Old Well: UNC Chapel Hill Campus

Monday, October 1, 2012

The myth about cholesterol

For years I’ve believed all the hype that high cholesterol sharply increases your risk for heart disease. I’m dubious about that now. Did you know that people with low cholesterol get heart attacks, too? Are you aware that nearly half of those with atherosclerosis have low cholesterol? Or that half of those with high LDL never suffer any complications? Something else seems to be going on.

I’ve suspected this for some time, but I didn’t know the mechanism behind it until now. Not all LDL is the same. A variant type exists, often hereditary, where the LDL type is smaller and denser, increasing your risk for heart attack or stroke. It isn't LDL per se, but the kind of LDL you have. This kind puts you at greater risk, since small LDL particles can more easily infiltrate the arteries and cause blockage. You can get a good reading at your doc’s on your cholesterol levels, LDL and HDL, be thin as a rail, exercise daily, yet still be at risk. You can even pass an EKG stress test and drop dead several days later. You come across this story often.

There are two things you should do, whether you agree or not with my particles hypothesis.

1. The next time you go for a blood check, which should be annually at the very least, ask for a particles check to determine the type of LDL you have. An added dividend is it will show whether you’re insulin resistant, a precursor to diabetes. Your test will even categorize your risk for heart attack or stroke: minimal, moderate, high, highest.

2. If you do have small particles, there are ways to improve, or transition, to large particles, the healthier kind; namely, cutting carbohydrates, especially from unrefined sources such as processed foods and sweets and exercising vigorously at least 150 minutes weekly, i.e., 30-minutes daily.

Be warned that eating fats, especially the saturated kind, has its own dangers, but in the end, unrefined carbohydrates are the primary threat to a healthy heart. If you think about it, carbohydrates are turned into blood sugar (glucose). If there's one insidious source of disease, not just coronary, it's sugar!

Let me close with my own experience. Last May I was found to have high small particle lipids. Over the last three months, I’ve practiced my own counsel. Result, my August lab showed a 25% drop in small particle total.

As always, sound nutrition is your key to good health and longevity.

rj