The Cholesterol Scam

This is the continuation to the previous post and the Cholesterol series (1, 2, 3) Just before going further on the Total cholesterol story, a quick recap of the key points.

Cholesterol is a vital substance for life. Hence, body synthesis of its own, if not provided thru diet. All our body cells, heart and brain are made of cholesterol and need of cholesterol to function.  

There is nothing called Bad or Good cholesterol, it’s a fictitious term. Both LDL and HDL are not cholesterol. They are lipo-proteins, two different transport mechanisms for cholesterol and both LDL and HDL are essential for body functioning.

Cholesterol deposit on the Artery due to the inflammation. Since, cholesterol has a pro-inflammatory property.

Study published on Journal of Immunotoxicology (above), which tells cholesterol sulfate inhibits Leukotriene synthesis. Leukotrienes are the key for pro-inflammatory, immune-signaling lipids that initiates free radical destruction in the body.

The last post ended with 1) who fixed the total cholesterol level up to 200 as a healthy level?  2) On what basis they arrived to this magical number 200.

National Lipid Association {(joins hand with National Institutes of Health and other medical associations) who is backed and funded by pharmacology industry} fixes the so called “Normal or Optimal” level of Cholesterol.

Before going to the number 200 md/dL, please bear in mind that, they never talked about the lower level. In other words, what is the range that considered dangerously low? (No cholesterol = No life) “Normal” total cholesterol level was initially at 240, later to 220 and today (now) fixed at “200”. Why? Read further.

If one can define, High and Normal level or range, there should be a "minimal level" also to be exist. Since, cholesterol is the vital substance, what is the minimal level? Why it’s not defined?  I don’t know………. (refer normal vs abnormal)

Okay, let’s begin with the magical number “200”.

As per the data from the Framingham Study the total cholesterol level of the healthy subjects varies from 105 – 343 mg/dl  (or 2.8 to 8.8 mmol/l)  {Framingham Study data’s are available online. Google and find yourself) same data had been plotted below in normal distribution or bell curve.  (Learn basics of normal distribution curve here )

After 26 years, the study data had been plotted with and without CAD. Two curves are plotted one with those who are affected by CAD (Red in colour) another the people who are heathy or without CAD (Blue in colour)  {CAD - Coronary artery disease is the narrowing or blockage of the coronary arteries, Known as atherosclerosis}

Look at these graphs carefully…….

A – The brown region represent (150 – 200 mg/dl) the absolute risk of CAD, which is about 20%

B – The green region represent (200 – 225 mg/dl) the absolute risk of CAD, which is also about 40%

A+B – both brown and green together represent (150 – 225 mg/dl) the absolute risk of CAD, which is about 60%

C - The yellow region represent (above 300 mg/dl) the absolute risk of CAD, which is also about 90%

Note : The above percentage are only the risk percentages (not actual).  Risk is nothing but, the CHANCE of something can happen later, but it’s not a GUARANTEE that it will. Example : Air bag in the car can reduce the risk of death (to certain percentage) in case of collision. But, it doesn’t guarantee it will prevent from death. Check yourself the rate of death with and without airbag accidents from the traffic statistical dept. you will surprise. Please note, I am not against Air bag! But definitely against cholesterol limits (will write a separate post of this various kind of “Risk” later)

Let’s make the further interpretation from the graph………..

So, people who have <200 mg/dl  can also have CAD.  (Lower TC level doesn’t guarantee you anything)

Just by an additional of 25 mg/dl ( 0.647 mmol/L) the risk factor doubled. Is that makes any sense ?  25 mg/dl is a pretty small value or it is the range your TC will stay between two different day. Example, If you measure the TC on daily basis for week and tabulate, you will find the +/- 25 mg/dl (approx.) is the average variation between days. In other words, it can 200 one day and 225 next day (depends on the food you eat on the previous day night) so, Sunday, Tuesday, Friday you are in risk and other days, you are out of risk !!!!!!

Most Interestingly, People are between 200 to 225 mg/dL will have more risk than people are with <200 and >225 !  Honestly, I don’t understand anything………Did You?

Finally, significant number of individuals with elevated cholesterol (from 225 to 300 mg/dL) don’t have coronary artery disease.

This is why I say, measuring total cholesterol is meaning less and doesn’t reveal anything about CAD. It’s just a mere number.

