05: The Truth About Cholesterol
Today on the podcast I’m tackling the boogeyman of nutrition: CHOLESTEROL. Want to know whether whole eggs are bad for you? And what high cholesterol REALLY means? Tune in to hear a guest interview with Carly Stagg, my Operations Manager, certified Nutritional Therapist, and (almost!!) Registered Nurse as we chat all things cholesterol.
EPISODE 05: The Truth About Cholesterol
SHOW NOTES
(0:00) Intro
Welcome back to the Club!
Cholesterol is the big boogeyman but it is so misunderstood and I get a lot of questions around the topic, so I invited on… my operations manager Carly. She’s a Nutritional Therapist, (almost) Registered Nurse, and future nurse practitioner.
Carly and I are not doctors, but we’re nutritionists and this our jam. And there are a lot of foods - Real Foods - that people are scared to eat like eggs and red meat because they are told it will be bad for their cholesterol. Christians we have to use our Godly compass
I think a lot of people are under the impression that it would be ideal to get cholesterol as low as possible but that would be a big mistake. Big mistake, huge!
Q. Let’s start with why we NEED cholesterol.
Cholesterol is not this evil thing- it is vital. It composes the cell membranes of EVERY CELL IN OUR BODY.
HORMONES: Cholesterol is actually a building block that we need to make hormones- this is one reason why people who go vegan or eat really low-fat can lose their period, lose their libido, hair falls out, etc.
PREGNANCY: Cholesterol levels that are too low in pregnant women are associated with preterm delivery and birth defects such as microcephaly.
BRAIN HEALTH: Low cholesterol levels are also associated with ischemic strokes, depression and suicide attempts, and violent and impulsive behavior, among other negative effects.
LONGEVITY & MANAGEMENT OF INFLAMMATION: High levels of cholesterol actually correlate with longevity as it mitigates with inflammation. Eating plenty of naturally-occurring cholesterol gives your body the preformed building blocks it needs to fight off inflammation easily. Eating a low-fat diet does little to reduce the cholesterol level, and will actually deprive an inflamed body of the nutrients it needs. Because fat-soluble vitamins like A,D,E,K need fats (which contain cholesterol-like butter!) to be absorbed well.
Q. You mentioned why cholesterol is important in pregnancy. Might I add that breastmilk, the most natural, Real Food God Made on the planet is high in cholesterol and critical to a baby’s developing brain.
Ok so when we get a cholesterol test, the general reading we’re looking at is HDL, LDL and Triglycerides. Let’s start with HDL and LDL because you’ve probably heard that HDL is the “good cholesterol” and LDL is the “bad” cholesterol. But this is misleading. Break this down a little for us Carly and tell us the difference between the two.
A: Carly: HDL cholesterol is considered the “good” cholesterol because it helps the body get rid of excess cholesterol that’s in the bloodstream- takes it to the liver to be processed and removed. You want this number to be high- that’s a good thing :)
The number of your LDL cholesterol is a measure of how LDL cholesterol is considered the “bad” cholesterol- but it gets a bad rap. LDL cholesterol actually defends our body against inflammation caused by physical and psychological stress like work or family stress, infection, high blood sugar, and more.
In-depth info on cholesterol numbers from Dave Feldman: https://cholesterolcode.com/report/
Q: Chelsea - OK the LDL particles carry cholesterol to fight the inflammation in the same way a fireman carries and sprays water to put out the fire, right? So hating on LDLs is kind of like hating on the fireman who comes to put out your fire. It’s not the fireman’s fault right? It’s the fire that’s the problem! Same with our bodies. It’s the source of inflammation that’s the problem. So let’s expand a little more on what causes the inflammation in the body. What’s the source of our fire that’s causing cholesterol to show up?
Carly: Totally agree! If we look at the numbers, 50% of heart attacks leading to sudden death happen in patients with NORMAL cholesterol.
Why does plaque form in the arteries? Because of inflammation.
Too much cholesterol production inflames the whole system, which leads to deposition of LDL in the artery. There’s a vicious cycle of inflammation that is self-perpetuating. High blood sugar leads to an increase in oxidation of the plaque, which makes the plaque more and more unstable.
As the plaque further destabilizes, it begins to look more and more like a foreign attack on the immune system. An autoimmune-like process occurs, which causes the body to attack the plaque. This attack specifically can lead to it rupturing and causing a cardiovascular event like a heart attack or stroke.
Causes of this inner fire which triggers the whole process: processed food, sugar, chronic infections, inflammation, ongoing exposure to environmental toxins like mold, pesticides, glyphosate, etc.
Q. But it’s not the cholesterol we eat that causes higher cholesterol?
A: Carly. Nope! About 80% of cholesterol in your body is actually manufactured by your body (in the liver, intestines, adrenal glands, and reproductive organs) and the body ramps up its production of cholesterol in response to inflammation. Cholesterol production is specifically stimulated by high levels of leptin and insulin. So reducing simple carbs and sugar to reduce insulin, and incorporating intermittent fasting to regulate leptin, are two of the most important things you can do to reduce cholesterol.
