Cholesterol can be confusing and tough to understand if you don’t know what you’re looking for. Most of us think in terms of what we typically get from the doctor when we have a cholesterol test. It looks something like this:

It’s important to break this down into something a little deeper and more meaningful. Let’s keep this simple.

  • Cholesterol isn’t bad. We need it to function. Here is a list of the good things that cholesterol does:

    • Helps us be able to absorb fat soluble vitamins

    • Builds and maintain cellular membranes

    • Helps us synthesize many hormones in the body, specifically sex hormones.  This means that you need cholesterol to utilize testosterone, estrogen, and human growth hormone.  These are many of the hormones that help support lean muscle, sex drive, metabolism, and much more!

  • LDL Particle size matters!!! It’s not that the simple numbers we see in the chart above don’t tell us something, they just don’t tell us enough.

    • HDL is typically known as the “good cholesterol”- it travels through the blood removing bad / oxidized cholesteral.

    • LDL is known as the “bad” cholesterol.  

    • If you are on cholesterol lowering medication then you obviously know that you have a higher total or especially a higher LDL count.  But… you know your particle count?

    • LDL is made up of 2 types of particles. Large = harmless and Small = the actual “bad” cholesterol. Only if you have a high small LDL particle count should you be concerned. So, if you are on any medication to lower your cholesterol, you know your LDL small particle count… right?!

    • Most of the time doctors go by total cholesterol and LDL to give you prescription meds. Speak up! Ask for a greater breakdown and see your LDL particle count!

It’s not always about Cholesterol. Not all heart disease is related to cholesterol. As a matter of fact, less than half of all people who have their first heart attack have high cholesterol. Instead, we see inflammation as one of the biggest indicators of heart disease. The problem is that we don’t measure inflammation nearly as often as cholesterol. Inflammation is measured in a blood panel by seeing CRP (c-reactive protein), PV (plasma viscosity), and other blood markers.

What causes inflammation? Well, that’s simple. Inflammation is caused not by consuming fat, rather it is caused by the over consumption of sugar and highly processed carbohydrates.

This doesn’t mean that you have to give up all foods that are packaged or processed and it doesn’t mean that you should cut all sugar out of your diet. I suggest looking at creating a healthy relationship with sugar, one in which you are in control, not the sugar. As for highly processed foods… you don’t have to give up those sweet, salty, creamy, carmely, savory treats you love. You might want to think about limiting how many you have, though.

If you have high cholesterol, do you know your LDL particle count? If you have high cholesterol, and specifically a high small LDL particle count, you might want to consider limiting sugar and highly processed carbs even more.

NutritionAaron Leventhal