You may be thinking that fixing the TC at 200 because, that’s where the minimal risk percentage of CAD. If you think so, you are wrong. Fixing at 200 will cover only the 45% of population (only 45% will fall into normal range). Which means 55% of the population will fall in above normal or risk category and needs to be treated. In other words, you can sell cholesterol control drug to 55% of the population.

If it fixed at 225, 65% of the population will fall under the “safe” category. Rest 35% of population only buy the cholesterol control drug. More and more you increase the limit, less population falls under risk category. This is the ONLY reason it fixed at “200” in order to maximize the cholesterol control drug sale.

Over the period, (due to the false propaganda, people are advised to reduce cholesterol by cutting down the saturated fats and increase the carbohydrate) general population TC level had consistently falling. In order to target the maximum sale of the cholesterol control drug, the “normal” limits had been keep changing (from 240 to 220 and now fixed at 200) to protect the business of pharmacology industry. In return, the medical associations gets sponsorship and funds. This is why I call this is a cholesterol scam.

“200” is considered normal today. But who knows what will be the  “normal” tomorrow?  They may reduce the TC level further down, depending on the total population vs total cholesterol level. The normal limit had been adjusted to keep the sale of drug and insurance premiums high at all time. After all, cholesterol drugs is a several billion dollar business and keep growing at very good rate.

The below chart drawn from data from 164 countries (via the World Health Organization and BHF-HEARTSTATS) graphing cholesterol levels against all sorts of diseases and conditions.

Click on the image to enlarge

By analyzing the above graph……Look at the blue line, it sweeps when cholesterol falls below 200 mg/dL.  Both the green lines disappear (no diseases) when cholesterol is over 220mg/dL

The Norwegian study (was done with 52, 087 Norwegians, age between 20 to 74 for about 10 year span).  Findings revels the following…….

For the women, Cholesterol had an inverse relationship with all-cause mortality and CVD and U-shaped relationship with Ischemic Heart Disease. In the Men case, Cholesterol had a U-shaped relationship with total mortality and CVD.

So far, there is no proven link between high cholesterol and CVD/CHD. But, there are many studies shows the direct association between low cholesterol and mortality. Now it’s up to you!

So, What is the better indicator for CHD/CVD ?  The most reliable (as on today) is the TG:HDL (the ratio between the Triglyceride and High Density Lipoprotein)

TG:HDL is not only for CHD/CVD, Its one of the proven criteria for the diagnosis of metabolic syndrome, which is also known as Reaven’s syndrome, named after Gerald Reaven, MD, of Stanford University. As per his studies, TG:HDL >3 is considered High (high risk of  CVD) and TG:HDL <1 considered as low (Low or no risk of CVD)  (Note : the ratio given here is in mg/dL)

Now, check my TC and TG:HDL from the previous post. Impressed ?  Also, find below few published research articles in this regard. It is impossible to get TG:HDL <1 without HFLC.

Finally, I end this post with the Quotes from renowned cardiologists

"The cholesterol myth has caused large numbers of healthy people to believe that they were at high risk for a heart attack. Relying on cholesterol levels as a risk factor for coronary artery disease may not be wise since 80% of coronary patients have the same cholesterol as individuals who do not develop the disease."   -   Dr. Gene Millen

"I freely admit to being wrong. As a heart surgeon with 25 years experience, having performed over 5,000 open-heart surgeries, today is my day to right the wrong with medical and scientific fact."

"Without inflammation being present in the body, there is no way that cholesterol would accumulate in the wall of the blood vessel and cause heart disease and strokes. Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped."  - Dr. Dwight Lundell, 

Cholesterol - Myth

Since, I was quite busy at work and personal commitments, couldn’t post for the past two weeks. Thanks for your WhatsApp messages, asking about my well-being. Coming back to the business……….

In the past two posts (post1 & post 2) we have seen, how cholesterol is important for life and the erroneousness in the present lipid profile calculations. In this post, let’s see how to reduce the Triglyceride and Increase the HDL. Also, the relation between lipids and heart diseases.

Though Hypertriglyceridemia (high triglyceride level) is not only associated with Coronary Heart Diseases (CHD) Also, correlate more closely with waist circumference (abdominal obesity) Type II diabetes, pancreatitis (inflammation in Pancreas) non-alcoholic fatty liver, obesity, conditions like, low HDL and small, dense LDL particle formation. 

