The Cholesterol Nonsense Continues

I really thought we were done with all the anti-cholesterol nonsense, but it just won’t go away.

The anti-cholesterol narrative has been thoroughly discredited over the past couple decades, and even the Dietary Guidelines for Americans has removed their previous dietary limits for cholesterol consumption due to a lack of supporting evidence (although they still suggest consuming as little cholesterol as possible) (1).

But, most people are still avoiding cholesterol-containing foods like eggs and red meat, and the incredibly harmful and dangerous cholesterol-lowering drugs are still the most prescribed drugs in the United States (2).

The anti-cholesterol story began with the notion that high blood cholesterol levels cause plaque formation, which causes heart attacks. This led to the recommendations to reduce dietary cholesterol, which are still pervasive today.

But, not only does cholesterol not cause plaque formation or heart attacks, it actually protects against them and is one of the most protective nutrients available to our bodies.

 

Cholesterol Does NOT Cause Heart Disease

Efforts to link cholesterol to heart disease have gone on for half a century and have failed miserably.

Well, I guess it depends how you define “failed,” considering the amount of cholesterol-lowering drugs sold and the persistence of the anti-cholesterol dietary advice. But as far as scientific evidence goes, they have certainly failed.

The most influential heart disease study ever done found that the cholesterol levels between those who developed heart disease and those who didn’t were nearly identical (3).

This hardly supports that cholesterol causes heart disease, and many other studies have found that people with higher levels of cholesterol are less likely to die from heart disease and that those with heart disease who have higher cholesterol levels are less likely to die from any cause (4, 5, 6, 7, 8).

This is not to mention that the amount of cholesterol we eat doesn’t affect our blood levels of cholesterol or our risk of heart disease! (9, 10) Our bodies produce their own cholesterol, so the amount of cholesterol we consume has little effect on the amount of cholesterol in our bodies.

In fact, our bodies use between 1,000 and 2,000 mg of cholesterol per day, and if we reduce the amount of cholesterol we consume then our bodies simply make more in response.

So, not only do the cholesterol levels in our blood not cause heart disease, eating high-cholesterol foods doesn’t increase those levels anyway!

But what about the plaques that form in our arteries and cause heart attacks? Aren’t they made up of cholesterol?

Yeah, partially. But, blaming cholesterol for the plaque is kind of like blaming firemen for a fire.

As you’ll read about in a little bit, cholesterol is a vital part of our immune system. So, while it is found in atherosclerotic plaques, it’s there as a protective factor rather than a cause (11). Polyunsaturated fats and their metabolites, on the other hand, are also found in these plaques and play a more causative role by contributing to oxidation and inflammation (12, 13, 14, 15).

But, while cholesterol levels, plaque, and heart disease aren’t affected by the amount of cholesterol we eat, they are directly affected by our metabolism.

 

Cholesterol and Metabolism

Cholesterol levels are influenced by many different variables, but the factor that has the largest effect is metabolism. This relationship between cholesterol and metabolism has been known for 100 years but is now largely ignored (16, 17, 18).

When our metabolism is high, we produce more cholesterol. But, we also use more cholesterol to produce the protective steroid hormones (and for other uses), which reduces the amount of cholesterol in our blood (18).

The opposite occurs when our metabolism is low. We produce less cholesterol and use less of it to produce the protective hormones, leaving more of it in the blood (18).

So, while the larger amount of cholesterol in the blood isn’t a problem on its own, it’s representative of a low metabolism, which is a problem and is associated with heart disease (19, 20). Plus, it means the body is using less cholesterol, which is also a problem due to cholesterol’s beneficial effects.

 

The Protective Effects of Cholesterol

Cholesterol is one of the most protective nutrients that exist in our bodies. It’s vital for brain function, immune function, and digestion, and is the precursor to the extremely important steroid hormones.

Our brains contain around 25% of all the cholesterol in our bodies because of its importance in brain function (21). And, a lack of cholesterol is associated with impaired cognitive function as well as depression and impaired mental health (22, 23).

Cholesterol also plays a major role in our immune system and is able to prevent infections and detoxify harmful toxins like endotoxin (11, 24, 25).

And, due to cholesterol’s protective effects, low cholesterol and cholesterol-lowering drugs have been shown to increase the risk of cancer and all-cause mortality (26, 27).

In other words, we can stop with the anti-cholesterol nonsense!

We NEED cholesterol and we don’t need to avoid foods that contain it (like eggs and other animal foods) or that increase our bodies production of it (like sugar and saturated fat). In fact, the cholesterol-producing and metabolism-supporting effects of these foods make them some of the best foods for supporting health.

If you have high cholesterol then a low metabolism is to blame, not these foods, and a cholesterol-lowering drug is not the answer.

 

References
5 Comments
  • Komelon
    Posted at 18:46h, 13 September Reply

    Jay, I love all your articles. Making Peat (and others) concepts accessible for everybody is a great idea. This one is particularly easy to understand and does a great job of debunking the official propaganda. I have one question though, when doctors and nutritionists talk about “good cholesterol” versus ” bad cholesterol”, how does it play into your explanation?

    Thanks!

    • Jay Feldman
      Posted at 10:40h, 14 September Reply

      Hi Komelon.

      Thanks, I’m glad you’re enjoying them!

      The idea that HDL is the “good cholesterol” and LDL is the “bad cholesterol” isn’t really supported.

      Cholesterol itself is extremely protective and plays a major role in the immune system. HDL, which is a protein carrier of cholesterol, carries cholesterol to the liver from the periphery, often along with toxins that need to be detoxified and/or excreted by the liver. This is why toxins like alcohol, endotoxin, and PUFA (or more accurately the breakdown products of PUFA) increase HDL levels. So while HDL itself isn’t harmful, high HDL levels may not be a great sign.

      LDL is the carrier that transports cholesterol from the liver to the periphery, where it can be used for repair or converted to the protective steroids, among other things. If the arteries are damaged, LDL deposits cholesterol there to aid in repair, which is why it’s blamed for causing plaque buildup (I mentioned why it isn’t actually responsible for the plaque buildup under “cholesterol does not cause heart disease”).

      LDL levels often increase with a low metabolism as a protective measure. This causes more cholesterol to be carried to the tissues to drive the production of the protective steroids. So, like HDL, while LDL itself isn’t harmful, very high LDL levels typically aren’t a great sign. However it’s definitely worth emphasizing that the demonization of LDL itself is entirely misplaced. That being said, when LDL is composed of greater amounts of polyunsaturated fatty acids, this allows it to become oxidized/damaged which may contribute to plaque formation and eventually cardiovascular disease.

      I hope that’s helpful!
      Jay

      • Komelon
        Posted at 11:59h, 14 September Reply

        Super helpful, thanks!

  • Wendy
    Posted at 12:15h, 26 June Reply

    What if we have a low metabolism and too low cholesterol? Does low metab always = low cholesterol?

    • Jay Feldman
      Posted at 17:11h, 29 June Reply

      A low metabolism doesn’t always equal low cholesterol, and low cholesterol can be dangerous because of the many important functions of cholesterol. Typically, increasing sugar consumption (fruit sources, honey, table sugar, etc.) and/or increasing saturated fat consumption will help raise cholesterol production.

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