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The changing role of cholesterol: Debunking old myths

By Joanie Koplos

The number 1 killer of adult Americans is still heart disease. The most prevalent form of coronary problems today is arterial disease with 14 million U.S. citizens affected. These kinds of numbers are sure to produce a few inaccuracies or myths about cholesterol, which has fallen into the ever persistent role of the “bad guy” in treating this mega-health problem. In Part 3 of this series, let’s explore some of these old myths:

Myth 1: Cholesterol is always bad. As you read in Parts 1 and 2 of this series, cholesterol, transported by LDL and HDL, can be dangerous when the LDL count (not the cholesterol itself) gets too high and leads to plaque buildup in the arteries, where a possible heart attack or stroke can occur. However, cholesterol is essential to various body processes. From insulating nerve cells in the brain to providing structure for cell membranes and the production of certain hormones, it is an absolutely critical part of the body.

Myth 2: Americans have the highest cholesterol levels in the world. As a nation, we can certainly use a lot of slimming down, but when it comes to total cholesterol counts, we are solidly middle-ground. 2005 World Health Organization statistics reveal American men rank 83rd in the world in the number, while American women rank 81st. In both cases, the average American cholesterol total number was 197 mg/dL, a still high number for even very healthy individuals according to our Wellness Director, Dr. Jared Ko (see Part 2).

Myth 3: Everyone should aim for the same cholesterol levels. The fact is that there is not one particular number for everyone. Your ideal numbers depend on your risk factor profile. Some of the more outstanding coronary risks are: having high blood pressure, being obese—especially with inactivity—being diabetic, smoking, and having a strong genetic background of heart disease. The higher your number of these risks, the lower your total count and LDL count should be.

Myth 4: Children can’t have high cholesterol counts. Like adults, if their liver only works partially, they may have an elevated cholesterol count. Research has shown that atherosclerosis—the narrowing of the arteries that leads to heart disease—can start as early as age eight. While the onset of actual vascular problems may not occur to them as youths, they are still more likely to experience cardiovascular difficulties much younger than their adult peers. Therefore in July, 2008, the American Academy of Pediatrics released guidelines that recommended children who are overweight, have hypertension (high blood pressure), or have a family history of heart disease can be tested as young as two years of age.

Myth 5: High cholesterol is caused mostly by diet. The most important factor in deciding a person’s cholesterol levels is heredity. As mentioned in Part 2, the liver is supposed to remove excess cholesterol from the body, but genetics determines how effectively this process is able to maintain a healthy level. For those fortunate people whose liver function is near normal, a healthier diet can be the solution, reducing cholesterol levels by 10 to 15 percent.

Myth 5: It’s always better to control your cholesterol through diet alone rather than with medications and diet. Again, while this may be an option for those with healthier functioning livers and good cholesterol numbers, individuals with high numbers and high coronary risk factors where diet control and exercise alone is not working, statin medications might need to be introduced.

Myth 6: Some dietary foods are strictly taboo. As mentioned in Part 1 of this series, 25 percent of cholesterol comes from food. A few food items that were strictly forbidden in a healthy cholesterol-controlling diet have now been allowed in moderation. Among these recently added foods are beef and eggs. Small portions of lean beef have been found not to hurt a cholesterol-lowering diet. Eggs, while high in cholesterol at 200 mg (the daily dietary requirement of cholesterol is 300 mg), are considered an excellent source of protein and contain unsaturated fat. One or two eggs weekly are now allowed. Margarine has been considered healthier than butter for your diet, but margarine may also be high in trans fatty acids. Also be aware of labels that say “0 mg cholesterol.” Saturated fats and trans fats have been found to have a larger impact on the raising of LDL numbers than a high-fat diet.

Next edition: Part 4: More recent research on cholesterol





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