Cholesterol

Sep 16, 2015

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

Cupertino is a small city in California in the foothills of the Santa Cruz Mountains. Given that, it is surprising how often Cupertino is mentioned in documents all over the world. For example, a 2003 NATO stabilization force document called Atlas raises the world, states Within the German-Italian Battle Group, the Cupertino with our Italian comrades proved to be very fruitful. This whole statement doesn't make any sense until you realize that earlier versions of spell check didn't like the word cooperation spelled without a hyphen. When spell check saw cooperation with no hyphen, the only correction the spell check algorithm could think of was Cupertino. That glitch caused untold hundreds of documents to talk about a small Californian city instead of getting along. It happened so often, it is referred to as the Cupertino Effect.

For years, we have had an Egg Effect when talking about blood cholesterol. Pat from the pharmacy was telling me a story about his dad, his doctor and eggs. Years ago Pat's dad, Jack, went in for check up. The doctor asked about what Jack had for breakfast. Jack said he ate 2 eggs every day and on Sunday's he ate 3. The doctor freaked out! Are you trying to kill yourself? I think was the quote. The doctor was worried because there is so much cholesterol in eggs that eating eggs would raise Jack's cholesterol and cause a heart attack or stroke. That way of thinking is now officially wrong.

Eating foods high in cholesterol will not raise your blood cholesterol. Yes, you heard me right. Go get those 3 over easy eggs at Corrina's tomorrow. The USDA 2015 Dietary Guidelines for Americans have come out and they officially list cholesterol as not a nutrient of concern for overconsumption. Again, in plain speak that means eating cholesterol doesn't raise your blood cholesterol levels.

What is cholesterol? Cholesterol is a naturally occurring substance in the body that is essential for life. If you had no cholesterol in you, you would die. Cholesterol helps form bile acids in your digestive system, hormones in your endocrine system and important components of every cell membrane in your body. Your liver can makes all the cholesterol you need. So again, the cholesterol you eat doesn't go directly into your blood stream. Your liver makes cholesterol for you.

Why does your doctor test your blood for cholesterol if it is essential for life? Why does your doctor care if your blood cholesterol is too high? Your doctor cares about blood cholesterol levels because if they are too high for too long you have higher chance of getting a heart attack or a stroke. Heart attacks and strokes account for about one third of all the deaths in Canada.

The primary target of cholesterol lowering therapy is something called LDL. If LDL or bad cholesterol is high, we have many, many studies saying that increases the patients chance of having a heart attack or stroke. The most common LDL lowering medications are the statins. The statins stop the liver from making as much cholesterol. The statins do a good job of reducing LDL. In fact, if we reduce someones LDL with statins we can reduce their chances of heart attacks and strokes by 25% to 35% with five years use.

What does all this LDL, and HDL stuff mean? When your liver makes cholesterol, it puts it into the blood stream. Cholesterol is a kind of fat or lipid. Since blood is mostly water, cholesterol doesnt mix well with it. The liver has to mix the cholesterol with proteins to get it to stay in the blood. This mixture of cholesterol and protein is called a lipoprotein. If you take a blood sample and spin it really fast in a centrifuge, it separates based on density. Different layers in the sample have different densities. Low Density Lipoprotein or LDL is often called bad cholesterol because it transports cholesterol from the liver to places like the lining inside the arteries. Through a complicated series of events, these cholesterol deposits can cause blockages that slow or stop blood flow. If blood flow to the heart muscle is stopped, that is a heart attack. If blood flow to the brain is stopped that is a stroke. High Density Lipoprotein or HDL is called good cholesterol because it transports cholesterol away from the cells lining the blood vessels. This can decrease the chance of blockages.

So if eating cholesterol is okay and won't increase our blood cholesterol, what shouldn't we eat? That is more complicated. Eating lots of sugars and carbohydrates is probably bad. Eating lots of carbohydrates raises the blood triglycerides. Triglycerides are another blood lipid that does similar bad things as high blood cholesterol. Eating trans-fats is probably bad. Trans-fats are found in margarine, many commercial baked goods, such as cookies and cakes, and most deep-fried foods. A clue to their presence is the words "partially hydrogenated" on the list of package ingredients. Eating saturated fats might be good or it might be bad. The 2015 USDA dietary guidelines still stay you should consume less that 10% of your total calories from saturated fats. However a March 2014 meta-analysis in the Annual of Internal Medicine, Chowdhury et. al. found no association between the intake of saturated fats and the chance of having heart disease.

I do smell a conspiracy when it comes to the Cupertino Effect. Cupertino, besides confusing spell check algorithms, is known for something else. Cupertino is known as the headquarters of Apple Inc. These Cupertino spell check issues seem to date from the early 2000's. I think Steve Jobs was just subliminally paving the way for the 2007 release of the iPhone and Apple's subsequent world domination. Now that Steve Jobs is gone and we are all cleared to eat eggs, I think the Poultry Lobby is poised to strike. Be afraid. Especially of their spokes person, that big angry chicken off of Family Guy.

 

As always if you have any questions or concerns about these or other products, ask your pharmacist.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca

Heart Attack and Stroke Risk calculator: https://www.cvdriskchecksecure.com/FraminghamRiskScore.aspx

USDA dietary guidelines and cholesterol - http://health.gov/dietaryguidelines/2015-scientific-report/pdfs/scientific-report-of-the-2015-dietary-guidelines-advisory-committee.pdf

Chowdry et. al. Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk: A Systematic Review and Meta-analysis -http://annals.org/article.aspx?articleid=1846638&resultClick=3

Cupertino - http://www.cupertino.org/

 

Oops RadioLab - http://www.radiolab.org/story/91721-oops/

Angry Chicken from Family Guy - https://www.youtube.com/watch?v=W4WGQmWcrbs

 


Read more Health Articles