Two eggs over easy. A slice of cake at your daughter's wedding. A big ol' brownie on a Friday afternoon because, hey, it's Friday afternoon. If the very mention of these minor indulgences is already causing you to panic about cholesterol, let's take a step back. Poor cholesterol does not necessarily deserve its bad name. Like sugar, cholesterol is a necessary part of a healthy body's make-up. Without it, we could not function. Of course, too much of a good thing is never a good thing but more on that later. First of all, what is cholesterol, really, and what do we need to know about it?
Cholesterol is Fat
Cholesterol is fat. Now, before you recoil in horror, let’s remember that fat is also a good and necessary thing, especially when that fat is in the form of cholesterol. Cholesterol is a type of fat that falls under the category of "sterol," which helps the body produce steroid hormones. Without these, cells could not stay together to do their vital work; food could not be digested in the intestines; and estrogen and testosterone would not be produced in women and men. Cholesterol, to say it again, is necessary.
It is so necessary that the body produces some cholesterol itself, regardless of your diet. Put simply, the cells in your body are like little guardian angels. They watch your intake of substances – both harmful and helpful – and react as best they can to any deficiencies or surpluses. Most bodies needs roughly 1,000 milligrams of cholesterol at all times to function properly. So, when your cells sense that you have not taken enough cholesterol in your diet, they synthesize it. The key ingredient in this synthesis is carbon, which is gathered from food. Proteins, carbohydrates and fats are all rich sources of the carbon used by the body to make its own cholesterol.
All Cholesterol is Not Created Equally
All bodies create cholesterol, but not all bodies create it, store it and use it in the exact same way. This is where that brownie on a Friday afternoon comes into play – or doesn’t; it depends on your body. When the body starts to go about its task of transforming your food into the cholesterol it needs, it is faced with a complex challenge. It must break down the food into manageable bits, bundle these bits into even more manageable bits and send these bits through the blood to the liver, which repackages these bits yet again and bundles them into low-density lipoproteins, or LDL. The LDL carry the cholesterol to the body’s cells, which do the good work described above. At the same time, the liver produces a molecule called high-density lipoprotein, or HDL. HDL carries the cholesterol away from the cells, essentially cleaning the system of unneeded cholesterol. This dual action—LDL delivering cholesterol and HDL removing cholesterol—is essential. If there is a problem in a step of this process—for example, a malfunctioning liver—the cholesterol may not be packaged correctly, and a variety of health problems, including coronary artery disease, can result.
So what factors inhibit or contribute to the most beneficial production and processing of cholesterol?
Genetics always comes first. Just as height and eye color vary, so do internal functions like the processing of cholesterol. A few genes can disrupt the optimal production and flow of cholesterol described above. The result is a condition called “Familial Hypercholesterolemia,” which causes too great an increase in LDL and ends up blocking arterial pathways. As the name implies, you may know you’re at increased risk of this condition because of family history, but regular checkups to monitor cholesterol levels can reveal your situation, too. If you suffer from Familial Hypercholesterolemia, that little indulgence in a treat on a Friday afternoon should be considered a major indulgence, and you will need to be extra vigilant.
Smoking: Smoking cigarettes has no effect on the production of LDL, but it significantly decreases HDL. A harmful surplus of cholesterol is the result.
Diet: Human breast milk and high-protein foods, such as dairy products, meat and fish, are major sources of the body’s cholesterol. Fats also contain cholesterol, and “trans fats” are thought to be a major contributor to imbalanced levels of LDL and HDL. With trans fats, the body produces too much LDL and not enough HDL, so, once again, cholesterol is not cleared from the system, which results in arterial clogging. In case you don’t know, trans fats are usually artificially created. Unfortunately, they taste great, so they are placed in junk foods and added to otherwise healthy meats.
Medication: While many drugs are made with the intent of lowering LDL, some drugs are actually associated with increasing LDL – or lowering HDL, thus creating a harmful imbalance. Prednisone, which is an anti-inflammatory; beta blockers, which are used to treat high blood pressure; and anabolic steroids, which promote puberty and correct some forms of impotence, are three of these. Statin drugs, on the other hand, help block the body’s production of LDL, but problems arising from statin medications may include liver damage and a decrease in the body’s ability to produce CoQ10, or Ubiquinol. Patients suffering from too-high cholesterol levels or other risk factors who are on a statin therapy regime should speak with their doctor about supplemental nutrients.
So, back to that piece of cake or that steaming plate of bacon and eggs...back to that genetic predisposition and those useful medications. Ultimately, it’s up to you and your doctor to monitor your cholesterol, but at least now you know what it is and why it is so important. And in the spirit of fairness, let’s give cholesterol its due—and some of its good name back.