High Cholesterol: Are Carbs The Problem?
PREVIEW: another underlying factor to plaque formation besides high-cholesterol & why “high cholesterol” isn’t as simple as avoiding high-cholesterol foods or as concerning as we’re told.PS — if you end up loving this article, enjoyed learning from it, or found it useful for your family and can think of anyone else who may find it interesting, please help me get it in their hands! Send via text, email, or messenger below!
We’re told to avoid egg yolks, butter, and animal meat to lower our cholesterol and reduce plaque in our arteries — but what if high cholesterol foods aren’t what cause high cholesterol? What if the type of carbohydrates we eat has a stronger connection to plaque formation than any other food group to date?
I mean, let’s be honest, doesn’t it feel ass-backwards to recommend ultra-processed cereal (with every ounce of cholesterol stripped away) more than whole foods from animals and plants (naturally full of cholesterol)? #justasking
What’s cholesterol, and why our body needs it:
Cholesterol is just a specific type of fat molecule. Since it’s a fat molecule, it’s not soluble in water (it can’t just float around in our water-based bloodstream to get where it needs to go). So to get cholesterol where it needs to go, our body shuttles it around in little taxis that are water-soluble called lipoproteins.¹ ² ³ We’ve got multiple types of lipoproteins, which maybe you’ve seen on bloodwork that your doctor has ordered to see how much cholesterol you have inside each:
LDL (low-density lipoprotein) = delivers triglycerides & cholesterol to our cells.
HDL (high-density lipoprotein) = collects the used LDL and returns it to the liver to be excreted as waste.
Total cholesterol = all cholesterol in all lipoproteins
And others like VDL, IDL (precursors to LDL), or chylomicrons that we won’t get into.
These lipoproteins are CRUCIAL because they’re carrying the cholesterol our body uses:
build cell membranes (lets nutrients in, kicks waste/toxins out)¹ ² ³
create bile (helps us digest fats & fat-soluble vitamins A, D, E, and K2)⁴ ⁵
form estrogen, progesterone, testosterone, cortisol, and aldosterone (essential for pregnancy, libido, hair growth, emotional stability)⁶ ⁷ ⁸ ⁹
Then, is high LDL really a problem?
We’re warned of high cholesterol in general (for the wrong reasons) — but it’s specifically LDL that we’re told is the “bad cholesterol” for a combination of 3 reasons:
The poor epidemiological study called the Framingham Study correlated (didn’t prove) high LDL with a higher rate of heart disease
The common “response-to-retention” theory which assumes the more LDL in our bloodstream, the greater risk of plaque forming¹²
When you combine these 3 things together, you get professionals who generally assume the more LDL = the more plaque (if plaque = heart disease, then LDL = heart disease).
BUT THERE ARE ZERO CONCLUSIVE STUDIES THAT PROVE LDL in circulation leads to more plaque formation… actually, the researcher who claimed the cholesterol we eat increases the cholesterol in our blood proved this was not true. On top of that, there are just as many epidemiological studies showing a “correlation” between LDL and heart disease as there are epidemiological studies showing NO CORRELATION! Meaning: why recommend one way over the other??
BETTER YET, there are interventional studies proving LDL itself is NOT HARMFUL and high LDL is actually PROTECTIVE:
Studies of people on LDL-lowering statins or inhibitors show their cardiovascular disease progressed despite low LDL levels.¹³
LDL binds to toxins released by bacteria in the body allowing the toxins to be excreted as waste and prevents bacteria from proliferating, causing much lower mortality rates and inflammation in mice.¹⁴ ¹⁵ ¹⁶
A study of 347 adults over the age of 65 found a significantly lower risk of dying in those with elevated total cholesterol/LDL levels.
A study of 105 adults over the age of 80 found those with the highest total cholesterol/LDL had less than half the mortality rate of those with lower levels.
The Framingham study (the same one used to justify low LDL) actually shows a much bigger correlation between high HDL, high LDL, and lower rates of cardiovascular disease when the results are grouped by levels of HDL.
Obviously, there’s more at play than just “high cholesterol levels” when it comes to plaque formation; clearly high levels of cholesterol or LDL aren’t the only thing that matters, if at all.
We know plaque can be caused by “sticky” LDL
Science will never stop teaching us new things, and so far, it’s taught us a lot about how our body uses cholesterol: we know LDL passes through our arteries, delivers the cholesterol, and then makes it way back out to be recycled or excreted as waste — but what a lot of our professionals aren’t aware of (or sharing about) is that science has also taught us SOME (not all) LDL particles are getting “stuck” as they pass through our arteries.¹ ² ³ ⁴ ⁵ ⁶ ⁷ ⁸ ⁹ If every particle was getting stuck, we’d be dead…
Q: So then, what makes some LDL particles get stuck and others don’t? What causes certain LDL particles to pass through our arterial walls and deliver cholesterol, but never make it back out to our bloodstream because it got caught forming plaque instead?
