The Misrepresentation of Cholesterol: The Good, the Bad and the Flat Out Lies


Around 1 million Americans suffer a heart attack each year. CAD (Coronary Artery Disease) is the most common type of heart disease in the United States. Often, the first sign of CAD is a heart attack.

Cholesterol often takes the unwarranted blame for the buildup of plaque, leading to narrowing of the arteries, ultimately contributing to these cardiac events and untimely deaths.

You may have been told that you must lower your total cholesterol to improve your cardiovascular risk. This typically coincides with a prescription for a statin drug and suggestions for a low-fat diet.

At Natural Heart Doctor we know that half a century old science is not the best we can do. We have better ways to identify risk factors and prevent heart disease.

The ‘Good’

High-density lipoprotein (HDL), often referred to as the ‘good’ cholesterol. It brings various forms of cholesterol back to the liver for cleanup and removal from the body. Like a garbage truck collecting waste, we like this number to be higher so there isn’t ‘waste’ floating around the bloodstream.

Low HDL is an independent risk factor for CAD. This means regardless of being a non-smoker, no family history, etc., having low HDL will still mean you are at higher risk of developing heart disease.

Elevated triglycerides (I like my patients TG under 90) are also an independent risk factor for heart disease. Triglycerides come from carbohydrates, especially fructose and other simple carbohydrates in the diet. Triglycerides should have a low ratio to HDL.

My doctor told me LDL was BAD

LDL alone is not a true risk factor. LDL delivers cholesterol and triglycerides that are critical for tissues around the body. If HDL is the garbage truck, LDL is like a UPS truck delivering what’s needed to tissues around the body.

LDL, when it’s large and fluffy, is absolutely normal and necessary for the body. However, when lots of LDL combines with other factors, it then can increase the risk of heart disease.

Inflammation and sugar are the true enemies.

Oxidative stress (obesity, smoking, poor air quality, pesticides, etc.) leading to inflammation PLUS a diet high in simple carbohydrates leads to elevated insulin and triglycerides. This encourages oxidation of LDL particles.

The liver cannot easily take up the oxidized LDL for removal and they are much more prone to deposit plaque formation. When they float around in the bloodstream longer, they become smaller and more dense. Small dense LDL (sdLDL) are more likely to infiltrate the inside lining of blood vessels and lead to atherosclerosis.

How do I know my risk?

Important factors to assess risk for CAD

  • High Triglycerides
  • Insulin Resistance
  • Low HDL
  • Small dense LDL
  • Oxidized LDL particles

Unfortunately, most doctors will not look for all of this information. Make sure you have a functional doctor who takes a deeper look rather than just reaching for the script pad.

If you don’t have one, call us. We help patients all across the US (and then some!)

The Flat out Lies

For decades now, the standard medical advice has been to limit saturated fats and increase whole grains to improve cholesterol. This “heart healthy” diet replaces fat with carbohydrates, making triglycerides go up and HDL go down. Bad news.

This advice is likely to have contributed to our country’s obesity epidemic and astronomical rate of diabetes and pre-diabetes – placing people at genuine risk.

In actuality, bacon, butter and egg yolks will not elevate your cholesterol or your risk factors for CAD.

Lower carbohydrates, especially simple carbohydrates (namely fructose) and lots of healthy saturated fats, are the key to lowering inflammation and improving insulin sensitivity.

Moral of the story

Both HDL and LDL are critical for body-wide function. The actual problems to identify, prevent and/or reverse risk factors are inflammation and insulin resistance.

The common dietary guidelines suggest that increasing whole grains will lead to an increased TG:HDL ratio and take you further from your desired heart health.

Avoid foods in a standard American diet:

  • Fast and processed foods
  • Seed oils
  • Sugary drinks and sweets
  • Grains, cereals, breads and pasta
  • Alcohol

Instead, reach for whole foods. We recommend an ancestral diet consisting of:

  • Grass fed and pasture raised meat and poultry
  • Wild caught seafood
  • Pasture raised eggs
  • Organic produce


Please share this with your friends and family. If you want to learn more about your risk of heart disease, speak with one of our health coaches or establish with one of our practitioners.

Call (480) 535-6844 option 4


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