Thursday, December 1, 2005

Cholesterol: It does a body good

A growing group of folks dare to say that more might just be better
By Vesna Vuynovich Kovach

It’s an integral part of every cell in your body; embedded in each one’s membrane, it quite literally keeps you together. Over a remarkably wide range of temperature, it keeps your cells firm enough that they don’t soften into mush, yet supple enough not to crystallize. It’s also a vital ingredient in cell manufacture and repair.

This same substance is the principal building block of many of your most important hormones, including the sex hormones progesterone, estrogen and testosterone, and several adrenal hormones, too: cortisol, cortisone, aldosterone. You need it to make the glucocorticoids that regulate your blood sugar. You also need it to make the mineralocorticoids that balance minerals and regulate blood pressure.

Pivotal in brain synapse function, this plentiful component of mother’s milk is critical to the development of a baby’s brain and neurological system.

As if this all weren’t enough, this same substance is also essential for your body’s synthesis of Vitamin D. Your liver needs it to create bile salts and acids for effective digestion; its name means “bile solid” in Greek.

What is it, this magical substance so central to all animal life? Here are some clues that probably won’t help. It’s soft, white, waxy and crystalline. You have about five ounces of it in your body, most of which you make yourself. Some comes from the food you eat.

It’s cholesterol.

We hear about cholesterol all the time, everywhere from the evening news to product labels. Many of us plan our diets, if not our entire lifestyles, around it – or anyway, around avoiding it.

But for something we spend so much energy thinking about, how many of us know what it actually is: what it’s made of, where it comes from, what it looks like? And what, if anything, it’s good for?

The information is not so readily available to the casual seeker. Even an Internet search for “cholesterol benefits” will turn up mostly information about ways to get rid of it – or, more precisely, how to have less floating around in your blood (serum cholesterol) – rather than about the various benefits of cholesterol itself.

Cholesterol fits many categories. It’s an alcohol, by virtue of having an OH component. It’s a lipid, which is a family of substances that includes fats and waxes. It’s also a steroid, which is a type of lipid. Cholesterol is the precursor to pregnenolone, used to synthesize all the body’s steroid hormones.

Cholesterol needs to get wherever cells need mending. The logical way to travel is through the circulatory system; that is, by floating along in the bloodstream. But there’s a problem: cholesterol can’t dissolve into your blood, because it’s not easily soluble in water. Our bodies have developed an ingenious workaround. We pack up individual molecules of cholesterol into lipoproteins, little globes made of water-soluble protein on the outside and fat-soluble lipid on the inside – and away they go, like little submarine travelers.

The lipoproteins that carry cholesterol away from the liver toward cells that need repair are less dense than the ones that bring it back to the liver. Hence the familiar terms low-density lipoprotein (LDL) and high-density lipoprotein (HDL) – the so-called “bad” and “good” cholesterols. Technically, the cholesterol itself is the same; it’s the submarines that are different.

Incidentally, plaque, that infamous cholesterol-laden tissue of arterial walls, is not a residue of cholesterol swimming by, even though it is associated with high blood cholesterol levels. It’s not like a bathtub ring; rather, it’s built into the artery tissue on a deeper level.

All animals produce cholesterol. Plants don’t. That’s why meat, eggs, butter and other animal foods contain cholesterol, while absolutely all vegetable oil is cholesterol free. Same goes for all grains, fruits and veggies.

Even the strictest vegetarian folks have cholesterol – sometimes even at levels deemed too high by current standards. In fact, some research seems to show that our bodies work to maintain a level of cholesterol that’s consistent within each individual, so that if you eat less, your body makes more, and vice versa.

None of the information above is considered controversial. Recently, though, there has been a groundswell of controversy regarding cholesterol’s role in coronary heart disease (CHD).

A growing community of physicians and layfolk worldwide reject what they’ve dubbed the “diet-heart idea”: the view that saturated fat and cholesterol (read: animal food) leads to blocked arteries and heart attack. According to them, the reason cholesterol is present in damaged, lesioned arterial walls is because of its role in cell repair. They hold that cholesterol is part of the solution, not part of the problem.

High levels of blood serum cholesterol don’t cause heart attacks, they say, any more than high numbers of plaster casts cause broken bones. They point to examples that seem to contradict the conventional view, like the Masai tribespeople of Kenya who live almost entirely on meat and milk, yet have ultralow rates of CHD.

As possible culprits for the CHD epidemic, they cite smoking, stress, bacterially caused inflammation, and modern “fabricated” foods – margarine, nonfat cream cheese, boxed breakfast cereal. To the typical health-conscious consumer, theirs seems a topsy-turvy worldview in which just about all the modern dietary improvements turn out to be positively lethal.

The critics of the diet-heart idea admit that not all animals are designed to eat food that contains cholesterol. Lettuce-chomping rabbits, for instance, are virtually unable to metabolize this substance in their diet, even though, like all animals, they produce it internally.