If you are looking at your lab tests, it is most important to pay attention to your levels of leptin, insulin, triglycerides, and inflammation markers such as C-reactive protein and homocysteine (which all show the root cause of the high cholesterol) rather than your total cholesterol, HDL and LDL levels.
Q: Ok and just for people who don’t know - because we’re getting kind of nerdy in our terms - Insulin is the hormone that the body releases to store your food energy - especially carbohydrates. So the more carbs you eat the more insulin shows up and the more insulin show up the more cholesterol shows up. So that’s why Carly is saying reducing sugar and processed carbs is helpful. And leptin is the hormone that regulates appetite and fat storage. I like to call it the “put-down-your-fork-sister hormone, the one that tells us to stop eating. Unfortunately, that hormone can become dysregulated in the body and this would lead to an increase in cholesterol as well.
Well what about genetics? A lot of people, and I mean like every person I’ve ever worked with who has high cholesterol, tells me they have the family gene for it. Even my husband, who had “high cholesterol” in his 30’s - and who was put on a statin - IN HIS 30’s! - was told he obviously had the family gene for it and even if he ate cardboard he would have high cholesterol and so he had to take a statin. But I know good and well he was not tested for that. So can you speak a bit to this? Isn’t there a test to detect true genetically inherited cholesterol issues? And by the way, my husband is no longer on a statin.
A: Carly speaks to Familial hypercholesterolemia
Ok so this experience with your husband is actually WAY more common than you might think. Oftentimes healthcare providers will point to the cause of high cholesterol as genetics without actually testing for it. I believe this is because it improves compliance with statins and removes the need for dietary/lifestyle changes. Providers don’t have time to go through this with their pts so they just give up on it altogether. Not to mention the outdated dietary guidelines which will do little to actually help with the cholesterol levels.
The actual prevalence of FH in the population is between 1/200 and 1/500 people. So not nearly as common as people think.
Testing for FH... severe LDLc elevations in the absence of secondary causes of hypercholesterolemia with triglyceride levels that are within the reference range or mildly elevated and HDL cholesterol (HDLc) levels that are within the reference range or slightly low. A probable diagnosis of heterozygous FH can be made if the LDLc level is greater than 330 mg/dL or if tendon xanthomas are present in a patient with an LDLc level above the 95th percentile. Definitive diagnosis can be made only with gene or receptor analysis.
Q. What about people who do genetic testing and find out that they are carriers of the APOE4 gene which predisposes them to high cholesterol and alzheimer’s disease?
A: APOE4 is the most important genetic risk factor for Alzheimer’s Disease. Here’s the deal on the stats. On a SAD diet, if you have 0 copies- 9% chance, Single copy of apoe4- 30% chance, 2 copies- 50-90% chance. BUT (that’s a big BUT)- you have the power to change this. Those stats are based on observational studies in SAD dieters. Dr. Dale Bredesen who’s a leading Alzheimer’s researcher argues that Alzheimer’s is largely a metabolic problem- contributed to by inflammation, toxic exposures, and metabolic changes.
Listen to this podcast (linked in show notes) from Dr. Dale Bredesen about Alzheimer’s. https://chriskresser.com/prevention-and-treatment-of-alzheimers-from-a-functional-perspective-with-dr-dale-bredesen/
If I had this gene mutation, I would focus on anti-inflammatory foods, turmeric, omega 3s, nuts and seeds and getting plenty of sleep, doing stress management techniques.
Q. Well what about triglycerides? Tell us how those fit into the picture?
A: Triglycerides are actually my main focus much of the time. If triglycerides are high, the two main causes are sugar and inflammation. Cut out processed carbs and sugar, reduce stress, omega-3s. Those are the basics for getting triglycerides under control.
Q: Let’s circle back to LDLs because even if you have a high LDL number it may not mean it’s problematic. You have to take particle size into account. LDL could be made up of Type A or Type B particles. Type A are what I call the light and fluffy particles and those aren’t a big deal. But Type B particles are what I call the BBs - like hard and dense little particles that can lodge into your arterial wall and those are the problematic ones. But most standard cholesterol panels do not test for particle size so you have to ask for that.
Carly what are other lab tests we can look at to get a more comprehensive view of our inflammatory factor and risk of heart disease?
Carly- Yes, Cholesterol testing is more a relative risk equation than a cut-and-dry concrete “risky or not risky” answer. Absolutely getting a comprehensive lipid panel is super important- particle size testing is extremely informative.
If you are looking at your lab tests, it is most important to pay attention to your levels of leptin, insulin, triglycerides, and inflammation markers such as
C-reactive protein (<1mg/L)
homocysteine
TG: HDL ratio (for risk of heart disease) - .5-1.9 (optimal) rather than your total cholesterol, HDL and LDL levels.
