Consider a news headline such as, “car drives off the road, injuring four pedestrians.” Reading this headline without knowing more could give a misperception that cars are out to hurt people. So cars are harmful.

You might think that reaction is silly. After all, everyone knows it was some driver that took the car off the road, and the news media just writes that way. Well, medical news media make similar statements about cholesterol, except in this case they really mean that cholesterol is the villain. Just like cars are involved where most pedestrian injuries occur, so cholesterol appears in cardiovascular and other diseases. Statistically, some diseases occur more often with high cholesterol, so the simple assumption is that cholesterol needs to be controlled.

It is not only cardiovascular disease that implicates cholesterol. Published in Nature Communications, a study conducted at VCU Cancer Center found a link between the most common form of brain cancer and an increase in cholesterol production. The study found a gene called “EGFR” is over-expressed in brain cancer cases, meaning this gene is more active than usual, leading to a chain reaction ending in production of more cholesterol, which then speeds brain tumor development. Like healthy cells in the body, cancer needs cholesterol to build cell membranes, and since cancer grows rapidly, it needs increasing levels of building blocks. The study concludes that this form of brain cancer can be slowed by inhibiting the EGFR chain reaction that which then would decrease cholesterol.

Similar conclusions have been drawn by various studies finding a link between high cholesterol and cardiovascular disease (CVD). In fact, standard protocol for those who have any signs of CVD is to prescribe statin drugs to force the cholesterol levels lower — often even when the levels are in the “normal” range. Many physicians will prescribe statins if the cholesterol levels are higher than “normal” as a CVD preventative measure. All this is based on the “circumstantial evidence” that cholesterol is the villain. However, this use of statins is controversial in the medical community. In an article published in Evidence-Based Practice, it is stated, “There is no clear evidence that statin therapy improves either cardiovascular mortality or all-cause mortality in non-diabetic patients older than 65 years who do not have known heart disease.” In other words, we don’t see a reduction in deaths using cholesterol lowering drugs, unless there is some disease already present. If cholesterol leads to artery blocking and even some forms of cancer, why doesn’t lowering cholesterol help prevent those diseases?

A closer look at cholesterol
Your body needs cholesterol. In the rush to reduce cholesterol artificially, some people have actually suffered from their levels being too low for their bodies to perform normal metabolic functions. Cholesterol is used to build cell membranes and nerve sheaths, and in nerve conduction, cell signaling, hormone production, and various biochemical pathways. It is necessary for synthesis of vitamin D. If too low, nervous system and mental conditions can develop, and eventually blood vessel development can be hampered, leading to strokes due to sudden small vessel breakage. The body makes cholesterol as needed, unless hindered by medications.

Not all cholesterol is the same. HDL (high density lipoprotein) and LDL (low-density lipoprotein are very different. Higher HDL levels are considered good, because they sweep away excess LDL. Even this does not tell the whole story. Different categories of LDL exist, based upon the size of the LDL molecule. The different cholesterol sizes react differently in the body.

A major purpose of serum (in-blood, circulating) cholesterol is blood vessel repair. When a tear or crack occurs in a blood vessel, cholesterol acts as a patch, much like a band aid, over the damage. It circulates through the blood, and even at high levels does no damage to the blood flow in normal vessels. When widespread micro-level blood vessel damage occurs, due to consistently high blood sugar levels, or due to high blood pressure, cholesterol patches happen frequently. LDL cholesterol circulating constantly allows for an immediate patching response, as leaking blood vessels are considered an emergency to the body. Unlike the smooth inner lining of the vessel walls, these patches have rough surfaces that promote inflammation. LDL-laden macrophages (white blood cells) called “foam cells” develop in response to the inflammation, blistering up the patch and making it oversized.

This is where diabetes and hypertension ties in with cardiovascular disease, as the blood vessels weaken from chronically high sugar levels and chronically elevated blood sugar, this causes more leaking and more cholesterol patching. Was the cholesterol the villain, or was it a necessary response to the vessel damage?

