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We’ve all heard the warnings about cholesterol over the last few decades.
High cholesterol is bad for you.
It will clog your arteries.
High LDL cholesterol is one of the risk factors for heart disease. High HDL cholesterol levels are good - whatever that means. Maybe you were even prescribed cholesterol-lowering drugs, and aren't really sure why.
But as we get more research results, we’re starting to discover we’ve been misled about cholesterol’s role in the body.
Let me explain.
In this article:
- What You Need To Understand About Cholesterol
- What You Need To Know About Lipoproteins
- Dave Feldman Will Help You Understand The Truth About Cholesterol
- The Low Carb Cholesterol Challenge
- The Weight Gain Experiment
- The Resistance Training Factor And LDL Levels
- More Promising Initial Data Points
- Busting The Cholesterol Myth
What You Need To Understand About Cholesterol
Cholesterol isn’t really a fat. It’s a fat-like waxy substance with specific purposes in your body. Cholesterol:
- Provides raw material for certain hormones:
- Makes up all of your cellular membranes; in other words, the outer shell of your cells is made of it.
- Comprises part of your brain; without it, your brain can’t function correctly
- Makes up part of your nervous system; specifically, the insulation around the nerves
- Helps make bile; a detergent-like substance that allows your body to break down fats in order to get the benefits of nutrients such as fat-soluble vitamins and essential fats. As well, bile helps your body make certain vitamins such as vitamin D.
- Helps provide vitamin E and other antioxidants, which play a role in neutralizing free radicals and pathogens.
Your body makes about 3,000 mg of cholesterol a day, which is about 75% of the cholesterol in your body. Thus, about 25% of it comes from your diet.
While it’s true that cholesterol is part of the plaque that can clog your arteries, it’s not the cause of it. In other words, though it’s part of the crime scene - it’s not the criminal. Rather, cholesterol is there as part of your body’s healing process to repair a wound in the arterial wall.
Let me touch on triglycerides for a moment to help dispel some of the common worries about them. Triglycerides:
- are a type of fat that makes up fat cells
- are something you consume for energy or to store fat
- can be converted from carbohydrates you eat
You’ll often see triglycerides referred to as lipids. Your body contains several types of lipids. What’s key for you to know is that they’re all what’s called hydrophobic: they don’t mix well with water. But because they need to travel throughout your body for the healthy functional reasons I mentioned above, your body has to add something called a lipoprotein to allow lipids to be transported throughout your body’s watery environment.
What You Need To Know About Lipoproteins
Now that you know lipoproteins are like boats, which carry and deliver the lipids your body needs to be healthy, I’ll break down the five most common types. They are:
- Chylomicron: chylomicron is also known as ultra low-density lipoprotein (ULDL). It carries dietary fat from your small intestine to the cells. It’s created when you eat fat. Once it’s done delivering triglycerides, chylomicron gets absorbed by the liver.
- VLDL: stands for very low-density lipoprotein. When you’re fasting - in other words, not eating - your body takes the fat from your liver and transports it to the cells.
- IDL: intermediate density lipoprotein, which is used to transport fat by the body as it’s transitioning from using VLDL on the way to the next type, LDL.
- LDL: low-density lipoprotein, which also carries fat from your liver to your cells. When it’s done with its purpose, it gets recycled by your liver.
- HDL: high-density lipoprotein, which carries excessive cholesterol that’s lingering from transport by the other four lipoproteins back to your liver where they’re recycled or repurposed.
Another way to understand the lipoproteins is to envision them as relative sizes to each other. The lower the density, the bigger the particles, and vice versa. Smaller particles like HDL can be more dense; that is, more of them are packed into the same space than the larger, lower density ones.
Each of these lipoproteins has its own percentage of triglycerides, cholesterol, and protein that it carries.
But wait, there’s more! I’ll turn it over to cholesterol expert Dave Feldman.
Dave Feldman Will Help You Understand The Truth About Cholesterol
Dave Feldman is a software engineer who used his technical expertise to learn everything he could about cholesterol, after going on the keto diet and seeing his total cholesterol and LDL skyrocket. Determined to discover what the results truly meant, he embarked on a rigorous course of testing over several years - with himself as the sole subject.
He takes constant metrics, measuring his blood sugar and ketone levels. Dave also takes a picture of everything he ingests, including supplements and water. He’s so obsessive about this that he offers $100 to anyone who catches him ingesting something without taking a picture of it.
I was so impressed by Dave that I invited him to speak at my annual Keto Summit a while back.
Here are some of his most important points:
- What Dave calls The Dietary Fat Inversion Pattern is something he was able to identify over the course of his experiments. That is, he became able to confidently predict that the more cholesterol one consumes, the less is found in the blood, as indicated by the LDL-C test which measures the total cholesterol amount within the LDL. Using the macros in food, Dave showed he’s able to predict with a high degree of accuracy, from the macro amounts of food, what the cholesterol levels in his blood will be.
- He also developed The Lipid Energy Model, showing the lipid system is dynamic, not static, similar to a network - which is how Dave relates his cholesterol work to his expertise as a software engineer. As in a computer network, the different components communicate with each other, resulting in a specific outcome. Of particular note in this model:
- Your body contains a quintillion of LDL particles - that’s 1,000,000,000,000,000,000 boats. Clearly, your body considers the delivery of lipids throughout your body to be essential.
- Think of triglycerides as the boat’s (LDL’s) passengers. What, then, is cholesterol? It’s the life rafts.
- I’ll now introduce another set of lipoproteins: apolipoprotein. In the boat analogy, apolipoprotein is the captain. It binds to the lipid and directs the processes.
- There are different apolipoproteins, referred to simply by the letters A, B, C, D, E, H, J, L, M. Each of these has several sub-classes.
