Most people need a quick refresher on the cholesterol in food and blood cholesterol. Some cholesterol is necessary to make hormones, vitamin D, bile acids, and the membranes that line your cells. Since a specific amount of cholesterol is needed for good health, the liver manufactures 2 ½ to 5 times as much as we eat. The cholesterol that we eat doesn’t significantly impact blood cholesterol because the body just compensates for what we eat by manufacturing more or less in the liver. Sometimes people ask, “What foods contain the good cholesterol?” There is only one type of cholesterol in food. When someone uses the term “good cholesterol,” they refer to the HDL cholesterol in their blood. “Bad cholesterol” is the term used to describe LDL cholesterol in the blood.
Liver cells make cholesterol, fatty acids, and other lipid compounds. Ultimately, these lipids are packaged with proteins as VLDL and travel throughout the body. As the VLDL journeys throughout the body and is dismantled, cholesterol becomes the predominant lipid, and the VLDL becomes LDL. As LDL accumulates in the arteries, blood flow is restricted, and blood pressure increases.
It is a myth that only VLDL is dangerous; an increase in LDL regardless of the size and density increases the risk of heart disease. If you have high LDL and high HDL, you can’t be too confident that the HDL makes up for the elevated LDL. LDL has a much more substantial impact on heart disease risk. The higher the LDL, the earlier and more likely a person is to experience a heart attack or stroke, regardless of their HDL.
The liver produces HDL to remove cholesterol from the cells and carry it back to the liver for recycling or disposal. This process explains how HDL prevents plaque buildup in the arteries, and why it is referred to as the “good” cholesterol. HDL also has anti-inflammatory properties that prevent arterial plaque from breaking apart and causing heart attacks.