Cholesterol Vs. Fat: Understanding the Difference - Ask a Nutritionist

Transcript:

TERESA: Welcome to Dishing Up Nutrition's “Ask a Nutritionist”. I'm Teresa Wagner, a Registered and Licensed Dietitian with Nutritional Weight & Wellness. Today we're answering a question from a listener about fat and cholesterol, which is good; which is bad; and how it works. There is a lot of media about fat and cholesterol.

One day it's good for you, and the next day it's going to cause you to gain weight, and you are going to have heart disease because of the fat and cholesterol that we're eating. With all the differing opinions, let's dive into the topic. So grab your headphones, your earbuds, your AirPods, or just turn up your speakers and sit back and we'll get started.

What is cholesterol & its roles in the body?

So let's get started with cholesterol. Cholesterol is a fat like, waxy substance that helps your body make cell membranes, many hormones, and vitamin D. The cholesterol in your blood comes from two different places. It comes from the foods you eat and from your liver.

Get cholesterol labs drawn when fasting

So when you think about this, when you go to have your blood drawn to measure your cholesterol levels, we want you to be fasting because that gives us a better indication of the cholesterol your liver is making.

And that is really what we're trying to get the answer to when we're having those labs drawn. If prior to a blood draw you ate a breakfast with a couple of eggs, which contain 372 milligrams of cholesterol, as your body is digesting those eggs and that cholesterol, it's in your bloodstream because of that digestion. And so that will show up on your labs and elevate your cholesterol levels. So that's why we recommend being fasted when you go in to get that blood drawn.

Does consuming cholesterol through diet impact blood cholesterol levels?

This is important for you to know because current research indicates that for most people, the amount of cholesterol in your diet has minimal impact on your overall blood cholesterol levels. As far as dietary cholesterol is concerned, cholesterol is cholesterol. We don't have a good and a bad cholesterol in foods. So if you're eating meat or eggs, shrimp or butter, the dietary cholesterol, it's all the same.

Breaking down HDL & LDL cholesterol

Where the good and the bad designations come from are in the types of cholesterol that come from our liver. HDL being called the good cholesterol and LDL being the “bad cholesterol”. But this doesn't really give us the whole story. We need LDL cholesterol just as we need HDL cholesterol. It's the types of LDL that matter the most and unfortunately, most of us don't get the testing that we need in order to determine if our LDL cholesterol is something to be concerned about even if the levels are outside the reference range of given on those lab results.

It has to do with the size of the LDL. Small dense LDL molecules are damaging to our blood vessels. Bigger, fluffier LDL are not. To visualize, imagine a tennis court. The net is your blood vessels. Small LDL cholesterol are golf balls, and larger LDL are beach balls. If a beach ball is thrown against the net, it will lightly hit the net and bounce back into the court. If we think about this being our blood LDL, it can lightly bump off of our arteries and stay and float through our blood vessels.

If a golf ball is thrown at that net, it could either damage the net or pass right through. If this is your blood vessel, this is how it causes a problem. Their small size allows them to more easily damage and penetrate the artery walls, leading to plaque buildup, inflammation, and ultimately, a higher risk of cardiovascular disease.

Our standard test do not test for LDL particle size. This is a test that you can request, though, and I encourage you to do this. Not only can it save lives, but the more we become educated and ask, the sooner this will become standard because of the demand for it. And I believe, because this is the current science, it will inevitably become a regular part of our checkups. So let's start asking for it. We may have to pay for it now, but perhaps this could save the lives of our children or grandchildren.

Discussing roles of different types of cholesterols, fats & how they work in body

Let's back up a bit and discuss the roles of different types of cholesterols and fats and understand how they work within our body. All types of cholesterol travel through the bloodstream in small packages called lipoproteins, which consist of a fat, the lipid, or the lipo part of that word, and that is on the inside, and on the outside are proteins.

So let me give you another analogy. It's like mail. We don't put our letters directly in our mailbox. First, we put them into an envelope. The protein is the envelope and the cholesterol is the letter. Going back to the two main types of cholesterol I mentioned earlier, LDL and HDL, LDL is a low density lipoprotein, and it's often labeled, as I said earlier, the bad cholesterol.

