Whoever started talking about cholesterol without getting involved HDL and LDL let him cast the first stone. Generally, we know that there is a “good” one and a “bad” one, but we are not clear which is which. And, above all, there is usually another big question: good or bad for what?
Their names come from the English acronyms “High density lipoprotein” and “Low Density Lipoprotein” or, what is the same, high or low density lipoproteins. This is because cholesterol is a lipid, a molecule known colloquially as fat. But, for its transport through the body, a type of capsules, known as lipoproteins. Those with high density transport cholesterol from cells to liver, where it is processed for excretion, outside the body. On the other hand, those with low density make the opposite path. They carry cholesterol from the liver to the cells.
For all this, HDL is often known colloquially as “good cholesterol” and LDL as “bad cholesterol.” It is true that it is better to have a greater amount of fats of this type that are directed to the liver for elimination. Additionally, when there is a lot of LDL being transported into the cells, along the way can accumulate in blood vessels, increasing the risk of heart disease and stroke. But still, it’s important to keep in mind that it’s too simplistic to reduce cholesterol to something good or bad. In science, especially as it relates to our health, shades of gray are much more common than stark blacks and whites. Let’s see then what we know about cholesterol.
Demonization of fats: a very old story
Fats, in general, have been demonized for many years. So much so that it promoted the birth of the fruitful business of low-fat products. You see a lot in the dairy field. Skimmed milk, very sugary yogurts, but skimmed, low-fat cheeses…
Everything is based on remove fat from milk, but at what price? There are no studies that show that it is dangerous, but there is a lot of scientific literature about its benefits. For example, the vitamins in milk are fat-soluble. That is, they cannot dissolve in water, but they can dissolve in fat. Therefore, if we eliminate the fat, we take the vitamins with her.
Then there is the confusion of eating sugary yogurt, but skimmed, thinking that it is the healthiest thing we can consume. We put the focus where it does not belongwhen, in reality, not all fats are dangerous.
Although the term “fats” can be used colloquially for any lipid, it is primarily used to refer to fatty acids. The basis of its structure are carbon chains, linked to hydrogens, but also to each other, like the links of a metal chain. These bonds between carbon and carbon can be single or double. If they are all simple, it is Saturated fats. On the other hand, if there are any double bonds, they will be unsaturated.
Generally we should increase the consumption of unsaturated fats, since they are easier to break down. But, even in the case of saturated ones, it depends a lot on the food they come from. For example, it has been seen that those coming from red meat and butter They are the most dangerous.
Now, what does cholesterol have to do with all this? It should be noted that it is not a fatty acid, but rather another type of lipid. However, it seems that there are also some myths about.
The benefits of cholesterol
Cholesterol is a very important molecule. To begin with, it is part of the lipids that make up the cell membranes. But that is not all. It also intervenes in the metabolism of vitamin D, in the synthesis of some hormones and in the absorption of calcium, among many other physiological processes of great relevance.
Therefore, we should not demonize it. It is important that cholesterol travels to cells in low-density lipoproteins. LDL cholesterol, therefore, is necessary.
The myths of cholesterol and statins
David Diamonda neuroscientist at the University of South Florida, a blood test was performed whose results showed high levels of LDL cholesterol. For this reason, his doctor decided to prescribe treatment with statinsthe drug most commonly prescribed in these cases.
These are used because they inhibit an essential enzyme in one of the main pathways of cholesterol synthesis. Enzymes are reaction catalysts. That is, they reduce the energy needed to carry out a reaction, so that it can be carried out more quickly, with less effort. They are a kind of tools, without which, many times, reactions cannot occur. Therefore, the inhibition of one that intervenes in cholesterol synthesis results in a decrease in the levels of this lipid in the blood.
Diamond knew all this; but, furthermore, he wanted analyze scientific literature about. Little by little, and joining other colleagues, he analyzed the studies of the last 50 years on cholesterol and statins and came to an interesting conclusion. According to him and an international team of scientistswhose results were published in 2018, the majority of studies that demonize cholesterol and praise statins have large methodological errors. Furthermore, some clinical trials whose results were not favorable to the main hypothesis are excluded. This indicates that it is something that should be studied in greater depth.
Knowing this, Diamond improved their cardiovascular risk markers simply with exercise and a healthy diet. She stopped short of taking the statins; since, for him, the risk of suffering from cardiovascular diseases is something much more complex than simply intervening in the synthesis of cholesterol.
Logically, this does not mean that we should neglect the analyzes and not give importance if cholesterol levels are very high. But it is true that we should not bet everything on reducing the supposed bad cholesterol either. Because the lion is not as fierce as they paint it, nor is LDL as bad as they describe it.