DEAR DR. BLONZ: I read your column about statins and cholesterol, and have a related question. I was recently advised (again) to avoid foods with cholesterol because I have too much in my blood, but many of the foods I love to eat contain cholesterol. Exactly how bad is cholesterol? What is the connection between the amount of it you eat and the amount in your blood? I have had discussions about this with my physician, but would like your advice. -- S.T., Greenville, South Carolina
DEAR S.T.: There are many factors in the connection between dietary cholesterol and that found in a blood test.
Cholesterol is a lipid substance, part of a large group that includes fats and oils. These have a unique ability to oxidize into troublesome compounds that increase disease risk, most notably cardiovascular disease. Some lipids are worse than others, but all seem to have this potential. Because our blood is a water-based medium, lipids must be transported around attached to proteins appropriately named “lipo proteins.”
A member of the sterol family of lipids, cholesterol is a large, complex compound with a build that looks like a piece of chicken wire. It was found initially in gallstones, the painful masses that sometimes form from bile inside the gall bladder. Accordingly, the name “cholesterol” is Greek for “the sterol found in hardened bile.” Cholesterol serves many functions in the body: It is needed to help the brain work properly, it keeps our skin watertight and it provides the basic building block for sex hormones and other essential substances.
The negative image of cholesterol comes from studies where elevated blood levels were found to be a predictor of disease. Examination of damaged arteries in those with cardiovascular disease tended to show a cholesterol-laden buildup. It was unclear whether cholesterol was directly responsible, but the weight of circumstantial evidence remains significant.
There is an important distinction between the cholesterol in our diet and the level in our blood. In the average individual consuming a balanced diet, the effect of dietary cholesterol on the blood level appears to be of secondary importance. Only about half the amount of cholesterol we eat gets absorbed. And if there were absolutely no cholesterol in our diet, the body would make all it needed on its own.
A healthful diet and lifestyle have always been key, but some of us must take special care due to a genetic predisposition to produce excessive amounts of cholesterol.
Greens, grains, fresh fruits and vegetables, nuts and seeds have the right stuff to help the body process dietary fats and cholesterol. You didn’t mention your exercise habits, but keep in mind that an active lifestyle keeps your muscles and systems demanding fats for energy, rather than having the bulk of dietary calories routinely headed for storage. It is also critical to avoid an excessive intake of sugars.
When we eat and live well, the importance of dietary cholesterol shrinks dramatically. You state that many of the foods you love to eat contain cholesterol. You also indicate that this is not the first time you have been counseled. If you want to keep your cherished foods on the plate, make that shift in your lifestyle and diet to include more foods and activities to keep your healthful rhythms intact.
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