However, at Nutritional Weight & Wellness, we see it differently. LDL is crucial for delivering cholesterol from the liver and to the tissues and organs where it's needed. It also repairs cells and helps to produce hormones. This is not to say that we don't need to pay attention to our levels of this one. It's just understanding that it's not all bad. And knowing the particle size is more important than just knowing how much. LDL we have.

On the flip side, we have HDL or high density lipoprotein. HDL helps transport cholesterol away from the arteries and back to the liver where it's processed and removed from the body. Think of HDL as a recycling truck traveling around the bloodstream, picking up extra cholesterol and taking it back to the liver to be reused or eliminated.

This process helps prevent cholesterol from accumulating in the arteries and forming plaques. But wait, there's more. There are other types of lipoproteins that play essential roles in transporting fats and cholesterol. On your labs you may have seen the VLDLs or the very low density lipoproteins. VLDL is produced by the liver and primarily carries triglycerides.

VLDL triglycerides are a type of fat molecule that's transported in the bloodstream, and high sugar intake from our diet can significantly increase the VLDL triglyceride levels contributing to potential health risks like heart disease by promoting the liver to produce more of these fat particles.

Essentially, excess sugar consumption can lead to elevated VLDL levels due to a process called de novo lipogenesis. This is where the body converts excess sugar into fat.

So let's do a quick review. VLDL, very low density lipoproteins, these are large and have a high triglyceride content and are related mostly to dietary sugar intake.

LDL, low density lipoprotein, these are smaller and primarily carry cholesterol to the tissues. There are different sizes of LDL particles. The smaller they get, the more damaging they can be. High density lipoproteins are HDL. These are the smallest and the densest, with a high protein content, and they have the role of transporting cholesterol back to the liver to be recycled or eliminated. Even though these are denser and smaller in size, they are not associated with vascular damage like the small, dense LDL particles. 

Breaking down different types of fats: saturated & unsaturated

Now let's talk about fats. Not all fats are created the same. We have saturated fats and unsaturated fats. Saturated fats are often found in foods like butter, red meat, and cheese, and they have been under the microscope for years. While it's possible that saturated fats can raise LDL cholesterol levels, they also play vital roles in the body.

Saturated fats are necessary for cellular function, for hormone production, and for the absorption of fat soluble vitamins. The key with saturated fats is to consume them in moderation and a part of a balanced diet that includes the unsaturated fats as well. Total elimination of saturated fat is not necessary.

And then we have the unsaturated fats, which are further divided into the monounsaturated fats and the polyunsaturated fats. These fats are considered beneficial for our heart health. Monounsaturated fats are found in foods like olive oil and avocados and nuts. They can help reduce LDL cholesterol levels and help to maintain healthy cells.

And then we have the polyunsaturated fats, which include the omega-3s and the omega-6 fatty acids. Omega-3s are found in fatty fish like salmon, flaxseeds, and walnuts, and have an anti-inflammatory property and help to support brain health.

These are very good for cardiovascular health. Healthy omega-6s are found in things like seeds, eggs, and nuts. And also one of my favorite supplements, GLA. And these are essential for growth and development. It is important to maintain a proper balance between the polyunsaturated fats, between omega-3 and omega-6. We want to have more omega-3s than our omega-6s.

Diet recommendations to maintain healthy cholesterol levels

So what should your diet look like in order to maintain healthy cholesterol levels? Well, focus on a balanced, real food way of eating like we have been saying at Dishing Up Nutrition for over 20 years. Rich in vegetables and some fruit, adequate amounts of protein, incorporating healthy fats from fish, nuts, and olive oil. And don't forget about the fiber. It helps to reduce the absorption of cholesterol into your bloodstream.

And of course, high cholesterol levels are associated with an inflammatory state. So keeping our blood sugar levels within the healthy range by eating low amounts of sugar and eliminating processed carbohydrates from our diet can be very helpful for keeping our blood sugar balanced.

And also we want to watch out for those refined damaged fats that tend to have higher levels of omega-6 fatty acids in them, the unhealthy version of those omega-6. So a whole food, real food diet, including lots of fiber, vegetables, fruits, adequate protein, healthy fats, and avoiding our processed carbohydrates and sugars, refined oils will go a long way to keeping you healthy and keeping your cholesterol in a healthy range naturally.

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