Cholesterol is actually important for us because:
We use it to make bile salts which is required for the digestion and absorption of fat! It’s also how our body produces all our hormones like estrogen, cortisol, testosterone, etc. And it gives structure to our cells!
Surprisingly enough, its actually NOT essential for us to consume cholesterol in our diet because our body is fully capable of making all of the cholesterol we need! (our bodies are so cool)
So, back in the 60s through to the 90s we were told to reduce cholesterol in our diets to reduce the amount of cholesterol in our blood. However, dietary cholesterol isn't the primary contributor that leads to negative health outcomes!
'You mean, I can actually eat eggs and not worry about the cholesterol?!'
YES! (but it does depend on how many and in what you cook them)
because when we have enough cholesterol present in our bodies, a healthy body will not absorb more from the food we eat!
We have regulatory systems in place that prevents our cells from absorbing more cholesterol than we need, so any excess cholesterol not needed or not absorbed is either made into bile salts, hormones or recirculated.
Now, we don't want high amounts of cholesterol circulating in our blood because if we do have any cuts or tears in our blood vessel walls (usually from sharp sugar molecules), that's where cholesterol will go and accumulate leading to atherosclerosis.
When a vessel needs to be repaired, the most effective thing is something sticky that can withstand the pressure in the vessel wall. So the body recruits a type of white blood cell called monocytes to be deposited in the vessels where the repair needs to take place.
These cells change into into macrophages which is a special cell that can engulf bacteria, other dead cells, and protect the body from infection. Macrophages engulf and absorb low-density lipoproteins, AKA LDL particles, which results in the formation of the 'foam cells' that are a hallmark of the atherosclerotic plaque.
HDL cholesterol can actually latch onto these foam cells and LDL cholesterol and bring it back to the liver for further processing and break down. So this is why HDL is considered the 'good cholesterol' and LDL is considered the 'bad cholesterol.'
SO HOW DOES SOMEONE GET HIGH CHOLESTEROL?!
Well, it's generally from a diet high in fat, mainly saturated fat.
Check out the photo below to compared saturated and unsaturated fat.
The majority of foods high in saturated fat are also high in cholesterol which caused people to believe that foods high in cholesterol caused high cholesterol in the body.
Saturated fat increases the levels of LDL cholesterol in the body which means the body now has more LDL for vessel repair, tissue repair and organ repair. While repairing these parts of the body is ideal, we don't want an accumulation of plaque to form!
It wasn't until people studied eggs and found that high egg consumption did not increase cholesterol in the body, which left foods high in saturated fats to be the villain causing high cholesterol and leading to negative cardiac outcomes.
HOW CAN WE LOWER OUR CHOLESTEROL?!
Decrease the amount of animal fat your consume and increase the amount of plants you consume. Plants contain sterols that look a lot like cholesterol and if your eating more plants than animals, the body will absorb more sterols, potentially decreasing the amount of cholesterol we have in our bodies.
We cannot burn cholesterol like we can burn fat because its not an energy source the body can use, however that doesn't mean exercise won’t help! Getting regular daily movement can allow for better digestion of fats and improving blood flow helping the body use and mobilize cholesterol!
Consuming enough fiber throughout the day can aid in digestion. Men need a minimum of 30-40g and women need a minimum of 25-35g per day.
Replacing saturated fats with monounsaturated fats may decrease LDL-cholesterol and triglycerides as well as maintain HDL-cholesterol. This means switching to olive, avocado, and coconut oils when cooking and reducing or eliminating butter and margarine. You should be consuming 25-35% of your daily intake from fat sources. This includes nut butters, avocado, fatty fish, nuts and seeds, and healthy oils.
Live a lifestyle rich in omega 3s, fish, get more exposure to sunlight, manage and reduce stress, eat more fruits and veggies, whole grains, and get in more physical activity.
Get your blood levels checked regularly (every 3-4 months) if you're concerned about your heart health or if you have a family history of heart related issues. A lipid panel is generally done to check everything related to heart health.
Seeing a registered dietitian like myself regularly can help you manage your nutrition and daily diet so you can live a heart healthy lifestyle!