Expert Panel Madness

Added: 2026-05-05

[00:00:00]Today's question, why do we need to manage our cholesterol levels?

[00:00:04]>> We don't.

[00:00:04]>> But this can be confusing because cholesterol is actually essential for life.

[00:00:08]>> They're worried about adding to the confusion.

[00:00:11]So now they're going to add to the confusion.

[00:00:13]>> Yeah. It's a bit like being told your car needs oil to run, but that oil that you put in might also destroy your engine. Come on, people. Let's make it make sense.

[00:00:22]>> I just think it's more complicated than that. That contradiction you mentioned is exactly why this matters so much because cholesterol is in every single cell in our body.

[00:00:30]>> Without it, you die immediately. Build cell membranes. It makes your hormones.

[00:00:34]Helps you digest food. Even creates vitamin D when sunlight hits our skin.

[00:00:39]>> Sounds terrible. It's making all these good things. So, it makes sense, doesn't it, to actually lower it so there's less for the body to do? Well, hang on a minute. I'm confused again.

[00:00:47]>> So, why does it have such a terrible reputation? It's because when you have too much of a specific type of cholesterol floating around your bloodstream, >> well, there's only one. It's called cholesterol.

[00:00:57]>> It starts accumulating inside your artery walls, literally building up layer by layer.

[00:01:01]>> But why does it build up? There must be some root cause they're missing.

[00:01:04]>> And this buildup then eventually is what leads to heart attacks and strokes, right?

[00:01:09]>> Yeah. When scientists introduce cholesterol into arterial structures, it doesn't just get clogged up. There has to be damage inflicted first for there to be any kind of deposit of anything.

[00:01:19]We're talking about roughly 140,000 deaths annually in England alone from heart disease with high cholesterol contributing to about a quarter of those deaths.

[00:01:27]>> Oh my god. Are you serious?

[00:01:29]>> That's insane, isn't it?

[00:01:30]>> Yeah.

[00:01:30]>> How can you actually prove that?

[00:01:32]>> You know, it has earned the nickname the silent killer.

[00:01:34]>> Why would the liver create something that kills the heart? The body's an idiot.

[00:01:38]>> It's simultaneously keeping us alive and also potentially killing us.

[00:01:42]>> I know, right?

[00:01:44]>> And it makes very little sense.

[00:01:46]>> Yeah, it does make no sense. It's almost like nonsense.

[00:01:49]>> Elevated LDL cholesterol, which is effectively bad cholesterol.

[00:01:52]>> Now, there's still no bad cholesterol.

[00:01:54]There's just cholesterol >> is one of the most modifiable risk factors for cardiovascular disease.

[00:01:59]>> Is it because there's a pharmaceutical company that's able to lower it and they weren't able to raise HDL? I think that might be the reason. There's been some research analyzing data from I think it's over a million individuals and it found that for each 1 mill mole per liter increase in LDL cholesterol or bad cholesterol >> still no bad cholesterol >> is associated with about a 20% increased risk of coronary heart disease.

[00:02:20]>> What for me and for Steven as well? I mean how could he possibly know our risk? It must be one heck of a study.

[00:02:26]>> Yeah. Well, they must have missed this study. I mean it was only 12.8 million people in Korea having higher rates of cholesterol meant that they lived longer. ah they probably missed that British Medical Journal from 2016 report. It was only 68,000 participants but the conclusion there was that those with high levels of LDL seem to live longer or they must have missed this study where they were looking at newly diagnosed cancer patients they would live longer. They saw that correlation and if you lowered the cholesterol they had more chance of dying. Oh, and they must have missed that Norwegian study.

[00:02:55]People with lower levels of cholesterol had a higher risk of dying. They must have missed that one.

[00:03:00]>> Oops. We're talking about cholesterol management having a measurable and significant effect on heart disease risk.

[00:03:08]>> Indeed. You see, we need to micromanage our body's cholesterol levels because the body's just so stupid. It's an idiot.

[00:03:14]>> And when your arteries get narrowed or blocked, the consequences affect everything. So, it's your brain function, your energy levels, your ability to exercise, literally everything.

[00:03:23]>> Silly human body. I mean, your foolish liver and my foolish liver creating all that cholesterol that just kills humans.

[00:03:30]>> It can sound overwhelming, but when it comes to cholesterol, it is something you can manage.

[00:03:34]>> What you mean you can get a pharmaceutical intervention to lower it?

[00:03:37]>> And taking statins can reduce it by up to 60%.

[00:03:40]>> Hang on a minute. The guy who created the very first cholesterol-lowering drug, Akira Endo, actually refused statins when his doctor recommended he takes them. It's almost like he knows they're harmful [snorts] to take.

