Cholesterol Newsbytes

Menstuff® has compiled newsbytes on the issue of cholesterol.


Dietary Cholesterol and Cardiac Risk

We have heard for decades that a high blood level of cholesterol is an important risk factor for atherosclerosis, and thus for heart attacks and strokes. We have also heard for decades that, in order to help keep our cholesterol levels down, we should be avoiding high-cholesterol foods in our diets. (Most specifically, we have been told that eating too many eggs is bad for us.)

(Editor's note: Check back in history. I believe that you'll find that Dr. Kellogg created this myth. Alleged reasoning: eggs are a competition for cereal. And nothing more. And the government has bought this "theory" until now.)

But in February, 2015 Americans heard the startling news that the government’s Dietary Guidelines Advisory Committee has voted to end its longstanding recommendation that we avoid foods that are high in cholesterol. Eggs (and shrimp and lobster), it now appears, are healthy foods again!

This news was not a complete surprise to anyone who has been following the medical literature in recent years (or indeed, for recent decades). For that matter, this should not be particularly newsworthy for most doctors, especially cardiologists, who ought to understand something about cholesterol metabolism.

There has never been any convincing clinical evidence from well-conducted studies that dietary cholesterol greatly increases cardiovascular risk. The dire warnings about eating cholesterol have been based largely on theoretical concerns.

Then, in 2013, a major meta-analysis was published in the British Medical Journal that looked at eight clinical studies analyzing dietary cholesterol and outcomes. Among the almost a half-million individuals enrolled, there was no association between egg consumption and the risk of coronary artery disease or stroke. (If anything, the trend was in the other direction; toward a protective association with egg-eating.) This study may not be the final word on the matter, but it’s the best evidence we have to date, and it’s the best we’re likely to have for a long time. It is this meta-analysis, most believe, that finally moved the government’s dietary committee to finally change its recommendations.

This Information Is Compatible With What We Know About Cholesterol Metabolism

We have known for years that cardiac risk is specifically associated with LDL cholesterol levels. It may surprise you to know (and, one fears, it may surprise many doctors to know) that dietary cholesterol has no direct effect on LDL cholesterol.

When you eat a high-cholesterol meal, the cholesterol that gets absorbed through the gut is packaged in chylomicrons (and not in LDL particles), along with the fatty acids from your food.

The chylomicrons are then released into the bloodstream, and they deliver the fatty acids you have just eaten to the tissues (muscle and fat). The chylomicron remnants - which include all the absorbed dietary cholesterol - are taken to the liver for processing. The cholesterol from your diet, then, is not delivered directly to tissues, and is not directly incorporated into LDL particles.

Generally, chylomicrons are completely cleared from the bloodstream within an hour or two after a meal. This is one reason you are supposed to be fasting when you have your blood lipid levels measured - nobody is interested in measuring the cholesterol in chylomicrons, since chylomicron-cholesterol is not associated with cardiac risk.

Dietary cholesterol can, in fact, have an impact on LDL cholesterol levels, but only indirectly. It is the liver’s job to synthesize the “right” amount of cholesterol based on the body’s needs. (The cholesterol handled by the liver is loaded onto lipoproteins and is released into the bloodstream where it eventually becomes LDL cholesterol.) So, if you eat a lot of cholesterol, the liver is supposed to reduce its synthesis of cholesterol - and its production of LDL cholesterol - to compensate.

To reiterate, dietary cholesterol is not directly delivered to the tissues, and is not directly packaged into LDL particles. The liver - that great regulatory organ - is interposed between dietary cholesterol and LDL cholesterol, and one of its duties is to adjust its production of cholesterol in response to your diet, in order to keep LDL cholesterol levels in some normal range.

Therefore, it should not be a great surprise to doctors who follow the medical literature, and who understand cholesterol metabolism, to learn that dietary cholesterol plays no major role in determining cardiovascular risk.

The Bottom Line

We egg lovers would like to welcome the government’s dietary panel into the 21st century.

How Low Should Your Cholesterol Go?

The message to reduce your cholesterol is loud, but is it clear? Read on to find out exactly how low your cholesterol should be and learn to get it where it belongs.

Lower Bad Cholesterol in One Month Without Drugs

If you've cleaned out a clogged bathroom pipe before, you have some idea what the inside of a guy's veins look like when he has high cholesterol. Luckily, you can fix the problem -- and you don't need a pipe wrench to do it. A simple veggie diet, followed for just one month, can lower your bad cholesterol by as much as 29%! (And if you're already on LDL-lowering drugs like Lipitor, Zocor, or Mevacor, this will just add to their benefit.) Cleaner pipes in 30 days -- now doesn't that sound appealing?

Doubling up on Cholesterol Drugs Makes a Difference

Trying to get your "bad" cholesterol down and your "good" cholesterol up can be a difficult task -- one that may have just gotten easier. New research shows that a certain drug combination packs a powerful punch when it comes to keeping cholesterol in line.

Cholesterol-Lowering Drugs Safe And Effective In Children

The cholesterol-lowering drug, simvastatin, significantly reduced cholesterol levels in children with inherited high cholesterol, according to an international study published in the rapid access issue of Circulation: Journal of the American Heart Association.

Test Drug Drives Up 'Good' Cholesterol

First human study of medicine shows promise.

New Drug Raises Good Cholesterol

After only four weeks, people who took an investigational drug were able to increase their 'good' cholesterol levels by 34 percent, according to a report in Circulation: Journal of the American Heart Association. Also, 198 people lowered their LDL cholesterol (the 'bad' cholesterol) by 7 percent.
Source: American Heart Association

Margarine better than butter, but genes play a role

Butter or margarine? The question has troubled cholesterol-conscious consumers who were first told the answer was margarine, then were told margarine contains trans fatty acids, which are cholesterol-raising fats.

High cholesterol can limit oxygen supply to heart

In findings that point to a new risk factor for heart disease, researchers have found that high cholesterol levels may impede the delivery of oxygen to tissues throughout the body.

Some surprising bad news about olive oil

Well, maybe we have been wrong about olive oil for all this time -- in this study, sunflower and rapeseed oils did better at keeping LDL (bad) cholesterol levels down. But don't let the news spoil your salad -- it can still be a tasty part of a healthy diet.

Not all fats are created equal

Is margarine better than butter? Are you confused about dietary fats? Well, you're not alone. With a wealth of sometimes contradictory scientific reports, sorting out the monunsaturated from the trans fatty acids is difficult.

Does Lipitor affect the immune system?

"I have been taking Lipitor for the last two years to lower my cholesterol. Last year I had an outbreak of cold sores on my lip. Could this problem be related to Lipitor?"

Does morning grapefruit interact with evening medication?

The grapefruit effect lasts up to three days, so drinking grapefruit juice in the morning could still impact your evening cholesterol medicine.

Should I take Lipitor, or lose weight?

"My doctor wants me to take Lipitor to bring my cholesterol down, but I'm in very good health at 5'8", 135 pounds. I eat a low fat diet, and run and walk three miles six days a week plus work out with weights after running. Should I take Lipitor or lose weight?

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