How to Fix Your Heart Naturally with Saturated Fat and Cholesterol

By Dr. Frank Yap, MD -

For decades, you've been told that eating saturated fat raises your cholesterol levels, particularly low-density lipoprotein (LDL) cholesterol, which is often labeled "bad." 

Contrary to popular belief, cholesterol is not the enemy. In fact, it's one of the most vital substances in your body. As Zoe Harcombe, Ph.D., explains in The Primal Podcast episode below, "You have no life, you have no cell form without cholesterol. It is that vital to the human body and that is not up for debate."

Every cell in your body requires cholesterol to function properly. The chemical formula for cholesterol is C27H46O, and it remains the same whether it's labeled "good" or "bad" cholesterol. This fact alone should make you question the conventional wisdom about cholesterol. If your doctor talks about "good" and "bad" cholesterol, consider asking them to explain the chemical formula for each.

This simple question helps expose the flaws in the current narrative surrounding cholesterol and heart health. Remember, your body produces cholesterol for a reason — it's essential for life itself. Instead of fearing cholesterol, it's time to understand its crucial role in your health.

The Myth of Saturated Fat and Cholesterol

For decades, Americans were told to avoid cholesterol-rich foods like eggs and butter, as doctors believed that dietary cholesterol was a direct cause of heart disease. The fear stemmed from the work of Dr. Ancel Keys, whose “Seven Countries Study” in the 1950s suggested a link between saturated fat consumption and heart disease.

But, as Dr. Marty Makary, a surgeon and professor at Johns Hopkins University explains, Keys’ study was fundamentally flawed—he cherry-picked countries that supported his hypothesis and ignored others, such as France and Switzerland, where high-fat diets coincided with low rates of heart disease. Despite numerous follow-up studies, including the Minnesota Coronary Experiment and the Framingham Heart Study, failing to support Keys’ claims, the low-cholesterol message stuck.

In 2015, the American Heart Association revised its guidelines, acknowledging that dietary cholesterol isn’t the culprit it was once believed to be. Despite this, many people avoid foods like eggs and full-fat dairy, while the real problems—sugar and processed carbohydrates—are often overlooked.

According to Zoe Harcombe, who has a Ph.D. in public health nutrition: 

"I don't see how saturated fat can raise LDL cholesterol. I don't know the biochemical mechanism by which that can happen."2

In fact, the relationship between saturated fat intake and cholesterol levels is far more complex than previously thought. When you consume saturated fat, it doesn't directly impact your cholesterol production. Your body processes fats in your digestive system, breaking them down and packaging them into chylomicrons — large lipoproteins that transport fats throughout your body.3

Meanwhile, cholesterol production occurs separately in every cell of your body, with your liver playing a significant role. The idea that eating saturated fat automatically raises cholesterol levels is an oversimplification that doesn't align with the complex biochemical processes in your body.

Understanding Lipoproteins: The Cholesterol Taxi System

To truly grasp how cholesterol functions in your body, it's crucial to understand lipoproteins. Harcombe explains them as a "taxi system" for fats and cholesterol in your bloodstream.4 Just as oil doesn't mix with water, fats can't freely circulate in your blood. Instead, your body packages them into lipoproteins. Think of them as taxis with a water-friendly exterior and a fat-friendly interior.

The main types of lipoproteins are chylomicrons, very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), LDL and high-density lipoprotein (HDL). Each plays a specific role in transporting fats and cholesterol throughout your body. When you hear about "LDL cholesterol" or "HDL cholesterol," remember that these terms are misleading.

LDL and HDL are the taxis, not the cholesterol itself. This distinction provides a deeper understanding of how your body manages fats and cholesterol, and explains why simplistic "good" versus "bad" labels don't accurately reflect the complex role of lipoproteins in your health.

The Truth About LDL and Heart Health

Contrary to popular belief, LDL plays a vital role in your body's health. Each cell in your body has LDL receptors, which grab these taxis when they need the cargo inside. This cargo includes not just cholesterol but also triglycerides, phospholipids and proteins, all of which are necessary for cellular health and repair. The idea that LDL is inherently harmful doesn't make sense from a biological standpoint.

Why would your body produce something designed to harm you? As Harcombe points out, "We'd have died out long ago if there was anything [detrimental] in real food or any serious malfunction in the body."5 Instead of fearing LDL, it's more productive to understand its role in your body's intricate system of nutrient delivery and cellular maintenance.

Harcombe explains that the concept of "small dense LDL" versus "large fluffy LDL" is also largely unfounded. She argues that the endothelial wall in its natural, undamaged state does not allow anything to pass through, including LDL particles. The idea that small dense LDL penetrate the arterial wall more easily than large fluffy LDL is, according Harcombe, "complete and utter nonsense."6

Instead, she suggests heart disease is more likely caused by damage to the endothelial wall from factors like poor diet, smoking, pollution, chemicals and stress. When damage occurs, your body sends cholesterol as part of the repair process. This is why cholesterol is often found at the site of arterial damage — it's there to help, not harm.

