Cholesterol 101

From keto diets to eggs on toast, what (the heck) to eat to support cholesterol levels

Cholesterol Confusion

After years of cholesterol myths, there is still a lot of fear around what to eat and what not to eat.

Cholesterol a waxy, fat-like substance, plays crucial roles in the body. It's essential for building cell membranes, producing hormones, aiding in digestion and nutrient absorption and more.

Though old fat-free dietary guidelines have been replaced, there is still a lot of confusion over what, if any, dietary fats we should be having. With diets such as keto and paleo gaining popularity, it’s important to understand whether keto foods and fat bombs in your coffee are helping or hurting your health.

Types of Cholesterol

  • Low-density lipoprotein (LDL): Often referred to as "bad cholesterol," because high LDL levels can contribute to plaque buildup in arteries, leading to heart disease. The main purpose of LDL is to transport cholesterol to cells in the body where its is needed.

  • High-density lipoprotein (HDL): Known as "good cholesterol," HDL helps remove LDL from the bloodstream, reducing the risk of heart disease and stroke.

  • Triglycerides: While not technically cholesterol, elevated triglycerides can also contribute to heart disease. Elevated levels of triglycerides are often linked to high sugar and refined carbs. Triglycerides are a different type of lipid used to store unused calories and provide the body with fuel between meals. Our modern diets full of carbs, sugar and excess calories are driving levels up.

Cholesterol Sources

  • Diet: Foods like red meat, processed meats and full-fat unfermented dairy- cream, ice cream, etc contribute to unhealthy cholesterol levels.

  • Liver Production: The liver produces cholesterol, even if none is consumed through diet.

Foods for Better Cholesterol

  • Fruits and vegetables: Rich in fiber, antioxidants, and other beneficial nutrients.

  • Whole grains: Provide fiber, vitamins, and minerals.

  • Lean protein: Choose fish, poultry, beans, and lentils.

  • Healthy fats: Incorporate avocados, nuts, seeds, and olive oil

  • Fermented dairy: Small amounts of live yogurt, kefir, raw cheeses

Foods to Limit/ Avoid

  • Trans fats: Found in processed foods such as ready meals, cakes, and ultra processed foods, these can raise LDL cholesterol.

  • Saturated fats: Found in red meat, processed meats, cream, and some tropical oils such as coconut oil. Grass-fed meat often has a more favourable fat profile so look for better quality.

  • Excessive refined carbohydrates: When you consume more than 60% of your daily calories from carbohydrates, your liver produces more cholesterol. Excess sugar causes your liver to convert sugar into triglycerides, a type of blood fat. High levels of triglycerides can increase your risk of heart disease, stroke, and heart attack. 

ApoB: A Valuable Marker

ApoB is a protein associated with LDL particles. Each LDL particle has one molecule of ApoB, so it’s thought to be a direct measure of LDL particle numbers. Studies have shown it's a more accurate indicator of heart disease risk than LDL cholesterol alone. Conventional cholesterol checks often miss this important marker, but functional testing can help identify your levels.

Eggs and Cholesterol: A Myth

While eggs contain cholesterol, moderate consumption has been linked to improved heart health. The focus should be on overall dietary patterns… essentially a couple of eggs a day is probably not only fine for most people, but protective of health in various ways.

Factors Affecting Cholesterol Levels

  • Age: Cholesterol levels tend to increase with age.

  • Gender: Women typically have lower cholesterol levels before menopause, with many struggling to balance levels during perimenopause and menopause.

  • Genetics: Some individuals may have a genetic predisposition to high cholesterol which needs careful consideration. Lifestyle adjustments won’t be enough for those who are born with a genetic mutation that causes abnormally high LDL cholesterol levels, known as familial hypercholesterolemia (FH). It’s estimated that global prevalence is about 1 in 300 in most populations.

  • Smoking and Alcohol: smoking has been shown to reduce healthier HDL cholesterol levels, while increasing LDL, while drinking alcohol raises the triglycerides and cholesterol in your blood. If your triglyceride levels become too high, they can build up in the liver, causing fatty liver disease. The liver can't work as well as it should and can't remove cholesterol from your blood, so your cholesterol levels rise.

  • Sedentary lifestyle: moderate exercise has been shown to raise beneficial HDL and help lower LDL.

Food inspiration for healthier cholesterol balance:

  • Fatty fish like salmon, sardines, mackerel with lots of colourful veggies

  • avocado on seeded bread and a splash of olive oil on top

  • homemade lentil soup

  • aubergine/eggplant or okra curry

  • olives, nuts and seeds as snacks or sprinkled on meals

    By understanding cholesterol, making informed dietary choices, and incorporating regular physical activity, you can support healthy cholesterol levels and reduce your risk of heart disease.

    As for keto…A plant-centred keto diet full of foods like oily fish, avocados, olives, aubergines, okra, and lots of other veggies can be great for helping balance cholesterol and overall health. A typical meat and saturated fat-centred keto diet complete with coconut oil in your coffee, otherwise knows as “bullet proof coffee”, on the other hand is a recipe for LDL and associated ApoB to creep up, or in many cases jump up!

    If you would like help with functional nutrition, testing and specific dietary and supplement advice, feel free to get in touch for a free 15 minute call.

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