A: Metabolic dysfunction
Metabolic dysfunction turns LDL into a problem
“Metabolic dysfunction” or metabolic syndrome is an umbrella term for any condition that describes a body having a hard time absorbing food efficiently (examples: diabetes, insulin resistance, reactive hypoglycemia, cholestasis, alzheimers, hypertension, obesity, etc).
And all these conditions notoriously damage structures & processes used to absorb LDL. Instead of letting LDL pass in and out no problem, metabolic dysfunction makes LDL and our arteries become “sticky” like a velcro-and-tennis-ball, match-made-in-heaven with an extreme affinity for eachother (increasing the risk of LDL getting stuck and forming plaque)!¹⁰ ¹¹ ¹² ¹³ ¹⁴ So, is it high LDL that increases plaque in our arteries, or the environment we create in our body that makes LDL more likely to turn into plaque?
Not only does metabolic dysfunction make LDL sticky, but it’s also been shown to increase levels of LDL in circulation!
Conditions like hyperglycemia and obesity increase sticky LDL in the bloodstream, and elevated sticky LDL in the bloodstream increases risk of future metabolic dysfunction (a never ending feedback loop!)
Insulin-resistance leads to the overproduction of LDL
To us, it sounds like a) increasing the amount of LDL in circulation, and b) encouraging the LDL to become sticky is a recipe for more plaque and heart disease.
Simple Carbs Are The Culprit
You could slap a statin on your cholesterol problems, and in severe cases you definitely want to weigh the risks against the benefits — but statins work by decreasing your body’s natural production of cholesterol, which then triggers your body to increase LDL receptors increase absorption of LDL; you’re not actually fixing the cholesterol , so you’ll medicate the “problem” the rest of your life, unless you learn to live a (imperfect) lifestyle that controls your cholesterol.
To get to the root of (problematic cholesterol,
you have to get to the root of metabolic dysfunction.
To get to the root of metabolic dysfunction, you have to build a body that burns carbs better.
And we believe the simplest, most sustainable way to get to the root of metabolic dysfunction (that makes the most sense) is by improving insulin sensitivity or reducing insulin resistance).
To improve insulin sensitivity, we have to minimize the simple carbohydrates that are increasing the amount of insulin in your bloodstream at rocket speed, overusing it to the point your body stops paying attention to it.
The reason we focus out simple carbohydrates is because they’re in the “simplest” form of sugar: when we eat them, our pancreas immediately releases insulin (to tell our cells it’s go-time and instruct our cells to absorb that sugar for energy).¹ ² But if we’re constantly consuming simple carbs and triggerin’ our body to release a bunch of insulin all day everyday — overtime, our cells get tired of insulin knockin’ on their door and eventually our cells don’t give a shit what insulin has to say: they ignore insulin (insulin-resistance).³ ⁴ ⁵ And unless our sugar-backup-tanks (glycogen) need to be refilled, that sugar from our food just sits in our bloodstream (high blood sugar) eventually getting stored in fat tissue causing a handful of (inflammatory) problems including hormone imbalances, increased appetite, restlessness, hard time waking up, headaches, weight gain, blurred vision, tumor growth, etc.⁶ ⁷ ⁸ ⁹ ¹⁰ Basically: simple carbs create the exact environment, metabolic dysfunction, and “sticky” situation that not only makes LDL more likely to turn into plaque but lowers HDL levels too (remember low HDL is not beneficial):
A cross-sectional study of of 6,000 adults were grouped by intake of simple sugars and showed a statistically significant correlation between higher amounts of added sugars and low HDL levels (remember: low HDL is not beneficial).¹¹
574 adults were observed over 4 years and higher carbohydrate intake correlated with lower levels of both HDL and LDL.¹²
In a meta-analysis of 300+ studies to review the efficacy of drugs used to manage Type 2 Diabetes, insulin-resistance was discussed as a risk factor of cardiovascular disease.¹³
And think about this: 88% of the American population has metabolic dysfunction to some degree¹⁴ rising from 25.3% (1988-94) to 34.2% (2007-10)¹⁵ — and what are diabetics with low LDL at greater risk for? Heart disease!¹⁶ ¹⁷
These are examples of significant correlations that the food industry, doctors, and medical researchers should be payin’ attention to and lookin’ further into — especially before sending shockwaves through the media.