Definitely, hypertriglyceridemia is not a good sign for our health. As per the present standards, between 101-150 mg/dl is considered as Normal. (Less than 100 mg/dl is Optimal) before knowing the way to reduce the triglyceride level less than 70, let’s understand what it is.

Triglycerides are the main constituents of vegetable oils or animal fats. Triglycerides less dense than water (floats on water), and at normal room temperatures may be solid or liquid. When solid, they are called "fats" or "butters" and when liquid they are called "oils". Hence, they are known as neutral fat(s)

Our body uses the triglycerides as an energy reservoir and later uses for energy (to support starvation periods) also account for the vast majority of fat stored in the human body. Triglycerides are the mechanism for storing and transporting the fatty acids as a fuel also, help to maintain the blood sugar level. (refer: Human vs Food)

We get triglycerides directly from the food (like animal fat and Oils) or the Liver synthesis from the excess carbohydrate we eat. (that’s the reason in HFLC, we restrict the carb’s to 50 grams / day)  Triglycerides are released into the blood stream, in the form of VLDL where it is delivered to fat cells for long-term storage. (Adipose tissue) High triglycerides levels are the major causes of Obesity and Insulin resistance (diabetic) 

As their name suggests, the triglycerides are composed of one molecule of glycerol and joined via ester bonds with three molecules of (free) fatty acids. 

Glycerol (commonly known as glycerin, is a simple polyol compound, colorless, odorless, viscous liquid that is sweet-tasting liquid belonging to the alcohol family) is the backbone for triglycerides. In short, if there is no Glycerol, there is no triglycerides.

In HFLC, we consume triglycerides directly from the food source (not allowing or pretty much limiting the liver to produce) and during the digestive process, the triglycerides in our food are broken down into glycerol and fatty acids. Glycerol used to maintain the blood sugar level and the fatty acids are used as energy. There is no storage (no weight gain, no blood sugar surge) 

HFLC allows the body to start breaking the stored triglycerides, for energy and blood sugar maintenance. Which leads to lose weight. Specially the waist size, where the triglycerides stored as adipose tissue.

So, by eating fat, you actually burring the fat. By eating carb, you store the fat.  If you want to reduce the triglycerides level, the one and only possible way is to cut down (all forms of) the carbohydrate to less than or around 50g per day and consume (good, old) saturated and mono-saturated fats without any guilt. 

In my case, when I quit, all grains, cereals, sugar, fruits, legumes, lentils and start eating meat, animal fat and butter, my triglycerides levels come down about 56%. i.e. from 121 mg/dl to 53 mg/dl. (I have many evidences of such drastic change in triglycerides level, those who follow HFLC)

Mar 2015

Feb 2017

According to the Basic Medical Biochemistry—A Clinical Approach, pages 476, 510-12  “Adipose tissue (fat) is stored only when eating carbohydrates. Excess energy from dietary carbohydrate is stored away as triglyceride in adipose tissue”     

HFLC is not only decreasing the triglycerides level, also it increases the HDL. In my case 40 to 56 mg/dl, which is about 40% increase.

Dietary cholesterol, has very less impact on serum LDL. A study in Metabolism (Ref: Metabolism 2001 May;50(5):594-597.) showed that “With even a 30% fat diet, increasing dietary cholesterol from 319 mg to 941 mg per day (about 300% increase), the blood LDL only increased a mere 6% (18 points)!” 

From the above study is in line with my case. With HFLC, my fat consumption increased around 300% but my LDL percent increased only about 84% (my fat consumption increased from 30g to 120g) Instead of small and dense LDL, it’s become large and fluffy ones.

As far as LDL is concern, high level or count doesn’t matter. It’s a mere number. It doesn’t revel anything about the CHD. But, the LDL pattern is very crucial. The small sized, high dense LDL are the one stuck (rancid and became a plaque) in the artery. The large and fluffy LDL’s are totally harmless and can’t stuck or block the artery.

Again, please bear in mind, the LDL is there in, the artery only to cure/heal the inflammation that caused by high carb food, elevated blood sugar and insulin levels. (will write the separate post on this)  In HFLC, your liver start to produce large and fluffy LDL. Also, doesn’t cause an inflammation. HFLC address the root cause rather than just to treat the symptom.

