Cholesterol myths debunked

One of the biggest misconceptions for years, out there is that cholesterol is “bad”.  We have been brainwashed about cholesterol so badly that even well qualified Nutritionist and doctors also recommend avoiding high-cholesterol foods for heart health, but thankfully those days coming to an end. Now we no longer should be concerned about eating high cholesterol foods. Let’s shed some light on very old and common myth.


Cholesterol – Vital for Life

Cholesterol is a sterol in the lipid family, naturally found and contributes to the membrane structure of every single cell in the body. To simplify this, our body is made up of cells, which is surrounded by a membrane.  These membranes are responsible for permeability and fluidity, which essentially control how a cell moves, interacts with other cells, and transports “important” things in and out. Thus, cholesterol is one of the main building blocks used to make cell membranes (the ever-important “lipid bilayer” of the cell membrane).


It also needs it to produce sex hormones estrogen, Testosterone, bile acids and perform various other important functions. Cholesterol in the skin is converted to a form vitamin D when it is exposed to sunlight. Simply put, you could not survive without it.


Practically it is, very difficult to explain how vital cholesterol is for us. If we had no cholesterol in your body, we would be dead. No cells, no bone structure, no muscles, no movement, no sex hormones, no reproductive system, no bile acid, no digestion, no nerve cells, no brain function, no memory, no human. In short, NO Cholesterol = No Life

More than 50% of the cholesterol we ingest from food is esterified (CE), which cannot be absorbed through our gut because of the bulky side chains they carry. Esterified Cholesterol can be De-esterified by pancreatic enzymes lipases and esterolase, so few ingested CE can be converted to UC. Hence eating cholesterol has very little to no effect.
Dietary cholesterol has very little impact on the cholesterol levels in your body.

To understand this, first we will have to understand that cholesterol is found in 2 forms – Unesterified cholesterol (UC) and cholesterol esterified (CE), and these forms determines whether we can absorb/store it or not among different sources.

Cholesterol is so vital to the body that body cannot risk leaving it to the chance to get it externally from food and can effectively make it itself, although it can also absorb only a very small amount of cholesterol from our foods.


But Hold on! Most of the cholesterol we eat is not getting absorbed and is excreted by our gut via stool. The reason is, we can only absorb unesterified cholesterol (UC) and not Esterified cholesterol (CE) because of the bulky side chains they carry. CE can be De-esterified by pancreatic enzymes lipases and esterolase, so few ingested CE can be converted to UC, but it competes for absorption with the vastly larger amounts of UC supplied endogenous cholesterol by our body. Hence, very little dietary cholesterol is absorbed.


In Short, Cholesterol production is very tightly regulated by our body homeostatic mechanisms. Higher dietary cholesterol intake leads to decrease in endogenous cholesterol production, whereas lower intake lead to increase the endogenous production. It can also be turned off when dietary cholesterol levels are high and even excess dietary fat (more than required to body) can be excreted by gut, thus it is very little affected by the foods we consume. 


There is No such thing as “good” or ‘’bad’ ’cholesterol - All cholesterol is good!

Cholesterol is cholesterol. The chemical formula for cholesterol is C27H46O. it cannot be good or bad. Let’s understand this why.

Cholesterol itself cannot freely flow in the blood as it is hydrophobic in nature. Therefore, it needs a vehicle (i.e Lipoprotein) who can carry and flow from one place to another place via bloodstream. There are two such types of vehicles: High-Density Lipoproteins (HDL) famously called ‘'Good Cholesterol’’ and Low-Density Lipoproteins (LDL) called ‘’Bad Cholesterol’’.

The HDL vehicles carry cholesterol from the peripheral tissues, including the artery walls, to the liver, where it is excreted with the bile, or used for other purposes whereas, LDL vehicles mainly carry in back direction i.e. cholesterol from the liver, where most of our body’s cholesterol is produced, to the peripheral tissues, including the vascular walls for different functions. Although all cells can produce cholesterol, but if they require more they call for the LDL vehicles, which deliver cholesterol into the interior of the cells. So basically, HDL (Good) and LDL (Bad) are NOT really cholesterol but just a carrier of cholesterol.


Your Blood Cholesterol Level does not matter!

Lipoproteins, which act as a vehicle also carries triglycerides. When blood triglycerides increase, the total number of vehicles also needs to increase to transport the increased triglycerides. That ultimately increases the total no. of LDL. Whereas, in case of increase in cholesterol lipoprotein only increases the size to accommodate.

More recently, higher-quality studies have shown that cholesterol in the diet is not associated with an increased risk of heart disease. That’s why, now the Dietary Guidelines advisory committee, USDA, American Heart Association and other health agencies have taken back the recommend dietary cholesterol intake level in 2015 which was <300 mg/day.

Blood cholesterol test does not even measure LDL- they guess it. To better understand it-  LDL particles are just as likely to stick to the artery wall as any other particles, regardless of its size or cholesterol content.

A new research Published in Journal of Expert Review of Clinical Pharmacology also clearly shows that it is not total cholesterol that correlates with heart disease, rather it is the number of vehicles (i.e LDL lipoprotein) who carry this cholesterol that correlates with atherosclerosis and heart disease.  So, it’s not the size of the vehicle, it’s the number of vehicles present.


Anyway, the takeaway is that cholesterol levels does not affected by diet, but diet does affect triglyceride levels. So, more blood triglycerides = more LDL particles = more chances for sticking to artery wall = more chances of buildup = Higher chances of atherosclerosis.


A study, published in American Journal of Clinical Nutrition, Mar 2008, shows that Low-carb diets drastically reduce triglycerides, while low-fat diets either don’t improve them very much or literally make them worse. Thus, it seems logical to follow Keto Diet, instead of low-fat diet.

Cholesterol Myths are Based on ‘’Bad Research’’

The original and most influential study at the heart of this hypothesis, is the Minnesota Coronary Experiment, conducted during the period of 1968-1973, found a relationship between dietary cholesterol and heart disease were flawed.


A New Review Study entitled ‘’LDL-C does not cause cardiovascular disease: a comprehensive review’’ of the published in Expert Review of Clinical Pharmacology, Oct 2018, have presented that how researchers of these reviews have mislead the world for many years by misusing and ignoring statistics and many other contradictory reports.


British Medical Journal, published a review of 19 studies in 2016 where the authors had followed more than 68,000 elderly people for several years after having measured their `bad` LDL-cholesterol. Not even a single study of them found that LDL-cholesterol was bad. Whereas, more recently, higher-quality studies have shown that cholesterol in the diet is not associated with an increased risk of heart disease.


A Review study published in American Journal of Clinical Nutrition in Aug 2015, Dietary cholesterol in the diet is not relation of dietary cholesterol with atherosclerosis and heart disease.


That’s why, now the Dietary Guidelines advisory committee, USDA, American Heart Association and other health agencies have taken back the recommend dietary cholesterol intake level in 2015 which was <300 mg/day.


We Say: I have mentioned it before, but it is worth repeating that Cholesterol is Absolutely vital for our existence. Now you know dietary cholesterol has nothing to do with your blood cholesterol and ultimately to heart disease. Most foods that are high in cholesterol are also super healthy and nutritious. so, don't avoid them just because of their cholesterol content especially the most nutritious egg yolk- Don’t throw its sole. Most importantly, information above given is a fact, not my opinion, if these science and fact does not convince you of the vital importance of cholesterol, nothing I say will.

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