The Cholesterol Myth

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Your doctor is lying to you... And he doesn't even know it.

If you are one of the 102 million Americans with high cholesterol, no doubt your doctor has told you that you are at risk of heart disease, the No. 1 killer in the U.S.

But that isn't true. Cholesterol has nothing to do with heart disease. In fact, half of all people admitted to a hospital for a heart attack have average or low cholesterol levels.

I still remember arguing with a senior resident while I was in medical school back in 2001. The traditional cholesterol model didn't make any sense to me. How can cholesterol be bad for us when our own livers make it regularly?

To understand how this myth became engrained as medical dogma, let's go over some of the facts about cholesterol...

What is cholesterol?

Cholesterol is a waxy type of fat we have throughout our bodies. It's a building block for many parts of our anatomy. For example, our body is made up of 37 trillion cells. Each cell has a membrane surrounding it that's made of cholesterol.

Cholesterol is a necessary component your body uses to make some hormones. It also covers the ends of the nerve cells in our brains. This helps them fire messages quickly around our brains.

There are two types of cholesterol – dietary cholesterol and blood cholesterol. Dietary cholesterol comes in the foods that we eat. Blood cholesterol is made by your liver. Structurally, they are the same, but dietary cholesterol has no effect on your blood cholesterol levels.

What do you mean my bacon double cheeseburger has NO effect on my cholesterol?

To repeat: The cholesterol in the foods you eat does not affect your blood cholesterol. In a study done in 1999, Harvard Medical School showed that eating an egg every day did not alter levels of blood cholesterol. So if you have high cholesterol and your doctor tells you to avoid eggs, he's wrong. In fact, eggs are packed with protein, zinc, iron, copper, and vitamins like A, D, K, B6, and B12... all vital nutrients. Likewise, other cholesterol-heavy foods (butter, shrimp, and fish) also have great health benefits.

But... that's not a license to eat whatever you want. Your liver will produce more blood cholesterol in response to certain foods, specifically those high in trans fat (more on these in a minute). High trans-fat foods include margarine, fried foods, microwave popcorn, and baked processed goods like cookies, cakes, and biscuits. It also includes fatty meats and foods cooked in highly processed cooking oil, like that bacon cheeseburger. These are the kinds of foods you should cut down on, not eggs.

What is heart disease?

Heart disease is caused by a process called atherosclerosis. This means that your arteries, which carry oxygen-rich blood to parts of your body, become less flexible and start to form hard, sticky plaques inside their walls. This can constrict blood flow (raising your blood pressure), and sometimes the plaques can break off and block smaller vessels. When a blood vessel gets blocked, blood cannot reach that tissue.

During a heart attack, one of the small blood vessels that feeds oxygen to your heart muscle cells gets blocked. The heart muscle in that area can't get the oxygen it needs to function, so it dies.

Plaques can also break off and travel up to the vessels in your brain. If they get stuck, they can block the vessels feeding your brain cells. Similar to a heart attack, the brain cells that need that oxygenated blood will die, resulting in a stroke.

Right. And my doctor says cholesterol causes these plaques...

That's the common belief. But it's not true.

So why does plaque form in my arteries?

In a massive 2012 study, 170 researchers worked through the data of 190,000 people with heart disease. They concluded that inflammation was the cause of the arterial plaques – not that cholesterol made the plaques, which then triggered inflammation.

This is what I've been saying for years: It's not cholesterol that you should worry about. It's inflammation.

You see, inflammation puts a lot of stress on your body. In your arteries, inflammation weakens or irritates parts of the walls. Your immune system kicks in to fight it and forms a plaque to "heal" the inflammation. These plaques are made of white blood cells plus cholesterol.

So, although cholesterol makes the plaques, cholesterol is not the reason you get plaques. Therefore, it's inflammation we should be fighting instead.

What causes inflammation?

Inflammation is the response of your immune system to an irritant. This can be anything from a cut or scrape on your hand to a viral infection like the flu, or an autoimmune diseases like rheumatoid arthritis.

Inflammation is the red, hot feeling you get when you start to heal. It happens because your body has sent out alerts that you're hurt and it increases the blood flow to that area. That extra blood carries immune cells that come and clear out the damage and try to repair your body.

Other factors also contribute to inflammation. Smoking, for example, causes chronic inflammation of your airways. And some foods increase your inflammation. Trans fat plays a big role. Simply put, our bodies cannot break down trans fats easily... They upset our immune system and trigger inflammation. The same is true for refined carbs like white bread, white sugar, and sugar substitutes like aspartame.

What can I do to reduce excess inflammation?

The first step is to avoid foods high in trans fat and sugar. You should also try to avoid overly processed foods like white bread and white sugar, which can cause inflammation, too.

So eat more anti-inflammatory foods. These foods can contain phytochemicals found in fruits and vegetables. These include lycopene (found in tomatoes), beta-carotene (found in carrots), and anthoxanthins (found in bananas).

Antioxidants also fight inflammation. Blueberries, my favorite food, are rich sources of antioxidants. You can also find antioxidants in coffee, dark chocolate, and wine.

Other studies have shown that regular exercise and maintaining a healthy weight also cut down on inflammation.

And brush your teeth and floss. Studies have shown that without good dental hygiene, the germs and bacteria that live in all of our mouths can contribute to chronic inflammation in our bodies.

What We're Reading...

  • Dr. David Perlmutter's book on how grains and sugar cause inflammation,Grain Brain. His tips and insight will change the way you look at food.