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Cholesterol Particle Size: Better Indicator For Heart Health?

Cholesterol, the word itself seems to be synonymous with increased risk of heart attack and cardiovascular disease.  The way it’s projected in the media you’d think all cholesterol does is clog your arteries.

The reality is cholesterol is an essential building block for the cells and is vital to human health. Not only is cholesterol a main precursor for all of our sex hormones and adrenal hormones, it also protects nerve fibers and repairs damaged cell membranes.

Many health experts refer to cholesterol as “nature’s Band-Aid” and this is a fitting description in my opinion. If you’ve followed my blog for a while now you’ll know that I’m highly suspect of the general consensus that elevated cholesterol levels automatically equates to increased risk of a heart attack.

More after the jump…

This theory simply isn’t holding up and the impacts of our massive experiment with statin drugs is yet to be determined. Let’s just say I’m not so certain the way mainstream medicine has been looking to treat cardiovascular heart disease is working all that hot.

I won’t go so far as some to assert that it’s all a conspiracy between big pharmaceutical companies and physicians, but changes in diet and exercise seem to be taking a back seat to a “pill solution.”

What our doctors are telling us about cholesterol

The general consensus among physicians is that we should look to keep out total cholesterol levels below 200mg/dl and our LDL levels below 100 mg/dl to avoid cardiovascular risk.

For the “good cholesterol,” HDL levels above 60 mg/dl is considered optimal.  I won’t argue with these assertions as the recommendations are pretty sound, but this doesn’t tell us the whole story.

Increased risk for cardiovascular health problems isn’t as simple as falling outside of these “acceptable” ranges.

Consider the following:

A recent study back in 2009 showed that an astounding 75% of patients hospitalized for a heart attack had cholesterol levels that would indicate they were NOT at high risk for cardiovascular health problems.

“Almost 75 percent of heart attack patients fell within recommended targets for LDL cholesterol, demonstrating that the current guidelines may not be low enough to cut heart attack risk in most who could benefit,” said Dr. Gregg C. Fonarow, Eliot Corday professor of cardiovascular medicine and science at the David Geffen School of Medicine at UCLA and the study’s principal investigator.

Researchers analyzed data from 136,905 patients hospitalized for a heart attack nationwide between 2000 and 2006 whose lipid levels upon hospital admission were documented. This accounted for 59 percent of total hospital admissions for heart attack at participating hospitals during the study period. Go to source.

Bottom line is the traditional parameters for identifying risk aren’t working!

Sure it’s important to be aware of your total cholesterol numbers and look to get your ratio in line, but there’s not necessarily an immediate concern that you’re going to drop dead of heart attack if your cholesterol is high.

In all fairness, many top physicians are recognizing this fact and moving towards more advanced measures of screening.

Instead of just looking at the TOTAL number of HDL and LDL in the blood, they’re looking at particle size.

Cholesterol particle size….the cutting edge of cholesterol screening

What does particle size have to do with anything? It appears a lot. Small dense particles are more atherogenic (meaning they’re more likely to cause the plaque in the arteries that leads to heart attacks), than larger, more buoyant cholesterol particles.

In short, not all cholesterol is the same. The smaller particles have the ability to sneak through the tiny holes in the walls of the arteries and lead to problems, whereas larger particles are more likely to be metabolized by the body.

So what does all this mean to you?

Certainly if you’ve had testing conducted that indicates you have high cholesterol, by all means take corrective measures with your diet and exercise routines.

If levels are really high, the use of statin drugs may be very helpful with getting levels in check. This isn’t a call to snub your nose at your doctor’s recommendation. I would simply caution against the long-term use and reliance on these drugs.

When possible the goal should be to get “off” these drugs with the help of lifestyle changes, not begin a long dependency on pills for cholesterol management.

In addition, I recommend you ask your physician about an “advanced lipid profile.” The advanced lipid testing looks at markers that standard blood cholesterol tests don’t.

The following is a list of example markers which can be examined with an advanced lipid profile test.

- Lipid profile (total cholesterol, HDL, LDL, triglycerides)

- HDL subtype (there are five HDL subtypes)

- LDL subtype (there are seven LDL subtypes)

- Homocysteine levels

- Lipoprotein(a)

- Fasting insulin

- C-reactive protein

- Apoprotein B and A1

- Fibrinogen

When a “bigger picture” is viewed with an advanced lipid profile, your doctor can give you a much better indicator of your overall risk for heart attack and cardiovascular disease.

Either way, high total cholesterol is simply a WARNING SIGN provided by your body that some things are out of whack.

Elevated cholesterol is likely a response by your body as a means of dealing with high inflammation. Remember, cholesterol serves a major role in repairing damaged cells. If you’ve been following a poor diet and not exercising, cholesterol is there to do it’s job as part of an immune response to heal and repair the body.

Fixing the inflammation problem goes hand in hand with naturally reducing cholesterol levels.

Read that last part again and let it sink in.

Statin drugs will NOT reverse inflammation problems, in other words they can’t make up for a crappy diet and lack of exercise. Statin drugs work to reduce cholesterol, which your body may have jacked up for a reason.

Once again, don’t throw out your prescription for a statin drug if your doctor recommended one. I just want you to see the bigger picture with all of this so you can be more informed when discussing your long-term objectives with your doctor.

In the future I’ll look to do an in-depth post on my top dietary and exercise recommendations for improving cholesterol levels naturally.

In the meantime, feel free to leave your comments and any questions.

Shane Doll is a certified personal trainer, fat loss expert, speaker, and founder of Shaping Concepts Fitness Training Studios. If you’re looking for a personal trainer in Charleston, you can receive a no-obligations personal training trial and consultation without risking a dime. Over 1000 Charleston area residents have transformed their bodies following our unique burst training workouts and simplified nutrition programs. Experience the Shaping Concepts difference today.

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Category: Hormones & Health.