In the second in a series of 4 articles on the truth about cholesterol–why you want it and how lowering it by all means is not healthy–begins by looking at the different “parts” if you will of the cholesterol molecules.
We most commonly talk about and test for LDL or “bad” cholesterol and HDL or “good.” The L in those two acronyms stands for lipoprotein and is basically a coating around the cholesterol that allows it to be water soluble and therefore move around and work in our blood.
LDL cholesterol-low density lipoproteins carry cholesterol to the cells for repair work as well as the many other important functions they have. HDL, high density lipoproteins carry cholesterol away from the cells and arterial walls and back to the liver to be used or disposed of.

Here’s the sixty-four millions dollar question: how can one part of cholesterol be good and the other bad just because one travels in one direction and the other moves in another?

Here’s a little history:
In 1948 The Framingham Study was begun. It was designed to study heart disease and followed 5,000 men and women to determine some common traits among those who succumbed to the disease.
Here’s an important point, this study was observational, not a double blind, placebo controlled testing environment. It simply tracked people and checked in with them over the years to see what they were eating, their lifestyle habits, and it checked blood levels and health markers looking for commonalities in those that ended up with heart disease.
In 1961 cholesterol was “discovered’ and although the Framingham study had to date uncovered important lifestyle factors that promoted heart disease, like smoking, once cholesterol was “outed” the medical world locked on to it as a way to prevent heart disease. It may have made sense initially but the thousands of tests and research papers that were produced to prove it was the culprit have never been able to do so.

Enter Ancel Keys, by all reports a blustery, self important scientist from the U of Minnesota. According to Dr. Dwight Lundel “Keys’ theory, one he actively promoted to an increasingly health conscious public, was that an association existed between the rate of cardiovascular disease of a population, serum cholesterol and their intake of saturated fats.”

Keys was able to convince the US government that dietary fat equaled increased rates of heart disease and death but the proof is in the health statistics.
Consumption of dietary fat decreased from the 1960’s to the 1990’s but the rate of heart disease did not and instead, the incidence of obesity and Type II diabetes soared. As the fat got stripped from our diet–as did the Yumm factor–heart disease rates soared and so did rates of depression and anti-depression drug sales.

Here’s where it gets interesting. The people in the Framingham study ate what they wanted and the amount of saturated fats varied widely. No matter how they twisted their findings they could not prove a cause and effect relationship between the fat participants ate and the cholesterol floating in their blood.

At the end of the study–22 years after they began to compile research–the scientists concluded:

“There is, in short, no suggestion of any relation between diet and

the subsequent development of chronic heart disease in the study group.”

I’m going to end here today. Tomorrow I’ll explain a little bit about how low-fat-diets-save-lives became the nation’s health dogma. As you might expect is has something to do with politics, lobbyists and Big Pharma.

I’ll also reveal what aspects of cholesterol do relate to food and what foods are dangerous ones, the ones to avoid.

Yesterday’s issue of the New England Journal of Medicine reports that the very inexpensive nutritional supplement niacin worked better to clear arteries than the not so cheap and side effect rich drugs Zetia– a drug used in addition to a statin, and Vyotrin– a single pill which combines a statin with Zetia. 

Much of the information I’m posting here comes from The Washington Post.

A recent trial gave 200 people one of the drugs or Niaspan, a form of the B vitamin Niacin. They were followed for 14 months. The results showed a decrease in artery clogging plaque in the niacin group but none in the pharmaceutical group. It’s plaque that causes problems and deaths not the cholesterol itself.

Vytorin and Zetia are among the most popular prescription drugs and were introduced with lots of fanfare and expensive advertising. Don’t worry though, Merck made their money back on those expenses. Last year, physicians in the United States wrote a total of more than 29 million prescriptions for them, and worldwide sales totaled $4.56 billion, according to Merck.

Critics of the study complained that it involved just 200 patients, was ended early, and examined what is known as a surrogate marker — the amount of plaque on artery walls — rather than evaluating the rate of heart attacks and stroke.

The study’s author, Allen J. Taylor of Walter Reed Army Medical Center and Washington Hospital Center, said the trial ended early because the results were quickly apparent. “It couldn’t be more clear,” Taylor said. “It would have been unreasonable to continue the experiment because the trial had met its objective — niacin is superior to ezetimibe.”

Because plaque can clog arteries and restrict blood flow to the heart and brain, cardiologists view plaque as a good indication for the risk of heart attack and stroke.

The patients who took Niaspan had less plaque in their arteries and also had higher levels of high-density lipoprotein or HDL. Known as “good” cholesterol, HDL is believed to remove cholesterol from the arteries and carry it back to the liver, where it is passes from the body.

The patients who took Zetia had more plaque in their arteries but lower levels of LDL. They also had more heart attacks, strokes and other cardiovascular problems than the patients taking niacin.

If you are on Zetia or Vyotrin please find out more about using niacin as a safe alternative. And if you are worried about LDL cholesterol being some form of evil to be avoided at all costs, please stop back here tomorrow and the days following. I’m going to do my best to explain simply why it’s not evil, why HDL and triglyceride levels are much more important to pay attention to, and why low levels of cholesterol is unsafe at any age but especially midlife and beyond.