Rethinking Cholesterol- Why we shouldn’t demonize cholesterol and why we should get a proper understanding of its formation and function
Objectives from this article:
- Realise that cholesterol is actually good for the body
- Stop blaming eggs for cholesterol problems and understand that protein, fats and carbohydrates can all lead to raising cholesterol
- How statins work to decrease cholesterol
- What to do if you want to decrease your cholesterol
The Background
Currently cholesterol is beaten up and treated like the bad the guy, when in fact cholesterol is very important for the body. It is a precursor for:
o Progesterone- helps regulate blood pressure, mood and sleep and more
o Aldosterone- helps to regulate blood pressure regulate sodium and potassium levels in the blood and more
o Cortisol- helps to regulate blood sugar, immune system, reduces pain (anti-inflammatory) and more
o Estrogen- helps with the cardiovascular system, helps with mood, cognition, sleep and more
o Testosterone- helps with muscle mass, increasing strength and endurance, improves hair and collagen growth and more
Each one of these hormones that is deficient leads to problems although the opposite can also happen when individuals have too much of one hormone. Such examples include when individuals have high estrogen, it can lead to many problems such as bloating, headaches, mood swings and more. If an individual attempt to lower cholesterol without looking at the whole picture and understanding their own symptoms this can lead to other health problems as the underlying problem that is causing the apparent issue is most likely not being addressed
So how does cholesterol form?
- Cholesterol is formed from 2x Acetyl CoA (molecules) joining together through the a reaction called the "Mevalonate pathway". After the Mevalonate reaction, more reactions occur to produce isopentenyl pyrophosphate than to farnesyl pyrophosphate... this continues on for a while eventually to form cholesterol. In short. 2 molecules react and join together to form a bigger molecule. Acetyl Coa -> Cholesterol.
So where does Acetyl Coa come from?
- Acetyl CoA can come from fat, protein or carbohydrates. They are just broken down versions of the macronutrient. Just as we have complex and simple carbohydrates and protein and amino acids, Acetyl CoA is those macronutrients broken down even more. As you see in the picture we can see how protein turns to amino acids and then can turn into pyruvate through a process called deamination and it can turn into Acetyl Coa through a process called deamination. Carbohydrates such as glucose turn into pyruvate through a process called glycolysis and then turns to Acetyl CoA through a process called pyruvate dehydrogenase. These processes aren’t important to know right now, just understanding almost any food can be broken down and then turned to cholesterol is the important information to take away
If you want to learn about how statins work and more about cholesterol continue reading though if you just wanted to get an introduction to cholesterol I would probably stop here.
How do statins stop cholesterol?
- Cholesterol stops the initial step in the mevalonate pathway and prevents the initial 2 acetyl CoA joining together. This is problematic as the body requires cholesterol for the above functions that we talked about regarding the hormones and how they affect the body- aldosterone, testosterone, cortisol, estrogen etc. 3
How effective are statins at preventing heart problems?
- Research from Arch Intern Med states that there is a reduction of 20-30% at preventing heart problems with statins, however they have used strange calculations which make the the results sound good to get to their conclusions. When I mean strange they use results and calculations that does not tell me whether or not this will help me if I take it. I actually need another calculation to work that out. This is called the NNT or numbers needed to treat. This calculation will calculate out how effective the medication is. The NNT calculates how many people need to take the medication to have 1 prevention. The article clearly states that it requires 67 people taking the medication to prevent one individual from getting a heart problem and if you do the math, that concludes that the medication has a 1.49% chance it will help not a 20-30% reduction.
“Clinical outcomes in statin treatment trails” by Ross et al 1999.
Arch Intern Med. 1999;159(15):1793-1802. doi:10.1001/archinte.159.15.1793
What should one do when they have high cholesterol?
1- Work with a health professional
2- Identify behaviours that are problematic and lead to high cholesterol.
a. Working with me I first analyse the individual with current symptoms, behaviour, nutritional and exercise patterns alongside a comprehensive blood analysis.
b. I next would check their ratio of phytic acid consumption to carnitine consumption. (It gets technical here but I found in my practice that The idea optimizing beta oxidation (which is the ability to utilise fat for energy) and decrease foods that contain anti-nutrients which leech nutrients from the body such as magnesium, calcium, iron, zinc and b12 (there is a reason why foods such as oats, bread and cereals have added minerals) produce great results that include resolving symptoms, improves energy and helps with cholesterol/triglyceride issues.
c. From their we have weekly check-ins to ensure the individual is improving and help educate the individual on the habits and behaviour that will help the individual and those that will be problematic to the individual
If you need help, click the link to get started with your free health and nutrition assessment for the month of March and we will look to give you a baseline and understanding of and where you are and where to start working on.
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