Are you cholesterol savvy? For decades, cholesterol risks, numbers, and information have been confusing, misguided, or even downright wrong. We all have cholesterol. A cholesterol measurement is one of the most common laboratory tests ordered, but does it give you the real picture of your heart health and risk? Take our cholesterol quiz to separate facts and myths and find out if you are cholesterol savvy.
Want to test your knowledge before reading the answers? Jot down your thoughts and decide which statements are facts and which are myths.
Only about 20% of the cholesterol in your body comes from your diet. The rest is synthesized your liver and intestines (1).
Cholesterol is a waxy, whitish-yellow fat. Cholesterol is needed to make vitamin D, hormones (including testosterone and estrogen), and fat-dissolving bile acids. It is a vital building block in cell membranes. Cholesterol can be found in every cell in the body.
Cholesterol doesn’t dissolve in the blood, kind of like how fat won’t dissolve in water. Instead, cholesterol bonds to carriers called lipoproteins. Lipoproteins are made up of cholesterol on the inside with a layer of protein on the outside. These carriers transport cholesterol between cells to be used for various biological functions.
When cholesterol is oxidized, it can embed into the artery wall which can lead to plaques and blockages.
While your absolute cholesterol number is highly influenced by your familial history, age, sex, and ethnicity (2), changes in total cholesterol are primarily achieved by weight loss (if overweight), diet, and exercise (3, 4).
As most people know, there are two primary types of cholesterol, Low-density lipoproteins (LDL) and High-density lipoproteins (HDL) cholesterol.
LDL cholesterol is taught as “bad,” and HDL as “good.” But there’s more to it than that.
There are actually two sub-groups of LDL particles. LDL subtype A is a large fluffy cholesterol particle that is less prone to oxidation and less likely to stick to arterial walls. LDL subtype B is a smaller and denser particle that is easily oxidized and more likely to build up in the arteries.
Subtype A LDL cholesterol is not necessarily a threat, and only oxidized LDL cholesterol forms plaques (5).
While high LDL cholesterol (specifically, high LDL subset B) is one of many risk factors of heart conditions and heart attacks, many people who have heart attacks have “normal” cholesterol levels (6).
When assessing risk, we should look at our heart illness risk overall, including weight, blood glucose, lifestyle, inflammation markers, blood pressure, triglycerides, and specifically LDL Subst B cholesterol numbers. It is not the primary risk factor.
Interestingly, more and more practitioners are looking at the ratio of triglycerides (TG) to HDL. In fact, when you calculate this ratio, you can infer your health risk of cardiovascular issues, blood sugar issues, inflammation and more.
Divide your triglycerides by your HDL cholesterol levels. Studies have found that a number of 1.0 or less is likely indicative of lower risk, and a number of 3.0 or more of highest risk.
Interestingly, a lower ratio is also linked to healthier LDL subset particle size (less subset B) (7, 8).
Both avocado oil and olive oil have zero milligrams of cholesterol. Foods derived from plants do not contain cholesterol.
Cholesterol is an active compound in the body. It reacts to oxidative stress and inflammation. Here’s how:
As free radicals move throughout the body and damage cells, cumulative oxidative stress rises. Next, the body mounts an inflammatory response and cholesterol comes in to patch things up.
When cholesterol can also become damaged and oxidized by free radicals. Oxidized cholesterol is sticky. It can embed into artery walls and potentially form plaques and blockages (9).
While statins may be right for some patients, no medication is completely safe, and no medication is completely effective.
While it is true that statins typically lower overall cholesterol, there are some harmful side effects of which you should be aware.
First, statins may lower total cholesterol too much. This can lead to inadequate cholesterol levels for proper brain function (25% of cholesterol is in the brain). It can also interfere with and inhibit the benefits of omega-3 fats. Statins metabolize omega-6 fatty acids which work against omega-3s and can promote resistance to insulin, and elevated blood glucose levels.
Like most medications, statins include a risk of damage to organs and systems in the body (10).
Lastly, chronic use of statins has also been shown to interfere with the body’s production of coenzyme Q10 (CoQ10). CoQ10 is critical for immune and nervous system health, and also bolsters heart health, proper muscle function, and healthy blood pressure, among much else. If you are on statins it is very important to supplement with CoQ10.
Are you savvy about cholesterol? Well, if you weren’t before, you are now. And, there’s great news! Most heart condition risk can be strongly influenced by lifestyle. Weight changes, anti-inflammatory foods, diets high in antioxidants, exercise, cessations from smoking, and more can help you reduce triglycerides, LDL subset B cholesterol, blood pressure, and more. What’s more, these can all improve your HDL cholesterol, too!
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Cholesterol can be confusing. However, the more you know, the more you can make needed changes for heart health. Thanks for taking our cholesterol quiz. From here, focus on whole body health, specific LDL cholesterol, blood pressure, triglycerides, and HDL levels. Eat healthy in the Keto Zone, exercise, and protect your heart!