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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Sitting Is Hazardous to Your Health

I just got back from an annual weekend Fitness Symposium where I learned many interesting things. However, the most shocking fact was the health care cost of inactivity is approximately $150 billion per year. That is the cost of not moving enough to see any kind of health benefits associated with regular exercise. Sitting Is Hazardous To Your Health!

The 2007 Physical Activity Guidelines from the American College of Sports Medicine and the American Heart Association for men and women under the age of 65 is:

• Moderate cardiovascular activity 30 minutes per day, 5 days each week, OR
• Vigorous cardiovascular activity 20 minutes per day, 3 days each week, AND
• 8 - 10 strength training exercises (8-12 repetitions each), 2 times each week.

And for men and women over age 65 and over:

• Moderate cardiovascular activity 30 minutes per day, 5 days per week, OR
• Vigorous cardiovascular activity 20 minutes per day, 3 days per week, AND
• 8 - 10 strength training exercises (10-16 repetitions each) 2 to 3 times each week, AND
• Balance exercises, if at risk of failing.

Where in both cases Moderate equals activities that reasonably accelerate the heart rate, such as a brisk walk, and Vigorous equals activities causing a rapid increase in heart rate, such as jogging.

Now the benefits of adhering to the above exercise guidelines are:

• Reduced stress, depression and anxiety
• Lowered risk of stroke
• Lowered incidence of breast cancer in women
• Reduced blood pressure
• Increased function and mobility with less pain in arthritis sufferers
• Improved total cholesterol and LDL cholesterol levels
• Enhanced cardioprotection of cardiovascular disease
• Improved body composition and weight management
• Increased bone density for a reduction of risk of osteoporosis
• Improved blood triglycerides and HDL levels
• Better management of diabetes
• Lower incidence of colon cancer.

Most people know the benefits of regular exercise, and still the majority of our population spend 75 to 95 percent of their day seated. According to the Center for Disease Control, 25 percent of Americans report no physical activity during leisure time and 50 percent do not accumulate 30 minutes of moderate activity on most days of the week.

After seeing these facts, my advise to everyone is to get off your seat and start moving. Sitting is indeed hazardous to your health.

Balance and Moderation the Key to a Healthy Diet, Part 5 - Fat

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In the final installment of this series on Balance and Moderation in your diet I'll talk about fat. Fat has also taken a bad rap over the years, but it is very essential to your health and well-being. Again, balance and moderation is the key.

For decades, the mantra for healthy eating has been “eat a low-fat, low-cholesterol diet.” Touted as a way to lose weight and prevent heart disease and other chronic conditions, millions of people have followed this advice. Seeing a tremendous marketing opportunity, food companies re-engineered thousands of foods to be low-fat or fat-free. The low-fat approach to eating may have made a difference for the occasional individual, but as a nation, it has nether helped us control our weight nor become healthier. In the 1960s, fats and oils supplied Americans with about 45 percent of their calories. About 13 percent of the population was obese and less than one percent had type 2 diabetes. Today, Americans take in less fat, getting about 33 percent of calories from fats and oils; yet 34 percent of the population is obese, and eight percent has diabetes (mostly type 2). (Source: Harvard School of Public Health).

Research has shown that the total amount of fat in your diet isn’t linked with weight or disease. What actually matters is the type of fat in your diet. Trans fats and saturated fats increase your risk of cardiovascular disease, while monounsaturated and polyunsaturated fats do just the opposite. But then you ask, “what about cholesterol in food?” The answer is, for most people the mix of fats in their diets influences cholesterol in their bloodstreams far more than cholesterol in food.

Almost all foods contain some fat. Even foods like carrots and lettuce contain small amounts of fat. That’s a testament to how important fats are for your health and well-being. Fat provides a terrific source of energy for your body as well as a great depot for storing it. It is an important part of cell membranes, helping govern what gets into and out of your cells. Your body uses cholesterol as the starting point to make estrogen, testosterone, vitamin D, and other vital compounds. Fats are also biologically active molecules that can influence how your muscles respond to insulin. Also, different types of fats can fire-up or cool down inflammation in your body.

Your body packages fat and cholesterol into tiny protein-covered particles called lipoproteins in order to get them into your blood stream. Some of these lipoproteins are big and fluffy, and others are small and dense. However, the most important ones to remember for your health and well-being are low-density lipoproteins, high-density lipoproteins, and triglycerides as explained below.

Low-density lipoproteins (LDL) carry cholesterol from your liver to the rest of your body. Your cells latch onto these particles and extract fat and cholesterol from them. When there is too much LDL cholesterol in your blood, these particles can form deposits in the walls of your coronary arteries and other arteries throughout your body. These deposits, called plaque can cause your arteries to narrow and limit blood flow, resulting in a heart attack or stroke. Thus, LDL cholesterol is called your bad cholesterol.

High-density lipoproteins (HDL) scavenge cholesterol from your bloodstream, your LDL, and your artery walls and ferry it back to your liver for disposal. Thus, HDL cholesterol is referred to as your good cholesterol.

