Clinical_PNI_image2_sI guess you agree that understanding nutritional information and what works for you can be quite tricky these days. We currently live in a world of fast communications where information is luxuriously available literally at the end of our fingertips (considering you have a computer or any device to access the Internet). However, paradoxically enough, it is more than ever difficult to figure out what is what and contradictory information can easily lead to an overwhelming feeling of confusion, especially so in the field of nutrition.

The problem is everyone thinks they know at least something about diet and the advisory contributions come from everywhere.  After all, we all have to make food choices on a daily basis. It is intrinsic to our lives. But I have to say, it is very easy to fall into traps. The more you want to know, the more likely you are to come across misleading advice. It takes a lot of digging to get to the real facts behind nutrition and one thing we always need to look for is ‘who’s talking’ and ‘why they’re saying it’. If it’s a claim on a food product that they want you to buy, take a step back and think twice. You need to investigate that claim somewhere else to try and see if the promises live up to the expectations. That’s one point to take home.

Second point: still using the example of a claim on a food product that is being advertised to you, the claim might be perfectly correct for that product but does that mean it will apply to you? I mean are you going to benefit from what it gives you? For example, a food that claims to be low in cholesterol. You have visited the doctor and the doctor told you that your cholesterol is high. You are then recommended to lower your cholesterol levels. So in that context, is it safe to say that the low cholesterol food in question will be good for you? It seems quite straight forward from that point of view but my answer is a resounding ‘not necessarily’. It won’t necessarily be good for you and chances are it will do nothing to lower your cholesterol either.  Let me try to explain it.

This is where it gets interesting. First important piece of information here is: approximately 85% of the cholesterol circulating in your blood is  manufactured inside your liver and only about 15% derives from food.  So if you really want to lower your cholesterol, you need to address the imbalance that is behind your high production of cholesterol, more than your high consumption of cholesterol.  What you actually eat in terms of cholesterol bears a relatively small effect on your blood cholesterol levels. That’s why it is so difficult to lower cholesterol just by lowering consumption of fat in your diet. Now how good ‘low fat’ or ‘fat free’ processed foods are for you is yet another story.  If fat has been removed from a natural food to fit the ‘low cholesterol’ claim, it is more than likely to have been processed beyond recognition (with few exceptions left).  Moreover, whenver fat is removed from natural foods, lots more unnecessary and sometimes more harmful ingredients need to be added to make up for taste and texture.  And here I would say is the start of the down slope of food processing that will provide you with poor altered nutrition.

In order to address your individual health needs through diet, you need to look into it with a lot more detail.  You need to ask WHY your body is producing excessive amounts of cholesterol in the first place.  I assure you there is a very good reason for it and your body would NOT be wasting resources on producing extra cholesterol if it did not HAVE to. The problem is, with conventional healthcare these days, the WHYs are not being asked as long as there is a drug that will interrupt whatever it is that the body was trying to achieve with that high cholesterol.

Yes high blood cholesterol has been associated to heart disease and considered a risk factor but the truth is cholesterol has not been demonstrated to be a CAUSE of heart disease.  In other words, you may lower your cholesterol but your heart disease risk does not go away.  Much the opposite in fact as research has actually demonstrated that low cholesterol is associated with increased mortality (1)(2)(3)(4)(5).  So maybe we are looking at the problem from the wrong angle: I would say it begs the question: why would the body produce more cholesterol in the first place? Maybe it just doesn’t have a better alternative to counteract other damaging processes that are occurring around the body.

Cholesterol is a very important type of molecule that is used everywhere in our bodies.  Cholesterol has been vilified and I bet a lot of people might even be under the impression that it serves no purpose in our physiology, as if it was just a ‘nuisance’ we need to get rid of.  At least that’s the impression you get from the drug approach of lowering cholesterol without trying to workout the reasons for its increased production inside the body.  This example of cholesterol and its bad reputation illustrates well my point about the dangers of sensationalism and misconceptions spread across the media in the field of nutrition.  These same misconceptions, coupled with manipulated information for commercial purposes, ends up affecting the great majority of our food choices nowadays.  Unless you go out of your way to try and sort the ‘good from the bad’ (and it will take you a lot of dedication to the quest), it is very difficult to escape the inadequacies of modern diet.  The saddest fact being: you might actually deviate from healthy eating even more if you try to eat according to ‘health claims’ stamped on foods.  A good strategy to get away from these traps is to buy foods which require no description or list of ingredients!

This is a topic for a long discussion but the end message I want to leave you with is: always take a step back and ask WHY.  Evaluate everything that is thrown at you (especially when it comes with a claim) and don’t be afraid to question.  You might not always get to the bottom of the issues but you’re going to contribute to your own understanding; which can only be good for your ability to make choices about your food, your diet, your health.


1. Kahn MR, et al. Low-Density Lipoprotein Levels in Patients With Acute Heart Failure. Congest Heart Fail 2012 Oct 16. [Epub ahead of print]

2. Afsarmanesh N, et al. Total cholesterol levels and mortality risk in nonischemic systolic heart failure. Am Heart J. 2006;152(6):1077-83

3. Muldoon MF, et al. Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials. BMJ 1990;301:309-14

4. Weiss A, et al. Serum total cholesterol: A mortality predictor in elderly hospitalized patients. Clin Nutr 2012 Nov 23 [epub ahead of print]

5. Sarria Cabrera MA, et al. Lipids and all-cause mortality among older adults: a 12-year follow-up study. Scientific World Journal Epub 1 May 2012