What’s your number? Have you ever been asked this in reference to the amount of cholesterol in your bloodstream? Nearly everyone has. I believe that cholesterol has received more publicity over the past decade than any other substance known.

Foods such as eggs and shrimp that contain significant amounts of cholesterol have been condemned as “bad” and foods that are high in refined sugar and saturated fat often proudly proclaim “cholesterol free!” as though that is the only nutritional question that matters. Ironically, no detrimental effect on circulation has ever been demonstrated to occur when eggs or shrimp are eaten, while foods high in saturated fat and refined sugar, even when “cholesterol free” can accelerate the atherosclerotic (artery hardening) process.

More alarming to me is the increasing pressure being placed upon older individuals with normal cholesterol levels and younger individuals with “high” cholesterol levels to take cholesterol lowering drugs. Two common misconceptions are driving this phenomenon.

The first is the widely accepted idea that there is a direct relationship between an individual’s cholesterol level and death from all causes and that the lower the cholesterol level, the better. The second is the notion that the only means an individual has to lower his or her risk of heart attack or stroke is to lower the cholesterol level.

I hope that by the time you finish reading this issue you will have a better understanding of what role cholesterol plays in your overall health, what controversies exist regarding the use of cholesterol lowering medications, and what alternatives are available in your attempt to limit the development of atherosclerosis in your body and subsequently prevent such complications as a heart attack or stroke.

Far from being a deadly substance, cholesterol is essential to health. It is used to manufacture cell membranes throughout the body and it is needed to produce our hormones. It is essential to brain development in children and is required by adults to manufacture chemicals necessary for proper function of the brain & other parts of the nervous system.

What’s your number? Is it 110, 160, 200, 230, 280, 320 or another figure? Does it really matter and should you really care? It is true that some general trends can be observed. As the level rises from the range of 140 or 150 a progressively higher percentage of individuals will suffer a stroke or heart attack.

Your number says very little about your personal situation, however. As many people have heart attacks with cholesterols less than 200 as those with cholesterols over 300. A man in attendance a one of my Personal & Family Health Seminars in July related that he had already suffered two heart attacks despite having a cholesterol level consistently under 180.

Conversely, as the cholesterol level drops there is a general trend toward the development of other diseases. Researchers at the University of Minnesota identified 350,997 healthy men and followed them for a period of 12 years. They found that those with the lowest cholesterol levels had twice the risk of dying of cerebral hemorrhage (bleeding into the brain), five times the risk of dying from alcoholism, three times the risk of dying from liver cancer and twice the risk of committing suicide.

This is easily understood when we consider that low levels of brain chemicals such as seratonin, which is derived from cholesterol, lead to depression, which in turn causes people to turn to alcohol or to commit suicide.

When someone tells me, “My cholesterol level is ___,” I really know very little. I don’t know if he or she is at increased risk for having a heart attack or stroke or not. More information is required to sort this out.

To better assess risk, subsets of cholesterol and fats should be checked. These would include HDL, LDL , triglycerides and often VLDL. HDL stands for “high density lipoprotein” -- cholesterol complexes that are tightly packed. This is sometimes referred to as the “good” cholesterol because, as a general rule, the higher the level of HDL the lower the risk of heart attack or stroke. LDL stands for “low-density lipoprotein” -- less densely packed cholesterol complexes. This is sometimes mistakenly referred to as “bad” cholesterol. Triglycerides are blood fats which are combined with cholesterol and protein to form VLDL “very low density lipoprotein”. Triglyceride levels tend to rise as HDL falls and fall as HDL rises. They, in themselves, do not correlate strongly with atherosclerosis.

A better question than “What’s your number?” is, “What’s your ratio?”, the amount of total cholesterol or LDL cholesterol compared to the amount of HDL cholesterol in the bloodstream. In general, the higher your ratio of total or LDL cholesterol to HDL cholesterol the greater your risk of suffering a heart attack or stroke.

The most important question, however, is almost never asked. The most important question is, “How much of your LDL cholesterol is oxidized?” The reason this question is so important is that LDL cholesterol in its natural state is harmless. Only when it is attacked by an unbalanced molecule called a free radical and “oxidized” does the body view it as a substance to be removed from circulation. When a white blood cell called a macrophage spots oxidized LDL it pulls it out of circulation and into the wall of an artery forming what is called a “foam cell”, the first stage of an atherosclerotic plaque.

The reason this question is rarely asked is that there is no commercially available blood test for “oxidized LDL” cholesterol. Such a test is really unnecessary. It has been demonstrated that taking vitamin E, at a level of 400 IU daily, is sufficient to keep nearly all of the LDL cholesterol in its natural, unoxidized form.

Knowing this, researchers at Cambridge University gave a group of heart attack survivors 400 IU of vitamin E daily. They compared their progress with a group of heart attack survivors who were not given vitamin E. After a year there were 50 % fewer heart attacks in the vitamin E group than in the control group, and when one looked at the number of second non-fatal heart attacks (suggesting that the level of disease entering the study was milder) the results were even more impressive. The vitamin E group had 77% fewer non-fatal heart attacks than the non-vitamin E group.

Other substances are capable of providing antioxidant protection. Plant chemicals, including those in green tea, also work well. Rabbits are meant to be vegetarians. They do well as long as they stick to their normal diet, but develop severe atherosclerosis very quickly when fed a diet high in saturated fat & cholesterol. It was recently reported that giving rabbits green tea along with the bad diet was highly effective in preventing the expected atherosclerosis.

If you are wanting to know your personal risk of having a stroke or heart attack you must ask not just one, but three questions about cholesterol. They are, “What’s my number?”, “What’s my ratio?”, and “How much of my LDL cholesterol is oxidized?” The first two questions can be answered by a simple blood test. The last, and most critical, can only be answered by asking yourself, “Am I taking adequate amounts of antioxidant vitamins, minerals, and phytochemicals?”

Total cholesterol, HDL and LDL levels are controlled to a great deal by genetic factors over which you have no control. Therefore your answer to the first two questions may be disheartening. Don’t become discouraged! I have great news for you! You have complete control over the answer to the critical question, “How much of my LDL is oxidized.” If you are taking 400 IU of vitamin E daily and including phytochemicals such as those found in green tea as part of your overall regimen you can confidently answer, “My cholesterol is beautiful! The good is good and the potentially bad is remaining in its natural form.”