LDL so-called “bad” cholesterol — neither cholesterol nor so bad

The body’s cells need a constant supply of cholesterol to function properly.

Because fat molecules, such as cholesterol and triglycerides, are insoluble in water, these lipids must be transported together with proteins (where the name ‘lipoproteins’ comes from) in the bloodstream.

Lipoproteins are complex particles with a central core containing mainly cholesterol and triglycerides surrounded by free cholesterol, phospholipids, and apolipoproteins facilitating the transport of fat molecules around the body. LDL stands for low-density lipoproteins and is one of the seven groups of lipoprotein.

The cholesterol in your blood comes from two sources: the foods you eat and your liver. When fats are ingested the cholesterol, plant sterols, fatty acids, and fat-soluble vitamins are transported into the tissues directly. However, between meals, cholesterol needs to be transported from the liver to the peripheral tissues so that they can function optimally (e.g., produce hormones, maintain integrity, repair cells, etc.). And the LDL metabolism is a key part of this pathway.

So, LDL particles are not bad, they are actually vital for proper health and vitality. But sometimes they might cause trouble.

When?

What matters the most in the atherosclerosis process is the size and the number of LDL particles, not the cholesterol within them.

There are 4 main subgroups of LDL particles: large, intermediate, small, and very small. Small, dense LDL particles are associated with a three times higher risk of CVD compared to large particles. This is because they have the ability to penetrate the artery wall much more easily than large LDL particles. It’s like throwing different-sized balls through a tennis net: a golf ball will be able to get through, while a tennis ball or a larger ball will not.

Plus, when smaller and denser LDL particles penetrate the artery wall, they are predisposed to oxidise more quickly, stimulating more inflammatory processes and calcification. And the more small balls you have in the bloodstream the more likely it is that more of them will get through.

Another significant process (alongside oxidation) when our beneficial LDL becomes damaged and starts creating problems in artery walls is glycation. If we constantly have too much sugar in our bloodstream, sugar molecules stick to the proteins and create damaging and toxic molecules called advanced glycation end products. Glycated LDL contributes to inflammation and ultimately to heart disease.

Cholesterol in itself is neither good nor bad; it is essential. It is carried by different lipoprotein particles and those particles in various circumstances might promote either health or disease. It is the various lipoprotein molecules, which carry cholesterol, that determine the level of risk or protection against CVD, not the cholesterol within them.

Problems only arise when these lipoprotein molecules penetrate the wall and the cholesterol in them becomes modified, starting inflammatory processes and calcification, which ultimately leads to the formation of atherosclerotic plaques.

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* DISCLAIMER: The content of this article is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or other qualified health care provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in any media published by myself.