Cholesterol - Part 2
Controversial Topics
There’s A LOT of controversy surrounding cholesterol, and in this section we’re going to tackle a few doozies. Let’s start with the dooziest (not really a word, but fits :).
Statin Drugs
Normally, I stay out of discussions about prescription drugs because this should be a conversation between you and your doctor. But, I make a small exception with statin drugs. The decision to take them is always between you and your doctor, but I find that they’re so often prescribed that many aren’t told about the possible side effects and long-term ramifications when taking them. That’s the purpose of this section, I want you to fully understand how these drugs impact your body, both good and bad.
CoQ10 Deficiencies and Statin Drugs
One concern is the impact of statin drugs on Coenzyme Q10 (CoQ10) levels in our bodies. You might be wondering, "What's the fuss about CoQ10?" Well, CoQ10 is an incredible antioxidant and enzyme that plays a crucial role in energy production within our cells. Unfortunately, statins have been found to interfere with the natural production of CoQ10, potentially leading to deficiencies.
Why does this matter? Well, when our CoQ10 are important for muscular function (and your heart is a muscle). When levels take a dip, it can manifest as fatigue, muscle weakness, and even cognitive difficulties (many of the side effects of statins).
CoQ10 is so important to the body its technical name is “ubiquinol”, steaming from the root “ubiquitous”. Be sure to talk to your practitioner about supplementing with CoQ10 if you’re considering a statin drug. Natural sources of CoQ10 are oily fish, organ meats, and nutritious legumes, but it can be hard to get enough through your diet because statins interfere with CoQ10. More on how to supplement in Part 3.
Statins and the Risk of Diabetes
This is an important issue when considering a statin drugs—diabetes. While ongoing research is exploring the relationship between statin use and the risk of developing diabetes, some studies suggest a potential connection, especially among certain age groups and individuals with pre-existing risk factors.
Menopause already sets the stage for more insulin resistance and a higher risk of Type II Diabetes, but so can statin drugs.
Several studies have explored the relationship between statin use and the risk of type 2 diabetes, with varying results. Here are a few notable studies:
Women's Health Initiative (WHI) Study (Culver et al., 2012):
This large-scale study analyzed data from over 150,000 postmenopausal women.
The researchers found a slightly increased risk of developing diabetes among women taking statins compared to those not taking statins.
However, the increased risk was primarily observed in women with other risk factors for diabetes, such as obesity and elevated fasting blood glucose levels.
Meta-analysis by Sattar et al. (2010):
This meta-analysis pooled data from 13 randomized controlled trials involving approximately 91,000 participants, both men and women.
The analysis found a modest increase in the risk of developing diabetes among statin users, but the absolute risk was relatively low.
The increase in diabetes risk was primarily observed in individuals with one or more risk factors for diabetes, such as higher fasting blood glucose levels or a higher body mass index (BMI).
Statin drugs stop your body from using insulin properly and may double your risk of being diagnosed with Type II Diabetes (https://tinyurl.com/2ptypzfm). I highly recommend checking your HgbA1c and fasting glucose on a yearly basis if you’re taking a statin drug (more on these tests in our Blood Sugar/Insulin Resistance masterclass)
Can I eat eggs and other sources of dietary cholesterol?
Short answer: Abso-f*cking-lutely!
Okay, I rarely swear (well, I rarely swear in my writing…in personal conversations? That’s another story) but the propaganda around dietary cholesterol drives me BANANAS!
About 10 years ago the media was filled with the headline “KFC’s Double Down is healthier than an egg!”. KFC’s double down was a horrendous low-carb version of a chicken sandwich. It was bacon and plasticky cheese sandwiched between two pieces of fried chicken. I don’t think it stuck around very long.
I’m sure their PR team was trying to get ahead of the critics calling out the inflammatory aspects of this sandwich (hello processed meat, plastic cheese, and fried chicken), so they looked at one nutrient in this sandwich – the cholesterol – and found it to be lower than what’s found in an egg. That created the headline that it’s “healthier than an egg”.
This headline boiled my blood and triggered one of my first ranting blogs (you can read it here: https://lisakilgour.com/articles/2010/11/kfc-double-down-healthier-than-an-egg-what)
Here’s the thing – 85% of the cholesterol in your body is made by your liver. Dietary cholesterol is actually ESSENTIAL for your body to function properly. Remember from Part 1, cholesterol is needed to absorb Vitamin D and to make hormones. The cholesterol in an egg is a requirement for your body, along with all of the choline and other fantastic nutrients you’ll find in an egg yolk.
Research has found that eggs actually lower LDL and raise HDL cholesterol in the body, making them a great addition if you’re looking to balance out your cholesterol levels.
But that KFC double down…well it’s chockfull of transfat which DEFINITELY causes a rise in cholesterol levels.
So…in a nutshell, don’t worry about dietary cholesterol, especially when it’s found in healthy whole foods like eggs. And, ignore the headlines…there’s a lot of spin campaigns by food manufacturers found in there.
Are saturated fats a problem?
Way back in the 1970s and ‘80s, fat was demonized…especially saturated fat. Butter was replaced by margarine in kitchens everywhere, because it was “heart healthy”.
…except, it wasn’t.
Much of the research that shows that saturated fat is bad for you is from this time, but the research is a tad problematic. Instead of just studying saturated fat on its own, researchers often added transfat to the mix since they were chemically similar. Actually, transfat was seen as HEALTHIER than saturated fat back in those days, because it starts out as a polyunsaturated fat, which is why margarine was seen as the better alternative.
But, the industrial process of creating a transfat may make something that looks similar to a saturated fat, but your body doesn’t agree. Transfats are very inflammatory, partially because they’re a very rigid fat that can damage arteries and cells. Natural saturated fats are much more bendy and don’t cause the same kind of damage.
More recent research looking at saturated fat often uses lard, often from animals raised on feedlots and fed an inflammatory diet. Fat quality matters in the body and there’s a world of difference between how the body uses organic butter vs. this type of lard. But, the research doesn’t differentiate this, and just says “saturated fat is bad”.
A few months ago I took a dive into the research behind coconut oil and butter and these types of saturated fat can lower cholesterol and reduce inflammation. (https://www.tiktok.com/@lisakilgournutrition/video/7169365512122600710)
The American Heart Association is still saying that saturated fat isn’t heart healthy…but they don’t substantiate these claims. I can’t find a single study done in the last 20 years that shows that saturated fat is a problem. Even their website doesn’t quote the research they’re using to make that claim.
So, here’s the research I’m using to say – don’t worry about whole food saturated fats like butter and coconut oil.
Meta analysis using 347,000 people found no connection between saturated fat intake and cardiovascular disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824152/
18 country study found no correlation between fat intake and cardiovascular risk. Higher saturated fat intake was found to be connected to a lower risk of stroke: https://www.thelancet.com/article/S0140-6736(17)32252-3/fulltext
And, this is a great Healthline article that looks at 5 studies on saturated fat: https://www.healthline.com/nutrition/5-studies-on-saturated-fat
So, use butter if you like it. Use coconut oil if you like it. Or don’t…but don’t be worried about it causing a problem for your heart.
Is there a controversial topic I’ve missed? Let me know and I’ll add it :)
Got any questions or comments? Comment below, jump to our private Facebook Group, or the Ask Lisa page :).