When it comes to cholesterol, there’s a lot of confusion—and fear. Over the years, we’ve been told that cholesterol is the enemy, particularly when it comes to heart health. Many of us have felt a pang of guilt as we’ve indulged in eggs or butter, fearing we were increasing our cholesterol levels and setting ourselves up for a heart attack. But what if much of what we’ve been told about cholesterol isn’t quite right?
Today, we’re diving deep into what cholesterol actually is, debunking the long-standing myth that dietary cholesterol is the culprit behind elevated blood cholesterol levels, and finally rethinking what really causes cardiovascular disease (CVD). Spoiler alert: it’s not just about the cholesterol number you see on your lab work!
What is Cholesterol, and Why Do We Need It?
First things first: cholesterol is not inherently bad. In fact, it’s a vital substance that our bodies need to function. Cholesterol is a type of lipid, a fat-like substance found in every cell of your body. It plays a key role in producing hormones, vitamin D, and substances that help digest food. It also helps to build cell membranes and protects nerve fibers.
Here’s the kicker: your body makes cholesterol naturally—specifically, your liver does most of the heavy lifting in producing it. In fact, even if you consumed no cholesterol from food at all, your body would still manufacture it because it’s that essential. Without cholesterol, your body wouldn’t be able to operate.
The Myth: Dietary Cholesterol Increases Blood Cholesterol
For decades, we’ve been told to avoid cholesterol-rich foods like eggs, red meat, and full-fat dairy. The logic was simple: eat foods high in cholesterol, and your blood cholesterol levels would spike, leading to clogged arteries and heart disease.
But modern science has started to chip away at this narrative. Numerous studies have shown that dietary cholesterol has a minimal impact on blood cholesterol levels for most people. That’s right—the cholesterol in your food doesn’t automatically raise your blood cholesterol the way we once thought it did.
In 2015, the Dietary Guidelines for Americans removed its recommendation to limit dietary cholesterol, citing that it’s no longer considered a nutrient of concern for overconsumption. What we now know is that for most people, the liver adjusts the amount of cholesterol it produces based on how much is consumed through food. Eat more cholesterol, and your body produces less. Eat less, and your liver ramps up production.
So, that means you can enjoy your eggs and avocado toast without feeling like you’re sabotaging your heart health.
Rethinking Blood Cholesterol: What Do High Levels Really Mean?
You’ve likely heard of the terms LDL (“bad” cholesterol) and HDL (“good” cholesterol). But this simplified view of cholesterol doesn’t tell the full story.
LDL (low-density lipoprotein) has been labeled as “bad” because high levels of LDL cholesterol can lead to plaque buildup in arteries, which increases the risk of heart disease and stroke. On the other hand, HDL (high-density lipoprotein) is considered “good” because it helps remove cholesterol from the arteries. The idea has been that lowering LDL and raising HDL is the golden ticket to heart health.
However, new research is showing that it’s not that straightforward. It’s not just about having “high” LDL; it’s more about the size and density of the particles. Smaller, denser LDL particles are much more likely to cause damage to the arterial walls than larger, fluffier LDL particles. This nuance is rarely discussed in the mainstream medical narrative.
Moreover, while statin drugs are often prescribed to lower cholesterol, they only target the number on the lab report, not necessarily the underlying issue that may be causing damage in the arteries. We need to ask ourselves: Is cholesterol the problem, or is it trying to repair something that’s already gone wrong?
The Real Cause of Cardiovascular Disease: Inflammation, Not Cholesterol
Here’s where we get into the heart of the matter: cardiovascular disease isn’t simply caused by “too much” cholesterol. If that were the case, everyone with high cholesterol would develop heart disease, and people with low cholesterol would never suffer from it. But that’s not what we see.
Instead, cardiovascular disease is increasingly being understood as a condition driven by chronic inflammation. Let me explain.
Your arteries are like a complex highway system delivering blood throughout your body. When inflammation occurs—whether due to poor diet, stress, smoking, lack of sleep, or other factors—it’s like potholes forming on those highways. Cholesterol, particularly LDL, is sent in to patch up those potholes. In this sense, cholesterol is more of a responder than a cause. It’s the fire truck racing to the scene, not the fire itself.
When inflammation is persistent, more and more LDL is sent in to deal with the damage, and over time, these “patch jobs” can lead to the buildup of plaques in the arteries. The plaques can harden and narrow the arteries, setting the stage for heart disease. But it’s the inflammation that’s the true culprit, not the cholesterol itself.
So, What Really Raises Inflammation and Leads to CVD?
If we want to lower our risk of heart disease, it’s time to stop demonizing cholesterol and start focusing on the real contributors to chronic inflammation. Here are some of the key factors:
1. Poor Diet
The Standard American Diet (aptly referred to as SAD) is high in processed foods, refined sugars, unhealthy fats (like trans fats and excessive vegetable oils), and low in nutrients. These foods create oxidative stress and inflammation in the body, which sets the stage for atherosclerosis (plaque buildup in the arteries).
To counteract this, we should aim for a diet rich in whole, unprocessed foods. Think plenty of vegetables, healthy fats (like those from avocados, nuts, and olive oil), and high-quality proteins. Reducing sugar and refined carbohydrates will also go a long way in lowering inflammation.
2. Lack of Movement
A sedentary lifestyle contributes to poor circulation and can exacerbate inflammation. Regular movement, especially gentle activities like walking, stretching, and strength training, helps keep the blood flowing smoothly, reducing the risk of plaque formation.
3. Stress
Chronic stress leads to elevated levels of cortisol, which can increase inflammation throughout the body. Managing stress through mindfulness, yoga, and simply taking time for self-care can significantly improve heart health.
4. Poor Sleep
Sleep is a major player in regulating inflammation. Poor sleep quality or quantity can raise inflammatory markers and increase the risk of heart disease. Prioritizing good sleep hygiene is essential.
5. Toxins
Exposure to toxins—whether through smoking, environmental pollutants, or even some foods—can promote inflammation in the body. Eliminating or reducing exposure to these toxins is critical.
Conclusion: Time for a Paradigm Shift
We’ve spent decades focusing on lowering cholesterol, but it’s time for a paradigm shift. Cholesterol isn’t the villain we once thought it was. Instead, we need to shift our focus toward managing inflammation—the true driver of cardiovascular disease.
By adopting a holistic approach that emphasizes a healthy, nutrient-dense diet, regular movement, stress management, and good sleep, we can protect our hearts more effectively than by merely trying to lower cholesterol numbers.
So next time someone tells you to skip the eggs or avoid red meat because of cholesterol, you’ll know better. It’s not the cholesterol that’s the issue—it’s everything else we’re doing that’s causing inflammation. Let’s focus on the real cause and take care of our bodies the right way.
