Spotlight on Cholesterol
We talk a lot about how eating a whole food, plant-based diet can influence your health, but we haven’t written much on specific health topics. This post is the first of what I hope to be a spotlight series where we will look at individual health issues and examine the role that diet can play. The first topic that I’ve looked at is cholesterol. Cholesterol is something that is very important to our health, especially when it comes to heart health, and is also something that we have a lot of control over—much more than most people realize.
First of all, what is cholesterol? Cholesterol is a waxy substance that is found in the body’s cells. Cholesterol is important because it helps to build and maintain cell membranes, and is also important for making hormones and vitamin D. Thankfully, we never have to worry about whether we are getting enough cholesterol because as the National Institutes of Health states, “Your body makes all the cholesterol it needs.” However, some people take in external sources of cholesterol through the foods that they eat. All animal products contain cholesterol. Plant foods, on the other hand, do not contain any.
There are two main types of cholesterol: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Sometimes, LDL is referred to as “bad cholesterol” and HDL is referred to as “good cholesterol.” This is because when too much LDL is flowing through the bloodstream, it builds up along artery walls. This buildup is what causes atherosclerosis (narrowing and hardening of the arteries), which can lead to heart attacks, strokes, and other life-threatening events. But whereas LDL is like the litterbug that throws garbage all over our precious inner environment, HDL is kind of like the garbage truck that collects everything and takes it to the dump. HDL drives through the bloodstream and picks up LDL along its way, eventually dropping it off at the liver to be broken down. The HDL truck can only hold so much garbage though, so when LDL levels are too high, the HDL truck can’t carry all of it, and it ends up piling up in our arteries.
So how does what we eat affect our cholesterol levels? Well, as I said earlier, some foods contain cholesterol while others do not. All foods made of/from animals—red meat, white meat, fish, eggs, milk, yogurt, cheese, etc—contain cholesterol. This makes sense because animals produce cholesterol within their bodies, and when we consume animals and their by-products, we are in turn consuming their cells, which contain cholesterol. People are often surprised to find out how much cholesterol some of the animal products that are usually labeled as “healthier choices” have. For example, a typical steak has around 100g of cholesterol. Chicken breast is hardly much better, averaging at about 93g, and the “heart healthy” salmon comes in around 110g! One cup of cheddar cheese has about 120g, and a single egg has 187g of cholesterol. Plant-based foods, on the other hand, have none.
But eliminating animal products may not be enough to keep cholesterol levels within a safe range. When talking about cholesterol, dietary fat intake is also important. Keeping the amount of fat, especially saturated fat, in your diet low helps to lower one’s cholesterol level. Saturated fat causes the liver to produce more cholesterol. Though the highest amounts of saturated fat usually come from animal products like butters, cheeses, and meats, some plant-based foods contain high percentages of saturated fat as well. This is one reason why oils—which are 100% fat—should be avoided. In addition, other high-fat plant foods like nuts, seeds, and avocado should be eaten sparingly (or eliminated completely) if cholesterol levels are not within a healthy range.
The typically prescribed blood level of cholesterol to shoot for is 200mg/dL or less. However, this cholesterol level does not mean that you are free from the risk of having a heart attack or other cardiac event. In fact, in the Framingham heart study—the longest-running study of cardiovascular disease—35% of cases of heart disease were among people who had cholesterol levels between 150 and 200 mg/dL. To truly protect yourself from heart disease, you should try to keep your cholesterol below 150 mg/dL. The best way to do this is to eliminate animal products from your diet, thus eliminating your intake of extra cholesterol, and to keep your diet low-fat as well.
Sometimes when people reduce their total cholesterol, their HDL level goes down to a point that concerns some doctors. However, this is not something to get too caught up on. Though there is a correlation between having higher HDL levels and having a lower risk of heart disease, this is not necessarily the case if your total cholesterol is below 150 mg/dL. To put it simply, it makes sense that the more HDL garbage trucks you have, the more LDL garbage that can be picked up—but the less garbage you have floating around in your bloodstream, the fewer garbage trucks you need to collect and dispose of it.
Heart disease is the leading cause of death for both men and women in the United States—one in every four deaths is from heart disease. The good news is that this is very preventable if people make healthy diet and lifestyle choices. As Dr. Esselstyn likes to say, “Heart disease is a toothless paper tiger that need never ever exist, and when it does exist, it need never ever progress.” Heart disease is one thing in life that we have control over. We do not have to live in fear. We can prevent atherosclerosis from ever developing, stop it in its tracks, and in some cases, even reverse it. And all of this begins with cholesterol.
Eat plants and make your heart happy <3
Esselstyn, C. B. (2009). Prevent and Reverse Heart Disease. New York: Avery.
National Institutes of Health (2012). What is Cholesterol? Retrieved from:
Physicians Committee for Responsible Medicine. Cholesterol and Heart Disease.
Retrieved from: http://www.pcrm.org/health/health-topics/cholesterol-