The cholesterol dogma
We have seen how fats are essential for life and how they are important to lower cholesterol. In this sense, it is the omega 3’s and omega 6’s essential fatty acids (EFA’s) that can lower cholesterol. Tropical oils and oils like EPA and DHA fish oils can also lower cholesterol. Others like oleic acid may not lower cholesterol, but do not raise it either.
Cholesterol is such a misunderstood topic that it would be worth going into detail about what it is, how it is used in the body and why it is important, as well as when it can become a problem. This is the topic of this blog.
According to the author of the book ‘Fats that heal, fats that kill’ Udo Erasmus, the ‘cholesterol scare’ is “Big business for doctors, laboratories, and drug companies. It is also a powerful marketing gimmick for vegetable oil and margarine manufacturers who can advertise their products as cholesterol free.’ According to him, “999 out of every 1000, depending on the expert source you read, can control their cholesterol levels and more importantly their cardiovascular health by nutritional means alone.”
So what is cholesterol?
Cholesterol is a hard waxy lipid that melts at 300 F. It is unique in the body because, as opposed to other substances, once it is made, it cannot be broken down and must be removed through stool (in the form of bile acids and cholesterol molecules). Fiber helps with this removal because it helps the movement of cholesterol through our intestines. However, if fiber is missing , cholesterol and bile acids are reabsorbed and this increases our blood cholesterol levels.
Our cells make their own cholesterol according to their need. The extra cholesterol is ‘hooked up’ to an essential fatty acid and shipped via our blood stream to our liver to be changed into bile acids, (as long as vitamin C and certain minerals necessary for this change are present). Our liver then ‘dumps’ bile acids into our intestine to help with fat digestion and removes the bile acids from our body with solid wastes with the help of fiber. This prevents cholesterol and bile acids in our intestines from being reabsorbed and recycled.
Cholesterol does not need to be obtained from foods because our body can make it from simpler substances: from the breakdown of sugars, fats and proteins, specially when we eat them in excess. The more calories we consume, specially from sugars, saturated and other non-essential fatty acids, the more pressure there is in our body to make cholesterol. In addition, the more stress we are under, the more cholesterol our body makes, because cholesterol is the precursor of stress hormones.
Main functions of Cholesterol
Cholesterol is essential for health. The many functions cholesterol plays in the body are proof of this. These vital functions are:
- Cholesterol is found in our cells’ membranes. Each cell membrane is equipped with the means to synthesize its own cholesterol. In the cell membrane, cholesterol has the important job of fine tuning the membrane fluidity, which constantly fluctuates under conditions of fat intake or fat deficiency. The more essential fatty acids (EFA’s) we ingest (which are fluid) the more cholesterol (which is rigid) will be built into membranes. This is one reason why EFA’s lower cholesterol levels. A diet rich in saturated fatty acids (SaFas), which are hard, means more cholesterol will be removed from membranes and moved back into the blood, this is why saturated fatty acids raise cholesterol levels. Our intake of fatty acids then is essential in this regard.
- From cholesterol our body makes steroid hormones (also known as sex hormones): estrogen, progesterone and testosterone.
- Similarly, our body makes adrenal corticosteroid hormones from cholesterol: aldosterone (which regulates blood pressure) and cortisone, which promotes the synthesis of glucose to prepare our body for the fight or flight stress responses we deal with everyday. Cortisone also suppresses inflammation.
- From cholesterol our body makes vitamin D, that regulates calcium and phosphorus metabolism.
- Cholesterol is used to make bile acids, which are vital for digestion of fats and fat soluble vitamins from foods.
- Cholesterol is secreted by glands in our skin to protect our skin against dehydration, wind, sun and water. Cholesterol helps heal the skin and prevents infections by foreign organisms.
- Our liver, intestine, adrenal glands and sex glands all make cholesterol for the other functions in which cholesterol is involved.
- During pregnancy, the placenta also makes cholesterol from which it manufactures progesterone, which keeps pregnancy from being terminated.