[00:03:52]lifestyle hubs, but also medical science has some good answers for all of this, doesn't it?

[00:03:56]>> Thankfully, yes.

[00:03:57]>> Medical science, do you mean billion and even trillion dollar drug industries?

[00:04:02]>> So, medical science means we can measure cholesterol accurately. And there are those medical interventions that work.

[00:04:08]>> So, when you do a blood test, they actually directly measure LDL levels.

[00:04:11]Oh, oh, no, no, no, they don't. It's a calculation. And if you have particularly low triglycerides or particularly high triglycerides, that calculation doesn't work. But we sort of ignore that. So medical science is taking a guess about triglycerides, making sure that isn't too low, isn't too high, and then making a calculation that we know doesn't actually work. But we still trust that number because it's trust the science cuz it's medical science.

[00:04:33]>> By the time you experience chest pain associated with cholesterol, that significant arterial damage has probably already occurred.

[00:04:39]>> How can you say that chest pain is associated with cholesterol?

[00:04:42]>> That's his association.

[00:04:43]>> Even when you feel perfectly healthy, you've got to keep an eye on these things.

[00:04:46]>> Yeah.

[00:04:47]>> No, [music] no way. So, we mentioned different types of cholesterol. Let's go through them for those who might not know.

[00:04:52]>> Um, it's one single molecule.

[00:04:54]>> Hang on a minute. I'm getting confused.

[00:04:56]I thought that there was also a bad cholesterol supposedly, >> but because it's fat soluble, it can't dissolve in your water-based bloodstream. So, what happens is your body packages this cholesterol into what are called lipoproteins. And they're essentially like little transport vehicles.

[00:05:10]>> Oh, that's right. Yeah. They're lipoproteins, not cholesterol.

[00:05:14]>> And the main ones are LDL and HDL cholesterol. Oh no, wait, spoke too soon. He still seems a little bit confused about the differences there.

[00:05:21]>> So LDL is low density lipoprotein and HDL is high density lipoprotein.

[00:05:27]>> Right. So not cholesterol then. Good.

[00:05:29]>> LDL cholesterol.

[00:05:30]>> Oh, spoke too soon.

[00:05:31]>> Carries about 2/3 of all the cholesterol into your blood delivering from your liver to cells for making hormones and repairing cell membranes.

[00:05:39]>> God, sounds terrible.

[00:05:41]>> So LDL doing its job is is actually helpful. But this is known as the bad cholesterol, isn't it?

[00:05:47]>> It is. And it >> But it's Oh, >> this is why it's so kind of confusing at times.

[00:05:52]>> Oh, it is so utterly confusing. I mean, it's helpful. It's bad. Our liver makes it. It kills people.

[00:05:58]>> When everything's working normally, LDL is doing its job in a normal and healthy way.

[00:06:02]>> What's normal anyway?

[00:06:03]>> The problem is when you've got too much LDL cholesterol circulating.

[00:06:07]>> Sorry mate, doesn't exist. You have LDL, lowdensity lipoproteins, and cholesterol. And that LDL particle can carry cholesterol, the only molecule of cholesterol that exists in reality, around in our blood for good reason.

[00:06:19]>> And what happens is it it starts infiltrating your artery walls, gets trapped, and starts to deteriorate. Your body sends in the white blood cells, the cavalry, to clean it up. Is >> that lovely?

[00:06:29]>> So, they basically keep eating these damaged LDL cholesterol particles until they're effectively stuffed. You might have come across what's called foam cells and that's what we're talking about here. But they also attract more white blood cells which creates a vicious cycle and the ultimate result is what is known as arterial plaque.

[00:06:45]>> They're talking about macrofages and white blood cells and foam cells. Well, there's a little clue there as well because that's damaged LDL, damaged LDL that have been oxidized. And the most common cause of oxidization and glycation is too much glucose in the bloodstream. Don't worry about that because that isn't modifiable. You you can't lower and modify your glucose intake. You can't do that. [laughter] >> So then when we look at HDL cholesterol particles, so these are high density lipoproteins. These are essentially known as good cholesterol.

