CHOLESTEROL – GOOD VS. BAD
WHAT CAN I DO ABOUT MINE?

By Neil Levin DC, CFT.

I’m often asked the following question: Doc, what can I do to reduce my bad cholesterol? 

I might respond: "There are several things that you can do about it.  Do you know the difference between good and bad cholesterol?"  A blank stare usually answers my question.

Don’t feel bad if you can’t answer this question, most people can’t.  Yet, the bottom line is that a basic understanding is essential if your cholesterol levels are out of sync.  With a basic understanding you will be able to make appropriate changes that can have a wonderful impact on your levels.

First of all, there is NO SUCH THING AS GOOD AND BAD CHOLESTEROL.  Cholesterol is cholesterol.  Cholesterol is also fat-soluble and not water-soluble.  Because of this, it cannot float along in your blood stream.  It just won’t dissolve.  Therefore our livers need to create water (blood) soluble proteins that can carry the cholesterol molecules through the blood.   Which proteins our livers create determine whether the medical community will label these water soluble carrier proteins along with their cargo (cholesterol and fat) as either good or bad cholesterol.

The “bad” cholesterol is labeled LDL, while the “good” cholesterol is called HDL.  We want our total cholesterol level (a combination of the two plus a few others) to be below 200, with our bad cholesterol below 130 and our good cholesterol at least 35.  I would prefer to see my male patients with a good cholesterol level (HDL) above 50 and my female patients above 60 (REF 1).

In simple terms, when we are overeating there will be lots of extra fats (cholesterol and triglycerides) absorbed from our digestive tract into our blood stream.  The liver will package these fats for distribution to the cells of our body and for deposition into fat storage in water-soluble LDL (short for Low Density Lipoprotein). 

On the other hand, when we are in need of energy, our livers will create HDL’s to pick up fat (cholesterol and triglycerides) from storage (and our arteries) and disperse it to cells that need more fuel.  HDL is short for High Density Lipoprotein. 

So you can see that when we eat too much we will tend to have high LDL’s and low HDL’s because we are depositing more fat into reserve than we are mobilizing.  This calls for the liver to make lots of LDL.

When we are eating less, or we are very active and therefore using lots of energy, our liver will make HDL’s to mobilize fat from storage to our energy hungry cells. 

When we have lots of HDL in our blood over long periods we will also tend to be losing weight and or building muscle tissue.  When we have high LDL’s in our blood stream for long periods we will tend to be in a fat storage mode, and gaining weight.  When we have a nice healthy balance of HDL /LDL we are in a state of good fitness. 

You can check out your own levels by looking at your most recent blood work up.  First check your basic total cholesterol, HDL and LDL levels.  Then look at your cholesterol/HDL ratio.  This ratio should be no higher than 4, although the average is 4.5.  A better number to aim for would be 3 or less (REF 2).  If your blood test results don’t give you a cholesterol/HDL level just divide the total cholesterol by the HDL and that’s your number.

With this understanding it becomes more apparent that by losing excess weight you will also be creating a healthier balance of HDL’s and LDL’s while lowering your overall cholesterol levels.

Enter TLC, an acronym for Therapeutic Lifestyle Change.  You will be hearing more and more about TLC as it is all the rage in the scientific community.  TLC involves eating right and exercise both of which will improve your cholesterol levels. 

Aerobic exercise (go for at least 20 minutes) creates a need to mobilize fat to muscle cells to fuel the activity over a relatively long duration.  This increases the need for HDL’s while simultaneously reducing the need for LDL’s (nice).  Therefore aerobic exercise will have a positive impact on your cholesterol levels (REF 3).

Eat smaller, healthier meals throughout the day, by eating a smaller breakfast, lunch and dinner and having healthy snacks in between as “hold me overs.” This will insure that you don’t overeat and therefore, create the need for your liver to create large quantities of LDL to transport extra fat entering your blood stream to fat storage areas.

This dietary strategy also has the benefit of fewer spikes in blood glucose, which lowers blood insulin levels. This will increases insulin sensitivity in your cells (very important) and reduce your tendency to store fat. These are two of the basic tenants of TLC.

Some other powerful tools exist that will help you in your quest to positively influence your cholesterol levels. These should be in your toolbox along with exercise and healthy food choices. They include: Omega 3’s from fish, niacin, pycnogenol, plant sterols and stanols, garlic, fiber, vitamin E, vitamin C, grape seed extract and policosanol (REF 4).

Feel free to browse our inventory to learn more about these nutrients and appropriate levels for supplementation.

References:

1.  http://www.americanheart.org/presenter.jhtml?identifier=183.
2.  http://www.medicenet.com/script/main/art.asp?articlekey=1463.
3.  Kodama et al., Archives of Internal Medicine. Vol. 167, No 10, May 2007.
4.  Pizzorno J.E., Murray M.T., Textbook of Natural Medicine Third edition, Churchill Livingstone, 2006, pp. 1506-1521.