Free The Great Cholesterol Myth by Jonny Bowden

present-day health recommendations to reduce cholesterol by any means possible started with the Framingham Heart Study. In 1948, when the study began, cholesterol was only measured as “total” cholesterol. If you knew what your cholesterol was, you knew one specific number (200 mg/dL or 220 mg/dL, for example). As recently as 1961 we didn’t have the technology to distinguish between “good” and “bad” cholesterol (HDL and LDL), much less the newer technology that allows us to zero in on different subtypes of the so-called “bad” cholesterol, which, as you can see, is far from being all “bad” after all.
    Even HDL, the so-called “good” cholesterol, isn’t
all
good. A study published in the December 2008 issue of the
FASEB Journal,
produced by the Federation of American Societies for Experimental Biology, challenged the conventional wisdom that simply having high levels of good cholesterol (HDL) and low levels of bad cholesterol (LDL) is necessary for good health. The researchers showed that even
good
cholesterol has varying degrees of quality and that
some
HDL cholesterol is actually bad news.
    “For many years, HDL has been viewed as good cholesterol and has generated a false perception that the more HDL in the blood, the better,” said the lead researcher, Angelo Scanu, M.D., of the University of Chicago. 3 “It is now apparent that subjects with high HDL levels are not necessarily protected from heartproblems and should ask their doctors to find out whether their HDL is good or bad.” Scanu’s study found that the HDL of people with chronic diseases such as rheumatoid arthritis and diabetes is very different than the HDL of healthy individuals, even when their blood levels of HDL are similar. Normal, “good” HDL cholesterol reduces inflammation; dysfunctional, “bad” HDL does not.
    Knowing you have a “high” LDL level is pretty much a useless piece of information unless you know
how much
of that LDL is the small, dense kind (harmful) and how much is the big, fluffy kind (not harmful in the least).
    THE GOOD, THE BAD, AND THE REALLY, REALLY UGLY!
    This just in: As of this writing, new research funded by the British Heart Foundation has uncovered still another subtype of LDL cholesterol that is particularly bad. It’s called the
MGmin-low-density lipoprotein
, and it’s more common in people with type 2 diabetes and in the elderly. It’s “stickier” than normal LDL, which makes it much more likely to attach to the walls of the arteries.
    This new “ultra-bad” boy is actually created by a process called glycation, which sharp-eyed readers will recall is one of the Four Horsemen of Aging. Glycation happens when there’s too much sugar hanging around in the bloodstream. The excess sugar starts gumming up the works, inserting itself in places where it doesn’t belong—in this case, the LDL molecule. (We’ll have a lot more to say about sugar and its role in heart disease later on in chapter 4 . Preview: Sugar is way more of a threat to your heart than fat ever was!)
    “This is yet one more line of research that explains why some people can have perfect cholesterol levels, but still develop cardiovascular disease,” said Gerald Weissmann, M.D., editor-in-chief of the
FASEB Journal
. “Just as the discovery of good and bad cholesterol rewrote the book on cholesterol management, the realization that some of the ‘good cholesterol’ is actually
bad
will do the same.” 4
    The point is that there is, indeed, “bad” cholesterol—even “
ultra
-bad” cholesterol—but simply using a shotgun pharmaceutical approach to lowering all cholesterol doesn’t accomplish anything and has significant unwanted side effects, as we will see in chapter 6 .
    Now that the four main characters in our drama have been introduced—oxidation, inflammation, cholesterol, and the arterial walls—let’s see how they interact in real life, and how they work together to create a dangerous situation for