Cholesterol in transport
For transport in our blood, cholesterol must be hooked to a fatty acid, preferably an essential fatty acid (EFA) and vitamin B 6. The 1/2 oz of cholesterol in our blood stream is found, together with triglycerides, phospholipids, carotene, vitamin E and proteins in carrier vehicles called plasma lipoproteins. There are two main groups of lipoproteins:
- Made up of two subfractions, the most important of which is LDL (‘bad’ cholesterol), it carries cholesterol and fats (triglycerides) from foods and our liver to our cells.
- The other fraction, called HDL (‘good’ cholesterol), carries cholesterol from cells back to our liver where it is changed back to bile. Both cholesterol and bile acids are excreted into our intestine, and eventually discarded with our stool.
Total blood cholesterol is all cholesterol in transit, being carried by the different lipoprotein vehicles to and from our cells.
Digestion of fats, oils and cholesterol.
Our body’s processing of fats and oils starts with digestion.
The liver is the organ that digests the fats and oils we eat. Poor digestion of fats/oils will show as a feeling of being tired and nauseous, which are signs of liver dysfunction. Digestion of fats is so essential for health that any problem with it will start the disease process.
In our mouth there is not much digestion of fats, except for mixing. In our stomach there is an enzyme that can split fats into their components, but this enzyme is inactive under normal stomach acid conditions. Our small intestine can digest a maximum of 10 grams every hour. The digestion process takes part in different stages. All of them have to be working in pristine condition for fat digestion to take place effectively. Digestive problems are a hidden epidemic and they should be addressed first before other health conditions can be resolved. The different stages that take place in digestion are as follows:
- Bile. The churning action of our intestines mixes fats with bile that our liver produced from cholesterol and stored in our gallbladder. Bile contains lecithin, which emulsifies fats, breaking it into tiny droplets. This increases the surface area of fat exposed to fat digesting enzymes and speeds up digestion of fats.
- Enzymes. Fat digesting enzymes are made by our pancreas and released into food mixture in the first part of our small intestine (duodenum). Digestion and absorption of fats continues to take place as food passes through our small intestine. Different enzymes in the alkaline pancreatic juice digest triglycerides, phospholipids and cholesterol present in food fats. These enzymes split fatty acids and the different components are absorbed separately into the cells lining our intestinal tract (mucosal cells) where they are put back together. By taking them apart first, our body makes sure that the complex chemical substances (proteins) that make up the tissue of the food we eat don’t get in our blood. If this happened an immune reaction would occur, where white blood cells, the soldiers of our immune system, would mobilize to the area to declare war and destroy these intruders. This is known as ‘food allergy‘ which is very stressful and costly to our body.
- Transport. Our mucosal cells build transport vehicles for fats out of proteins and phospholipids. These loaded bags are then dumped into our lymph vessels which ship them to a large vessel close to our heart where they merge with the bloodstream. The heart then pumps them to the rest of the body. These loaded bags never reach our cells, instead the body uses high-density lipoproteins (HDL) to take these fats to our liver, which makes another transport vehicle called very low-density lipoproteins (VLDL) which are transformed into LDL (low density lipoprotein). Our blood carries both VLDL and LDL, which in turn, transport the fats and cholesterol to our cells. What is more, each of our 100 trillion cells have on their membranes several ‘docks’ for receiving and unloading VLDL and LDL. When their requirement is filled, these docks shut down, and the extra fat and cholesterol continue to circulate in our blood (high blood triglyceride and cholesterol levels) until they are metabolized by our liver or stored as fat. Standard medical dogma considers HDL ‘good’ and LDL ‘bad’ but actually both are good for cardiovascular health.
This complex lipoprotein system ensures fats are digested, absorbed and transported to all cells to supply cells with the fats they need. It also ensures excess fats don’t build up in our blood. This system also moves excess cholesterol from our cells to the liver which converts cholesterol into bile salts, pours these salts into our intestine to aid in fat digestion, then gets rid of excess cholesterol in our stool with the help of fiber. Lipoproteins work efficiently when we eat fats as nature makes them, when we ingest rancid oils our body partially protects us by unpalatability, irritation of the delicate lining of our intestines, diarrhea and decreased digestion and absorption.
