by Mark Whalen

Cholesterol has been in the news recently because the federal government issued new dietary guidelines, and among the big newsmakers is that cholesterol is no longer a nutrient of concern. In other words, most of us don’t have to worry about eating foods high in cholesterol.

For over 70% of the population, dietary cholesterol has a minimal impact on our blood levels of cholesterol.   The other 30% are those that have a genetic predisposition to high cholesterol or are hyper-responsive to dietary cholesterol.

Dietary Cholesterol has long been linked with an increased risk in heart disease, heart attacks, strokes etc..  The reasons why cholesterol has been unfairly demonized are too complex for this blog, but let's just say the evidence linking dietary cholesterol to heart disease was less than strong.

Today is Part I of a two part blog post on Cholesterol.  Today I am going to cover what cholesterol is; why it's important; and what to make of the cholesterol numbers we get from the doctor.  Part II will cover ways to naturally lower/prevent high cholesterol.

What is cholesterol and why is it important?

Cholesterol is a waxy fat-like substance produced mostly in the Liver. In fact, about 75% of our supply of cholesterol is made in the liver. The other 25% comes from diet.

When your dietary intake of cholesterol goes down, the Liver’s production of cholesterol goes up. It also works in reverse—if you eat more cholesterol, your liver will decrease its production.

Cholesterol is part of every cell in our body and we cannot live without it.

Key functions of cholesterol are:

  • Helps to maintain the integrity of cell membranes-preventing them from becoming too soft, too permeable or too firm.
  • Precursor (raw material) for all steroid hormones in the body –sex hormones (androgens, estrogens), mineralocortocoids (maintain salt and water balance), cortisone and Vitamin D.
  • Precursor of bile acid, which is necessary for the digestion of fats.

Cholesterol is made up of several components known as Lipoproteins. Most us have heard of HDL (High Density Lipoprotein), LDL (Low Density Lipoprotein) and Triglycerides.  HDL is typically referred to as the ‘good’ cholesterol, while LDL is the ‘bad’ cholesterol.

Cholesterol Testing and Recommendations

Cholesterol testing is typically done during a fasting blood test. The four parameters measured are HDL, LDL, Triglycerides and Total Cholesterol (HDL + LDL + 20% of triglycerides).

Current Recommendations for these parameters are:

Total Cholesterol 100-200 mg/dL
HDL 40-90 mg/dL
LDL <130 mg/dL
Triglycerides 50-150 mg/dL

Your chances of developing (or having) heart disease increase with:

  • High total cholesterol, low HDL, High LDL or high triglycerides
  • Triglyceride to HDL Ratio- ideal to be in the 2-3 range.
  • HDL to Total Cholesterol: If HDL is <25% of total cholesterol, this is a strong indication of a heart disease risk.
  • Triglycerides higher than total Cholesterol level with a decreased HDL

If you fall into any of those concern categories, you may want to have more tests run to further identify your risk levels.  We will talk more about these in Part 2, but in regards to cholesterol testing, I wanted you know about the Vertical Auto Profile (VAP) Test.

Vertical Auto Profile Test

The typical cholesterol test measures the HDL and LDL numbers.  It does not give any information on the types of HDL and LDL you have.  That's right- there is more than one type of HDL or LDL.  The VAP test will identify what type, and how much HDL and LDL do you have.  The breakdown of what types of HDL and LDL you have are more important than the whole numbers of HDL and LDL.

LDL subgroups

LDL can be broken down into subgroups known as VLDL 1, 2 or 3(very low density lipoproteins). High levels of VLDL 3 are an indicator of higher risk.   The size of the LDL particles matters as well.

LDL Pattern A indicates large, less dense particles of LDL- think of them as fluffy clouds- too big to get into arteries and cause damage.

Pattern B contains small dense LDL particles- these particles indicate a much higher risk of heart disease.

Lipoprotein (a) is a key indicator of heart disease on it’s own that is not measured. High Lipoprotein (a) is correlated with a high risk factor for heart disease and strokes.

HDL Subgroups

HDL can be subdivided into HDL 2 and HDL 3.  HDL 2 are large particles that help remove cholesterol from the cells.  HDL 3 has little impact in this role.  Having more HDL 2 is therefore more protective against heart disease.

Bottom Line

If you are concerned about your cholesterol levels, take a closer look at the ratios between the numbers and speak with your doctor about getting the VAP test done ( I honestly don’t know if insurance covers this test).

For a great resource on this subject, check out the book: The Great Cholesterol Myth by Jonny Bowden and Stephen Sinatra.

In Part Two next week, I will cover how your cholesterol gets higher and what you can do to prevent/reverse it and some other indicators of heart disease risk.







Disclaimer: This article is for informational purposes only.   It is not intended to diagnose, treat, or cure any disease or illness. This article is not a substitute for medical advice.

Mark Whalen is a Licensed Acupuncturist and Board Certified Herbalist and the founder of Five Points Acupuncture & Wellness in Reading, MA.

Mark Whalen – who has written posts on Acupuncture Reading MA - Five Points Acupuncture & Wellness.


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