Low Density Lipoprotein

What are the benefits of having lower Low Density Lipoprotein (LDL) cholesterol levels?

According to MedlinePlus (2016), “Hypocholesterolemia” is “the presence of excess cholesterol in the blood.” Having excess cholesterol within the blood is marked by higher total serum cholesterol levels. Currently the National Cholesterol Education Program (NCEP, 2002) recognizes that total serum cholesterol levels between 200-239 mg/dL are borderline high, while cholesterol levels >240 mg/dL are high (p. 3167). This means that a higher total serum cholesterol level increases the risk of adverse coronary events and the inverse should also be true.

Currently the guidelines of the NCEP (2002) say that a “desirable” total serum cholesterol level is <200 mg/dL (p.3167). But according to Esselstyn (1998), “We now know that 35% of heart attacks occur in people with total cholesterol levels of 150-200 mg/dl, and a target level of only 200 mg/dL guarantees that millions of US citizens will perish of coronary disease” (p. 2T). Further research replicates those findings.

Recently researchers have found that the NCEP guidelines for Americans may not be desirable. According to Javed et al. (2010), a study of 65,396 individuals administered to the hospital with acute coronary syndrome had an average total blood cholesterol of 170.1 and an average LDL cholesterol of 103.4 (p. 1132). Based upon the current National Cholesterol Education Project guidelines, patients are being admitted to the hospital with “normal” and “desirable” cholesterol levels. Thus, these desirable cholesterol levels, <200 mg/dL, may not necessarily be accurate.

For optimal health, a cholesterol level of 150 or less appears to be a strong indicator of reducing the risk of developing, or potentially perishing from, coronary heart disease. Roberts (1999) believes that, although it is not entirely clear, the bulk of the scientific literature indicates that a LDL cholesterol level less than 100 is needed to prevent the progression of atherosclerotic plaque and that lowering the LDL cholesterol goals to <100 mg/dL may frighten the American public (p. 816). Roberts (1999) concludes with “the goal, I say, for everyone, is to have LDL cholesterol <100!” (P. 817). After years of research, the National Institutes of Health, & National Heart, Lung, and Blood Institute (2001) changed their guidelines for LDL cholesterol levels to reflect an optimal level for LDL cholesterol of <100 mg/dL. Further research continues indicate that lower LDL cholesterol levels decrease the risk of developing atherosclerosis. Atherosclerosis, according to the American Heart Association is “…fatty deposits that can clog arteries. These buildups are called plaque. They’re made of cholesterol, fatty substances, cellular waste products, calcium and fibrin (a clotting material in the blood).

Atherosclerotic events (heart attacks or stroke), according to O’Keefe et al., (2004) rarely occur in populations with total serum cholesterol levels between 100 and 150 mg/dL, thus estimating their LDL cholesterol to be between 50 to 70 mg/dL (p. 2142). Keeping total serum cholesterol levels low significantly lowers LDL cholesterol levels. According to O’Keefe et al., (2004), “although an LDL level of 50 to 70 mg/dl seems excessively low by modern American Standards, it is precisely the normal range for individuals living the lifestyle and eating the diet for which we are genetically adapted” (p. 2143). The reason we experience atherosclerotic events is because our current LDL cholesterol level is twice what it should be (O’Keefe et al., 2004, p. 2141).

While medication has its place in health care diets appears to have an impact on LDL cholesterol levels. According to NCEP (2002):

Despite the low risk for CHD (coronary heart disease) accompanying LDL- cholesterol levels that are optimal (<100 mg/dL) or above but near optimal (100–129 mg/dL), the intensity of clinical intervention required to achieve such levels for everyone in the population would financially overload the health care system. Drug usage would rise enormously (p. 3198-3199).

Prescription drugs are helpful but are not the only means by which to reduce cholesterol levels. Castelli (1998) suggested that in order to lower one’s LDL cholesterol levels, one “can achieve this with diet plus drug therapy, but if you can do it with a vegetarian diet, it works even better. It won’t take long before patients with symptoms tell you how much better they feel” (p. 64T). But Chiuve, McCullough, Sacks and Rimm (2006) recognize that while lipid lowering medication greatly reduce the risk of cardiovascular disease by 20 to 30%, there is still a 70 to 80% chance of an adverse coronary event (a heart attack or stroke). “The overall reduction in risk is relatively modest and could be greatly improved by the addition of lifestyle modifications” (p. 160). A whole foods plant based diet may be such a change to promote health by lowering cholesterol levels and improving overall health.

Eating You Alive – Dr Joel Fuhrman

Many studies have shown the relationship between whole foods plant-based diets and health. According to Roberts (1999), “Pure vegetarians (assuming that they do not have familial hypercholesterolemia and do not eat too much saturated vegetable fats) usually have total cholesterol levels <150 mg/dl and LDL cholesterol levels <100 mg/dl” (p. 816). De Biase, Fernandes, Gianini, & Duarte, (2007) found that the LDL level of those consuming a whole foods plant-based (vegan) diet averaged a total serum cholesterol level of 141.06 and had an LDL cholesterol level of 69.28 (p.34). These cholesterol numbers fall right in line with what researchers have been pointing too. Their research shows a stepwise progression of the consumption of meat and dairy products within the diet and the significant impact these foods have on total serum cholesterol levels as well as LDL cholesterol levels.

Dietary Pattern Omnivores Lacto-ovo Vegetarians Lacto Vegetarians Vegans
Total Serum Cholesterol 208.09 175.32 164.82 141.06
LDL Cholesterol 123.43 101.47 87.71 69.28

Figure 4. De Biase, Fernandes, Gianini, & Duarte, (2007). Recreation of diet and cholesterol level. Retrieved October 4, 2016.

Eating You Alive – Dr Maria Anderson “Personal Experience”

Nathan Pritikin took charge of his diet and successfully reversed his cardiovascular disease. In this video he sits down with Dr. John McDougall to explain how he changed his diet and the health implications doing so had on his life.

Nathan Pritikin: A Casual Conversation with Dr. McDougall (1982)

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