Harcombe advises focusing on maintaining overall health rather than obsessing over LDL particle size or numbers. By shifting your perspective, you begin to appreciate LDL as a crucial component of your overall health rather than a threat to be eliminated.

The Problem with Cholesterol-Lowering Drugs

While statins are widely prescribed to lower cholesterol levels, their benefits are overstated while their risks are often downplayed. Dr. Harcombe cites research showing that taking a statin for five years might only extend your life by three to four days.7 Meanwhile, the side effects significantly impact quality of life.

Common side effects include muscle aches, memory loss, cognitive decline and a general loss of vitality. More seriously, statins raise blood glucose levels, increasing your risk of developing Type 2 diabetes. A study published in 2024 in The Lancet8 provided the most comprehensive evidence to date on this connection, confirming and expanding upon findings first hinted at in earlier research, including the landmark JUPITER trial from 2008.9

By analyzing individual participant data from 23 large, long-term, randomized, double-blind trials, The Lancet researchers were able definitively show that the risk of new-onset diabetes increases with statin intensity. Low to moderate-intensity statin therapy was associated with a 10% increased risk of new-onset diabetes, while high-intensity statin therapy raised the risk by 36%.

Harcombe also shares the story of Duane Graveline, an astronaut who experienced severe memory problems while on statins. His experience, detailed in the book "Lipitor: Thief of Memory," highlights the cognitive impacts of these drugs.

Research published in Scientific Reports also found a significant association between long-term use of anticholesterol drugs (primarily statins) and an increased risk of pancreatic cancer.10 This effect was particularly pronounced in individuals who had been using these drugs for more than five years.

Understanding Cholesterol Tests

Harcombe reveals some surprising truths about cholesterol tests that you may not be aware of. Standard blood tests typically only measure total cholesterol and HDL cholesterol. LDL cholesterol is usually estimated rather than directly measured. This means your cholesterol test results may be far less accurate than you think.

Dr. Harcombe cites a study showing that typical cholesterol tests may be off by up to 20%.11 Additionally, your cholesterol levels naturally fluctuate throughout the year. They tend to be higher in winter months when your body is producing less vitamin D from sunlight exposure. This seasonal variation means the timing of your cholesterol test significantly impacts the results.

If you're concerned about your cholesterol levels, Harcombe suggests getting tested in late summer or early fall when your levels are likely to be at their lowest. Remember, a single cholesterol test doesn't provide a complete picture of your health.

While much attention is given to cholesterol, Harcombe emphasizes the importance of monitoring your triglyceride levels. Triglycerides are a type of fat found in your blood and are a valuable indicator of your overall health. High triglyceride levels are often associated with increased consumption of refined carbohydrates and sugars.

However, Harcombe cautions against becoming overly fixated on specific numbers. Instead, focus on maintaining a healthy lifestyle, including a diet low in processed carbohydrates and sugars. By doing so, your triglyceride levels are likely to naturally fall within a healthy range.

Remember, the goal is overall health, not achieving a particular number on a test result. That said, you get a more accurate idea of your risk of heart disease with the following tests:

  • Omega-3 index
  • HDL/total cholesterol ratio
  • Fasting insulin level
  • Fasting blood sugar level
  • Triglyceride/HDL ratio
  • Iron level

A Holistic Approach to Heart Health

Maintaining heart health involves more than just managing cholesterol levels or following a specific diet. Instead, adopt a holistic approach that includes several key factors. First, focus on eating real, whole foods rather than processed products. Pay attention to your sleep quality and manage stress levels, as both significantly impact your overall health.

While exercise is important, Harcombe suggests avoiding a sedentary lifestyle is even more crucial. She recommends incorporating natural movement throughout your day, and I agree that daily walks are an essential component of optimal health. Tending to your gut health is another key factor.

Anaerobic microorganisms are necessary for transforming indigestible plant matter into valuable fatty acids. These oxygen-intolerant bacteria flourish in environments devoid of oxygen, which necessitates sufficient cellular energy to sustain.

However, factors such as the consumption of seed oils and exposure to harmful substances like endocrine-disrupting chemicals (EDCs) found in plastics impair this energy production, making it challenging to preserve the ideal oxygen-free gut conditions.

This disruption leads to a shift in microbial populations, favoring oxygen-tolerant species over oxygen-intolerant ones. Notably, oxygen-tolerant microorganisms produce more potent endotoxins. Consequently, individuals with a higher proportion of oxygen-tolerant gut bacteria may experience more severe adverse reactions to plant-based carbohydrates due to increased endotoxin exposure.

It's worth noting that septic shock is a significant contributor to mortality rates, with endotoxemia often being the underlying cause. In fact, one could argue that endotoxemia resulting in septic shock surpasses heart disease and cancer as the No. 1 cause of death.

For instance, heart disease or cardiac failure frequently serve as a catalyst for endotoxemia. Therefore, enhancing mitochondrial function and maintaining a balanced gut ecosystem are critical strategies for preventing cardiovascular disease at a foundational level. By following these principles, you're likely to achieve better heart health naturally, without the need for pharmaceutical interventions.