Finally the total cholesterol level, as per the present standard above 200mg/dl considered abnormal level and you may be advised to take cholesterol drug to reduce. But, the truth is above 200mg/dl (with low TG and Large LDL) is a good sign that your liver is in healthy condition. In my case, the total cholesterol level increased from 190mg/dl to 300mg/dl. Which is about 58% (But, my fat consumption increased around 300%) 

According to the Framingham Study (largest study ever done on cholesterol) up to 340 mg/dl is perfectly normal. In fact, it’s Healthy! (refer: here  Also, will write in detail in the next post)

So next time, if you doctor ask to reduce the total cholesterol to less than 200mg/dl, ask him two simple questions, 1) who fixed the total cholesterol level up to 200 as a healthy level?  2) On what basis they arrived to this magical number 200.

If he can’t answer, don’t worry. I will tell you in the next post about big cholesterol scam.

Cholesterol – Most Misunderstood Lipid

From the previous post we understood, Cholesterol is an integral part of human development and health. without it there is no life. Therefore, body syntheses of its Own, even you avoid.

The synthesized cholesterol needs to be circulated/sent all over the body and the only possible way to transport it thru blood stream. But, the blood and cholesterol (waxy substance) doesn’t mix! Hence, a shuttle or carrier required to transport the cholesterol molecules all over the body thru blood stream.

Those shuttles or carriers are known as LDL (fallaciously/commonly known as bad cholesterol) & HDL (commonly known as good cholesterol) But both, LDL & HDL are NOT cholesterol. They are lipoproteins.  (LDL – Low Density Lipoproteins and HDL   – High Density Lipoproteins) apart from LDL, HDL, there are other two types of proteins namely, chylomicrons and VLDL (very low-density lipoprotein)

Lipoproteins not only carries of cholesterol but, also carries the triglyceride, phospholipids and protein in different proportions. Lipoproteins can be differentiated on the basis of their density and the types of apolipoproteins they contain. The degree of lipid in a lipoprotein affects its density—the lower the density of a lipoprotein, the more lipid it contains relative to protein.

Chylomicrons are synthesized by enterocytes from lipids absorbed in the small intestine. Its triglyceride-rich lipoprotein. The function of Chylomicrons is to deliver energy-rich triacylglycerol to cells in the body.

VLDL is synthesized in the liver, from excess dietary carbohydrates.  (note: NOT from excess Dietary fat)  Also triglyceride-rich lipoprotein to deliver energy-rich triacylglycerol to cells in the body. Once, the VLDL loses or releases   the triacylglycerol, they become denser and these particles are remodeled by the liver and transformed into LDL.

LDL :  VLDL remodeled by liver as LDL (If no VLDL, No LDL) The function of LDL is to deliver cholesterol to cells, where it is used as a cell membranes and synthesis of steroid hormones. Such an important LDL is named as Bad cholesterol! If no LDL, your body cells can’t make cell membrane and steroid hormones. In other words, LDL carries “fresh” cholesterol from liver to the cells.  

HDL is synthesized and secreted by the liver and small intestine. The function of HDL is to remove the excess cholesterol from the cells (Also, when a cell die, it releases the cholesterol also picked by HDL) is brought back to the liver by HDL in a process known as reverse cholesterol transport. Then in the liver the excess cholesterol is converted into bile salts. In other words, HDL carries “recycled” cholesterol from the cell to liver. 

So, there is nothing called “Bad cholesterol” or “Good cholesterol” First of all, they are not at cholesterol, they are lipoproteins.  Like BMI and Calories people were misinformed about a vital substance cholesterol. 

Next time if someone talk about Bad cholesterol and Good cholesterol, simply ask them to write the chemical formula of both good and bad cholesterol   (They can write only the C27H46O the chemical formula of cholesterol) they can’t because there is no such thing. Technically, if there is no LDL, no HDL, As simple as that. Hence, it’s impossible to increase HDL, without increasing LDL.

Our body has got an ability (naturally) to regulate the amount of cholesterol at any given point of time. I.e. when we ingest more cholesterol from food, the body produces less; when our cholesterol intake is low, the body makes more. Therefore, there is no effect or relationship between dietary cholesterol and blood cholesterol levels. 