In fact, they use this well-established bit of rabbit biology to bolster their pro-cholesterol view. They say it renders useless the many studies of harmful effects of dietary cholesterol using rabbits as test subjects – that although the results are dramatic, they can’t shed light on how dietary cholesterol affects humans.

One of the voices in the forefront of the diet-heart detractor movement belongs to a general practitioner in Sweden, Uffe Ravnskov, M.D., Ph.D., spokesperson for The International Network of Cholesterol Skeptics (thincs.org) and author of The Cholesterol Myths, which purports to detail how, from a seminal 1950s cross-nations study on, the actual findings of cholesterol research have been grossly misreported in study abstracts and by the press.

Ravnskov goes so far as to maintain that it’s only because rabbits are small, cheap and easy to handle that so much cholesterol (and other human-health-related) research has been done on them – and that the public pays the price in terms of misleading results that lead us – with futility – to adopt diets that are unappetizingly low in fat, to choose modern, high-tech alternatives (like margarine) to foods that have been part of the human diet for millennia, and to consign ourselves to a lifetime of taking expensive, powerful, yet little-understood drugs.

Moving our story closer to home, 2005 saw the birth of a Madison chapter of the Weston A. Price Foundation, an international organization dedicated to promoting traditional, natural foods. This is a natural foods movement with a difference.

Far from the conventional pro-vegetarian mindset that characterized the health foods movement throughout the 20th century, the WAPF view focuses sharply on the animal foods of our not-so-distant ancestors – beef, lamb, eggs, milk, butter – with an emphasis on natural, small-farm products, minimally processed and without artificial ingredients.

WAPF proponents like to point out that the rise in heart disease since the 1920s is concurrent with the decline in these foods.

At monthly meetings, local farmers bring their wares – raw-milk cheeses, grass-pastured meats and more. A lively Internet community thrives via a Web site (geocities.com/madison_wapf/) and online discussion boards. Topics include tips on home preparation of cream cheese and naturally fermented and cultured foods like yogurt and kefir – using whole milk, of course – and pointers to articles and books featuring obscure – some say suppressed – cholesterol-friendly nutritional and medical information.

If this seems far-out, consider that there are over 300 WAPF chapters in the United States alone. The Madison chapter is Wisconsin’s fifteenth.

Last April some 250 people flocked to the local group’s inaugural event, a talk given by the national organization’s founder and president, Sally Fallon, to hear her message of the dangers of cholesterol-lowering statin drugs (she says they’ve been linked to depression, cancer – and, perhaps ironically, heart disease), hydrogenated and trans fats (the mainstream is catching up to this particular caveat), and modern low-fat dairy products (she says they are thickened with dry milk powder for palatability – a source of “damaged,” or oxidized, cholesterol, which actually is dangerous for your heart.)

Testimonials to the healing power of cholesterol-rich foods are rife. Mary Smith, trim and energetic at 54, one of the event’s organizers, says following advice like that found in Fallon’s book Nourishing Traditions changed her life. “I was depressed and anxious for years,” says the former vegetarian. “I had terrible cravings all the time.” Now, when symptoms begin to return, Smith cuts out most everything except eggs, meat and, doled out over the course of the day, a full stick of butter. “I spread some on my eggs and some on my meat. If the eggs and meat are gone before I’ve eaten my full portion of butter, I just eat it straight.”

Another chapter founder, Mary Jo Fahey, suffered from chronic fatigue. “I wasn’t getting enough fat,” says the lean, self-employed writer who teaches workshops on making kefir and other naturally cultured foods. “I needed the energy.” Her favorite foods include a local farm’s heavy cream that’s “so thick, it’s like custard – you can practically stand up a spoon in it.”

And Martha Reilly, 50, an optometrist whose professional background includes nearly a decade of medical research, says she lost forty pounds and reversed her diabetic symptoms by switching from a low-fat diet centered on whole grains to one built on what she calls “good fats” – those found in grass-fed beef and raw milk. “Commercial livestock are fed the wrong foods to begin with,” she says. “So their fats aren’t as good.”

Certified Nutritional Consultant Kristina Amelong, 41, struggled with chronic bladder, sinus and yeast infections. “I was very, very sick. I was in pain all the time,” she says. She devoted herself to natural remedies, acupuncture and natural foods for years, but, she says, “It wasn’t until I started a diet with lots of fat that my health turned around.” In addition to her Atwood neighborhood practice, Amelong and her husband, Tim Cordon, boards goats at their farm in Blue Mounds. The goats belong to fellow natural foodies who want raw, non-homogenized milk.

Of course, conventional medicine does not condone these examples. Nor does it consider the diet-heart connection to be an open question. Major organizations ranging from the National Institutes for Health, the USDA, the American Medical Association, the American Heart Association and the Centers for Disease Control all are unequivocal that low-cholesterol diets can help prevent CHD, and that the opposite is risky.

But the cholesterol skeptics are confident they have the facts, and the history of human nutrition, on their side. “If the mainstream is right, then maybe I won’t live as long,” says Smith. “But it tastes good. And I feel good. And it’s better than being depressed.”