Lecithin and cholesterol
Lecithin is also important when it comes to cholesterol. The word ‘lecithin’ is derived from the Greek word for ‘egg yolk’ from which it was first isolated. Lecithin is considered to be our ‘edible soap’ because it breaks up fats into smaller droplets, this action is known as emulsification. Lecithin is important because it helps our digestion of fats and improve general health. All unrefined crude oils contain some lecithin, the richest source is unrefined soybean oil, which contains both essential fatty acids. Lecithin from other seeds only contains one of them: linoleic acid (LA) found in safflower, sunflower, hemp, walnut, pumpkin, sesame, flax, corn and sesame. Lecithin is removed from oils when they are refined.
Lecithin has very important roles for heart health and general health:
- It keeps cholesterol soluble.
- It keeps cholesterol isolated from arterial linings.
- It protects cholesterol from oxidation.
- Helps prevent and dissolve gall and kidney stones by its emulsifying action on fats.
- Lecithin is also important for our livers’ detoxification functions, and helps us from slowly being poisoned by breakdown products of metabolic processes that take place in our body.
- Lecithin increases resistance to disease by its role in our thymus gland.
- Lecithin is also important because it makes 22% of both the high density (HDL) and low density lipoprotein (LDL), both of which are cholesterol carrying vehicles in our blood. These vehicles keep cholesterol and triglyceride fats in solution in our bloodstream and carry them to and from all parts of our body.
- Lecithin is important component of bile, helping break down fats into smaller droplets, increasing their surface area and thus improving their digestion by enzymes.
- Finally, lecithin is also an essential nutrient.
The dark side of cholesterol
According to the author, cholesterol has been given so much attention by the medical community that it has been wrongly associated with cardiovascular disease. The reason is that it is found deposited along with fats, protein, fibrin, and calcium in the inner lining of our arteries, where it narrows them.
When cholesterol becomes a problem. Atherosclerosis.
Around 2/3 of the population of North America, Europe and the rest of the world suffer from arteriosclerotic deposits to some degree. These deposits are made of proteins, cholesterol, fats and minerals, they narrow arteries and slow down blood flow. What is more, cholesterol and saturated or processed fatty acids make our platelets sticky increasing the risk of clots. The combination of atherosclerosis and clots may completely block an artery, cutting off oxygen and nutrients to the cells of the part of our body supplied by that artery. These cells then die. If an artery to our brain is blocked a stroke occurs and depending on the size and location of the blocked artery the stroke may be minimal or fatal. Narrowed arteries to the heart produce chest pains on exertion (angina) or after a meal high in fats that makes blood thicker and less capable of supplying oxygen. Blockage of an artery supplying our heart results in a heart attack (coronary occlusion). If a clot blocks an artery in our lungs, pulmonary embolism occurs. A blocked artery to our legs results in impaired circulation that can lead to gangrene. Atherosclerotic deposits also harden our arteries resulting in raised blood pressure because our arteries’ resilience which normally takes up the pressure generated by each heartbeat (contraction) is lost. This results in a heavier load on our heart and kidneys which, when prolonged leads to water retention (edema) and heart and kidney failure.
