The Truth About Cholesterol
January 22, 2014
By Tiffaney Nish, ANutr
The Truth About Cholesterol
There is much more to cholesterol than simply having a high reading.

First of all, it is important to understand that not all types of cholesterol are bad. There are good and bad types of cholesterol, some which are naturally formed in the body and other which come from our diet. But it is the "bad" cholesterol sourced from the food we eat that is popularly referred to.

Knowledge and beliefs on cholesterol differ greatly, and the results of research further complicate the subject.

What is Cholesterol?

Cholesterol is a waxy, fat-like substance essential to health and produced by the liver in all animals. Cholesterol is needed to make certain hormones, produce digestive bile acids, transport molecules, and synthesize Vitamin D.

Cholesterol facts:

1. Cholesterol comes in several forms
  • Low-density lipoproteins (LDL-C) are typically categorised as "bad" cholesterol. In excessive amounts, this form of cholesterol can adhere to arterial walls beginning the pathology of arteriolosclerosis, which narrows the diameter of blood vessels, and can potentially fully obstruct blood supply if the cholesterol plaque becomes too big or bursts.
  • High-density lipoproteins (HDL-C), referred to as "good" cholesterol, are required to transport bad cholesterol back to the liver to be processed.
  • Another form of cholesterol known as Very Low Density Lipoproteins (VLDL-C), carry the highest concentration of triglycerides (fat) and have the strongest association with coronary heart disease (CHD).
2. Dietary cholesterol is not essential to health

The liver can synthesise sufficient cholesterol to meet the needs of the body. However, some individuals generate more cholesterol than others (familial hypercholesteremia). Dietary intakes from animal products are thought to exacerbate this, but research suggests that high dietary cholesterol intakes have little impact on overall cholesterol levels.

3. Trans-fatty acids can negatively impact on levels of LDL-C

However, close analysis of cholesterol studies shows that the effects of long-term saturated fat intake on cholesterol levels is unsubstantial. Different saturated fats (short, medium and long-chain), may exhibit different effects on cholesterol levels, but it is more likely the body's inability to metabolise fat properly that has the greatest effect on cholesterol levels.

4. Cholesterol readings

Most health professionals agree that cholesterol readings of less than 5.5mmol/L are ideal, with LDL levels below 3.5 and HDL levels of at least 1 being considered a lower risk.

Cholesterol levels must be taken into context

Cholesterol levels need to be taken in context when reviewing wellness. Why do some people with abnormally high cholesterol live to 100 whilst others with low cholesterol die of a heart attack at 45? Why do some people with very low dietary cholesterol intakes generate such large amounts of endogenous cholesterol?

1. Cholesterol quality

There needs to be sufficient HDL-C to manage the levels of LDL-C. This is known as a cholesterol ratio.

2. Physical activity

Exercise and an active lifestyle offer many protective mechanisms of action against cholesterol levels and the negative effects it can have on the body.

3. Diet

Fibre-rich foods and specific fibres such as beta-glucan found in oats can inhibit the absorption of cholesterol in the bowel. Foods abundant in antioxidants such as fruits and vegetables can provide protection against the oxidative damage of cholesterol.

Omega-3 fatty acids can also offset the negative impacts of cholesterol dysfunction; evidence suggests it is our high intake of omega-6 fats in respect to omega-3 that is detrimental to our health more so than saturated fat or dietary cholesterol intake.

4. Metabolic syndrome

More important than high cholesterol levels is lipid dysfunction. LDL-C carries cholesterol and triglycerides. The more fat (triglycerides) present in the blood stream, the more LDL-C the body has to generate to compensate.

This encompasses total blood triglycerides and is a complex pathology strongly correlated to high visceral fat levels, overweight/obesity and large waist measurements. It is often diagnosed alongside hypertension, insulin resistance, and type 2 diabetes, as well as other risky biomarkers such as C-reactive protein or homocysteine levels.

5. Thyroid function

Thyroid hormones have multiple effects on the regulation of lipid production, absorption, and metabolism. It stimulates the expression of HMG-CoA reductase, which is an enzyme in the liver involved in the production of cholesterol.

Treat the Cause of High Cholesterol, Not Just the Symptoms

Functional medicine stipulates diagnosing the underlying cause of high cholesterol before simply treating the symptoms. Gender, ethnicity, age, family history, lifestyle factors and other co-morbidities must also be taken into account when making an assessment.

We do know that high levels can increase your chance of cardiovascular disease, and the lifestyle patterns of Western society show cholesterol readings as a useful diagnostic tool that should not be ignored.

Tiffaney Nish, ANutr, graduated with a Bachelor of Health Science (Nutrition & Exercise Science) from Deakin University after studying Nutritional Medicine at Endeavour College, and has worked for Healthy Life, the YMCA and Belgravia Leisure. When she's not inspiring good health through health coaching and group fitness classes, you'll find her in the kitchen whipping up delicious, healthy, and often raw sweet treats! You can contact Tiffaney at
"Cholesterol levels need to be taken into context when reviewing wellness. Some people with abnormally high cholesterol levels live to 100 whilst others with low cholesterol die of a heart attack aged 45."