What’s up with cholesterol?

I’m often talking about the foibles of the medical establishment, though usually as related to pain management and such. But I’ve been reading a bit about cholesterol and it seems like conventional wisdom about several aspects of the topic has been turned on its head.

For example, the decades old advice about avoiding foods with high cholesterol (like eggs) doesn’t seem to hold up. Avoiding these foods doesn’t have much correlation with the cholesterol levels of your body. (Cholesterol is actually produced by your body.) In this case, you aren’t what you eat. Don’t take my word for it.

In February, however, the Dietary Guidelines Advisory Committee (DGAC) rocked the nutrition and medical worlds by changing their tune.

In its report, the committee states: “Previously, the Dietary Guidelines for Americans recommended that cholesterol intake be limited to no more than 300 mg/day. The 2015 DGAC will not bring forward this recommendation because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum (blood) cholesterol. … Cholesterol is not a nutrient of concern for overconsumption.”

Perhaps more interesting is the news on saturated fats which we’ve been advised to avoid for years because it raises cholesterol levels. You probably know that there are two types of cholesterol: Good HDL cholesterol and bad LDL cholesterol. But is LDL really bad? It turns out there are different subtypes of LDL

LDL comes in four basic forms: a big, fluffy form known as large LDL, and three increasingly dense forms known as medium, small, and very small LDL. A diet high in saturated fat mainly boosts the numbers of large-LDL particles, while a low-fat diet high in carbohydrates propagates the smaller forms. The big, fluffy particles are largely benign, while the small, dense versions keep lipid-science researchers awake at night.

So, by advising people to avoid saturated fats and eats more carbs, health advisors may have been inadvertently raising people’s levels of really bad, small LDL cholesterol.

Oops.

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