Dr.Garber’s Blog

Welcome back!

In the first part of this series I discussed a bit about cholesterol in general, how important cholesterol is to health and the fact that high cholesterol, in and of itself, is not necessarily bad. I want to touch briefly now on the different types of blood fats (lipids.) By now pretty much everyone has heard about “good” cholesterol and “bad” cholesterol. Well, it’s not quite as simple as just good versus bad but for our purpose here let’s use those terms. The so-called “good” cholesterol is HDL, which stands for “high density lipoprotein” and the so-called “bad” cholesterol is LDL, which stands for low density lipoprotein. A lipoprotein is simply a molecule that contains a fat and a protein together and it is in this form that fats move around through the blood stream. There are several other lipoproteins besides HDL and LDL, which is why, if you have a blood test that measures HDL and LDL as well as the total amount of cholesterol, the numbers don’t add up. It’s these other lipoproteins that make up the difference. As with everything in the body, it’s really about balance. So it’s not so much the absolute amount of these fats that’s important as it is the ratio. What we want is the HDL to be higher and the LDL to be lower, relative to the total amount of cholesterol. The lower the ratio of LDL to total cholesterol, the lower your relative risk of cardiovascular disease.

Another important class of lipids, called triglycerides, also play a role in cardiovascular health. Triglycerides are where the energy from food goes when you take in more calories than you need at the time. It is different than cholesterol and can be high when your cholesterol level is normal or even low. High triglycerides can play a significant, and independent, role in the production of cardiovascular disease.

As I mentioned in part 1 of this series, the real culprits that allow high cholesterol levels to become problematic are factors found in the blood that create inflammation and damage the inside of the blood vessels. It is when the lining of the blood vessels are damaged in this way that excess cholesterol may accumulate and form the plaques that can block blood flow. The two most important of these factors that I look at are homocysteine and C-reactive protein, often abbreviated as CRP.

Coming up in the third and final installment of this series I will tell you why I feel that statins, the drugs that are prescribed to reduce cholesterol, are harmful and how you can bring your lipid profile into a healthy balance through dietary and lifestyle changes and specific nutritional supplementation.