The Skinny on Cholesterol

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by Dr. Thomas Manger

There is always a fair amount of controversy
surrounding cholesterol. It's in the news, in our diets,
and in our bodies. Let's start with some background.

Cholesterol is a molecule that is in the "sterol" family.
This family of chemicals are the building blocks for many
important body compounds, including the sex hormones
(testosterone and estrogen), stress hormones (cortisol and
cortisone), bile acids that are used in digestion, vitamin
D, and other vital component of your cells' membranes.
Your liver makes as much cholesterol as your body requires,
and estimates how much to make based on your dietary intake
of saturated fats (among other cues). As you can see,
cholesterol is truly a vital need for normal body function
and physiology.

However, problems arise when the liver makes too much
cholesterol. Cholesterol is also one of the components of
athersclerosis. These are the plaques and deposits that
develop in the arteries throughout the body and can form in
the arteries that feed the heart, brain, and limbs. If the
plaques become too large or thick, they lead to chest pain
("angina") and heart attacks, stroke, and poor
circulation. In the United States, about 8 out of 10
people die from diseases related to athersclerosis! There
other factors that influence your risk for athersclerosis,
so don't think cholesterol is the only culprit. Smoking is
a huge risk, but that is for another time.

So Doc, now we know it's bad, what can we do about it? How
do we lower our blood cholesterol level? One way to
influence your cholesterol level is by limiting the amount
of saturated fat you eat. Saturated fats, put simply, are
those that are solid at room temperature. Examples include
butter or margarine, lard, and many animal fats. Contrast
these with unsaturated fats which are liquid at room
temperature (olive oil, canola oil, and most plant fats).
First and foremost, no matter what "diet" you eat, you
should strive to keep the saturated fats to a minimum. Too
many saturated fats will cause your blood cholesterol to
rise, putting you at greater risk for athersclerosis.

But what about the cholesterol in my food? Interestingly
enough, you probably don't absorb a lot of the cholesterol
you eat. Your body is very efficient at absorbing the fat
in your diet. It does this by using the bile acids made by
the liver and stored in the gallbladder. Remember, these
bile acids are made of cholesterol. The fats you eat
combine with the bile acids in the small intestine and are
absorbed into the body. Any excess bile acids that are
still in the small intestine after the fats are absorbed
are recycled and absorbed as well. Since the bile acids
are made of cholesterol (and are chemically very similar to
cholesterol), the cholesterol that you have eaten in
your diet has to compete with the bile acids in order
for it to be absorbed as well. As it turns out, very
little, if any, of the cholesterol you eat actually makes
it into your system. However, notice that of the fats
(saturated or unsaturated) are very efficiently absorbed
into your system to be used as fuel or stored for a latter

So what's the "skinny"? It is the saturated fats in your
diet that are most important to minimized, not the dietary
cholesterol. Often cholesterol and saturated fats are
found together in foods, but not always. For instance,
lobster is very high in cholesterol and protein, but not
high in saturated fats. Eating lobster is really quite
healthy and "heart smart", at least until you dip it in the


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