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Today we’re finally going to get to the big topic of saturated fats, cholesterol, and the relationship of your lipid panel to your risk for heart disease. Are you ready?
Did you know that half the people that are hospitalized after a heart attack have normal cholesterol levels? What about the fact that 25% of the people with premature heart disease have none of the traditionally recognized risk factors? Yet we continue to hear that cholesterol and saturated fats lead to heart disease, and that we should do everything, including lifelong medication, to keep our cholesterol levels low and our saturated fat intake to a minimum. Does this seem just a little bit sketchy to anyone else but me? We’ve already discussed the role of inflammation in heart disease, and the dietary changes you can make to avoid it, but how exactly does your lipid panel influence your risk for heart disease?
The Types of Cholesterol
Ok, so if you pull out the results of your latest lipid panel, you’ll see a bunch of numbers: triglycerides, total cholesterol, HDL cholesterol, and LDL cholesterol. Traditionally we’ve been told that total cholesterol should be less than 200, and that LDL cholesterol is the “bad” cholesterol, and HDL cholesterol is the “good cholesterol”. Well, turns out it isn’t so simple. There are two types of LDL cholesterol, one type seems to have no relation to your risk of heart disease, and the other one does. Confused yet? I don’t blame you. Stick with me here for just a second, as I hope this will help you have a more informed discussion with your doctor the next time he suggests you get on a statin drug. (Or, just skip to the next section about what to eat, whatever works for you!) The first type of LDL cholesterol is big and fluffy, kinda like a cotton ball. It bounces around, not really hurting anybody. The second kind is small and dense, and it bounces around your blood vessels like a BB fired out of a gun. Eventually, these particles can get lodged in your vessel walls, creating a plaque. Then one day you wake up with chest pain and you’re given a diagnosis of atherosclerosis, or, even worse, you have a heart attack.
So, you’ve probably noticed by now that there isn’t any category on your results sheet for cotton ball LDL and BB pellets LDL. How can you tell which one you have? Look at your ratio of triglycerides to HDL cholesterol. If your ratio is less than 2, you have a lot of cotton ball LDL’s. If its greater than 4, you’ve got a lot of BB LDL’s. How much does that impact your risk of heart disease? Well, according to research done at Harvard, having a high triglyceride to HDL ratio can increase your risk of heart disease up to 16 times the risk of someone with a low ratio. It’s pretty significant.
The Impact of Diet
It is true that your liver produces cholesterol, and that some people produce more than others. Does that mean that your fate has already been determined and there’s nothing you can do about it? Absolutely not. Being careful of the kinds of fats you consume can greatly impact your numbers. The biggest thing to remember is that you need to avoid trans fats. Research has shown that trans fats reduce HDL cholesterol and raise both LDL and total cholesterol, thereby shifting your ratio in a negative direction. In numerous research studies, including the studies conducted by Dr. Walter Willet of Harvard, saturated fat was only weakly related to heart disease when compared to the same amount of calories from carbohydrates. Though it hasn’t been proven anywhere (at least to my knowledge), I would bet that this weak association has more to do with the inflammation present in the saturated fat of CAFO animals, who are already sick and inflamed, rather than the saturated fat itself. But that’s just my theory.
How to Avoid Trans Fats
This answer is pretty easy, actually. Trans fats are created when liquid vegetable oils are partially hydrogenated with high heat, which is an industrial process. Industrially produced trans fats are not found in nature (there are some natural trans fats, but these do not seem to have the negative effects that industrial ones do). So if you want to avoid them, avoid processed foods. This can include cookies, baked goods, soups, frozen dinners, margarine and other fake butter spreads, etc. Eat real food! Opt for butter instead of margarine, cook from home, or, when you do have to pick something up, read the labels and look for trans fats. If you still have a hard time including butter in your diet, olive oil is a great monounsaturated fat that is widely recognized as being very heart healthy.
If you’re still not convinced and you want to do some more reading on the connection (or lack thereof) between saturated fat and heart disease, check out this great post by Stephen Guyenet, or any of the links in my reference section.
B. Sears, MD. The Heart Attack Culprit: Cholesterol Isn’t to Blame, republished on CBN.com, excerpted from The Omega RX Zone, The Miracle of the New High Dose Fish Oil.
J.M.G., C.H.H., and J.E.B., Fasting Triglycerides, High Density Lipoproteins, and Myocardial Infarction. Circulation; 1997; 96: 2520-2525.