Does Cholesterol in Food Matter?
People worry whether eggs or other high-cholesterol foods negatively affect blood chemistry, but they're focusing on the wrong thing.
Google the word "cholesterol" and most of the info you'll find is about lowering it. The most common questions? Can I eat eggs? How about shrimp and other high-cholesterol foods? Are they "safe?"
Well, the amount of cholesterol in the food you eat doesn't appear to matter much at all. Your body makes cholesterol on its own, pretty much no matter what. Eat a lot of cholesterol and your body makes less. Eat less cholesterol and your body makes more.
Yes, food matters in determining your cholesterol levels, but it has little to do with the amount of cholesterol in that food. Instead, cholesterol levels have to do with a couple of other issues:
- The amount and type of carbs in that food.
- The amount of saturated fat you eat in combination with the cholesterol you ingest.
Carbs and Cholesterol
If someone regularly eats a lot of simple carbs, they often develop insulin resistance, leading to increased blood sugar levels. Along with this comes an increase in the rate at which fats are broken down. This leads to elevated levels of blood fats or triglycerides. You also find a decrease in good cholesterol (HDL) and an increase in bad cholesterol (LDL).
This triumvirate of heart terror β high triglycerides, low HDL, and high LDL β is thought to play a big role in plaque buildup in the arteries. Too much plaque and you'll start clutching your chest at inopportune times.
But you don't necessarily have to be insulin-resistant for carbs to negatively affect cholesterol levels. Just being a carb junkie and having more than about 60% of your daily calories come from carbohydrates (especially heavily processed carbs) tells the liver to start manufacturing more cholesterol.
Saturated Fat and Cholesterol
Now it gets tricky. The cholesterol in food does matter if you eat a lot of cholesterol in combination with a lot of saturated fat.
For example, most red meat contains a lot of saturated fat and a significant amount of cholesterol, so when you eat it regularly, you usually see an increase in LDL cholesterol. The good news is that the saturated-fat-laden steak also raises HDL cholesterol, so your total cholesterol to HDL ratio (a supposed marker for cardiovascular disease) isn't altered.
So, in general, high-ish cholesterol foods that don't contain a lot of saturated fat like eggs and shrimp won't affect LDL cholesterol levels, but high-cholesterol, high-saturated fat foods like steaks and other cuts of red meat will.
However, red meat shouldn't affect your long-term cardiovascular health because it doesn't appear to affect the LDL/HDL ratio. So, the question is, should you eat steak and hamburgers with impunity?
The research is sometimes confusing. A study from 1991 found that if Americans cut the amount of saturated fat they ingested, they could delay 42,000 deaths each year⦠by an average of two weeks.
That's not quite as bad as it sounds because "average" means that some people might have extended their life by several years while others might have extended their lives just long enough for their Hot Pockets to finish microwaving. But even so, any lengthening of lives probably had little to do with cholesterol itself.
So, What Causes Heart Attacks?
Doctors can't agree on what causes heart disease. Sure, there are some statistical probabilities pointing to the wisdom of lowering blood pressure and cholesterol, but they don't mean squat if you're one of the roughly 50 percent of men or 63 percent of women who die from heart attacks while not exhibiting any symptoms or strong risk factors.
The only thing that doctors and scientists seem to agree on is that heart disease is a disease of inflammation. What's common to just about everyone who dies of a heart attack is a large collection of white blood cells known as macrophages. These macrophages collect around fatty deposits and secrete enzymes that digest protein. The insides of blood vessels are made of proteins, and in trying to eliminate the fatty deposits, the blood vessels are eaten away, made thinner, and made more susceptible to plaque or rupture.
What surprised researchers, though, was that they also found these macrophages in presumably healthy arteries. This indicated that the inflammation was systemic and not localized.
What Should I Do?
Clearly, the science of cholesterol is evolving, but in the meantime, there's solid evidence to support the following:
- Strive to reduce inflammation in general. Shore up your body with plenty of anti-inflammatory omega-3 fatty acids (mostly DHA) by taking Flameout (Buy at Amazon).
- Add Micellar Curcumin (Buy at Amazon) to your supplement list to further reduce inflammation (and for all its other health benefits).
- Avoid lots of carbs, especially highly processed carbs. Carbs raise cholesterol and triglycerides while reducing HDL levels. More importantly, the resulting insulin resistance leads to inflammation, which is definitely bad for the heart.
- Improve insulin sensitivity in general to keep inflammation low.
- It looks like eating foods high in cholesterol but low in saturated fats, like eggs and shrimp, won't negatively affect your health.
- Meats high in saturated fat and cholesterol are probably okay to eat in moderation because they elevate both HDL and LDL, thus leaving the total cholesterol ratio unaffected. However, eating too much saturated fat regularly leads to inflammation, which the heart doesn't like.
- Substituting polyunsaturated fat (like olive oil) for saturated fat in cooking reduces LDL cholesterol and total cholesterol so that you get a better cholesterol ratio (LDL to HDL).
- De-stress as much as possible.
But Just in Case...
It's possible that high cholesterol might someday prove to be the demon it's been portrayed as. Maybe the scientists will reconcile the apparent contradictions in the data. Given that possibility, it's smart to be at least a little proactive about cholesterol, especially if your numbers look very bad.
One tip is to take a serving of sugar-free Metamucil (Buy at Amazon) before breakfast and another before dinner. Psyllium removes bile from the body, which causes the liver to make more bile by using the cholesterol available in the blood. This in turn lowers cholesterol. (If you don't physically remove cholesterol, it just gets recycled.) The psyllium works much like the medicines known as bile-acid binding resins, e.g., cholestyramine.
References
- Neugeboren J. Open Heart: A Patient's Story of Life-Saving Medicine and Life-Giving Friendship. August 6, 2003.
- Dehgan M et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet. 2017 Nov 4;390(10107):2050-2062. PubMed: 28864332.
- Siri-Tarino PW et al. Saturated Fatty Acids and Risk of Coronary Heart Disease: Modulation by Replacement Nutrients. Curr Atheroscler Rep. 2010 Nov;12(6):384-90. PubMed: 20711693.
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