Not All Cholesterol is Bad: Uncovering the Bigger Picture for Heart Health

October 25, 2024

Our bodies are usually good at letting us know when something is wrong. Feeling lightheaded? It might be low blood sugar. Having trouble sleeping? It could be stress or too much coffee. Cholesterol is different. If it’s too high, your first warning sign could be a heart attack. By then it’s too late. 

So how do you know if you have high cholesterol? And what steps can you take to lower cholesterol? Perhaps even more importantly – do you know that it’s not just about your cholesterol levels? The type of cholesterol also matters. Instead of anxiously waiting for reduced blood flow or blockages while your heart attack risk steadily increases, it’s time to get ahead of the problem. That means evaluating the underlying disease and treating it with precision. Here’s how to do it. 

All About Cholesterol 

Although we often hear nothing but negativity when it comes to cholesterol, this waxy, fat-like substance is not only extremely beneficial, it’s actually vital for a healthy, well-functioning body. Vitamin D from our diet and sunlight contributes to healthy bones and our overall well being but it couldn’t be utilized without cholesterol. Steroid hormones and sex hormones are also derived from cholesterol, as are glucocorticoids and mineralocorticoids. Within the placenta, ovaries, testes, and adrenal cortex (which is responsible for cortisol, aldosterone, and androgens), cholesterol is first converted to pregnenolone; following oxidation it becomes progesterone, an essential hormone.  

The problem is that cholesterol doesn’t dissolve in liquids. This means that as a fat soluble substance, cholesterol needs help to be transported through the bloodstream. This is accomplished by lipoproteins –  mainly low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Many call LDL cholesterol the “bad cholesterol” while HDL cholesterol is commonly called the “good cholesterol.” This is because when large amounts of LDL cholesterol traverse the bloodstream, they leave behind fatty deposits. These deposits form plaque which can build up in the blood vessels and lead to heart conditions like arteriosclerosis.

So although LDL is usually associated with blockages, HDL actually picks up cholesterol from around your body and then transports it to your liver where the organ removes it. Without a lipid panel test it’s almost impossible to know your cholesterol levels – especially your LDL cholesterol levels. The good news is that getting the test is simple – you don’t even need to leave your house. The first step is visiting Kyla online and taking an easy health quiz. This will help identify areas where you can improve your health. The quiz will also help you find the best at-home test for you. 

The challenge with just looking at cholesterol levels, is that high cholesterol alone doesn’t always indicate elevated heart attack risk. That’s why Kyla has begun offering the Cleerly test, a non-invasive heart test for individuals. California residents can order the test after downloading the Kyla app and speaking with one of our doctors. Residents of other states will need to speak with their own physician. Designed by Cleerly, a digital healthcare company, the test is a clinically-proven, AI-based digital care platform. It works with coronary computed tomography angiography (CCTA) imaging to help clinicians precisely identify the level of plaque build-up in a patient’s arteries. 

Using an X-ray which takes one-dimensional pictures of the heart and then combines them into a three-dimensional image, CCTA is able to look at how blood flows through the patient’s body while highlighting any blockages or other abnormalities in the arteries by use of a nontoxic dye. The test can identify personalized risk factors for heart disease along with more comprehensive insights through advanced testing.

Once you’ve ordered your blood test kit, you’ll receive it in two-to-four days along with easy-to-follow instructions for sample collection. After collecting a blood sample, return it to our labs postage free. The results will deliver insights into whether or not you have high cholesterol. Plus, you’ll have an opportunity to speak with a Kyla doctor who can offer personalized advice about the steps you can take to lower cholesterol. 

After downloading the Kyla App, and enrolling in high cholesterol treatment with Kyla’s Dedicated Health Program, you’ll be able to consistently track your progress. By using nutrition and lifestyle enhancements while setting goals and taking action every day to help achieve them, you will be able to empower your health journey. You can stay ahead of chronic conditions like those caused by high cholesterol. Leveraging home blood tests and AI-generated actionable next steps, will put you on a path toward lengthening your healthspan. Healthspan is the number of healthy years you’ll enjoy. By downloading the Kyla App, you’ll be able to extend them!

