Hey everybody this is Nick Deliberato. There is a great deal of confusion surrounding heart disease and cholesterol.  We’ll take this in bite-sized segments. The information I’m going share may conflict with what you have been told or intuitively believe. There are a handful of reasons for this; the most important is that much of early nutritional science has been entrenched in well-intentioned mistakes. In other words, things such as gaps in technology, confirmation bias, poor study design and mistaking correlation with causality. In my own conversations with patients I’ve been surprised to hear medical recommendations that are incongruent with current nutritional and lipidology-based evidence.

Most Doctors are highly intelligent and will tell you that they intend to protect a patient’s best interest.  Today’s current environment doctors do not get ample time to teach and coach his or her patients. Please note that this information is not meant to provide medical advice or take the place of medical advice or treatment from your physician. I offer this for educational purposes. My goal is to bring attention and boost patient competency when advocating one’s health.  I Really hope that this helps to bring some faulty logic to the surface.  


 So let’s lay some groundwork. Cholesterol is steroid alcohol. It is essential to life and we cannot function without it. It is a critical component in every cell membrane.

At any given point 25 % of the cholesterol levels in your body come from the diet and the liver produces the other 75 % internally. The majority of cholesterol in food cannot be absorbed. The body tightly regulates the amount of cholesterol in the blood. Eat less dietary cholesterol and the liver produces more. Eat more cholesterol and cholesterol production goes down.

Cholesterol is fat-soluble and requires a protein to transport it through the blood. Think of it as a delivery service using taxis or boats.  These boats are called lipoproteins and without them we would die. Lipoproteins are not there to put us in an early grave. In fact they transport cholesterol, triglycerides, fat-soluble vitamins, and antioxidants. Unlike Amazon Prime there is no monthly fee for these deliveries. Perhaps you have not heard this term however most are familiar with a standard lipid panel. It is measuring the amount of cholesterol stored on the boats. HDL cholesterol, triglycerides and LDL cholesterol concentration.

Good & Bad Cholesterol

So are there good and bad cholesterol? The sooner we move away from this logic the better. It’s misleading and distracts from the primary driver.

The 2 key factors that play a role in atherosclerosis are the number of LDL particles and the oxidation of the LDL particle. If you wan tot better understand the mechanism of atherosclerosis aka “arterial plaque” go ahead and google the response-to retention hypothesis.

Let’s give a shout out to cholesterol for all it does for us:

  • Makes up 50 % of the cell membrane

  • LDL cholesterol plays an important role in our immune system

  • It’s the precursor for all sex hormones

  • It’s important for intestinal wall integrity.

  • It makes up 20 % of the myelin sheath the wraps around our nerves.

  • Cholesterol helps to prevent oxidative damage

We’ve all experienced a certain air of seriousness when someone reluctantly shares a high cholesterol score. But is there reason for concern? Did you know that there is a direct correlation with low cholesterol levels and higher death rates? Just look at the results from 3 of the largest studies: The Framingham Heart study, Honolulu Heart Program and the Japanese Lipid intervention Trial. (In total a sample size over 70,000 people) 

So far we’ve established that Cholesterol is not the enemy, but more of a misunderstood patsy.  The risk lies with the LDL-particle number and Oxidized LDL.  Unfortunately we have been fed a mistruth that eating saturated fat and cholesterol are to blame. It’ s not as blatantly fabricated as a stork delivery system for our infants, but many scientists have worked hard to find a better explanation. During the genesis of the diet-heart hypothesis theory there were many scientists that were more suspicious of excess sugar and carbohydrate consumption. However their hypotheses/argument were strategically suppressed.  I would suggest that you read The Big Fat surprise by Nina Teicholz.  You can thank me later.

 For most people eating saturated fat and cholesterol does not raise serum cholesterol levels in the blood. Some people (1 in 4) have been coined hyper responders and may experience an increase in blood cholesterol when they eat saturated fat and cholesterol in the diet. Moreover the majority of research suggests that dietary consumption of cholesterol and fat does not increase the risk of heart disease even in the minority that experience a increase in blood cholesterol levels.

 The bottom line: it’s really difficult to find a large and well-designed study that can demonstrate a direct association between dietary cholesterol and heart disease.

 What’s more interesting is the research looking at different macronutrient protocols. A recent review of clinical trials examining the affect of low-carb and high saturated fat diets found significant decreases in several cardiovascular risk factors:

 < in triglycerides

< fasting blood glucose

<blood pressure


<plasma insulin

<C-reactive protein

<abdominal circumference

In the next segment/video we’ll talk more about factors driving heart disease, LDL particle number and Oxidized LDL.