Is Cholesterol Bad For You? May 28, 2013 nutrition 5 Comments Is Cholesterol Bad For You? Are Saturated Fats Bad For You? Heart Health Myth I have recently been getting more and more comments from both my dietitian colleagues, and those who have connected to me in this online world, about how intriguing and useful the information being provided is where I attempt to explain and find the middle ground between the Eastern and Western medical practices; So I thought I would break into it yet again today. I certainly am not the only person out there doing this, but I am more than happy to be a representative from the Western medicine side of the continuum who tries to continue to bridge the gap, as I do find that most people typically sharing this information are from the Eastern side and therefore there is some bias in the assurance of the correctness of the content that is being provided. In all honesty, I too am constantly trying to paint a clearer picture of this, however I tend to do this quietly in my room with a lot of readings in front of me, and only craft and share my blog posts once the deciphering and clarification in my own mind has been made! I also like to think that if we take a preventative approach rather than a curative one, than the differences between the Western and the Eastern worlds minimise quite profusely; Particularly with medications and herbs being taken out of the equation (yes I know that was quite simplistic, it certainly wasn’t meant to offend anyone, but they do seem to be two of the greatest differences between the two approaches!). So since the whole butter vs margarine (and throw in the mix coconut oil) debate has become so topical, I decided the cholesterol, heart health, and how we actually measure risk connection, better have a proper investigation. Olive oil..monounsaturated fat, I am happy to say these are good for you! At uni we were taught, which was also in line with how Western doctors would decide to make a referral for patients to see a dietitian, that when someone has high LDL-cholesterol in a standard blood test, they must be at a higher risk for cardiovascular disease (CVD). Now, just to clarify, I am the one who always likes to play it safe with dietary advice or analysis, meaning, I would suggest to continue to look at LDL-cholesterol until (or if ever) this is proven to be invaluable in a mainstream sense; However I am also open to looking at some of the other potential measurements that we should be looking out for which seem to also be able to show peoples true health risks. So I have done some research and a few of the key factors that have continually come up and I felt were worth sharing were: 1. Triglyceride : HDL ratio is an independent risk factor for CVD and is definitely worth looking into (not just total cholesterol : HDL). The dietary factors that seem to raise triglycerides are refined carbohydrates / high glycemic index carbohydrates, as well as alcohol (and this is the part of the equation that you want to bring down). Check out this study’s abstract as an example or here for a full article shared by the American Heart Association. Alcohol, associated with raised triglycerides. 2. There are different types of LDL, and by measuring the sub-fractions, rather than just the total LDL-cholesterol, we are able to get a greater idea of whether the LDL that is present is actually the type that increases ones risk of CVD, or whether it is the benign form. From my understanding, the more dangerous sub-fraction seems to increase as triglycerides go up (linking back again to the refined carbohydrates in the diet). Here is a test that is available in Australia for this type of assessment. Here is the abstract for an article that looks at the importance of measuring LDL-number and size, rather than just total LDL- cholesterol (which is what is routinely checked by doctors). The refined carbohydrates mixed with the fats are not a good combination for your heart health. 3. Given LDL-cholesterol has been one of the key measurements looked at for so long in regards to its connection to CVD, I find this meta-analysis from 2011 of almost 350,000 people extremely interesting, (I suggest the dietitians out there at least take a peak at it). I also find this huge review from 2010 to be quite thorough, and in line with a lot of the other information that is out there. Why these are interesting is that if we are avoiding saturated fat (because they raise LDL-cholesterol which supposably is the risk factor for CVD)..then this study blows that on its head! (thereby LDL-cholesterol is again not as valuable as once thought). Playing my normal roll of middle ground dietitian, I am taking from some of this, that it is equally important to recommend people replace saturated fats with unsaturated fats (and I’ll throw in there a particular mention to omega-3 polyunsaturated fats based on all my other research for my book The Clean Separation), as it is to simply suggest people decrease their saturated fat intake in general; and that for someone to consume a few grams of naturally occurring saturated fats in full cream dairy or meat, which also provide an array of other nutrients, may not be as harmful in the long run (irrespective of the blood test LDL-Cholesterol coming down when their consumption is reduced). omega-3s…great! I think being smart about how you utilise this information is just as important as the information itself. Slathering butter onto everything you eat, or making ‘health bites’ filled with copious amounts of coconut oil is not the answer; if you have a family history of high cholesterol or CVD, sitting on the conservative side is still recommended (at least from me!). For example: The Heart Foundation recommends no more than 6 egg yolks a week, and from my understanding, in some other countries they cut this down to 4 if you have high cholesterol; I usually suggest that if you are eating an otherwise healthy diet, and you are not at a high risk for CVD, than an extra couple of eggs is not going to be the make or break of your health (and could even help with satiety and weight loss which separately can assist with reducing cholesterol levels anyway!); However if you are at a higher risk for CVD, just sit with precaution and don’t go over the recommendation until (if ever) we are completely proven otherwise. Is cholesterol bad for you? Scrambled eggs, have more than 2 eggs in them usually, and typically are made with butter or cream..just be smart about it. So in summary I’d suggest: 1. Next time you have your cholesterol tested, ask about these other tests for particle number and size; AND that 2. You take a close look at your triglycerides and your HDL readings. 3. Finally, I’d recommend you start to think about where in your diet those refined carbohydrates are, and begin thinking of ways of making your meals have a lower glycemic load (if you need help with this just ask your dietitian). For those of you already onto this type of information, fantastic! For those of you who haven’t been previously, I hope this was a little enlightening, As for the science, it keeps evolving, so I guess this story will be continued. For now, The Travelling Dietitian x Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Click to share on Google+ (Opens in new window) Related 5 Responses Tim Crowe May 29, 2013 Great post Kara and certainly agree that the evidence for saturated fat and heart disease has been declining somewhat (though is certainly there) with more focus needed on the advice we give for what it is replaced with (healthier oils and higher fibre foods rather than the public defaulting to processed carbohydrate sources) rather than cutting it out all together. Physical activity, smoking, fibre, fruit and vegetables, polyphenols, and fish all have a role to play so too much focus on saturated fat can detract from these key areas. Log in to Reply Travelling Dietitian May 29, 2013 Thanks Tim, really appreciate your comments. I totally agree with everything you just said! Log in to Reply a girl on a bike - dietitian/sports dietitian May 29, 2013 Brilliant! I’ve been reading the same literature & your post pretty much reflects my view on this topic at the moment. 🙂 Log in to Reply Travelling Dietitian May 29, 2013 Thanks 🙂 Nice to know some of my colleagues are on a similar page! Log in to Reply Bryan November 28, 2013 Because the admin of this site is working, no doubt very shortly it will be well-known, due to its feature contents. Log in to Reply Leave a Reply Cancel ReplyYou must be logged in to post a comment.