Introduction to cholesterol

There is considerable debate about cholesterol. Cholesterol is the substance that produces plaque in your arteries. This plaque starts developing in people starting about age 4. In many people, it eventually "clogs" the arteries, which can lead to heart attack or stroke. The exact mechanism by which these events happen is still the subject of intense debate, but many general details are clear. For a basic background from the American Heart Association, click here.

Unfortunately, rumors also abound, which gives the impression nothing is really known. That impression is false. Heart attack and stroke rates in the United States could easily be reduced by 50% by simple dietary and behavioral changes - consuming vitamin C and E, fish oil or fish, getting 20 minutes of exercise by walking three times a week or other sensible exercise. See related essays on fish oil, antioxidants, omega-3 fatty acids, controversial effect of salt on blood pressure, aspirin dosage, and soy.

Cholesterol level may not matter. The LDL/HDL level, so-called bad vs. good cholesterol, appears to be important. But one can have a high cholesterol level, but a really good level of HDL that can be produced by exercise and consuming healthy fats. Such a person is probably better off than someone with much lower cholesterol that is mostly LDL. To reduce your anxiety, make sure you get both levels tested and discuss the ratio with a competent physician.

Lipoproteins are proteins which carry cholesterol to and from the liver. Cholesterol is essential in the body, especially in cell membranes. We can synthesize all we need, and can also break it down to carbon dioxide, burning it like any other fat. Low density lipoproteins are low density because they bind a lot of cholesterol (fat floats over water), and carry cholesterol from the liver to the body. High density lipoprotein (HDL) has little cholesterol, and carries cholesterol back to the liver. The ratio of total cholesterol to HDL is important to your health. The higher the ratio, the higher the risk. Most healthcare providers want the ratio to be below 5:1. A ratio below 3.5:1 is considered very good.

However, the main hazard to health is oxidized LDL (ox-LDL). Unfortunately, this is very expensive to measure. Free radicals are loose electrons that are very harmful, created by inflammation, senescent cells, obesity, lack of vitamins, trans fatty acids, and more. ox-LDL is recognized as foreign in the blood, and mast cells consume it. When they consume a lot, they turn into foam cells, like whipped cream, and stick to the arterial walls causing plaque. This is the plaque that causes heart attacks and stroke.

We have evolved methods to protect us from ox-LDL. LDL and HDL bind many molecules of vitamin E which trap free radicals to protect cholesterol. The fat-soluble vitamin E in LDL transfers the free radical to water soluble vitamin D. There is an enzyme which regenerates the vitamin C, removing the free radicals to form water, which is harmless. But if you are deficient in vitamins C and E, you will develop lots of plaque.

AREDs contains vitamin E and C, taken once a day. Mito-C has vitamin C, and should be taken twice a day. The combination will protect you from ox-LDL and plaque.

Doctors have lowered the level of LDL that is considered safe substantially over the years, especially since statins have been developed. Statins have many unpleasant side effects. The reason higher levels of cholesterol are hazardous is primarily that it has a lot of ox-LDL, as our obese society generates free radicals. My LDL level is 140, my HDL is 90, a total of 230, which current doctors consider hazardous. But since I take AREDs and MIto-C, and my ratio is 2.6, I have no concern about heart disease or stroke.