High Cholesterol Causes

If you’re concerned about high cholesterol, you may wonder what are some causes of this build up? Having higher than normal cholesterol levels increases your risk for heart disease. So does dyslipidemia, which is when there are excessive amounts of lipids in your bloodstream. Other conditions like hypertension or diabetes along with excess belly fat also raise your heart disease risk – this is increased exponentially if you also have high cholesterol levels. 

Although most vitamins and nutrients must be consumed, your body already produces all of the cholesterol it needs. That’s why high cholesterol is so closely linked to the consumption of trans or saturated fats. An important part of any low cholesterol diet is avoiding or reducing consumption of red meat – especially the more fatty cuts. Full-fat dairy products are another group of high cholesterol foods to avoid. Simply switching to low or nonfat dairy can make a huge difference in any low cholesterol diet. Store-bought treats including cakes, cookies, and other sweets are often higher in trans fats than the homemade variety.  So, if you must have a sweet dessert, make it yourself. 

Avoiding foods with added salt or sugar is a good strategy. So is selecting foods that can actually increase HDL cholesterol. These are foods that are loaded with unsaturated fats like nuts and avocados along with vegetable oils like canola or olive. High-fiber foods like black beans and oatmeal can also prevent increases in your LDL cholesterol levels while increasing your good, HDL cholesterol. 

Body weight is a primary indicator of whether or not someone will have normal cholesterol levels. Unfortunately, the percentage of Americans who are overweight keeps growing. The Body Mass Index (BMI) uses height and weight to determine whether or not someone is a healthy weight. BMIs over 25 are considered overweight while an obese BMI is over 30. 

According to the CDC, 75% of Americans are overweight with 40% of them having an obese BMI. Many people try to ignore these numbers – half of people who are over 25 on the BMI index believe they are at a healthy weight. Yet anyone who doubts the BMI index should have their cholesterol levels checked. That’s because carrying excess fat or having a BMI over 25 alters the way your body processes and utilizes cholesterol. It also hampers removal of LDL cholesterol from the bloodstream. When LDL cholesterol levels rise it also makes heart disease more likely. 

Equally important, physical activity is one of the best ways to lower LDL cholesterol. Repetitive, aerobic exercise can increase HDL cholesterol in the bloodstream which has the effect of reducing LDL cholesterol levels. “Exercise is a great place to start if you’re trying to lower bad cholesterol,” cardiologist Leslie Cho, MD. explained to the Cleveland Clinic. “But it doesn’t stop there. Combining exercise with a healthier diet and lifestyle choices makes the most impact.”

Other lifestyle choices that can help you achieve normal cholesterol levels include reducing alcohol consumption (which can increase your cholesterol level) and quitting smoking (tobacco can actually reduce levels of HDL cholesterol). People who are over the age of 40 also have an elevated risk. This is because the older we become, the less efficient the liver becomes at removing LDL cholesterol. Certain medications including ones to treat acne and hypertension can increase your cholesterol levels as can a number of medical conditions including hypertension, diabetes, and lupus. Genetics can play a role especially with the inherited disorder familial hypercholesterolemia (FH) which affects the body’s ability to remove low-density lipoprotein. 

If you have any of these risk factors, a lipid panel test is an excellent starting point. However, the Cleerly test may be a better tool to help your doctor determine your risk for a heart attack. 

A Better Way

Rather than relying on symptoms, the Cleerly test looks at the issue. In research examining 1300 patients, the combination of AI and a 3D body scanner that was originally used to design clothing was better at identifying the risk of cardiovascular disease than looking at a BMI index. 