Controversy about cholesterol
The topic of cholesterol has received a lot of controversy, with many different interpretations about its cause. For 40 years, elevated cholesterol levels have been blamed for fatal diseases of our heart and arteries which include heart attacks, pulmonary and other embolisms, peripheral arterial disease, stroke, high blood pressure, heart failure, and kidney failure. According to the cholesterol theory, high total cholesterol and high low density lipoprotein (LDL) levels predispose us to cardiovascular diseases (CVD). For the author Udo Erasmus, the cholesterol theory has many flaws and he explains his point in the following way: CVD was rare before 1900. Then, during the first and second world wars, when less animal products and more vegetables were eaten the CVD death rate fell dramatically. According to this evidence it looks like high cholesterol levels predispose us to CVD and low cholesterol protects us. However, cholesterol consumption has remained the same since 1900, while cardiovascular disease increased greatly between then and now. During the two world wars, people ate more vegetables, less margarine and shortening and although fat and cholesterol consumption was lower, the consumption of minerals, vitamins, essential fatty acids and fiber were higher. Protein and sugar consumption were also lower during these wars. All of these factors, not cholesterol alone, have to be considered as possible reasons for the decrease in cardiovascular diseases and others degenerative diseases during those two wars. Stress too was higher back then, resulting in increased cholesterol production which if the cholesterol theory was correct, it should have increased incidence of CVD. He points to other evidence that seems to counteract the cholesterol theory. One is food traditions like that of the Inuit, who eat a traditional diet high in meat, fats, and cholesterol and have little atherosclerosis, cancer, diabetes, arthritis, and other degenerative diseases. Similarly, he refers to the work of the dentist Weston Price, who travelled around the globe in the 1930’s studying different cultures. He discovered that all traditional diets maintained the health of the local people, but within a single generation of introducing white sugar and white flour, physical degeneration skyrocketed.
More theories about cholesterol
With so many people having cholesterol-containing deposits in their arteries several explanations for how this is the case have emerged. A group of researchers think that the body cannot metabolize large amounts of dietary cholesterol effectively. Others think that a diet high in meats which contain too little cholesterol-removing-fiber is to blame. Still others believe that it is a diet low in micronutrients needed to properly metabolize cholesterol that is the cause. In this sense, research has shown that diets high in cholesterol which also include sufficient quantities of all vitamins and mineral micronutrients keep blood cholesterol levels normal and prevent atherosclerosis. Clinical evidence shows that atherosclerosis can be lowered by exercise, diet and micronutrient supplementation like vitamin C and B 3. Calcium, zinc, copper and chromium can also be helpful.
Other theories to explain the cause of CVD have gathered momentum and followers, these are:
- The triglycerides and sugar theory. This theory points to the fact that triglyceride levels increase with high intake of refined sugars, starches, excess calories and hard non-essential fats. Increased use of these in our diets parallels the increase in CVD since 1900, while intake of cholesterol has remained constant. Certain toxins and drugs also increase triglycerides levels, which also will increase cardiovascular risk.
- Sugar. British researcher John Yudkin blames sugar for the meteoric rise in cardiovascular disease. Sugar consumption is one of the quickest ways to increase triglycerides, because our body turns sugar into fats to protect itself from the toxic effects of excess sugar. Sugar also increases oxidation damage, inhibits immune functions and interferes with the transport of vitamin C. All of these actions of sugar can affect the development of cardiovascular and other degenerative diseases. Decreased consumption of refined sugars and non-essential fatty acids prevents and helps reverse CVD and other degenerative diseases. It also increases vigor and longevity.
- Oxidation theory. Recent discoveries show that oxidized cholesterol and oxidized fatty acids in triglycerides damage arterial walls leading to CVD. When antioxidants, which prevent this oxidation from happening, are lacking in foods then lipids and cholesterol are attacked by oxygen. According to this interpretation, increasing the intake of antioxidants like vitamin C, E, selenium, sulphur and limiting the intake of sugar, which interferes with the transfer of vitamin C, can help.
- Deficiency theory. It suggests that deficiencies of vitamins, minerals including antioxidants, fiber and EFA’s are the key causes of degenerative diseases.