[00:07:18]>> Yay. [laughter] >> Hell no. There's still only one molecule of cholesterol. HDL is yet another lipoprotein. [laughter] >> HDL, they collect excess cholesterol from tissues and artery walls and they transport it back to your liver for excretion. All they're talking about is pharmaceutical interventions that lower LDL. But what's causing the plaques in the first place? Well, that LDL that's going through your veins and your arteries, but it doesn't cause a plaque in your veins. It also doesn't cause a plaque in most of your arteries, only in predictable places. Strangely enough, where there's turbulent blood flow and there's also bifurcations. That's where your arteries split into two. And also, there's high pressure. It's almost like there has to be some sort of damage from the sheer stress that's within that artery. And the body has some sort of strange mechanism to fix it. There must be some substance that the body produces to protect the artery. Our ancestors, the humans that got us here talking about this, were eating mostly fatty animal nutrition from large ruminant animals. They ate the proteins and associated fats with all of their saturated fats and cholesterol. They didn't eat many plants at all. And they certainly didn't modify their cholesterol levels by introducing poisonous metabolic drugs. Why is fiber so good for our health if we can't digest it?

[00:08:32]>> Well, it's not.

[00:08:32]>> No, it's not.

[00:08:33]>> When it comes to our gut health, a critical factor is the short chain fatty acids made by bacteria in our gut. So, what are those?

[00:08:40]>> Oh, they're saturated fats. Oh, but that's bad, right?

[00:08:44]>> Short chain fatty acids are postbiotics and they're made by good bacteria in our gut when they digest fiber in our diet.

[00:08:50]So, you want to have a diet that's rich in fiber in order to make these short- chain fatty acids.

[00:08:56]>> False. We get short-chain fatty acids in animal proteins, too.

[00:08:59]>> And they have a critical role in our overall health.

[00:09:02]>> What I do think is very truthful about this video is the constant noise [laughter] because that's the only thing you're going to get from eating lots of fiber, bloating, and gas.

[00:09:12]>> So, they help to maintain the integrity of our gut lining. So, they help prevent leaky gut. They also influence our immune system, our hormones, our metabolism, and even our mood.

[00:09:22]>> So, I'm confused again. So, is saturated fat good or is it bad? Or is it only good when we make it from fiber, but it's really bad when we don't make it from fiber?

[00:09:31]>> And that's why being on a restricted diet is not recommended long term.

[00:09:35]>> So, don't go on a restricted diet.

[00:09:37]That's great advice. Excellent. Don't cut out red meat. Don't cut out eggs.

[00:09:42]Don't cut out fish. So, as much as I love the low FODMAP diet for treating SIBO, you don't want to be on that permanently because that can actually cause your short- chain fatty acids to plummet. Same thing with the carnivore diet.

[00:09:54]>> Oh, well, here's the thing. Short- chain fatty acids like butyrate have to be converted into ketones like beta hydroxybutyrate first before meaningfully nourishing the gut. Well, when in nutritional ketosis or on a carnivore diet or a different kind of meat-centric keto diet, we have beta hydroxybutyrate flowing through our blood feeding all of our gut thoroughly.

[00:10:13]>> I'm a gut health dietician and this is one of my favorite gut boosters, psyllium.

[00:10:18]>> Psyllium husk is derived from the plantargo of varta plant which is native to Asia, specifically regions of India.

[00:10:25]Thank goodness we have factories and planes to provide people all around the world with this pointless supplement.

[00:10:31]Psyllium contains viscous soluble fiber, which means that it absorbs water to form a gel. Why psyllium specifically?

[00:10:39]Because it's not the only soluble fiber in town.

[00:10:41]>> Oh my god.

[00:10:42]>> It's because it's an excellent regulator of digestion with the potential to help both constipation and diarrhea.

[00:10:48]>> So, it can help constipation and diarrhea. How does it do that? How does it know? the soluble fiber it contains isn't very fermentable, so it's both soothing to the gut and far less likely to cause gas, bloating, and pain.

[00:11:01]>> So, she's saying that fiber is good, but not the other fiber the last lady said is good because that causes gas, pain, and bloating. So, you've got to get this other supplement.

[00:11:11]>> Plus, psyllium contains a special substance known as arabinosyline that drives the growth of butyrate producing bacteria. And if you want butyrate, well, how do you think butter gets its name? Because it's full of butyrate, >> which is a short- chain fatty acid that's super important for gut and immune system health.

[00:11:30]>> And your gut, your interic cells and the bacteria don't care where the butyrate comes from. It can either come from the gut or it can either come from the bloodstream. And as we've already said, you've got beta hydroxybutyrate flowing in your bloodstream. Simple.

[00:11:44]>> Register dietician Heg with another MA minute. I want to talk about fiber. The amount of fiber minimum most people need to create a really healthy gut >> is none. All carbohydrates by definition are non-essential and that includes all types of fiber.

[00:11:58]>> Fiber is super important.

[00:12:00]>> No. No way.

[00:12:01]>> Because when it ferments, it creates a lot of really good bacteria and also what are called short chain fatty acids, which are super healthy chemicals that go and do great things in your body.

[00:12:10]>> Yep. Saturated fats. See you next time.

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