Cholesterol: Friend or Foe?

Over the course of time, the word cholesterol has developed a negative connotation. As a society, we have been bombarded with advertisements constantly reinforcing the concept that eating low-cholesterol foods will keep us “heart-healthy”.

So, cholesterol must be bad for us if we don’t want it in our food, right? Wrong.

Cholesterol is a fat-like steroid alcohol (sterol). It is naturally produced in every cell in the body. It can also come from food, such as animal protein (meat and dairy). However, contrary to popular belief, it actually plays a vital role in the body. Cholesterol:

  • Occupies approximately 30% of the structure of all cell membranes affecting its fluidity, receptor function and regulating pathways involved in cell signaling
  • Is a precursor for the making of bile acids that assist in fat digestion
  • Is a major component in the myelin sheath, the insulating envelope of nerves that helps conduct impulses
  •  Is a precursor for the making of vitamin D
  • Is a precursor for the making of hormones (i.e., estrogen, progesterone, testosterone, cortisol and aldosterone)

Where Did We Go Wrong?

Given what we now know about cholesterol and its impact on the body, how did it ever get a bad rap in the first place?

Simple: it became guilty by association.

In very modest terms, cholesterol is one component of the plaques causing atherosclerosis, making it the culprit of heart disease. As a result, the general recommendation now is that it must be avoided in your diet. However, your body makes most of the cholesterol you need— only about 10 to15 percent can be attributed to the food you consume.

Lipoproteins: Mass Transit for Cholesterol

Cholesterol and fats are insoluble (do not dissolve in water) and therefore need to be transported in the bloodstream in vehicles called lipoproteins. These are particles whose surface consists of a mix of phospholipids, cholesterol and specialized proteins called apoproteins (once bound to the lipoprotein they are referred to as apolipoproteins). These particles form a vehicle, with a core consisting of cholesterol and triglycerides. The apoproteins help to differentiate particles, make the particle more stable and, in some cases, bind to receptors on the surface of the cell to carry out specific functions.

Another differentiating feature of lipoproteins is their density, which is determined by the ratio of protein to fat in their structure. Denser particles have a higher protein to lipid ratio. In comparison, less dense lipoproteins have more cholesterol and triglyceride composition.


It is not the cholesterol content of these lipoprotein particles that increases the risk of conditions, such as heart disease and stroke, but rather the number of particles.

To put it another way: think about a traffic jam, where the cars are LDLs and the passengers are cholesterol. It’s the cars, not the passengers, which create the traffic jam. If the passengers got out of their cars and walked away, the traffic jam would still remain.

In keeping with the traffic analogy, cholesterol itself (passengers) cannot cause a car accident unless it’s been oxidized (a process in which LDL particles and cholesterol react with free radicals— think of it as rusting). Once oxidized, it begins an inflammatory process that leads to plaque formation inside the arterial walls (think massive debris pileup from the accident). However, for the cholesterol to get there in the first place, it must be carried by a lipoprotein particle (aka the car). No car, no traffic jam, no accident, no pileup.

In short: All these years we’ve been fixated on the passenger instead of the car. Therefore, by focusing on cholesterol, we’ve focusing on the wrong part of the equation when it comes to cardiovascular health.

What’s the Bottom Line?

The commonly used terms “good cholesterol” and “bad cholesterol” are really misnomers: is cholesterol friend or foe? The answer is it depends. Cholesterol itself is just cholesterol and it’s an essential building block for all the cells in our body. However, if it ends up in the walls of the arteries and gets oxidized it becomes part of the problem.

What We Offer

At Absolute Health, we are dedicated to improving your health and lifestyle for a better you. Our team of experts takes cholesterol testing above and beyond the standard for a better look at your cardiovascular risk factors and the need for improvement. We will then work together to educate you on interpreting your results. Thus, creating a personalized plan based on your individual needs to make you the healthiest you can be.

For more information or to schedule a consultation with one of our specialists, contact us today.