Get High on Health

There’s a problem with giving cholesterol too much attention: it distracts us from focusing on more powerful ways of lowering heart disease risk such as not smoking, exercising regularly and reducing trans fat, alcohol and sugar consumption.

If everyone:

  • stopped smoking
  • was physically active for 30 minutes or more a day
  • consumed less than 10 (for women) and 14 (for men) standard alcoholic drinks per week
  • ate less than 6 teaspoons of sugar each day (read the Sugar Series here)
  • avoided trans fats (addressed in future HEBs)
  • consumed a diet rich in fibre (addressed in future HEBs)

most people wouldn’t have to worry about their cholesterol levels (see last week’s HEB).

That’s because when you follow these guidelines, your body will effectively self-regulate your blood cholesterol. The exception is people with a rare genetic disorder known as familial hyper-cholesterol-aemia (hyphenated for ease of reading). If this is you, please continue to adhere to your doctor’s advice.

The average person makes about one gram of cholesterol every day, most of it in the liver. The amount you make on a daily basis changes in relation to your dietary intake. If you eat more cholesterol you will make less cholesterol and vice versa.

Cholesterol is also efficiently recycled by the body. The liver excretes it via bile into the digestive tract and about 50% of the excreted cholesterol is reabsorbed back into the blood by the small intestine.

Dietary cholesterol comes from animal foods such as meat, prawns, poultry, egg yolks, cheese, butter and breast milk. Contrary to what I was taught in medical school, eating these foods will NOT elevate small dense atherogenic LDL cholesterol levels. Of course overdoing anything will lead to health issues. However if you allow your body to guide you and if you eat a wide variety of whole foods, you will be fine. We need cholesterol from birth and breast milk contains 14mg of cholesterol per 100g, much the same as in cow’s milk. If you are not lactose intolerant and if you enjoy dairy, there is nothing unhealthy about enjoying full fat dairy products.

Plants do not make cholesterol. Some plant foods such as avocados, peanuts and linseeds actually reduce our absorption of cholesterol because they contain phytosterols that compete with cholesterol and reduce its uptake in the intestine. The key, as always, is a balance between plant and animal foods, determined by listening to your body. Pause before eating or planning your meals and ask yourself what it is you need. Everyone’s balance is different. By learning to tune in to your body you will start to recognise what is nutritionally right for you at any given time.

The reason that cholesterol gets so much attention is because there are drugs that can lower blood cholesterol. No one profits from you going for a walk except you, so walking will get less press than statins (the most frequently prescribed cholesterol-lowering medications).

The issue with statins is that although they are helpful in some people with a high risk of heart disease, they can also have unpleasant side effects such as myalgia (muscle pain), fatigue, digestive problems, mental fuzziness, confusion, memory loss, elevated blood glucose levels and occasionally liver damage. For some people, the muscle soreness and weakness is so severe that they stop exercising and become socially withdrawn – this is far worse than having high cholesterol. 

I am not advocating that you abandon your cholesterol-lowering medication if that’s what you’ve been prescribed. I’m merely suggesting that you speak to your doctor if you have concerns about side effects that are reducing your quality of life. Good health is determined by more than blood test results. It’s about feeling alive and having energy and enthusiasm to do what brings you joy and meaning.


Refer to our series on the real effects of sugar on the body by clicking on the links below:

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