It Ain't Really Just The Cholesterol That Contributes To Heart Disease.

What cholesterol really is and what it isn't.

The cholesterol molecule is something that we have a problem with.

On the one hand, it’s supposed to be good for us. As it is said on Medline,

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods.

We definitely do need to have a good supply of that to support healthy cell functions, because it is also said in this article that

In cells, cholesterol functions as an essential structural membrane component, and the metabolites of cholesterol have important biological roles as signal transducers and solubilizers of other lipids.

However, once the doctors do diagnose us with the symptom of high blood cholesterol, things change significantly. That blood test is all it needs for us to be prescribed a whole cocktail of medications to keep that symptom under control, in the hope that it doesn’t proceed further into heart disease, together with a few myths that are already well propagated and well known to society these days.

Unfortunately, the whole cycle of cholesterol synthesis and excretion isn’t very well explained. It’s easy to buy into those myths if one doesn’t understand the cycle:

Why We Don't Really Like Talking About Cholesterol At All

So let’s look at 3 of these myths that are commonly associated with cholesterol.

LDL is “bad” cholesterol, HDL is “good” cholesterol

Cholesterol is a fatty substance that is necessary for the synthesis of new cells. However, it cannot go directly from the liver to the cell via the blood, because fat and water don’t mix.

Ever seen how oil always floats on water in 2 separate layers? We call them “immiscible” because they don’t mix. Oil always floats on water because of its lower density.

Therefore, a lipoprotein has to bag up these cholesterol particles, enter the blood and travel through the blood to be the cholesterol mailman. It delivers the cholesterol particles to where they should go.

Want to hazard a guess on the lipoprotein’s density when it is packed full of cholesterol particles, then?

It would be lower than the density of the blood.

Whereas a lipoprotein that has delivered most of its cargo would be of a higher density.

Therefore we have low density lipoproteins (LDL) and high density lipoproteins (HDL).

Someone who is experiencing a suboptimal faecal movement would inadvertently reabsorb more cholesterol from their gut back into the blood, and that’s going to be packed into more of these lipoproteins, which do have a finite population. It would then be inevitable that the density of these lipoproteins get reduced over time, so there would be more LDL in the blood, wouldn’t there?

And when a doctor does the blood test for high cholesterol, they would then zoom in on the numbers related to LDL and HDL, wouldn’t they?

Having a well functioning digestive system is beneficial for supporting the elimination of cholesterol from the body.

Eggs (or any other food) cause high cholesterol

I believe very few of us have actually not heard of this statement.

The issue with cholesterol in our body is that we do have an inlet (from our food) and an outlet (in our faecal excretion). It would function similar to a bank account balance.

Why?

If we do want to accumulate money in our bank account balance, then we do have to take care of 2 factors (assuming that the bank account is earning zero interest):

1. How much money is actually entering our bank over time.

2. How much money we’re spending over time.

Because even if we’re earning a million dollars a month, we’d be in debt if our spending habits tally two million dollars per month, isn’t it? Our bank account balance will only grow if the net difference between what’s going in and what’s going out is positive.

In the same vein, our cholesterol levels will increase if we’re eating more than we’re excreting.

Strangely though, why is it that the myth only focuses on what we’re eating but never on what we’re excreting?

Because when a major proportion of the population is not consuming sufficient dietary fibre, but survive off processed foods and refined carbohydrates, we’d be seeing suboptimal faecal movements from them. And that affects their cholesterol elimination mechanisms, no?'

So it’s not just about eating eggs. They contain a good amount of proteins and other nutrients…

But are we able to eliminate waste cholesterol from our body effectively, or not?

High blood cholesterol causes heart attacks

That statement is partially true at best.

See, the issue is the accumulation of cholesterol as fatty plaques deposited on the walls of our arteries.

Now, Seriously, What's So Tricky About Cholesterol?

These plaques also tend to entrap foam cells, which are immune cells (macrophages) that have overconsumed oxidised LDL (oxLDL) - note: it is the oxidation that is a major player here.

Some foam cells die when entrapped in the plaque, creating a necrotic and highly pro-inflammatory core within the plaque. This pro-inflammatory core triggers the remaining surviving cells in the plaque to produce more matrix metalloproteinase enzymes that can digest away the collagen cap that seals off the plaque.

At the end of the day, if the collagen cap ruptures, we’d see a breakthrough… and the consequences of that breakthrough doesn’t bode very well for the person indeed.

To deal with heart disease, we’d actually have to pay more attention towards addressing the pro-inflammatory core of the atherosclerotic plaque.

Which falls under the realm of efferocytosis: