**EP99: All About Cholesterol**
Welcome to Dr. Warwick's podcast channel. Warwick is a practicing cardiologist and author with a passion for improving care by helping patients understand their heart health through education. Warwick believes educated patients get the best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love.
Well, it wasn't too long ago that the talk of cholesterol was everywhere, and it was the thing to be keeping an eye on. But it seems that certain diets have perhaps taken popularity or spotlight at the moment. Of course, it doesn't mean that we should neglect our cholesterol levels.
As cardiologist Dr. Warwick Bishop explains, "It is good to be chatting with you again, Warwick."
"It's good to be chatting with you as well, Tim. Thank you for giving me the opportunity to be on your show."
"You're very welcome. So let's start with the basics. What is cholesterol? Why does our body need it?"
"Cholesterol? Oil is a hydrocarbon. I'm going to use the science term there, but a hydrocarbon is something that's made out of, you guessed it, hydrogen and carbon. These are the basic building blocks of almost any organic matter. Our body uses it for the construction of things around the body, like cell membranes. It also helps us make some hormones within the body, and we use it to help dissolve fats when we're digesting."
"Now, does cholesterol actually travel around the body, or does it get stored somewhere and then pulled out when it's needed? How does that process work?"
"Look, it does both of those. The body makes its own cholesterol, and the body also consumes cholesterol. So we can consume it, and then we have these fantastic particles that package it up from our intestine and ship it around the body to where it's needed. We also have a liver that can produce it and put it in similar clever little particles to package it up and send it around the body. The fascinating thing about these particles that transport cholesterol and other fats around the body is if you think about it, fats float on water, and most of our plasma is water-based."
"Now we often hear about good and bad fats and good and bad cholesterol. Can you explain the difference for us?"
"So good and bad cholesterol is generally linked to these particular particles or transport mechanisms that I was talking about. The good cholesterol is the so-called high-density cholesterol or high-density protein sphere, which can, if you like, collect fat from the periphery, from the tissues, from the arteries, and take it back to the liver. The so-called bad cholesterol is the LDL cholesterol, the low-density one. This can deposit fat or cholesterol into the tissues. So that's where we hear good and bad cholesterol when we're talking about our blood panel results."
"Let's then talk about getting our cholesterol checked. And of course, most of us will have had that done at some stage of our lives. How much does our body actually need? And if we get a reading back, what should it be that indicates we're in a healthy range?"
"This is a really interesting space and probably a question that has created some of the confusion around where cholesterol sits at the moment. The backstory to that is that cholesterol of its own is not a great predictor of who's going to have a heart attack necessarily. Some people will have in their family really high cholesterols, and they may live their whole lives without anyone having heart attacks or strokes. But we may equally see people with really high cholesterols who have terrible arteries, giving rise to heart attack and stroke. The other observation is that sometimes we see people with lowish cholesterol who have heart attacks out of the blue. So there's a lot of confusion there, Tim, where people say, 'Well, what's the right cholesterol for me?' Well, the answer is often more complicated than that, and you need to look at all the factors that could be impacting an individual person."
"I just want to talk about diet for a moment with regards to foods that we should be eating, as in for good cholesterols, and foods that we should avoid, you know, that might give us the bad cholesterol. Can you give us a rough guide as to the good things we can eat and the bad things we should avoid?"
"I think in general terms, our current literature would support that a Mediterranean-style diet is probably the best way to try and approach healthy eating. Greens, some fruit, and really supplementing that with healthy oils. You really consider things like olive oil as healthy oil, but also things like nuts are very beneficial in that dietary mix. What's really important beyond that in terms of diet is a couple of things. First of all, it's really quite hard to alter your cholesterol by diet alone because your cholesterol levels in the body tend to be preset by your genetics. So there remains some uncertainty, and clearly, there are factors occurring beyond just cholesterol alone in these improved dietary approaches."
"Well, my special guest has been cardiologist Dr. Warwick Bishop. Now, Dr. Warwick has been featured in The Great Health Guide, which you can find online at greathealthguide.com.au. You can find more information about Dr. Warwick and these topics online at his website, which is drwarwickbishop.au. Warwick, we'll leave it there for today. Thank you so much for clearing that up for us and giving us that information. We will talk again real soon."
"Thank you."
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