The Cleery test also helps patients by ranking the progression of the plaque build up in the arteries. Heart disease is America’s number one killer. So why is its progression not marked in stages? There are stages of cancer – depending on how far the cancer has spread and where it is, the disease is ranked from Stage One to Stage Four. This is helpful for treatment plans and evaluating a patient’s overall health. Many other chronic conditions also have stages, or degrees of severity, including asthma, diabetes, and even high blood pressure. Yet the degree of plaque build up in the arteries hasn’t been ranked. Until now. 

Almost 20 million people in the U.S. have some form of heart disease. The disease is usually caused by lipids or fats including cholesterol and triglycerides, which can form arterial plaque. If this plaque build up is ignored, it can lead to heart attacks and strokes. 

Unfortunately, focusing solely on LDL cholesterol levels might not give the full picture. That’s because high cholesterol levels can sometimes be misleading in assessing heart health risks. Recently, a paper presented by Dr. James Min outlined an atherosclerosis staging system. This four-stage system creates levels relating to the seriousness of atherosclerotic plaque, the precursor to coronary artery disease (CAD). Each stage is based upon how much plaque resides in the arteries or total plaque volume. This is ranked from no plaque at all (normal), to mild, moderate, or severe.  

By incorporating AI-driven body scans and the staging system, cardiology can move past the last half-century when the specialty has really been “sickcare,” with a focus on symptoms of heart disease rather than the disease itself, atherosclerosis. Over 10 years of clinical trial data have revealed that it’s the type of atherosclerotic plaque buildup that matters most. Instead of waiting for reduced blood flow or blockages, it’s time to get ahead of the problem, evaluate the underlying disease, and treat it with precision. That’s why the first step toward better health is downloading the Kyla app, scheduling an appointment and completing the most important test you may ever take!

Sources:

  1. Min.,  James K. Min, MD, FACC, FESC, MSCCT. “New Staging System for Coronary Artery Disease,” Cleerly Health. https://cleerlyhealth.com/blog/new-staging-system-for-coronary-artery-disease
  2. Min, James K. Min, MD, FACC, FESC, MSCC. “Coronary CTA plaque volume severity stages according to invasive coronary angiography and FFR,” Journal of Cardiovascular Computed Topography. September-October 2022. https://www.journalofcardiovascularct.com/article/S1934-5925(22)00038-7/fulltext#secsectitle0010
  3. “How Do You Know If You Have High Cholesterol?” Complete Care. September 9, 2021. https://www.visitcompletecare.com/blog/how-do-you-know-if-you-have-high-cholesterol/
  4. Yarrarapu, Craig M., SNS, “Biochemistry, Cholesterol.Treasure Island (FL): StatPearls Publishing; 2024. https://www.ncbi.nlm.nih.gov/books/NBK513326/\
  5. “Lipid Panel,” John Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lipid-panel
  6. Pappan N, Awosika AO, Rehman A. Dyslipidemia. Treasure Island (FL): StatPearls Publishing; 2024. https://www.ncbi.nlm.nih.gov/books/NBK560891/
  7. “Preventing High Cholesterol: Key Points,” CDC. https://www.cdc.gov/cholesterol/prevention/index.html
  8. “Calculate Your Body Mass Index,” National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
  9. “Adult Obesity Facts,” CDC. March 14, 2024. https://www.cdc.gov/obesity/php/data-research/adult-obesity-facts.html
  10. “Does Exercise Lower Cholesterol?” Cleveland Clinic. November 3, 2021. https://health.clevelandclinic.org/does-exercise-lower-cholesterol
  11. Martin, Seth Shay. M.D., M.H.S. “What to Do When High Cholesterol Runs in Your Family,” John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/high-cholesterol/what-to-do-when-high-cholesterol-runs-in-your-family
  12.  Walter, Michael. “Better than BMI? 3D body scanner uses AI to measure metabolic health,”Cardiovascular Business. August 23, 2024. https://cardiovascularbusiness.com/topics/artificial-intelligence/better-bmi-3d-body-scanner-uses-ai-measure-metabolic-health
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