Cholesterol - What's In a Number?

We all hear about cholesterol and how it increases our risk of heart disease.  Most everyone either knows someone who is on a cholesterol lowering medication, or is on one themselves.  We are left to believe that high cholesterol is just an inevitable thing, or that it is genetic.  But the truth is that it doesn't have to be inevitable.  Unfortunately we are, to some degree, set up to fail.  Even those who want to lower their cholesterol by following the national guidelines are failing.  This is due to the fact that these guidelines are not based on the research.  If you take a closer look, you'll find that following the current guidelines will not help one achieve their goal.  So what will?  Keep reading, bear with me, and I'll let you know.

First we need to understand what cholesterol is.  Cholesterol is made by all animals and is not essential to obtain in the diet.  In fact the body makes cholesterol on it's own.  The purpose of cholesterol - it's an essential component of all sex hormones and the membrane that surrounds our cells.  Since we don't need more than the body can make, excess consumption actually leads to a build up of cholesterol in our bodies, which later accumulates in our blood vessels.  It isn't just cholesterol consumption that increases blood serum cholesterol levels.  Eating excess amounts of dietary fat actually increases the body's production of cholesterol as well.   This is why a vegetarian who eats oil, dairy, and processed foods like cookies, chips, doughnuts, pastries, etc. can still have a high total cholesterol level. 

LDL cholesterol (low density lipoprotein) is nasty stuff.  Just remember the first "L" in LDL stands for LETHAL.  LDL cholesterol is the stuff that, in excess, creates deposits in the vessels causing a build-up along the walls of the arteries that create a narrowing, and possibly an eventual complete blockage of the artery opening, causing the blood flow to significantly decrease through the vessel.  

One would think that the most common cause of a heart attack is the complete blockage of an artery.  In fact, more often the case is that a small, fatty piece of plaque ruptures or breaks off from the artery wall and travels through the blood stream to another location where it gets stuck and causes a blockage.  This could occur in the brain, a lung or coronary artery.  Scary stuff, no?

The current guidelines found on the American Heart Association's website are as follows:
Total cholesterol:  Less than 200 mg/dl
LDL: optimal is less than 100mg/dl, 100-129 mg/dl is considered "near optimal"

Now, if you look at medical research, the appropriate numbers seem a lot different than those listed above. For example, it's been known in the medical community for decades that 1 in 4 heart attacks occur in those with a total cholesterol level between 180-210 mg/dl.  The Framingham Study is a 50 year (and counting)  multi-generational heart study that revealed 1/3 of those with heart disease, participating in the study, had a total cholesterol of 150-200 mg/dl.

The Framingham Heart Study also found among their subjects that NO ONE WITH A HEART ATTACK EVER HAD A TOTAL CHOLESTEROL VALUE UNDER 150mg/dl!  That's huge!  Another study known simply as "The China Study", and considered to be one of the most comprehensive nutrition studies ever, discovered that residents of rural China (where heart disease is nearly non-existent) had total cholesterol levels that ranged from 90-150 mg/dl. 
So, you see, millions of Americans who are doing their best to follow the guidelines to decrease their risk for heart disease are getting sick, despite their best efforts, simply because they don't have accurate, complete information. Argh!! I get so worked up over this!

This is only a sampling of the research that can allow us to come to the following conclusion...
If we REALLY want to avoid heart disease, we need to get our total cholesterol levels below 150 mg/dl, LDL below 80 mg/dl, and decrease our fat intake. The most appropriate and effective way to achieve this goal, with or without cholesterol lowering medication, is to significantly increase our intake of high fiber vegetables, fruits, legume and whole grains and limit our intake of animal products.
 
So there you have it: the national guidelines and what the research tells us about the reality of avoiding heart disease.  If you are interested in learning more about this topic, I highly recommend reading Prevent and Reverse Heart Disease by Dr. Caldwell Esselstyn, Jr., The China Study by T. Colin Campbell, and Dr. Dean Ornish's Program for Reversing Heart Disease. 
 
Now that you have the information, you have the power to make your own educated decision about your cholesterol.  If you haven't had it checked recently, ask your doctor for a fasting blood serum cholesterol test.  You can also call your local pharmacy about cholesterol testing.  Some blood banks also offer to send your blood cholesterol results when you donate a pint of blood too.  
 
A great place to start is to try the recipe posted for Everyday Oatmeal - a great, cholesterol lowering way to start your day!  
 
In good health,
Your Nutritionista