- The vitamin C interpretation. The research of Linus Pauling and Matthias Rath points to the lack of anti-oxidants and how this leads to poor control of the free radicals normally produced by oxidation. These free radicals speed oxidation of cholesterol and triglycerides, which can damage arteries. Their work concentrated in what they considered to be the most potent of antioxidants, vitamin C. Vitamin C is used by the body for the production of collagen and elastin to keep our arteries, bones, teeth, cartilage, scar tissue and other tissues strong. Lack of vitamin C results in weakened arteries that bleed into tissue spaces. Under conditions of weak connective tissues, our body tries to compensate for this deficiency by thickening our arteries using an adhesive repair protein called apo made by our liver. This repair protein is a stronger risk factor for cardiovascular disease than LDL according to these researchers. In cholesterol studies and measurements, the effect of this protein and its carrier vehicle Lipoprotein (a) have been mistakenly blamed on LDL. When vitamin C consumption goes up, apo (a) levels decrease because less repair protein is necessary when there is enough vitamin C to keep connective tissue in our arteries strong. Since humans don’t make vitamin C, the only way to prevent this from happening is to supplement with vitamin C. We need high doses of it, from 5 grams upwards. Vitamin C alone cannot be used to prevent cardiovascular disease, sulphur containing amino acids, vitamin B3, Co Q 10 are also needed.
The combination of thickened (narrowed) arteries and sticky platelets sets the stage for heart attacks, strokes and emboli. In this sense, it is the saturated fatty acids that tend to make platelets more sticky when our diet is high on foods like beef, mutton, pork, dairy products, etc and low in the more fluid (less sticky) essential fatty acids. The problem with these saturated fatty acids is that they can be deposited within cells, organs and arteries along with proteins, minerals and cholesterol. A diet high in refined sugars has the same effects as these kind of fats because excess sugar is converted into these saturated fatty acids in the body.
Cholesterol in the 1900’s
According to the author, cholesterol cannot be the primary cause of CVD because our cholesterol consumption has remained about the same in the last 100 years, while CVD has skyrocketed. According to him, trans fatty acids and altered vegetable fats, sugars, processed foods lacking vitamins and minerals all deserve suspicion. Butter is not to blame for our increased fatty degeneration because our consumption of butter since 1910 has decreased while that of margarine rose by 9 times. In the same way, consumption of saturated acids, cheese, ice cream, frozen deserts and low fat milk all increased. Of special interest is the higher consumption of sugar, from 15 pounds in 1815 per person to 135 lbs today. At the same time our consumption of fiber decreased and refined flours increased.
How cholesterol is measured
For the last 30 years doctors have measured our blood cholesterol levels as predictors of cardiovascular risk but the author believes this is more for business than prediction.
The most common way doctors use to measure total serum cholesterol level lumps the ‘good’ HDL and ‘bad’ LDL together. This total blood cholesterol is considered a general indicator of risk of cardiovascular disease but can be inaccurate. According to it, a ratio of 3.5 or lower indicates low risk of CVD. Cholesterol in this way is measured as milligrams of cholesterol per deciliter of blood volume (mg/dl). Recently, the medical profession introduced a new measurement for blood cholesterol, in millimoles of cholesterol per liter of blood (mmol/L). This new measurement is more complex and more difficult for non-tecnical people to understand than the old measurement. A number of 200 mg/dl becomes 5.15 mmol/L in the new system, for example. To roughly convert the old measure to the new, divide the old number by 39.
The way doctors have explained HDL and LDL is that high ‘good’ HDL in our blood indicates that the system for removing excess cholesterol is functioning well and preventing the accumulation of cholesterol in our arteries. A high ‘bad’ LDL level on the other hand indicates that our system is being overloaded by cholesterol from food which is being deposited in our arteries and is increasing our risk of high blood pressure, heart attacks and stroke. The author believes much profit is invested in this old dogma.
A lot of research has yielded new information about cholesterol and heart health. The new findings show a different view of cholesterol as follows:
- Oxidized cholesterol. Recent findings show that only oxidized LDL cholesterol damages arteries and leads to atherosclerosis. When our body’s normal antioxidants which normally prevent oxidative damage to arteries become depleted, cholesterol and fats (triglycerides) become oxidized and cause damage to arteries. Oxidation also uses up antioxidants lowering already low levels. EFA’s also lower blood fibrinogen/fibrin levels that could thicken our arteries because of lack of vitamin C.
