What Your Dr. May Not Tell You About Cholesterol

How Much do Your Cholesterol Numbers Really Mean?

Are you being sold a bill of goods by the pharmaceutical industry?

By John R. Lee, M.D. and Virginia Hopkins

The so-called “normal” levels for cholesterol seem to go lower and lower as the years pass. Today they are so low that, according to the numbers, 20 percent of all American adults should be taking drugs to lower their cholesterol levels. This is a such a blatant scam that the only mystery is why the national media hasn’t exposed it.

Did you know that a direct link between high cholesterol and dying from a heart attack has never been made? In truth, high cholesterol levels can be one of many symptoms of heart disease, just as a runny nose can be one of many symptoms of the flu. Forcing cholesterol levels down with drugs without addressing the underlying conditions that caused the symptom in the first place, and then declaring that the drugs reduce heart disease, is like taking an antihistamine when you have the flu and then declaring that you’ve cured it because your nose stops running. Increasingly lower “normal” cholesterol numbers is all about selling drugs.

The American public has been led to believe, over many decades, that cholesterol is awful, gummy stuff that sticks to your arteries and clogs them up, leading to a heart attack. The other half of the American cholesterol myth is that every time you eat food that contains cholesterol, your cholesterol levels rise. These are only half truths, and they’ve been held out as the whole truth, the better to sell cholesterol-lowering drugs. Let’s take a closer look at what cholesterol really is.

Cholesterol is the Mother of All Hormones

Cholesterol is a fat-soluble steroid from which all of the steroid hormones are made. Cholesterol is also very important to brain function, being a component of the myelin sheath that protects nerves and nerve impulse propagation. Both your hormone balance and your brain function suffer when cholesterol is excessively low.

Eating food with cholesterol in it does not in and of itself cause chronically high cholesterol levels. In humans, 80 to 85 percent of our cholesterol is synthesized in the liver from sugars, and only 15 to 20 percent is synthesized from dietary fats. For the majority of humans, any excess that comes through the diet is excreted.

Cholesterol in your bloodstream is attached to one of several different molecules. The ones that have received the most attention in Western medicine are high density lipoproteins (HDL), and low density lipoproteins (LDL). The problem with LDL-cholesterol is not so much its mere presence or quantity in the blood, but the fact that it is easily oxidized or made rancid, and this sets up the conditions for the arterial plaque that clogs arteries. Once we know this, the key question becomes, “what causes LDL to become oxidized?”

The key answer is that the right nutrients are our first hedge against oxidation. The antioxidants such as vitamins C, A, E, the carotenes and the bioflavonoids protect us from oxidation. All of these are found in fresh fruits and vegetables—the single food group most lacking in the American diet. HDL cholesterol helps protect LDL from being oxidized and again, what keeps HDL high, first and foremost is a good, wholesome diet. The B vitamins, and particularly niacin, found in abundance in high quality protein such as meat, fish and eggs, lower LDL levels and raise HDL levels.

It’s notable that the cholesterol-lowering drugs don’t do a good job of raising HDL.

Eat Your Way to Heart Health

Foods that can significantly help in healing heart disease and improving cholesterol profiles include garlic, onions, and fiber-rich foods such as vegetables. A glass of red wine with dinner has also been shown to keep cholesterol healthy, but this only holds true if you drink in moderation.

Fats and oils play an important role in cholesterol levels, but not because eating them raises cholesterol levels. Eating too many unsaturated vegetables oils, which are unstable and thus prone to becoming rancid, can create an excess oxidation burden in the body and make your LDL cholesterol more dangerous. The trans fatty acids, called partially hydrogenated oils on food labels (found in many processed foods), have now been conclusively shown to significantly increase the risk of heart disease and are slowly but surely being eliminated from many processed foods.

Let’s Give More than Lip Service to Lifestyle Changes

Research is clear on the fact that a good diet and exercise can effectively lower cholesterol. However, among conventional doctors, the prevailing attitude is that once lifestyle changes fail—which they are sure to without a lot of support from the doctor—then the next step is drugs. Thus, the primary focus becomes which drug to put the patient on.

What Do Cholesterol Levels Really Mean?

Although very high or very low levels of LDL and HDL cholesterol should get your attention, the most important number is your cholesterol ratio. What does this mean? Total cholesterol = HDL cholesterol + LDL cholesterol + insignificant amounts of a few other species such as Intermediate Density Lipoprotein (IDL) cholesterol. Some folks like to make a ratio between HDL and LDL, while others like the ratio between HDL and total cholesterol. Both ratios represent the same thing— the balance between HDL and LDL. One could simply subtract the HDL from the total cholesterol and the result would be the LDL (since the other cholesterol type constituents are insignificant). I like to use total cholesterol and HDL cholesterol because, in the testing process, these are the only cholesterols actually tested. The LDL is derived from a formula that includes triglyceride levels and is truly only a calculated guess.

The “normal” ratio of total to HDL cholesterol in the U.S. is 5 to 1. That means that the HDL cholesterol represents one-fifth (20%) of the total cholesterol. This ratio is not very healthy. It is better if the total to HDL ratio is, say, 3 to 1. This would mean that HDL represents 33% of the total cholesterol. An example would be a total cholesterol of 210 and an HDL of 70. In that person, the HDL is 33% of the total cholesterol, and that is a better percentage than just 20%. The nice thing about ratios is that it does not matter what units are used in recording the concentration of the various cholesterol types. You report a total cholesterol of 6.9, and HDL cholesterol of 1.8. This means that your HDL is 26% of your total cholesterol. Not too bad but it could be better. If you are over 65, this cholesterol reading can be ignored. High cholesterol levels have never been significantly correlated with mortality in people over the age of 65.


Yes, I’m interested in finding out more about cholesterol in the booklet, John R. Lee’s Commonsense Guide to a Healthy Heart.