Dietary Cholesterol
Alright so if simple carbs are what impact the way LDL interacts with our arteries — does that mean cholesterol-rich foods don’t matter? In my opinion, simple sugars and dietary cholesterol go hand-in-hand but dietary cholesterol is not as problematic as simple sugars and here’s why:
In addition to the cell membranes, hormones, etc… the cholesterol we eat is specifically needed to make bile (helps digestion)¹ ² ³ ⁴ but our liver actually makes a large portion of the cholesterol we need everyday and regulates it’s own production based off how much cholesterol we’re getting from our food (liver makes less when we eat cholesterol-rich foods, and liver makes more when we don’t eat enough)⁵ ⁶ ⁷ ⁸ ⁹ ¹⁰ which means dietary cholesterol is not the same as the cholesterol our liver makes, but we use them the same way (packin’ it up into little lipoproteins until there’s no more space and creating more lipoproteins to package up the rest) and if we increase our intake of cholesterol, we are increasing the number of LDL particles (LDL-P) in our blood which has been correlated with cardiovascular disease and metabolic dysfunction.¹¹ ¹² ¹³ ¹⁴ ¹⁵ ¹⁶
But if we increase the number of LDL particles (with dietary cholesterol) and we’ve created the “sticky” situation (with simple carbs) — we’re adding more LDL into a broken system, meaning: we’re making more LDL particles circulate through an environment that’s encouraging them to turn into plaque. Both simple carbs and dietary cholesterol are at play and part of the equation, but simple carbs are setting cholesterol up for failure and making high-cholesterol levels more problematic than truly are. And if we’re concerned or having problems with plaque (ie. high blood pressure, atherosclerosis, embolisms, etc), it’d be more effective to minimize simple carbs first so our body can benefit from cholesterol!
Worry-free cholesterol foods when enjoyed in combo with a “sticky-free” environment:
Eggs
Meat
Seafood
Butter
don’t give up carbs
Opt for Complex Carbs
Does the “sticky” situation mean we should avoid any and all carbohydrates? Nooo, way. Sure my job as a nutritionist is to help every client be more self-aware of their carb intake & find their body’s happy medium but we never, ever eliminate carbs completely. They’re an incredibly efficient, easy source of energy for our brain and muscles — and the goal is to build a body that burns carbs better.
What we can do is make educated decisions to understand what type of carb we’re eating. And the alternative to simple carbs (the “simplest” smallest form of sugar) are complex carbs (the longer molecules of sugars with added fiber). This means they take longer to be metabolized, require less insulin at once, and keep you full for longer. https://lowcarbcardiologist.com/low-carb-ldl-a-call-for-reason/ Ultimately, the type of simple sugars you decide to minimize involves a lot of personal preference, your own judgement, and your unique body’s biology (we offer Strategy Sessions to support you through it)!! But let’s recap a few:
final food for thought
Cholesterol Ain’t A Curse
It’s all about context. Minimizing dietary cholesterol matters, but minimizing simple carbs may make more sense for you if you’re lookin’ to get to the root and reduce your risk of plaque. If you ever have questions, need help, or wanna share your personal story — don’t hesitate to message me! But it’s about taking in the overall health of our body instead of just LDL levels. It’s less about lowering cholesterol to prevent plaque — and more about minimizing the chances our LDL & arteries become an abnormally dangerous duo. Once we realize that the measurements we’re told to worry about are actually an inaccurate predictor of plaque or heart disease, the stress of high cholesterol melts away.
And if the doctor you love, trust, and depend on is recommending less eggs, meat, or salt in order to lower your cholesterol — maybe you should consider bringing him/her the research that proves simple sugars have a stronger connection to high cholesterol than eggs or meat? He/she should be open to it, receptive of it, and willing to help you understand how dietary cholesterol works in your body (or refer you to a nutritionist in his network who can).
Rooting for you, Danika.
The Problem With Low-Cholesterol:
It’s clear we’re recommended to “lower cholesterol” with plant-based fats — but why aren’t they sharing the research that (actually) proves lowering cholesterol isn’t necessarily “healthy.”
The Minnesota Coronary Experiment showed vegetable oils reduced cholesterol by 14% but INCREASED risk of heart disease/death by 22% for every 30 mg/dL compared to saturated animal fat.
The Sydney Heart Health Study showed vegetable oils had a 62% HIGHER death rate than saturated fats despite lowering cholesterol.
Cholesterol is so essential: our cells, hormones, bile, and vitamin D don’t function without it.
Cholesterol is made by our body when we don’t eat enough cholesterol-rich foods; this is the bodily process many statins suppress. However, creating our own cholesterol requires a lot of energy, which is why our body prefers to get cholesterol from our food and suppresses production of it’s own cholesterol when we’re eating enough of it. Maybe our body is overproducing cholesterol because you’re not eating enough cholesterol-rich foods.
Cholesterol-rich foods have yet to prove they lead to plaque as much as CARBS. Like we’ve mentioned, cholesterol is crucial, and often only becomes a problem or leads to plaque when we create an environment in our body that allows the cholesterol to get stuck in our arteries. There are so many nutrients that influence cholesterol levels besides fats¹ ²
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By the way! I’m Danika.
Middle-class, low-maintenance woman from the outskirts of town who didn’t keep trusting a broken, ass-backwards system to tell me the whole truth and what’s best for me. The internet can be so bittersweet sometimes, but I hope this space becomes a resource that inspires you to simplify the most important foods, make the most informed decisions & stress less about living perfectly! Craving a realistic, root-cause approach to real food? Maybe we’re your cup of tea.
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