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How Sugar Really Affects Your Cholesterol

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Elizabeth Klodas, MD, FACC - Blogs
By Elizabeth Klodas, MD, FACCBoard-certified cardiologistJuly 10, 2017
From the WebMD Archives

If you’re like most people, you probably think it’s high-cholesterol foods like eggs or shrimp that are the worst for your cholesterol levels. But that’s not really the case.

Because it’s not actually the cholesterol in food that’s the problem. Most of the cholesterol that circulates inside our bodies is made inside our bodies, and not absorbed from the diet. So, it’s not about avoiding foods that naturally contain cholesterol, it’s about avoiding foods that prompt our bodies to create cholesterol.

The most powerful driver of cholesterol production?

Believe it or not, it’s sugar!

When I say sugar, I mean added sugars and simple carbohydrates that can be rapidly turned into sugar within our bodies. Think not only sweets (like cakes and cookies, candies and other desserts), but other foods containing or made from refined grains – like white rice, breads, bagels and pasta.

All carbohydrates are absorbed as sugar. And when blood sugar levels go up (like after eating a bagel), the body responds by releasing insulin. Insulin is a vital hormone that makes sure sugar is stored in our bodies for use between meals. But it doesn’t just cause sugar to be stored. It shifts our bodies into storage mode in general.

And what’s the storage form of cholesterol? LDL, bad cholesterol. If insulin levels go up, LDL goes up. What’s the non-storage form of cholesterol? HDL, good cholesterol. If insulin levels go up, HDL goes down. And what if you’ve stored all the sugar you can and there’s still excess circulating in your blood stream? Insulin helps turn that sugar into fat. The result? Triglyceride levels go up.

Some of the worst cholesterol profiles I’ve seen have been in people who eat a low-fat, low-cholesterol diet but don’t pay attention to the amount, or source, of sugar they’re consuming. Instead of eating fruits and vegetables and whole grains, they’re eating fat free popcorn, and low cholesterol bread, pasta, and low fat cookies.

But to be clear – sugar that occurs naturally, like in fruits – has a very different effect on our biochemistries. Sugar that comes in the form of a whole food (like an apple) is absorbed slowly because it takes more time to digest an apple, and this helps insulin levels to stay steadier. Note that I’m talking about a whole apple – not apple sauce or apple juice (which is digested more quickly, losing some of the positive effect on your biochemistry). So, when eating carbohydrates, stick as close as you can to the original form (whole foods and grains). It’ll help you keep your insulin levels – and your cholesterol – in check.

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About the Author
Elizabeth Klodas, MD, FACC

Elizabeth Klodas, MD, FACC, is a cardiologist and founder of Preventive Cardiology Consultants in Minneapolis. Her professional interests include noninvasive cardiac imaging and valvular heart disease, but her true passion is heart disease prevention.

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