The Truth About Cholesterol

0:00Sunna Van Kampen:Welcome to Catching Up With The Royals, a brand new show with me, Richard Coles. And me, Emily Andrews. Every week we'll be going beyond the headlines, lifting the lid on what life is really like behind the palace walls. Hello sir, good morning. I'm the Sun's new royal correspondent. Oh, he said, look at me up and down. Things are looking up. We'll be diving into the moments everyone's talking about. What does the world owe you if all of a sudden you've handed back your crown? Meghan and Harry can't keep hold of their stuff. We'll reveal the secrets of an organisation usually shrouded in mystery and explore defining moments of royal history to see how the past still shapes the monarchy today.

0:38Now, you actually knew Princess Anne.

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1:47Welcome back to The Unprocessed Truth. And today we're going to be talking about something that's been drilled into our heads for decades. Cholesterol. Cholesterol has been painted as the villain behind heart disease, and doctors told us to lower it at all costs. So supermarkets lined the shelves with cholesterol-free labels and low-fat options. Now, I'm not here to give you all the answers, but I'm here to ask some questions that need further investigation so that we can open our mind to the fact that cholesterol might not be the villain we once thought it was. because the science behind this is shifting.

2:27Cholesterol, it turns out, is an all-important health marker, but may not be on its own the single thing that causes heart disease. In fact, looking at cholesterol in isolation is part of the problem because it actually on its own tells us surprisingly little about someone's actual risk of heart disease. So we're going to dig into cholesterol and why it matters and why it doesn't tell the full story. We'll look at stuff like the French paradox, the longevity secrets of the blue zone, and the history of how cholesterol became demonized in the first place, and some of the latest thinking on metabolic health.

3:11Now, the cholesterol story we were told. For decades, the message was simple. High cholesterol equals clogged arteries, heart attacks, and early deaths. This was based on research from the mid 20th century, much of it led by a scientist named Ansel Keyes. Keyes put forward what became known as the diet heart hypothesis, the idea that dietary fat, in particular saturated fat, raises cholesterol and the cholesterol clogs arteries and causes heart disease. To support this, he published the famous seven countries study, which appeared to show a strong link between fat consumption and heart disease rates.

3:52But here's the controversy. Keyes originally had data from 22 countries. When you include all of them, the connection between fat and heart disease becomes much weaker, and in some cases non-existent. Critics argue he selectively presented the data that fit his theory and omitted the rest. Despite this, his work became hugely influential, shaping dietary guidelines for decades and fueling the low fat craze of the 1980s and 90s. So let's get into the French as one of the countries that were admitted, and this is now known as the French paradox. It's one of the most famous challenges to Ansel Keys' ideas.

4:37The French diet is rich in saturated fat, cheese, butter, cream, red wine, and yet France has one of the lowest heart disease rates in the developed world. If cholesterol and saturated fat were the whole story, the French should have had some of the worst outcomes, not the best. So the question is, are there other cultural factors like slower eating, liking to take walks, strong social connections that matter far more? This is work that still needs to be studied. Now, let's fast forward to the blue zones, the region of the world where people live the longest with the healthiest lives. Okinawa in Japan, Sardinia in Italy, and Nicoya in Costa Rica are some of these famous places.

5:28Now, the surprising bit is that many people in these communities have cholesterol levels that would be considered high by Western standards, and yet, again, they experience some of the lowest rates of heart disease and live well into their 90s and 100s. What they share is not perfect cholesterol, but rather holistic metabolic health. They eat minimally processed foods, they move their bodies all day, and they maintain social ties and manage stress. Their longevity is about the whole system, not one particular marker. So let's get into the nuance of cholesterol because I'm sure you'll all have heard of HDL, LDL and triglycerides.

6:16Now, not all cholesterol is the same. HDL cholesterol is often called the good cholesterol. it's the recycling system it helps carry cholesterol away from the arteries and back to the liver where it can be processed and removed higher HDL levels are generally protective now LDL cholesterol is often labeled as the bad cholesterol but that's a bit oversimplified LDL carries cholesterol to tissues which is normal and necessary the problem arises when LDL particles become oxidized or when there are too many small dense LDL particles which are more likely to lodge in artery walls and contribute to plaque buildup.

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8:12Large fluffy LDL particles are considered less risky. Triglycerides are another important marker, essentially a measure of fat in the blood, which combined with low HDL can be a much stronger predictor of heart disease risk than total cholesterol alone. This is why simply saying a high cholesterol equals bad totally misses the point. The type of cholesterol has to be considered and the context of metabolic health and whether there's actual plaque in the arteries matter far more than a blanket cholesterol number. So let's look at metabolic health then. So if cholesterol alone doesn't predict health outcomes very well, what should we be paying attention to.

9:00Now metabolic health is quite a broad phrase. That could include stable blood sugar and good insulin sensitivity, high blood pressure, a waistline or good fat distribution, so not being overweight, and low inflammation markers. Research has shown that people with high cholesterol but good metabolic health often have better outcomes than people with normal cholesterol and poor metabolic health. So it's about context. Now, let's be fair to the doctors here. From a doctor's perspective, cholesterol testing is still widely used and for a good reason. It's simple, it's an inexpensive test that's easy to measure, and it can act as an early red flag for potential cardiovascular issues.

9:53Doctors don't ignore metabolic health, but cholesterol is a convenient starting point, especially when you're screening large populations quickly. So while cholesterol might not be the whole story, it's still a useful tool in our medical toolkit. The issue is when people view it as the only story and the only marker they understand and latch onto and focus on. So I want to be clear here. I'm not a doctor. I'm not saying this should be taken as medical advice. If you have concerns about your cholesterols, please speak to a qualified health professional. If you're worried, one of the best ways to get a clearer picture of your artery calcification is to do something privately called a coronary artery calcification scan, which can actually show you if there's plaque building up in your arteries.

10:46This is a far better way to predict heart disease than a cholesterol number measured from the blood. So there is so much to understand here and nuance to unpack. I could have done a two-hour episode on cholesterol and we could go far deeper, which we may well do in the future with a doctor and a nutritionist. But some key takeaways for you here. Don't obsess over cholesterol alone. look at the nuance of your metabolic health blood sugar blood pressure blood body composition and inflammation make sure you look at the details HDL LDL particle size and triglyceride add nuance to this story your lifestyle is fundamental here you need whole foods you need daily movement you need good sleep and stress management to improve your health outcomes no matter your cholesterol number and learn from the French.

11:41Eating slowly, focus on quality and living a less stressed life is really important. And the blue zones as well, obviously are one of the world-renowned examples where actually if you want to live long and healthy, it's all about movement. But one of the most underrated things is social connection, community, and of course, eating minimally processed foods. So essentially, I want you to do your own research, stay curious, stay learning, stay skeptical, and always double check things and go deeper. Because in the world of AI and chat GPT, it's so easy to take the first answer that's given to us.

12:24But the reality is, this stuff is oversimplified. We need to go deeper. Our body is a system of interconnected processes and organs and measuring one biomarker is not going to tell you anything about your health. So my view is that cholesterol is not the villain we once thought it was, but it's also not irrelevant and the story is very nuanced. A simple number cannot define our health. We need to focus on the bigger picture of metabolic health, lifestyle and habits that keep our body healthy and in balance. So thank you for tuning in. If you found this perspective helpful, please share it with a friend who's stressing about their cholesterol.

13:10And remember that health isn't about that number. It's about how it all fits together and take a proactive step today, tomorrow, the next day, so that you can be that little bit healthier. Thank you for listening.

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