Chris Masterjohn

Like all those things that cholesterol does are incredibly important.

But I think a lot of people, their cholesterol going up can be a sign that they're not using it properly.

And so I think that's why you do see – it is true that if you take people at a certain age, you can see inverse correlations between cholesterol levels and mortality.

But if you take people who are younger and you look at who's going to get heart attacks later, you do see that higher cholesterol when you're younger prospectively predicts

a higher risk of heart disease later.

And I don't think that's because cholesterol causes heart disease, but I think it's because it's a reflection of your overall metabolism being more slow in terms of actually using up the cholesterol.

Makes sense.

But it's interesting, though, that if you look at the mechanisms of how does cholesterol

How does cholesterol cause atherosclerosis?

The cholesterol is inside a lipoprotein, which is like a spherical container for the cholesterol.

It's got a bunch of fat-soluble vitamins and other things in it.

But the outside is fatty acids, specifically in the form called phospholipids.

But what happens that drives the atherosclerotic plaque is that the fats you get from seed oils that are on the outside of it get damaged.

And when they get damaged, the immune system recognizes it as a toxin that could hurt the blood vessel.

And so the immune system gobbles it up and sequesters it.

And that sequestering is like a quarantine.

And that's what the plaque develops from.

And so that's why even though you see prospectively that if your cholesterol is higher, that that predicts that you're more likely to get heart disease later, in the randomized controlled trials, you saw something quite different.

when they used seed oils to lower the cholesterol.

So the Minnesota Coronary Survey was another, I mentioned the LA Veterans Administration Hospital Study.