High LDL cholesterol is a serious reality and may require intense medical treatment by your health care provider; however, there are a number of myths and misconceptions surrounding LDL cholesterol. For example, you may think cholesterol is totally evil and you need to keep away from it in your diet. In addition, you may be confused about cholesterol's connection to heart disease. First, know that cholesterol is not inherently evil, and your body makes its own; however, a group of independent medical authorities say that high LDL is enshrouded in hype, and current practice guidelines about cholesterol thresholds need to be revised.
Myth: LDL is All Bad
LDL refers to the low-density lipoprotein carrier that shuttles cholesterol around your body. Another carrier is high-density lipoprotein, or HDL. LDL is often labeled bad, and HDL, good because of their harmful and helpful characteristics. LDL can clump up with other particles and cause plaques that block the flow of blood. HDL helps remove LDL. But cholesterol is cholesterol, and it has several critical biological functions. It helps maintain the integrity of cell membranes, serves as the building blocks of hormones, protects bone health and keeps toxins out of skin. In "YOU: On a Diet," Drs. Michael Roizen and Mehmet Oz write that LDL is an important part of your body's "artery repair kit." It helps repair damage to the walls of your blood vessels, making it not the inherent evil you may think it is.
Myth: Eating Cholesterol Raises Cholesterol
Dietary cholesterol is only minimally related to blood cholesterol levels. But with food product marketing and news reports, it's easy to see how some might believe lowering the amount of cholesterol you eat might somehow improve your lipid profile. In fact, the saturated fats you eat and, in some cases, excessive amounts of carbohydrates, cause dangerous changes to your cholesterol and lipid profile. Saturated fat, reports the American Heart Association, raises your LDL while too many carbs in your diet is linked with reduced HDL and high triglyceride levels.
Controversies in Cholesterol
The National Heart, Lung and Blood Institute is a major public health authority responsible for issuing guidelines on the detection, evaluation and treatment of cholesterol. Current guidelines say a total cholesterol reading of more than 200 mg/dL is high, and an LDL greater than 160 mg/dL is high. These guidelines are based on the long-running Framingham Heart Study, which determined as early as 1961 that cholesterol levels were related to heart disease; however, noted and controversial doctor of osteopathic medicine Joseph Mercola wrote recently "Not only is cholesterol most likely not going to destroy your health (as you have been led to believe), but it is also not the cause of heart disease."
What's High and Low?
Mercola believes unless your total cholesterol is greater than 330 mg/dL, cholesterol is not useful for predicting your risk of heart disease. He says high HDL are protective from heart disease, so it's possible to have high total cholesterol and have low risk of heart disease because your HDL is high. And he says it's possible to have low cholesterol and have high risk of heart disease because HDL is low. It should be noted the Framingham study indeed found HDL is protective of heart disease, but guidelines about cholesterol treatment haven't been changed as result of recent criticism. Mercola further criticizes that the goals for LDL in treating high cholesterol are unrealistically low. Current guidelines aim to get your LDL below 100 mg/dL. Treatment involves diet and exercise, along with prescription medication. Treatment is more aggressive if you have multiple risk factors for heart disease.
High LDL: An Invention?
Two nutrition researchers from the Weston A. Price Foundation, another controversial organization, say high blood cholesterol is an invented disease. Sally Fallon and Mary Enig ---and Mercola --- say a few decades ago there was little mention of hypercholesterolemia. It was mostly the problem of people with total cholesterol levels above 240 mg/dL with other complicating factors like smoking and obesity. They suggest the threshold for high cholesterol was lowered to 200 mg/dL to increase the number of people who are prescribed cholesterol medications. There's no simple way to verify that allegation. It should be noted, however, that current guidelines encourage people to stay in touch with their health care providers to prevent high blood cholesterol, and the first line of defense is lifestyle changes involving no medications. It should also be noted that in May 2011, the National Institutes of Health stopped a major clinical trial on the combination of niacin and statins because it wasn't stopping heart attacks.
References
- Hepatitis.org.uk; The Cholesterol Controversy; Mark Johnson
- National Heart, Lung, and Blood Institute National Cholesterol Education Program; High Blood Cholesterol: Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III); May 2001
- Huffington Post; The Cholesterol Myth That Could Be Harming Your Health; Joseph Mercole; Aug. 12, 2010
- Framingham Heart Study: Research Milestones
- Weston A. Price Foundation; Dangers of Statin Drugs: What You Haven't Been Told About Popular Cholesterol-Lowering Medicines; Sally Fallon and Mary G. Enig; June 14, 2004
- National Institutes of Health; NIH Stops Clinical Trial on Combination Cholesterol Treatment; May 26, 2011
