There seems to be allot of misinformation/confusion regarding cholesterol, so lets talk about it. I’ll break down the issues one by one.
Is cholesterol absorbed in the body?
Yes, It is absorbed in the intestines
Does dietary cholesterol affect serum cholesterol?
Yes, dietary cholesterol can be absorbed in the intestines and become serum cholesterol.
So why do studies show that adding cholesterol to someone’s diet does not significantly effect serum cholesterol?
Cholesterol follows a reverse exponential curve in terms of its effects on serum, meaning that adding 200 mg of cholesterol to a diet that has, for example 500 mg in it already is not going to have the same effect as adding 200 mg to a diet with only 50 mg in it.
This dose response curve is also why things such as plant sterols and the drug Ezetimibe are able to lower cholesterol. Cholesterol is also excreted in liver bile, but can be reabsorbed which is why fiber helps regulate cholesterol.
Why are there so many studies with this flawed design?
There is allot of money in heart disease and foods high in cholesterol.
So what happens if you have high levels of cholesterol?
Well it can speed up development of atherosclerosis, which is the arteries getting blocked due to build up of cholesterol and other materials on the arterial walls. This increases blood pressure, reduces blood flow and can even lead to a heart attack.
It has also been linked to Alzheimer, due to the brain’s blood vessels being blocked, getting less blood flow and the surrounding tissue dying, lower back pain due to that area needing clean blood vessels to deliver nutrient to the lower spine, and most famously erectile dysfunction due to blood flow to that area being restricted, which is why Viagra, a vasodilator, is able to treat it.
So what about the claims that cholesterol does not directly cause to atherosclerosis?
This is technically true, in the same vein that saying chronically high IGF-1 levels do not cause cancer, or flammable objects don’t cause house fires, its not really the cause but it is a huge contributing factor. A proper diet with lots of vegetables and low amounts of fructose lowers risk quite a bit, but I personally wouldn’t bet my life on it.
So what should you do?
Honestly its up to you, as long as you know the risk do what ever you want.
In the event you do want to lower your cholesterol reduce long chain saturated fats, hydrogenated oils, cholesterol and fructose consumption, eat more fiber and reduce your body fat percentage. To what degree you need to do this is dependent on genetics.
You can also do a fast every once and a while which I may write up a guide on if there is interest.
Why did the FDA remove the cholesterol limit if cholesterol is so bad?
At the previous level it served little purpose, the difference between 300 mg and 500 mg is not that significant, so its now just a generalized “limit cholesterol and saturated fat”. They also list it as “not a nutrient at risk for over consumption” because of the way high intakes work.
Do I need to go vegan?
Ehh I don’t think so, it has benefits but strict vegan has allot of downsides.
If you want to get the health benefits without the big downsides/cost keep the gelatin capsules, fish oil, whey isolate when its cheap and any non-vegan things that are functionally identical to vegan options. Other then that don’t forget protein and supplements.
Should I take a statin?
First I am not a doctor, so if your doctor says something you should probably listen to him over me.
From what I can decipher if you are at a very high risk then yes, while you work to lower your cholesterol and become healthier. Statins are effective but they are over used and have allot of side effects.
Is it true carnivores can’t develop atherosclerosis?
They are more resistant to it and regulate cholesterol better then humans can, unless you feed them a large amount of sugar, or remove their thyroid in which case yes.
What about the keto diet?
I would wait on more research unless you are one of the groups that really heavily benefits from said diet. If its shown it can be done long term without raising cholesterol to unsafe levels it looks rather promising.
Does HDL or LDL particle size matter?
HDL seems to be an indication of good heart health rather then an actual protective factor, this is why HDL raising pharmaceuticals haven’t been approved as they haven’t been shown to do much.
Particle size does seem to have a very slight effect but it’s incredibly minor.