The Truth About Cholesterol

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Once again, I am not a medical doctor and this should not be considered medical advice, but here's what I personally believe about cholesterol based on my interpretations of the research I have done.

Warning. The pharmaceutical companies do not want you to know this.

Once you know the truth, you cannot un-know it, so proceed with caution.

If you’re like me, once you realize you’ve been duped, you’ll feel mad.

Contrary to popular belief, high cholesterol isn't necessarily bad for you.

Cholesterol DOES NOT clog your arteries
Cholesterol DOES NOT lead to heart disease
Cholesterol IS NOT a good predictor of heart disease
Cholesterol IS ESSENTIAL to your existence
Cholesterol is used by every cell in your body
Cholesterol is your friend

Cholesterol-lowering drugs (statins) are useless, ineffective, unnecessary and a complete waste of money... there is absolutely no reason to ever take them for 99% of the population.

People with high cholesterol tend to live longer than those with lower cholesterol.

According to a UCLA study, 75% of people who have a heart attack, have cholesterol levels that are considered to be in the normal, or safe range.

How can that be?

Your total cholesterol level tells you NOTHING about your health

If you eat foods low in cholesterol, your body simply makes more.

If you eat foods high in cholesterol, your body simply makes less.

The most important metrics to know about cholesterol is the triglyceride to HDL ratio. Ideally, you want it to be better than 2:1

Ideally, you want your HDL to be 60 or above, so as long as your triglycerides are 120 or lower, that is considered to be in a healthy range.

HDL is typically referred to as “the good cholesterol”, while LDL is considered to be the “bad cholesterol”, but in reality, most LDL cholesterol is perfectly good, or at least benign.

The standard lipid profile won’t tell you whether your LDL is good or bad. You need to request a particle size test. Large fluffy LDL particles are nothing to worry about, while small dense LDL particles can be a cause of concern.

Small dense LDL particles are caused by consuming sugar and grains.

Here are the 3 things that you should look for when you are trying to determine healthy cholesterol levels:

1. Triglyceride to HDL ratio

1:1 or less is optimum. which means if your triglycerides are 80 and your HDL is 80 (or more), that is fantastic!
2:1 = Low Risk (Triglycerides 100, HDL 50)
3:1 = Moderate Risk (Triglycerides 120, HDL 40)
4:1 = High Risk (Triglycerides 120, HDL 30)

2. Remnant Cholesterol

This is a simple formula that is also a better predictor of heart disease than total cholesterol.

Take your total cholesterol, then subtract your LDL and your HDL. Whatever is left is your remnant cholesterol.

Under 19 is ideal
20-30 is a moderate risk
30 and above is a higher risk

If your Total cholesterol is 260 (which most doctors would freak out and try to put you on a statin) but your LDL was 170 and your HDL was 75, your remnant cholesterol would be 15:

260 Total

-170 LDL

-75 HDL

= 15 Remnant

3. Particle size

Many people refer to HDL as the good cholesterol and LDL as the bad cholesterol. While HDL is certainly good, LDL isn't necessarily bad. There are different types of LDL. Large fluffy LDL is benign. Small dense LDL can be dangerous, so if you are concerned about your LDL numbers, ask your doctor for a particle size test to determine how much of the small dense LDL you have.

FWIW, eating sugar and grains are what causes elevated small, dense LDL whereas eating a diet high in saturated fat tends to raise your HDL and LDL, but the LDL is typically the large fluffy kind.

When you adopt a well-formulated ketogenic diet... you can pretty much stop worrying about cholesterol.

This calculator will help you determine your risk of heart disease based on your lipids.

Extra Credit: (there is a ton for this episode)

First, check out a recent episode of The Keto Show where I interview Dr. Gary Shlifer about the advice he gives his patients regarding cholesterol.

Watch this 2.5-minute clip from the documentary "Fathead" to see how the theory about saturated fat and cholesterol causing heart disease came to life:

If you are really concerned about cholesterol, invest the 45 minutes to watch this video:

And here's an even deeper dive into the weeds if you really want to understand why you don't need to worry about raised cholesterol levels when living the low-carb lifestyle: