• Cholesterol in the body
  • HDLs, LDLs, and other lipid particles
  • From food to cholesterol
• The cholesterol connection
  • The role of diet
  • The role of inflammation
  • From cholesterol to heart attack or stroke
• What causes heart disease
  • Risk factors for heart disease
  • Metabolic syndrome
  • Protective factors
  • For women: Hormone therapy
  • Weighing the risk factors
• Why treat cholesterol?
  • Benefits of lowering your cholesterol
  • What are the risks of treatment?
  • Is treatment worth the trouble or the cost?
• Your cholesterol test
  • When to test
  • Taking the test
  • Understanding your test results
  • Physical examination and further tests
• Do you need treatment?
  • Seven-step assessment
  • How low can you go?
• Beginning treatment
  • Pinpoint the cause
  • Start your program
  • Adopt a cholesterol-lowering diet
  • Start an exercise program
• Drugs, herbs and other choices for lowering-cholesterol
  • Statins (Reductase inhibitors)
  • Ezetimibe (Zetia, Vytorin)
  • Bile acid binders
  • Fibric acid derivatives (fibrates)
  • Niacin
  • Drug combinations
  • Selective estrogen receptor modulators (SERMs)
  • Herbs, vitamins, and other substances that may lower cholesterol
• Treating other lipid problems
  • What to do about low HDL
  • How to treat high triglycerides
• Taking an individual approach
  • Cholesterol in racial and ethnic groups
  • Cholesterol in people who have heart disease
  • Cholesterol in people who have diabetes
  • Cholesterol in people with chronic kidney disease
  • Cholesterol in women
  • Cholesterol in the elderly
• Resources
• Glossary

From food to cholesterol

As you eat, your intestine absorbs fat from food. Intestinal enzymes rapidly dismantle the long, complex fat molecules into their component fatty acids, reassemble them into new triglyceride molecules, and package these—along with a small amount of cholesterol—into chylomicrons (see Figure 2). The amount of triglyceride-rich particles in the blood increases for several hours after a meal, as the intestine releases a barrage of chylomicrons filled with triglycerides. That is why you’re asked to fast before going in for a cholesterol test that measures the different lipids in your blood. If you don’t, the triglyceride amounts appear higher than usual, which skews the readings of the other lipids as well.

At the same time, dietary carbohydrates and proteins that are absorbed from the intestine pass to the liver, which converts them to triglyceride molecules, packages them with proteins called apolipoproteins and cholesterol, and releases the resulting VLDLs into the bloodstream. As chylomicrons and VLDLs course around the body, they temporarily stick to the walls of blood vessels in muscle tissue that needs energy or in fatty tissue (adipose tissue) that stores energy. Enzymes come along and remove most of their load of triglyceride molecules, which are then transported inside the muscle or fat cells. As triglyceride is drained from the chylomicron or VLDL particles, their protective protein coats are rearranged and reconfigured, essentially giving them a new address label that can be read by the liver or other tissues that take up lipoproteins.

The following reviews have been left for this report. Log in and leave a review of your own.

I was recently diagnosed with high cholesterol and purchased this report. It gave me easy to understand explanations of everything from how food becomes cholesterol to what a lipid test reveals to the various treatment options. It’s packed with lots of charts and illustrations that make even the most complex topic easy to understand and use. Jim M., CT

This report is extremely helpful. At one level,the report reiterates what our doctors are always nagging us about anyway (diet, exercise, etc.) But more importantly, the report clearly explains why all these things are important and how they work, so maybe we will actually be moved to do what our doctors say. Even on the easier recommendations, such as omega-3 fish oil for high triglycerides -- I learned here why that works (makes blood platelets less sticky and helps protect the linings of arteries). And it does work, very well indeed -- nothing else brought my triglycerides down, for decades, but fish oil did a dramatic job very quickly. This report has very clear explanations & brilliant diagrams (e.g. "how statins work"). I highly recommend it. Bob C. AR

Admittedly I am a skeptic about the worry of high cholesterol. I'm 65, have 480 LDL and zero plaque. None. I think cholesterol may correlate but it certainly doesn't "cause" heart disease all by itself. I wrote to the author, Mason Freeman, with a sample of what I consider errors in this report and I was sort of surprised by his responses. He agreed with me that total cholesterol " is not useful in predicting CAD events in people over 70" (not stated in report), he agreed that "lower carbohydrate diets work to lower TGs" (not mentioned in report), he seemed to me unconcerned that the NIH risk calculator gave me a more than 10x risk of heart disease compared to direct imaging of my coronary arteries simply because my cardiologist "used an entirely different data set...". The idea that two "predictors" of risk vary wildly is apparently not cause to reject the incorrect method. He also admitted in his email that "one-third of men who have very high cholesterol levels and did not have heart attacks or the two-thirds of women...", but I certainly didn't feel these concepts were emphasized in the booklet. It is my opinion that the report has more errors and I whole-heartedly do not recommend it. Read works by U. Ravnskov, MD, PhD for quite a different perspective on cholesterol.

My cholesterol is higher than it should be but I am trying to lower it with the help of diet, exercise and fish oil. This report was an excellent source for understanding cholesterol, where it comes from, how your body processes it and helpful hints to manage it. I am so glad I ordered this invaluable guide and I refer back to it again and again.