• James Tippett MD

Understanding Cholesterol - Part 2

In last week’s Part 1 article, information was presented about how cholesterol is beneficial and necessary for maintaining health but when present in excess in our blood can be harmful.

It was noted that our bodies make adequate amounts of cholesterol so consuming cholesterol-rich foods is not necessary. Also, recall that factors impacting the tendency to develop arterial plaque (atherosclerosis) and compromise blood flow to vital organs included: levels in the blood of LDL (bad) and HDL (good) cholesterol; and the proneness of an individual to the processes of oxidation and inflammation.

Approximately 85% of cholesterol in our blood comes from the production of this lipid by the liver and the remaining 15% from the consumption of certain fat. Research has begun to show that our genetic make-up, not diet, is the major driving force behind cholesterol levels in the majority of people. However, the way individuals process cholesterol varies widely, and some people seem to be more vulnerable to foods high in lipids (fat and cholesterol).

So, what dietary factors decrease the level of LDL, increase the level of HDL, and neutralize the tendency to oxidation and inflammation thus decreasing the risk for atherosclerosis?

For decades, common sense dictated that to prevent high levels of cholesterol in our blood we should restrict ingesting high cholesterol foods. All of us regardless of IQ could have come to that conclusion, right? Wrong! The truth is that most cholesterol-rich foods, such as eggs and shrimp, are not unhealthy and don’t significantly elevate blood cholesterol levels. The real culprits are fats! Fat and cholesterol are both lipids but distinctly different in chemical structure and function. It may seem confusing, but the fact is that eating excessive fat increases cholesterol more than eating high cholesterol foods. The biochemistry of this process is a bit beyond the scope of this article. However, if you will bear with me, we will discuss some basic biochemistry in hopes of helping you understand food labels.

Fat is a molecule that consist of long chains of carbon and varying amounts of hydrogen. It is said to be a saturated fat if it contains a large amount of hydrogen and unsaturated if only a small amount. A saturated fat, also called a hydrogenated fat, is solid at room temperature (butter) and an unsaturated fat exists as an oil (plant fat like olive oil). Diets high in saturated fat (animal and dairy products) are deleterious and raise cholesterol levels while magnifying oxidation and inflammation. Unsaturated fats from plants and fish are protective because they reduce LDL, raise HDL, and have anti-inflammatory and anti-oxidant properties. Fish oil (an omega 3 fatty acid) is an unsaturated fat found in oily fish (salmon and tuna). In recent times, it has been touted as an agent that prevents heart disease. Commercial fish oil supplements have become very popular but recent studies have shown that these supplements are not very beneficial and to get the benefits from this fat, we should consume oily fish.

The most harmful fat currently known is trans-fat which is a partially hydrogenated fat commercially made through a chemical process that adds hydrogen to vegetable oils. Hydrogenation solidifies liquid oils increasing the shelf life and improving the flavor and texture of foods that contain them. These fats exist naturally in very small amounts (marbleized beef) but still can be found in processed foods and baked products. In the past, it was widely used for frying by fast food chains; say hello to Mickey D’s fries and pies of the past. Trans fat is so detrimental that the FDA has issued a gradual ban on its use. Beware that it is still used in commercially produced cakes, pies, cookies (especially with frostings), doughnuts, biscuits, margarines and even microwave popcorn.

Many experts recommend following the Mediterranean diet for heart and cardiovascular health and I strongly agree. This diet emphasizes fish, vegetables, fruits, olive oil, whole grains, nuts and perhaps best of all, red wine ☺. Hopefully, the information provided in this article will help explain why this diet is recommended. Try following this diet and you will find that it provides tasty food, but know that it is OK to have an occasional steak and potato meal on special occasions.

Well, it looks like we are going to need Part 3 to complete this series on Understanding Cholesterol.

Next week, we will discuss prescription medications to treat hypercholesterolemia (elevated cholesterol). So, don’t forget to grab a copy of the Herald Journal.

Dr. Tippett is the founder of Comprehensive Quality Healthcare Providers, a Concierge Internal Medicine practice located at 1210 Commerce Dr. Suite 106 Greensboro, Ga. 30642. He can be reached at 706-510-3659. Visit his website at



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1210 Commerce Dr, Suite 106

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