If Cholesterol Isn’t Causing Heart Disease, What Is?

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By now, you’ve likely heard that cholesterol has been getting a bad rap. And it’s true; as the link between cholesterol and heart disease has been scrutinized, some serious questions have been raised. One Finnish study of more than 1,000 subjects even found there wasn’t a link between cholesterol and heart disease they could find, even among individuals predisposed to heart conditions. But if it’s not cholesterol causing heart attacks, what is?

In theory, this is how it was supposed to work. You eat too much cholesterol, specifically low-density lipoproteins or LDL, and it’s absorbed into your arterial walls. White blood cells go into your artery walls and if they over eat, they get stuck and die there. When they die, they burst, so that LDL, and any other LDL you’ve absorbed into the wall, attracts more white blood cells. So they collect, over time, into arterial plaques on the walls of your arteries. Eventually these plaques break off and completely block blood flow to some part of the body, causing a heart attack or stroke. But the first step in that process is now under question.

You’re not off the hook if you’ve got a history of heart disease or stroke. One aspect that nobody is questioning is that if you cut the fatty foods, you’re better off in terms of heart disease, so buy that vegetarian cookbook and start eating out of it. Still, this was widely assumed to be the smoking gun, and the fact that dietary cholesterol is increasingly looking innocent raises a few questions.

The most basic is, if it’s not dietary cholesterol, what is causing atherosclerosis? Some blame rancid fats, as Americans are becoming more likely to eat them due to spoiling food and unregulated supplements. Others believe it’s pollution or environmental factors, or a genetic factor we haven’t found yet tied to the immune system.

Secondly, why is it tied so closely to diet? Nobody’s questioning the value of cutting out the fats if you’ve got a risk of heart disease. Is your body producing too much cholesterol in the first place, and the extra LDL is aggravating it? Is it some other risk factor? We just don’t know.

All that said, eat more salads and enjoy steaks in moderation, especially if you’re at risk for heart disease. And keep an eye on the research, as well. This might open a new and fascinating field of research as we figure out just what heart disease really is.

(via Vice)

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