Q. The last cholesterol test I had - it’s actually been several years now and I probably need another one - was around 245 I think. And that probably sounds shocking to many of you because industry standard is 200 or below. But for me personally, it doesn’t worry me a bit. My other markers are good, I’m in good overall health and there’s no way- in -you -know -what I would take a statin to artificially lower my cholesterol number so that I can meet some acceptable number that was influenced by pharmaceutical companies who want to sell more statins. Lemme tell you how I really feel! The standard number used to be 250 - the threshold keeps getting lower and lower and I’m more worried about people not having enough cholesterol to support their brain health and all of the body systems we talked about at the beginning of this conversation. I mean, taking a statin significantly increases your risk of alzheimer’s disease.
Carly, you want to weigh in on statins?
A: Absolutely! With statins, the key is a solid risk/benefit analysis. For people with severe FH or severely high cholesterol due to lifestyle, statins may be necessary (at least in the short term) just because of the high high risk of cardiac events associated. While you’re figuring out less risky therapies or implementing lifestyle change to put out the fire they can be indicated. You’ve gotta talk with your doctor/NP about it to see what’s right for you- I recommend IFM trained practitioners- you can find one in your area by using their website locator. (link in show notes)
The way statins work is by inhibiting your body’s production of cholesterol (which mostly occurs as you sleep). However, this comes with a caveat. It also reduces your body’s supply of a vital enzyme called Coenzyme Q10 (CoQ10 for short) which is important for muscle function. Guess what? Your heart is a muscle too!
With that said, long-term use of statins without simultaneous use of CoQ10 can damage muscles, leading to heart failure and serious side effects like rhabdomyolysis. Some researchers even have linked statins with dementia because of the inhibition of this enzyme (although there are also studies suggesting it decreases dementia risks . Statin side effects also include liver impairment (no bueno, when our livers are overburdened as it is!).
Statins deplete other nutrients as well such as Vitamin D, calcium, tocopherols and tocotrienols, vitamin K2, vitamin A, heme A, selenium, carnitine, copper, zinc, and carnitine. They can also lower levels of hormones such as testosterone and progesterone.
So let me give it to you straight about these statins: If you think about it, these inflammatory negative effects occur because these high LDL levels are desperately trying to repair inflammation. If the LDL goes away, the damage continues unchecked. The goal is to fix the root of inflammation instead of bandaiding the “symptom” of high LDL.
If you need to take statins, watch for signs and symptoms of nutrient deficiencies (like fatigue, weight gain, muscle pain) and make sure you are also taking a CoQ10 supplement. CoQ10 is a vital antioxidant and statin therapy depletes it by over 40%.
Q: So as we wrap up here What are a few things we can do to optimize our cholesterol levels?
A: Now you’ve learned that the root cause of so many cardiovascular health concerns is actually INFLAMMATION. This is both good and bad news. The good news is, these risks are not solely based on your genetics, so you can do something to reduce them! The bad news is, any number of things can cause inflammation.
Here are a few things to look into that may be causing inflammation in your body: food sensitivities, low hormone levels, chronic infections like sinusitis or gingivitis, macro balance (maybe eating too many carbs OR too few), gut inflammation (like candida overgrowth), and chronic stress!
Taking a Vitamin K2 & D3 supplement keeps the arteries flexible and healthy and prevents the hardening and stiffening which is associated with atherosclerosis.
Eat wild-caught fish or take an omega 3 supplement to balance out your inflammatory process. Click here to shop for my favorite Cod Liver Oil softgels. Click here to shop the liquid (if your kids are young enough that you could get away with that 😉).
Eat real food- I promise, this takes care of about 80% of all problems. Limit simple carbohydrates (including fruit) and sugar. Eat vegetables. Don’t stress about the types of fats you’re eating (Just avoid trans fats like margarine and shortening.)
Intermittent fasting to reset insulin and leptin levels
Exercise! Yep, it’s simple. But it helps reduce stress, blood pressure, and gives your heart a little workout to make it more efficient.
SLEEP! If sleep were a pharmaceutical drug, it would be a #1 best seller. Sleeping is literally the best thing you can do for your body. And it makes the other lifestyle changes easier. It’s FREE although the opportunity cost is there!
Chelsea: Yep, it pretty much comes back to the basics. Eat Real Food the way God made it, get lots of rest, move your body, get sunshine, laugh with your friends, and get in the Word to overcome the stress and worry in your life. Period the end, mic drop. But listen, I do want to remind you about asking for the particle test to distinguish whether or not you have the harmful LDL’s. It’s not a part of the standard test but is really helpful information.
Alright. Thank you so much Carly for joining me to break this down for the peeps. Friends, I know we threw out a lot nerdy terms today and so if it would be helpful for you to go back and read what we talked about you can do that in the podcast shownotes found at thecn.com in the podcast section. And hey, if you would leave a review on itunes or share this podcast with a friend or family member I would so appreciate it. I’m always praying the Prayer of Jabez found in 1 Chronicles that asks God to increase my territory of the people I can reach to spread the message of Real Food the way God made it. Thanks for helping me do this yall. Have a healthy and blessed week
(63:15) Outro & Disclaimer
Thanks for listening! Have a healthy and blessed week!