Also, it’s not possible to consume too much cholesterol (thanks to satiety hormones) but, it is possible to take less or no cholesterol. this case body (liver) needs to work hard to produce its own.

Now let’s see how the blood lipid profile (cholesterol test) was done……….. 

When your physician asked for standard blood lipid profile test. Where total cholesterol, HDL and Triglyceride are the ONLY measured parameters, the rest LDL and VLDL are derived parameters, using an equation derived by William Friedewald in 1972, Known as Friedewald equation.  

For mg/dl :

Total cholesterol  (TC) = LDL + HDL + Triglyceride/5   or  LDL = TC – HDL – (TG/5)    

For  mmol/L   :  

Total cholesterol  (TC)  = LDL + HDL + TG/2.2     or     LDL  = TC – HDL  – (TG/2.2)  

  

From the above, to derive the total cholesterol, there are only three different variables (3 different lipoproteins) are present. Whereas we have 5 different (variables) lipoproteins namely, chylomicrons, VLDL, LDL, HDL and TG !

But, in the equation Chylomicrons were totally ignored and VLDL, LDL were estimated. (VLDL = TG divide by 5 for mg/dl and TG divide by 2.2 for mmol/L) In order to find all the variables precisely (without estimation) we need to find at least one more variable, which is LDL. 

The ratio of TG and VLDL is (assumed as) constant at 5:1 for mg/dl and 2.2 for mmol/L. But, there is no valid physiological justification/reasoning provided for the constant.

After reviewing the lipid profile report, Physicians advise to decrease the LDL, Total cholesterol (TC) and Triglyceride (TG) and Increase the HDL.

It’s really possible to do so ? Here is an example…….

Case 1 :   LDL = Total cholesterol – HDL – (Triglyceride/5)           =>              128  = 200 – 60 – (60/5)

(Where, LDL = 128 ; TC = 200 ; HDL=60 ;  TG = 60 and VLDL = 12 )

Case 2 :  LDL = Total cholesterol – HDL – (Triglyceride/5)           =>              60  = 200 – 60 – (400/5)

(Where, LDL = 60 ; TC = 200 ; HDL=60 ; TG = 400 and VLDL = 80)

Observe both the cases, if you want to reduce LDL so called “bad cholesterol” then your Triglyceride levels will go very high. I.e. LDL and TG inversely proportional!  But, your doctor will advise to reduce both LDL and TG (because he believes LDL blocks the artery and TG is the cause for Obesity) but he won’t say how.  Because he, himself doesn’t know!

Your physician ask you to reduce LDL (because he was told to believe it’s bad) and increase the HDL. It’s impossible to increase HDL without increasing the LDL. Because, HDL production is controlled by LDL. The function of HDL is to remove the excess cholesterol from cell surfaces and from other lipoproteins. If there is no excess cholesterol, how body produce more HDL?

In Case 1, VLDL is 12 and LDL is 128, and the Case 2, VLDL is 80 and LDL is 60. We know, VLDL remodeled by liver as LDL (by removing triacylglycerol and some proteins, the percentage of weight that is cholesteryl esters increases and become LDL) other words LDL not produced directly by the liver. Just comparing the LDL, VLDL ratios, Is there any correlation between them?

Also, your doctor may tell you to reduce the total cholesterol level and Increase the HDL (because he was told to believe it’s good) but, as per the equation both TC and HDL are directly proportional. If you increase HDL (It possible ONLY by eating saturated fat, but your Doctor will say don’t eat!) your total cholesterol also will increase, then he will prescribe cholesterol drug to reduce TC!  Does it make any sense?

This is how the cholesterol formula works!! It’s still in practice and medications were prescribed based on this estimations! Is there any way to measure LDL directly? There are more than one technique is available to measure LDL accurately but not in practice. 

Moreover, LDL count doesn’t reveal anything. Rather the the count, LDL particle size and the ratio between the TG and HDL will reveal much more about CHD (Will write in detail later)

So, why this flawed formula still in practice?  All the credits goes to the Medical Associations, Drug Industry, food industry, Insurance companies and the media were joined their hand together to sell the pack of lies to the common people, to protect their interest (business)

Still do you believe cholesterol is bad for us? If yes, ask yourself, then why does the body (liver) needs to produce ? If you say No, wait for the next post