Does Cholesterol in Food Affect Your Cholesterol Levels?
It seems that a disproportionate amount of the 5 million or so terabytes of information on the internet are devoted to advising people on how to lower their cholesterol.
The bulk of this advice seems to be a debate about whether it's okay to eat eggs or shrimp or some other high-cholesterol food; whether they're "safe" or if they'll cause your arteries to plug up as snugly as your toilet when your four-year-old nephew tried to flush down a big Idaho potato.
Let me try to shine a little light through that murky sea of terabytes and say that the amount of cholesterol in the food you eat doesn't appear to matter much at all.
Partake regularly in the Tuesday night, all-you-can-eat "Shrimp-A-Palooza" at the local seafood shanty. It probably won't make a difference. Pop eggs like you're in prison and your fellow inmates, to alleve the boredom, bet you a carton of cigarettes that you couldn't eat 50 of them, hard-boiled. Still won't likely matter.
Neither situation would probably make much difference because your body makes cholesterol on its own, pretty much no matter what. That's an over-simplification, but eat a lot of cholesterol and it makes less. Eat less cholesterol and it makes more. Oh, food matters alright in determining your cholesterol levels, but it's got little to do with the actual amount of cholesterol in that food.
Instead, cholesterol levels have to do with a couple of other issues:
- The amount and type of carbohydrates in that food.
- The amount of saturated fat you eat in combination with the cholesterol you ingest.
If someone regularly eats a lot of simple carbs, they often develop insulin resistance, which leads to increased levels of blood sugar. Along with this comes an increase in the rate at which fats are broken down. This leads to elevated levels of blood fats or triglycerides. You also find a decrease in good cholesterol (HDL) and an increase in bad cholesterol (LDL).
This triumvirate of heart terror – high triglycerides, low HDL, and high LDL – are thought to play a big role in the buildup of plaque in the arteries. Too much plaque and you get the aforementioned Idaho potato-in-the-toilet effect and you clutch your chest and start to hear your Mee-maw calling to you from the beyond to come home.
But you don't necessarily have to be insulin resistant for carbs to negatively affect cholesterol levels. Just being a carb junkie and having more than about 60% of your daily calories come from carbohydrates (especially heavily processed carbohydrates) sends the liver a perfume-scented missive to start manufacturing more cholesterol.
Here's where it might look like I'm contradicting myself a little bit. You know how I said the cholesterol in food doesn't matter? Well, it does if you eat a lot of cholesterol in combination with a lot of saturated fat.
Say you like to pound down steak. Most red meat normally contains a lot of saturated fat and a significant amount of cholesterol, so when you eat it regularly, you usually see an increase in LDL cholesterol.
The good news is that the saturated-fat-laden steak also raises HDL cholesterol, so your total cholesterol to HDL ratio (a supposed marker for cardiovascular disease) isn't altered.
So, in general, high-ish cholesterol foods that don't contain a lot of saturated fat like eggs and shrimp won't affect LDL cholesterol levels, but high-cholesterol, high-saturated fat foods like steaks and other cuts of red meat will.
However, as stated, the red meats shouldn't affect your long-term cardiovascular health because it doesn't appear to affect the LDL/HDL ratio. So the question is, should you eat steak and hamburgers and such with impunity?
The research is sometimes confusing. A study from 1991, funded by the US Surgeon's Office, found that if Americans cut the amount of saturated fat they ingested, they could delay 42,000 deaths each year by, drum roll please, an average of two weeks.
That's not quite as bad as it sounds because "average" means that some people might have extended their life by several years while others might have extended their lives just long enough for their Hot Pockets to finish microwaving.
But even so, any lengthening of lives probably had little to do with cholesterol itself.
Doctors, for the most part, can't agree on what causes heart disease. Sure, there are some statistical probabilities that point to the wisdom of lowering blood pressure and cholesterol, but they don't mean squat if you're one of the roughly 50 percent of men or 63 percent of women who die from heart attacks while not exhibiting any symptoms or strong risk factors.