- LDL uses Apo B; HDL uses Apo A; and, IDL uses Apo E. But the key point to remember is that these different apos have several jobs: to convert VLDL to IDL to LDL; direct the lipoproteins through the circulatory and lymph systems to the cells; and, help communicate where the boats start and end up in the body. Without the apos, the other lipoproteins would be mindless bags of fat and cholesterol.
- Fasting is a key part of this energy model. When you’re not eating, your cells still need energy. Your liver helps out, using fat cells. VLDL is the liver’s boat that will transport triglycerides to your cells to provide energy.
- When the VLDL's transport job is done, it switches to its next job: it becomes the LDL boat. Additionally, LDL uses vitamin E to neutralize pathogens. But what happens when LDL runs out of vitamin E? It cleverly binds itself to the next pathogen to help clear it from your body.
- In addition to energy delivery, lipoproteins play a support role. Specifically, this is HDL’s role. You’ve heard it referred to as the good cholesterol, right? Here’s why:
- The cholesterol found inside HDL is, indeed, good for you; thus you want your HDL level high in order to have high levels of the cholesterol it contains.
- HDL works closely with the so-called bad cholesterol, LDL, to (as I mentioned) neutralize pathogens and free radicals with vitamin E.
- “But wait,” you say, “Aren’t VLDLs and triglycerides associated with disease?”. Yes, they are, but only if they’re found lingering in the bloodstream. On the keto diet, you may find that your triglycerides have dropped. This is because you’re using them more effectively, there are fewer triglycerides per lipoprotein boat; and, there are more LDL particles that started out as VLDL particles which delivered the fat.
See how LDL has been unfairly demonized?
The Low Carb Cholesterol Challenge
Dave issued what he called the Low Carb Cholesterol Challenge in response to complaints that people on a low carb high-fat diet (like keto) are unreasonably comforted by having low triglycerides and high HDL even when their LDL has increased. There are health professionals who still believe people with these markers are significantly increasing their risk of heart disease.
Dave’s challenge? Submit to him the best study you can find which shows normal, non-treated people who have 1) High HDL, 2) Low Triglycerides, and 3) High LDL, and who have high rates of cardiovascular disease.
Six months after he issued his challenge, he hadn’t received even one study showing this. But, interestingly, he had received several valid studies of just the opposite. In fact, the data he’s received has shown that LDL whether low or high is less of a factor for cardiovascular health than one’s HDL and triglycerides levels.
To up the ante, Dave put out what he called an LDL bounty - $300 to the person who submitted a study that met his guidelines. He even modified the guideline for LDL levels from high to above average.
Two months after he put out the bounty: silence.
Not one person had claimed the $300.
But that’s not all.
The Weight Gain Experiment
As part of his utter commitment to learning the truth about cholesterol, Dave performed another experiment on himself: he deliberately induced hyperinsulinemia (a high insulin state) by temporarily going back to a standard American high carb diet and gaining weight. This gave him the chance to observe and compare cholesterol as he gained weight.
Dave primarily ate a lot of bread and other starchy foods, rather than sugary foods. (He cautions people not to do this experiment themselves because of the risks involved with hyperinsulinemia.)
His blood pressure ramped up, in addition to his weight gain As his weight climbed, so too did his triglycerides. But they then dropped as he entered the controlled keto diet phase of his experiment and began to lose weight.
And, despite what you may have heard that LDL drops when you lose weight, Dave experienced the exact opposite. As he switched back to keto, his LDL went from 133 mg/dl to 238.after a weight loss of just 5 pounds. Because of this, he counsels people who are losing weight on keto to not even check their lipids for awhile.
The Resistance Training Factor And LDL Levels
And, finally, Dave conducted a resistance training experiment - on himself, of course.
He hypothesized that by making his muscles sore with resistance training, the muscles eat LDL particles to repair and grow.
How did he come to this? Cell membranes are made up of two things: phospholipids and cholesterol. LDL is made up of the same two things. Therefore, Dave believed, his hypothesis seemed reasonable. For twenty days he controlled for diet, exercise, and sleep. His LDL dropped 13% after two specific resistance training interventions.
I think you'll agree with me when I say this is certainly worth keeping in mind.
More Promising Initial Data Points
Despite these stunning results, Dave still had some uncertainty about the risk factor of LDL cholesterol. He decided to have himself tested with something called the carotid intima-media thickness test (CMIT). It’s used to diagnose the extent of carotid atherosclerotic vascular disease before the person displays any symptoms.
Dave had been tracking his CMIT results every six months for two years. He was happy to discover his left carotid artery was regressing; that is, thinning. Typically, with age, it should have been staying the same or thickening. His right carotid artery displayed similar results.
But both carotid arteries actually thickened substantially while he was back on his standard American diet for his weight gain experiment. After just four weeks back on a high carb diet, both carotid arteries had a pronounced thickening, indicating a higher risk factor for vascular disease.
Though only ten data points at the time showed this correlation, Dave is clearly onto something important here - showing a beneficial correlation between a keto diet and early markers of carotid atherosclerotic vascular disease while it’s still asymptomatic.
Busting The Cholesterol Myth
You can see how the simplistic myth of high cholesterol levels has led us astray for many years.
Dave Feldman is one of the pioneers in cholesterol research that’s helping us understand cholesterol’s complex role in our health.
Now that you have this compelling data, I hope you’ll consider it in light of your particular situation. Talk to your doctor about your test results. See what he or she has to say. Keep an open mind. I know this is a lot of information to take in, especially because it runs contrary to many years of what you’ve been told.
But it’s worth your health to assess new information as it becomes available. You may discover ways to boost your health that you'd otherwise never know about.