What is cholesterol and is it necessary to have cholesterol in our diets? This article takes a quick look at some of the common misconceptions surrounding the topic of good cholesterol (HDL) and bad cholesterol (LDL) and the conflicting advice being handed down by a variety of sources.

“The world’s biggest killer is ischaemic heart disease, responsible for 16% of the world’s total deaths. Since 2000, the largest increase in deaths has been for this disease, rising by more than 2 million to 8.9 million deaths in 2019”

(Source Link: World Health Organisation).

The leading causes of heart disease are directly related to lifestyle choices. A diet high in saturated fats, trans fats and cholesterol have all been linked to heart disease and related conditions such as atherosclerosis, in which injury is caused to the artery wall from plaque. (Source Link: CDC)

Recently, a friend of mine who has been on a plant-based diet for the past 12 months, had a general blood test   which returned perfect results except for one minor thing — according to the doctor, her HDL (High Density Lipoproteins) was too low. No cause for alarm, but to lower her risk of heart disease in years to come, she was encouraged to increase her intake of “good fats”. She came to me with these results a little concerned saying that she will need to increase her dietary fat intake. Immediately I was sceptical for a variety of reasons.

One being that general level of nutrition education among medical professionals is limited and according to RACGP,

“in many cases, medical students received little to no education” on nutrition.”

(Source Link: RACGP)

Another being that most studies on nutritional effects on humans are industry driven/funded.

Plus, I was of the understanding that having low cholesterol levels was healthy, but what do I know. So, I decided to dig a little to see if there really is a cause for concern. What I found was some of the muddiest waters of industry biased information that I have encountered so far. It is no wonder people are confused.

Take for example this key tip from The Australian Heart Foundation’s web page which claims…

“Include a variety of healthy proteins. With this in mind, lean cuts of meat and reduced fat dairy products can also help keep your cholesterol down and your heart health up!”

(Source Link: Heart Foundation – Five ways to lower cholesterol).

Is this for real? Meat and dairy products are good for lowering cholesterol? Coming from an organisation that slapped its heart healthy tick on everything from sugary cereals to highly processed dairy products, meats, margarine and oils to frozen pizzas.

That’s right, the Heart Foundation supports the consumption of junk food. Of course, it was no surprise to discover that a fee was required to gain the Tick of Approval.

According to this article found in news.com.au,

“The Heart Foundation was accused of selling its credibility when it took $300,000 a year from McDonalds to allow it to put a Tick on its Fillet-o-Fish burger and chicken nuggets.”

(Source Link: news.com.au)

In a document released by Food Legal,

“The Heart Foundation admits that its own criteria will not always meet the requirements of the Food Standards Code: Criteria in each category will not always meet the Food Standards Code definitions of ‘lower’ or ‘low’, ‘high’ or ‘higher’. This is because for some foods, these definitions represent a target that is too far from the current average market levels and therefore;

(Source Link: Food Legal)
  • would not provide an incentive for reformulation;
  • may present food technology challenges beyond the current ability of the market; and
  • could dramatically alter the taste and therefore consumer acceptance.”

The Heart foundation tick has since been retired and has now been replaced with a similar scheme known as the Health star rating which is similarly controversial.

With this being just one small sector of the food/health industry regulatory system at work, it is easy to see that the financial wellbeing of industry has a huge influence on the information received by the public.

So, back to cholesterol. On February 19, 2015 the Dietary Guidelines Advisory Committee stated that…

“…available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol…Cholesterol is not a nutrient of concern for overconsumption.”

(Source Link: Dr. Neal Barnard, youtube.com, seen 2021).

Suddenly everyone was convinced that eating eggs was our saving grace. Not only did this statement justify eating eggs, but people also felt they had the green light to eat all animal products including dairy and processed meats. With this in mind, it is of no surprise that statin drugs are now the most commonly prescribed medications in Australia and the United States.

Dr Neal Barnard states cholesterol is necessary, but dietary cholesterol is not. Your body produces cholesterol, and the main purpose is for its role in healthy cell membranes. Cholesterol made by the body is stored in the cell membranes to maintain the cells fluidity. What this means is that cholesterol is found in high concentration in the lean parts of meat. Take away all the fat, and there is still plenty of cholesterol. But wait, didn’t the Heart Foundation recommend a diet of lean cuts of meat? Confusing huh?

Then it gets even more confusing with all the hype surrounding HDL or “good cholesterol”. Apparently, we need to consume more HDL to prevent heart disease and the main food source associated with HDL is eggs. In fact, many doctors now recommend eating eggs to raise HDL and there are countless articles out there saying the same. In an article published by WebMD, they state that…

“HDL cholesterol scavenges and removes LDL — or “bad” cholesterol.”

(Source Link: WebMD)

Simply put, HDL helps to remove LDL from the body. If that is its main purpose then it stands to reason that if your test results show a low level of LDL, then in comparison your HDL should also be low.

So why is my vegan friend, who’s LDL level is about a quarter of that of a meat eater, being told to increase her HDL? The way I see it, is that high HDL does not prevent heart disease on its own. It simply decreases LDL in the blood stream which, in turn, may decrease the risk of coronary heart disease. If you have low LDL, there is no need to increase HDL.

High HDL does not = healthy.

While watching a lecture by Dr Neal Barnard, Adjunct Associate Professor of Medicine at the George Washington University School of Medicine and President of the Physicians Committee for Responsible Medicine, I discovered this “meaty” little bit of information:

The dietary guidelines for Americans, which are used to set government food policy in America and abroad, refer to the findings from 12 studies that…

“the effect of plasma lipid concentrations…is modest and appears to be limited to population subgroups.”

(Source Link: Dr. Neal Barnard, youtube.com, seen 2021 ).

In other words, the effects of cholesterol are minimal.

He then goes on to display all 12 trials and reveals that 11 of the 12 trials were funded by the egg industry with the other funded by the seafood industry.

Meat, eggs and dairy contain cholesterol and are recommended as an integral part of a “healthy” diet according to a variety of industry funded studies and despite these recommendations, statin drugs are still the highest prescribed medications and heart disease is the number one killer globally.

For me this poses a major conflict of interest when research used to determine policy is funded by the industries that stand to profit the most from the findings.

Recommending foods with cholesterol to combat heart disease is like recommending cigarettes to fight lung cancer.

Unfortunately, due to this conflict of interest, it is almost impossible to give my friend a definitive answer other than to state the fact that eating a whole food plant-based diet does dramatically decrease cholesterol and the risk of coronary heart disease.

“Ground-breaking research shows that a plant-based diet doesn’t just prevent heart disease but that it can manage and sometimes even reverse it.”

(Source Link: pcrm.org/health-topics/heart-disease)

Furthermore, that if the main purpose of HDL is to fight off LDL levels in the blood stream, it stands to reason that if your LDL is low there is no need for your HDL to be high. Also, that healthy oils can be found in a huge variety of plant foods from avocados to nuts and legumes, and that a balance of all omegas can be sourced from quinoa and flaxseed which rules out the need for seafood.

These findings are my own opinions based on my own research into cholesterol and in no way should be constituted as medical or nutritional advice.

I urge you to watch this documentary by Neal Barnard and perhaps check out the two great videos linked below. After all, your health is your responsibility.

Mic the vegan-The Big HDL Myth: Good Cholesterol Examined

Mic the vegan- Are Vegan Cholesterol Levels Too Low?