The only thing that doctors and scientists seem to agree on regarding heart disease is that it's a disease of inflammation.
What's common to just about everyone who dies of a heart attack is a large collection of the white blood cells known as macrophages. These macrophages collect around fatty deposits, and they secrete enzymes that digest protein.
The insides of blood vessels are of course made of proteins, and in trying to eliminate the fatty deposits, the blood vessels are eaten away, made thinner, and made more susceptible to plaque or rupture.
What surprised researchers, though, was that they also found these macrophages in presumably healthy arteries. This indicated that the inflammation was systemic and not localized.
Clearly, the science of cholesterol is, well, evolving, but in the meantime, there seems to be solid evidence to support the following:
- Avoid lots of carbs, especially highly processed carbs. Carbs raise cholesterol and triglycerides while reducing HDL levels, but perhaps more importantly, the resulting insulin resistance leads to inflammation, which is definitely bad for the heart.
- Improve insulin sensitivity in general to keep inflammation low.
- It looks like eating foods high in cholesterol but low in saturated fats, like eggs and shrimp, won't negatively affect your health.
- Meats high in saturated fat and cholesterol are probably okay to eat in moderation because they elevate both HDL and LDL, thus leaving the total cholesterol ratio unaffected. However, eating too much saturated fat on a regular basis leads to inflammation, which, as stated, the heart doesn't like.
- Substituting polyunsaturated fat for saturated fat (in cooking, for instance) reduces LDL cholesterol and total cholesterol so that you get a better cholesterol ratio (LDL to HDL).
- Strive to reduce inflammation in general. Shore up your body with plenty of anti-inflammatory omega-3 fatty acids by taking Flameout®. Consider taking baby aspirin, as long as your doc gives you the okay. Add Micellar Curcumin™ to your supplement list. De-stress. Walk naked through fields of wheat at dawn. Whatever it takes.
Okay, I'm about to piss you off. It's possible that high cholesterol might someday prove to be the demon it's been portrayed as. Maybe the scientists will reconcile the apparent contradictions in the data.
Given that possibility, it's probably smart to be at least a little proactive about cholesterol and do a little more than just accepting the recommendations I laid out in the last chunk of text.
Besides, I'm loath to dismiss cholesterol numbers that are high, high like the number of Spartans who resisted a million Persians during the battle of Thermopylae.
While I follow/acknowledge all the observations/recommendations, I described in this article, along with exercising and supplementing the hell out of myself, my total cholesterol normally averages about 220 mg/dl ("normal" is anything under 200). It probably has to do with genetic factors, especially since I'm Finnish and Finns, as a people, have boasted some of the highest cholesterol numbers in the world.
Despite all the contradictory evidence about the implications of "high" cholesterol, I still take it somewhat seriously. As such, I take a serving of Metamucil (psyllium) before breakfast and another before dinner.
Psyllium removes bile from the body, which causes the liver to make more bile by using the cholesterol available in the blood. This in turn lowers cholesterol. (If you don't physically remove cholesterol, kicking and screaming, it just gets recycled.) The psyllium works much like the class of medicines known as bile-acid binding resins, e.g., cholestyramine.
This strategy has allowed me to whack my hereditarily high cholesterol levels back down into the normal range. As they say, better safe than sorry, or rather, better safe than dead.
- Neugeboren J. Open Heart: A Patient's Story of Life-Saving Medicine and Life-Giving Friendship. August 6, 2003.
- Dehgan M et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet. 2017 Nov 4;390(10107):2050-2062. PubMed.
- Siri-Tarino PW et al. Saturated Fatty Acids and Risk of Coronary Heart Disease: Modulation by Replacement Nutrients. Curr Atheroscler Rep. 2010 Nov;12(6):384-90. PubMed.
- TC Luoma TC's Big Damn Book of Knowledge. Harlequin Press. Fresno, 2014.
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