cause. It is our modern diets and types of cholesterol circulating in our blood.

Heart disease continues to impact more people year after year. You could also add in brain diseases like Alzheimer’s, Dementia and Parkinson’s.

You know what’s conveniently left out of most mainstream research and dialog?  Sugar and Seed Oil intake. Plus take a good look at our FDA; especially the Corporate Food Pyramid and their suggestions. 

Both Sugar and Seed Oil drive up blood sugar and increase oxidation.

Excess sugar in the blood is then stored as fat in the form of triglycerides.  

One of the best indicators of heart health is the Triglyercide to HDL ratio.

If you generally have less oxidative sugar stored as fat (triglycerides) and more carriers back to the liver (HDL); it’s a recipe for longevity.

The Sugar Research Foundation (SRF), now known as the Sugar Association, was involved in a scandal in the 1960’s where the sugar industry paid for research to downplay the health risks of sugar and shift blame to fat.

Don’t blame fat for what sugar does. From my research and understanding, I see excess sugar in the blood from the modern day diet, as a major contributor to high LDL levels. Excess sugar is transported to our liver which turns it into LDL and triglycerides. Note we now have excess LDL. Over a prolonged period these LDL vehicles atrophy and create inflammation which can be observed as (plaque) in the blood stream. 

Figure 4. John Yudkin proposed that sugar was the predominant dietary factor that underlies the majority of cardiovascular mortalities.

As you have increased amounts of sugar in the blood the body stores it as triglycerides which are a type of fat that circulates in the blood and are stored in fatty tissue to be used by the body for energy. They are the most common type of fat in the body. 

The Sugar aids in causing LDL molecules to become dysfunctional. All of which can lead to rapid artery clogging and an increased risk of thrombosis (a formation of a blood clot inside a blood vessel).

Simple sugars, like fructose, can raise triglycerides and LDL. Fructose is a sugar often found in fruit. 

You cannot make HDL with sugar. Only from fats and protein! In fact, eating too much sugar can actually lower HDL cholesterol levels:

Sugar can also inhibit the enzyme Lipoprotein lipase, that helps remove triglycerides from the body. 

In 1968 the perfect cholesterol level was 222, and even a level of 350 was considered OK! Now there is a lot of nuance here, one certainly is, that sugar was not nearly as present then as it is today. Cholesterol was mainly made from fats and proteins (HDL).

The types of cholesterol circulating in our blood make all the difference.

LDL comes in four forms: a large form known as Very Low-Density Lipoproteins (VLDL). A slightly more dense form know as Intermediate-Density Lipoproteins (IDL; VLDL Remnants). The familiar Low-Density Lipoproteins (LDL), and lastly Lipoprotein (a) (Lp (a)) known as a small LDL particle. The image Figure 5 below highlights the size visually. 

Figure 5. Classes of Lipoproteins.

A diet high in saturated fat mainly boosts the numbers of large-LDL particles, while a low-fat diet high in carbohydrates propagates the smaller forms of LDL particles.

The big thing to note is: small dense LDL particles are more susceptible to oxidation, which could result in an enhanced uptake by macrophages. Meaning these LDL particles atrophy and macrophages (which are a type of white blood cell that surrounds and kills microorganisms, remove dead cells, and stimulate the action of other immune system cells) are dispatched to clean up the waste. 

These LDL particles are all considered pro-atherogenic, which refers to changes that mimic the early stages of atherosclerotic plaque development. Atherogenesis is a chronic vascular inflammatory disease that occurs when lipids build up in the arterial wall. In a more simple explanation the LDL particles, more specifically the small LDL particles, are the major culprit in creating plaque in our arteries. (5)

3 ) So now you’re thinking.  How can I lower my risk of heart disease?

Eat healthy fats like:

• Fish (wild caught)
• Nuts (Walnuts, pistachios and Macadamia are my top three)
• Eggs-whole (pasture raised)
• Olive oil (organic)
• Avocados
• Quality Meats (pasture raised, from a rancher)

Also incorporating fiber into your diet from fruits (mainly the ones that end in berries) and cruciferous veggies. Try to eat fruit that’s ripe according to your geographic growing season; for example you probably can’t harvest an orange if there’s snow on the ground where you live. Berries have the lowest amount of sugar and are packed with phytonutrients and antioxidants.

Avoid foods that include:

• Sugary sweets and beverages
• Highly processed foods
• Vegetable/Seed oils
• Fried foods

The modern day diet plus a sedentary lifestyle is a recipe for disease.

So what’s the conclusion?

Cholesterol is not inherently bad. 

It’s a necessary building block for many functions of the human body.

Not all LDL is equal: the large LDL particle is usually the majority of the LDL showing up on a standard blood profile and seems mostly benign. The small LDL particles, made mostly from carbohydrates, is the major plaque culprit. 

The main take away is to limit processed foods that damage and break down our good cholesterol HDL and create bad cholesterol (small LDL). If you need medication, work to get off it as soon as possible to restore natural regulation of hormones to your body. (Make sure you work closely with a Dr. and never do anything new without checking first.) 

This topic is extremely laborious to understand; it’s taken me years to piece it together and I’m still learning. Just know that there’s much much more to just saying cholesterol is bad. Stay curious.

All the Best,

Resources 

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383754/

(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837572/#:~:text=The%20brain%20has%20cholesterol%20content,layer%20increasing%20nerve%20conduction%20velocity.

(3) https://my.clevelandclinic.org/health/treatments/antihyperlipidemic

(4) https://academic.oup.com/brain/article-abstract/147/5/1622/7596106?redirectedFrom=fulltext#

(5) https://www.ncbi.nlm.nih.gov/books/NBK305896/

(6) https://www.nbcnews.com/health/health-news/bad-cholesterol-it-s-not-what-you-think-flna1c9442109#

The entire contents of this blog are based upon the opinions of Corey Diggins, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this blog is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Corey Diggins. Corey Diggins encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.