Triglycerides comprise most of the fat that you eat and that travels through your bloodstream. Because triglycerides are your body’s main vehicle for transporting fats to your cells, they are essential for good health. However, an excess of triglycerides can be unhealthy.

The type of fat in your diet determines to a large extent the amount of total and LDL cholesterol in your bloodstream. Cholesterol in food matters too, but not nearly as much. You can basically break the fats in your diet into three categories; good, bad, and very bad.

Good Fats

Unsaturated fats are called good fats because they can improve blood cholesterol levels, ease inflammation, stabilize heart rhythms, and play a number of other beneficial roles.
Unsaturated fats are predominantly found in foods derived from plants, such as vegetable oils, nuts, and seeds. They are liquid at room temperature.

Furthermore, there are two types of unsaturated fats: monounsaturated and polyunsaturated. Monounsaturated fats are found in high concentrations in canola, peanut, and olive oil, in avocados, nuts like almonds, hazelnuts, and pecans, and seeds such as pumpkin and sesame. Polyunsaturated fats are found in high concentrations in sunflower, corn, soybean and flaxseed oil. They also are found in foods such as walnuts, flaxseeds and fish.

Research has shown that replacing carbohydrates in your diet with good fats reduces harmful levels of LDL and increases protective HDL in your bloodstream. A randomized trial called the Optimal Macronutrient Intake Trial for Heart Health showed that replacing a carbohydrate-rich diet with one rich in unsaturated fat - predominantly monounsaturated fats - lowers blood pressure, improves lipid levels, and reduces the estimated cardiovascular risk.

Bad Fats

Saturated fats are called bad fats because they increase your total cholesterol level by elevating harmful LDL. Your body can produce all the saturated fat that it needs, so you don’t have to get any from your diet. In the US and other developed countries, saturated fats come mainly from meat, seafood, poultry with skin, and whole-milk dairy products. A few plant sources, such as coconuts and coconut oil, palm oil and palm kernel oil, also are high in saturated fats.

As general rule it’s good to keep your intake of saturated fats as low as possible. Saturated fats are found in many foods, including vegetable oils that are mainly unsaturated fats, so you can’t completely eliminate them from your diet. Because red meat and dairy fat are the main sources of saturated fats for most people, minimizing them in your diet is the primary way to reduce your intake of saturated fat.

Very Bad Fats

Trans fatty acids, more commonly known as trans fats, are made by heating liquid vegetable oils in the presence of hydrogen gas, - a process called hydrogenation. Partially hydrogenating vegetable oils makes them more stable and less likely to spoil. It also converts the oil into a solid which makes transportation easier. Partially hydrogenated oils can also withstand repeated heating without breaking down, making them ideal for frying fast foods. This is reason partially hydrogenated oils have been a mainstay in restaurants and the food industry.

Trans fats are worse for cholesterol levels than saturated fats because they raise bad LDL and lower good HDL. They also increase inflammation, an over-activity of the immune system that is associated with heart disease, stroke, diabetes, and other chronic conditions. Even small amounts of trans fats in your diet can have harmful health effects. For every extra two percent of daily calories from trans fat (the amount in a medium order of fast food French fries) the risk of coronary heart disease increases by 23 percent. It is estimated that eliminating trans fats from the US food supply would prevent between six and 19 percent of heart attacks and heart attack-related deaths (more than 200,000) each year.

Recommendations for Fat in Your Diet

Are you confused at this point about the type of fats and their varied effects on your health? If so remember the basic message to replace the bad fats in your diet with the good fats. Here are some suggestions to help you limit the bad fats in your diet.

• Eliminate trans fats from partially hydrogenated oils. Check food labels for the presence of trans fats and avoid fried fast foods.

• Limit your intake of saturated fats by cutting back on red meat and full-fat dairy products. When possible replace red meat with poultry, fish, beans, and nuts. Also, try switching from whole milk and other full-fat dairy foods to lower-fat versions.

• Use liquid vegetable oils rich in polyunsaturated and monounsaturated fats in place of butter in your cooking and at the table.

• Eat one or more sources of omega-3 fats every day. Excellent sources are fish, walnuts, canola or soybean oil, ground flax seeds and flaxseed oil.

Here’s how you can calculate the grams of fat in your daily diet. Let’s use the 1800 calorie per day diet again. Assume that you consume 20 percent of your daily calories from good fats, so that’s approximately 360 calories from the fat in your diet. Now there are nine calories per gram of fat. 360 divide nine equals 40 grams – the amount of fat you can eat daily. Next, use the USDA’s National Nutritional Database mentioned before to calculate your serving sizes, and it’s easy to start balancing the amount of fat in your diet.

I hope that this series on Balance and Moderation in your diet has been understandable and helpful in your quest to a healthier and more fit life. Once you grasp this concept it's easy to incorporate into your life.

Let's face it. Life is meant to be enjoyed and part of the joy of living is enjoying good foods. On the other hand, if you don't have good health, how can you enjoy life? The task is creating a healthy lifestyle in which you don't deprive yourself of the things you love and enjoy. This is what balance and moderation is all about.