Health Hotline Magazine | March 2020

CHOLESTEROL: THE BREAKDOWN Cholesterol is so vital to human health that our bodies don’t rely on diet to provide it—most of the cholesterol found in our bodies is not from food but made via the liver and intestines (20% vs 80%). 3 It is a key building block for hormones, including estrogen and testosterone; it is required to make vitamin D; it gives cell membranes stability, keeping them healthy; it is involved in cellular communication and normal apoptosis (cell death); and it helps our bodies absorb the fat-soluble vitamins A, D, E, and K. The body works hard to maintain cholesterol homeostasis, or balance, and will reduce or increase endogenous production as needed. 4 There are two major types of cholesterol: High-density lipoprotein (HDL) and low-density lipoprotein (LDL). In general, LDL delivers cholesterol to tissues throughout the body, while HDL brings cholesterol back to the liver for excretion. You will likely have

heard that LDL is “bad” cholesterol and HDL is “good” cholesterol. But LDL is not inherently bad—it becomes unhealthy when it is oxidized, or damaged by free radicals. 5 Further, there are specific types of LDL which determine how susceptible it is to oxidation, and thus whether it is problematic. Large, fluffy LDL is known as “pattern A” LDL, and it is associated with a lower risk of cardiovascular disease (CVD). Then there is small, dense LDL known as "pattern B” LDL that is more vulnerable to oxidation and is significantly associated with an increased risk of heart attack. 6 7 Pattern B LDL is also associated with higher levels of triglycerides, another predictor of CVD. 8 And it is a diet high in refined carbohydrates, particularly sugar—not cholesterol—that increases levels of pattern B LDL and triglycerides. 9 10 11 12

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