If cholesterol is a required part of being healthy, how could it be a damaging factor at all? We all get bruises and cuts; blood vessels get damaged frequently, and they repair. Cholesterol is part of that process, and doesn’t necessarily lead to dangerous plaque build-up. Oversimplification is the answer. Just as the various sizes of the cholesterol molecule get lumped into the catch-all term “cholesterol”, so does normal and altered cholesterol get lumped together. LDL in particular is prone to oxidation and the smaller the molecule, the more easily oxidized it becomes. Free radicals, which better deserve the “villain” title, steal electrons from wherever they can, including cholesterol molecules. Oxidized or electron-poor LDL is automatically inflammatory, as it now wants to steal electrons and is electrically charged. The body recognizes this as dangerous, and inflammation results. If oxidized LDL is used to repair blood vessels, you now have irritating, inflammatory vessel patches attracting the immune system. Blood platelets, measured by platelet-activating factor (PAF), are attracted to the electrical charge and can cause blood clots to develop, which is a huge problem where cholesterol plaque has already restricted blood flow in the area.

So two people with “high” cholesterol”, one with high levels of oxidized LDL— particularly the small particle LDLs— and the other with low levels of oxidation, are at quite different cardiovascular risks. The standard assumption is first that high cholesterol is bad. Then the assumption that high LDL is a negative, and going down further perhaps they look at only V-LDL (very low density lipoprotein) as being the problem. They may assume that some percentage of that LDL is going to be oxidized for everyone, and don’t generally consider that as a further risk factor. Yet, virtually any molecule in a healthy cell that is damaged by free radicals will no longer behave properly in the body, and free radical-damaged molecules simply cause more free radicals. Perhaps now we are getting close to knowing the true “villain” in this story.

Keep your cholesterol — and the rest of your body — clean
We know how trans-fats are extremely damaging and inflammatory. Altered cholesterol fats are also inflammatory. The body is under constant assault from a “dirty” environment. Even normal metabolism causes some free radicals in the body. Anti-oxidants, which are rich in plant based, raw diets, are particularly effective in guarding against free radical damage. The opposite is true for inflammatory meals such as processed foods, arachidonic acid-laden meats, high sugar foods, and simple carbs. Inflammation is the common factor, and a multi-faceted approach is needed to reduce it. If inflammation is in check, many natural factors, such as cholesterol, work as they were designed to do. Once chronic inflammation has set in, numerous diseases are likely to follow, and they usually lead to more inflammation as the body attempts to deal with the increasing damage. Persistent effort is needed to push back against inflammation —not with medications (unless an emergency), but by taking away the need for the body to produce the inflammation.

Dr. Nemec’s Comments:
As stated cholesterol is good and necessary in the body. LDLs, VLDLs and HDLs are all good in the body and all serve very important purposes. The key that must be grasped is: good does not become bad by the amount but by the form of the amount. What does oxidized mean? It has lost electrons and in essence is more free radical in nature, looking to grab any electrons in any cells it comes in contact with. What causes cholesterol to oxidize? The number one cause is cooking. When you eat plant food that is living and raw, meaning it has never been heated or cooked in any way, it has not only the highest nutrients but also the highest antioxidant store because it has not lost electrons to the heating process. Also plants to not have cholesterol — this is only found in animal products. So where do plant eaters get the necessary cholesterol from? Your liver makes the cholesterol you need. It does not ever need to come from your diet because most everything you eat with cholesterol in it: dairy, eggs, fish, chicken, pork, red meat has oxidized cholesterol in it unless you eat it very fresh and raw. But why add more cholesterol to your body when your liver makes the perfect amount in the perfect ratio without any oxidation?

If all these studies were repeated with patients eating living and raw plant food you would see zero cholesterol problems and at least a 60-80% reduction of cardiovascular disease risk. This risk reduction would carry through to most every disease process.

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