- Lp(a) and its adhesive apo (a). Apo(a), a protein carried by Lp(a) is an adhesive protein used for tissue repair. Together with other repair proteins (fibrinogen/fibrin) it thickens our arteries in cases of weak arteries. Apo (a) seems to protect our arteries in cases of vitamin C deficiency by thickening them. It has been found that it is this lipoprotein Lp(a), which looks like LDL but carries the adhesive repair protein apo (a), that is a is a strong indicator of cardiovascular disease. Measurements on which the cholesterol dogma is based have erroneously lumped LDL and Lp(a) together. Separated from Lp(a), LDL alone appears to be a very weak risk factor. This means that LDL has been wrongly blamed for damaged done by Lp(a). In addition, Lp(a) often increases when levels of vitamin C decrease in our blood stream, and usually decrease when vitamin C levels increase. Increased intake of vitamin C (several grams a day) and other anti-oxidants can keep Lp(a) and apo (a) levels down, reverse scurvy and build strong thin arteries with strong connective tissue. Vitamin C snags free radicals preventing them from doing damage, it also recharges vitamin E which snags free radicals in oil soluble membranes. Vitamin C recharges sulphur containing glutathione, which snags free radicals that made it through the membrane into the cell. Since vitamin C is water soluble it is excreted after urination, so it would be good to replenish it afterwards.
Trans fats and cholesterol
We have seen how trans fats are detrimental to health. Trans fats can increase blood cholesterol levels by up to 15% and blood fat (triglycerides) by up to 47% very rapidly when partially hydrogenated vegetable oils containing 37% trans fatty acids are ingested. High triglycerides levels play a part in developing cardiovascular disease. If our diet contains cholesterol, the effect of trans fatty acids is enhanced.
A large well controlled study published in the ‘New England Journal of Medicine’ in 1990 shows conclusively that trans fats increase total cholesterol and LDL, both of which are correlated with increased cardiovascular disease, disproving manufacturers’ advertising claims that suggest that margarines can be good for the health of our heart.
EPA and DHA and cholesterol
These two fish oils can help with cholesterol because by being highly unsaturated they have a strong urge to disperse. So strong is their tendency to move apart that they help prevent aggregation of saturated fatty acids that like to stick together, helping to keep saturated fatty acids and cholesterol dispersed. EPA and DHA keep our platelets from getting too sticky, lowering the risk of blood clots. They also lower apo (a) and fibrin levels in our arteries. They lower triglycerides up to 65%, lower cholesterol and LDL to some extent and very low density lipo-protein (VLDL). They also lower blood pressure and protect against cancer.
Our body can convert alpha linoleic acid (LNA) (found in flax seed, chia, hemp seed, pumpkin seed oil, soybean, walnut and dark-green leaves) into EPA when it is accompanied by co-factors like B 3, B 6, vitamin C, magnesium and zinc. Two tablespoons of flax oil can be converted into 378 mg of EPA, approximately what two large capsules of fish oil will supply.
To sum up, fatty degeneration involves much more than cholesterol, it involves an imbalance of essential fatty acids, the presence of altered (toxic) fatty materials (trans fats, oxidized fatty acids, etc), an excess of non-essential fatty acids (fats, oils, cholesterol) in places or quantities where they are not normally found. Cholesterol is not essential to obtain from the diet because our body can make it, this doesn’t mean that eating cholesterol should be a problem. As long as our diet includes all of the other essential nutrients, antioxidants, fiber, good bacteria and is low in refined carbohydrates and sugars, cholesterol levels take care of themselves through the different cholesterol controlling mechanisms we have seen in this blog.
We at Healthy Hearts Club recommend to complement a balanced diet rich in essential fats with the ‘Heart and Body Extract’, together with the ‘Liver Support Compound‘ and the ‘Kidney/Bladder Extract‘ for maximum results. Thanks for reading.