Your body needs cholesterol and lipoproteins to function properly. Rather than trying to lower these vital substances, focus on providing your body with the nutrients it needs through a varied, whole-food diet. This approach not only supports heart health but also contributes to overall well-being.

By understanding the true role of cholesterol and lipoproteins in your body, it allows you to make informed decisions about your diet and health, free from the fear and misinformation that has dominated heart health discussions for decades.

Shifting Paradigms in Cholesterol Management

The revelations about cholesterol’s complex role in health are causing waves across the medical community and beyond. Importantly, these findings are prompting a reevaluation of cholesterol treatment guidelines that have been in place for decades.

Healthcare providers are increasingly moving towards a more personalized approach to cholesterol management. Instead of relying solely on total cholesterol numbers, doctors are considering a wider range of factors including race, genetics, and overall health status when assessing cardiovascular risk.

The pharmaceutical industry may need to adapt to new understandings of cholesterol’s role in health. As research reveals the complex relationship between cholesterol levels and heart disease risk across different populations, drug development and marketing strategies really ought to shift to reflect more personalized approaches to cardiovascular health management. Whether that will actually happen remains to be seen.

Public health messaging about cholesterol is also undergoing a transformation. The old mantra of "lower is always better" is being replaced with more nuanced advice. Dietary recommendations are shifting away from blanket low-fat guidelines to focus on overall diet quality and individual metabolic health.

These changes are empowering patients to take a more active role in their health management. With a better understanding of cholesterol’s complexities, you can make more informed decisions about your diet, lifestyle, and medical treatments.

Advanced lipid testing methods that provide more detailed information about cholesterol particle size and number are becoming increasingly important. These tests offer insights beyond standard lipid panels, allowing for more accurate cardiovascular risk assessment and targeted interventions.12

As our understanding of cholesterol continues to evolve, it’s clear that its impact extends far beyond individual health. It’s reshaping medical practice, influencing public health policy, and even affecting economic sectors.

To better understand the real-world implications of these findings, let’s look at some specific examples and case studies that illustrate the complexity of cholesterol management in different scenarios.

Real-World Scenarios Illustrate Complexity of Cholesterol Management

Consider the case of John, a 55-year-old White male with low HDL cholesterol levels. Traditional medical wisdom would have flagged him as high-risk for heart disease, and indeed, the REGARDS study13,14,15,16,17 confirmed that that low HDL cholesterol is associated with increased risk in White adults. So, for someone like John, a White male, the traditional wisdom about low HDL cholesterol increasing heart disease risk holds true.

In contrast, Maria, a 60-year-old Black woman with high HDL cholesterol, might have been considered at low risk for heart disease based on outdated guidelines. However, the new research suggests that high HDL levels aren’t necessarily protective for Black adults, prompting a reevaluation of Maria’s overall cardiovascular health beyond just her cholesterol numbers.

Another intriguing example is seen in highly trained, keto-adapted athletes. These individuals often display what appears to be paradoxically high cholesterol levels, yet they maintain excellent cardiovascular health.18 This phenomenon highlights the complex interplay between diet, physical activity, and cholesterol metabolism.

These scenarios underscore the need for a more nuanced and individualized approach to cholesterol management. They demonstrate that relying solely on standard cholesterol numbers can lead to misclassification of risk and inappropriate treatment decisions.

Given these complex scenarios, what can be done to optimize cholesterol management and improve health outcomes? The answer lies in a more holistic and personalized approach to health assessment and treatment.

Advanced Strategies for Optimizing Cholesterol Health

The takeaway is that improving cholesterol health goes beyond simply lowering your total cholesterol levels. A comprehensive approach that considers individual factors and overall metabolic health is key. Here are some strategies to promote optimal cholesterol balance. By embracing a more holistic strategy, you and your healthcare provider can work together to reduce your cardiovascular health risks.

•Personalized risk assessment — Healthcare providers should look beyond standard cholesterol numbers and consider factors like race, age, genetics, and lifestyle when evaluating cardiovascular risk.19

•Advanced lipid testing — This provides a more detailed picture of cholesterol levels than standard tests. These tests break down different types of LDL and HDL particles, giving you a clearer understanding of your individual heart disease risk.20 Importantly, this detailed information helps identify individuals at risk even when their standard lipid panel appears normal.21

•Diet — Instead of focusing solely on lowering fat intake, focus on the quality of fats consumed. Incorporating foods rich in omega-3s, and saturated fats such as butter and coconut oil, will help you maintain a healthy cholesterol level while supporting your overall heart health.

•Exercise — Regular physical activity, especially a combination of aerobic exercise and strength training, helps improve lipid profiles and overall metabolic health.22

•Targeted supplementation — For some individuals, targeted supplementation might be beneficial. For example, nutrients like omega-3s, niacin, and plant sterols have shown promise in supporting healthy cholesterol levels.23

Sources and References

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