Bad Cholesterol - Not Really

Another great article by Dr. Donald K. Layman

Cholesterol may be the most misunderstood molecule in the body. For years, the public was told that cholesterol was hazardous to health. Dietary guidelines recommended lowering cholesterol intake for heart health … and Americans did. From 1980 to 2000, Americans lowered daily cholesterol intake from about 700 mg (milligrams) to less than 300 mg and it had NO EFFECT AT ALL on risk of heart disease. Oops! It’s time to consider the rest of the story.

Everyone has heard about cholesterol and most adults know their cholesterol numbers including total cholesterol (TC), LDL cholesterol ("bad cholesterol"), and HDL cholesterol ("good cholesterol").  Most physicians will tell you that TC should be less than 200 mg/dl and LDL less than 130mg/dl (or even 45mg/dl). However, just using these numbers ignores the true facts about the roles of cholesterol in the body.

Cholesterol is absolutely essential for health. We need about 1000 mg of cholesterol everyday. Cholesterol is essential to build and repair cell walls; it’s the starting point to make steroid hormones such as estrogen and testosterone; it’s required to form bile for digestion of dietary fats; and it’s a major part of the insulation (ie. myelin sheath) that surrounds and protects every nerve in the body. Cholesterol is so critical to life that it would be an essential nutrient just like vitamins or amino acids except that we make it.

Our bodies make cholesterol in the liver and then send it out to every organ and cell throughout the body. Since cholesterol is a type of fat, it is not soluble in water and it has to be carried by proteins to move through the blood. LDL and HDL are the cholesterol carriers. These cholesterol transporters are called lipoproteins. LDL (low density lipoprotein) serves to carry cholesterol from the liver out to the cells. To be sure that every cell gets enough cholesterol, we produce more total cholesterol and more LDL than necessary. Because we must always have more than we need, the body created HDL (high density lipoprotein) as the return system. The extra cholesterol on LDL not needed by cells is picked up by HDL and returned to the liver. The liver sees the returning HDL and recognizes it made too much so it slows down LDL production. So the amounts of LDL and HDL in the blood represent a constantly changing balance of cholesterol production and removal. 

The common statement that LDL is “bad cholesterol” could not be further from the truth. Without LDL you would die within weeks. That is one of the reasons why low LDL (and low TC) relates to increase risk of stroke and risk of muscle pains. These are facts that pharmaceutical companies and physicians list in the fine print when they prescribe statin drugs that decrease normal liver production of cholesterol. 

The more important cholesterol number is the balance between LDL and HDL or the LDL/HDL ratio. Ideally this ratio should be 70 and have no risk of heart disease. 

There is one more important fact about LDL that your doctor never mentions and that’s LDL size. All LDL’s are not alike. Some are large and buoyant and others are small and dense. The large buoyant LDL’s are easy for the body to handle and rapidly removed by HDL, while the small dense LDL’s are difficult to handle, tend to hang around a long time in the blood, and are easy to oxidize. The oxidized LDL’s are the ones that can cause damage to the lining of blood vessels and lead to heart disease. This means you can have an LDL of 135 with large LDL particles and be totally healthy or an LDL of 135 with small dense LDL and be at risk. Unfortunately LDL size is not a test most doctors or clinics can measure, but you should always get your LDL/HDL ratio.

Okay, then what’s the relationship of diet to blood cholesterol? Well, it’s not what you might expect. Contrary to what you’ve heard, LDL and HDL have almost no relationship to dietary cholesterol or fat, but are heavily influenced by carbohydrates. For cholesterol, most Americans eat about 300 mg of cholesterol each day and only about half of that gets absorbed. The liver sees about 150 mg coming in from the diet but still needs a total of 1000 mg, so the liver knows to make the additional 850 mg to get the required daily total. Dietary intake is balanced with liver production. 

The real risk factors are dietary carbohydrates and insulin. Insulin is the problem because it disrupts the liver regulation of cholesterol production and LDL size. When you are 25 years old and physically active you can handle diets that are high in carbohydrates, but as we get older and less physically active the extra carbohydrates lead to excess insulin. The high insulin increases the key enzyme in cholesterol production (the enzyme is called HMG CoA reductase) and disrupts the liver’s ability to balance daily cholesterol needs. The high Carb diet becomes worse if it is also low in protein because that leads to reductions in the ratio of LDL/HDL and increases the small dense LDL’s. So the worse possible health situation is a diet with high Carbs and low protein and a lifestyle with low physical activity. 

These are the metabolic corrections of the METABOLIQ Lifestyle. METABOLIQ is great for weight loss, but it’s also perfect for adult health because it optimizes your LDL and HDL cholesterol system. METABOLIQ corrects the carbohydrate and protein problems and creates the metabolic balance that your body needs for long-term health. We always emphasize that Qivana is about systems approach to health and balancing the LDL-HDL system is yet another example of the amazing science behind the Qivana products.

For your health,
Dr. Donald K. Layman
Qivana, CSO


Dr. Donald K. Layman is Professor Emeritus of Nutrition in the Department of Food Science and Human Nutrition at the University of Illinois. With more than 33 years of teaching and research experience, Dr. Layman has numerous awards and recognitions, including awards from the American Society for Nutritional Sciences, the National Institutes of Health and the Nutrition and Metabolism Society.

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