We can agree that cholesterol is bad, right?
But staying on the myth-busting theme from last week, that might not be true.
Remember the story of how the sugar industry paid three Harvard scientists $50,000 to point the finger at saturated fat instead of sugar?
Well the drama doesn’t stop there...
The bigger myth that came out of that is the one around cholesterol. Tell me if this sounds familiar:
"Cholesterol is bad, the lower the better, and if it's high, you need a statin."
But just like everything else in nutrition we label as good and bad, there’s often another side to the story. One that’s not so black and white.
Let's Go Back In Time…Again
The cholesterol-is-bad story actually started a few years before the sugar industry got involved, with a researcher named Ancel Keys.
In the 1950s, Keys came up with what he called the diet-heart hypothesis.
The idea was what you know today…saturated fat raises cholesterol and high cholesterol causes heart disease so eat less saturated fat, lower your cholesterol, and you’ll save your heart.
You’re probably nodding your head because you’ve heard this before.
To try and prove it, he ran what's called the Seven Countries Study. He looked at fat intake and heart disease across seven countries and found a beautiful correlation. The more saturated fat people ate, the more heart disease they had.
And the idea was born that doctors, researchers, and everyone else have believed for the past 70 years.
But there’s more to the story that you probably don’t know…
Keys originally had data from 22 countries…not seven. He picked the seven that supported his theory and left out the ones that didn't. How convenient…
France was famously excluded. Think of all the croissants, butter, bread, and cheese they eat. Even with this, they have very low rates of heart disease. But this didn't fit his story, so it got left out.
The seven countries he kept told a nice clean story and that's the story that got published. A few years later, the sugar industry paid those Harvard scientists to back it up. And just like that, two cherry-picked pieces of research shaped the next 60 years of cardiology advice.
What Actually Raises Your Cholesterol
For decades you've been told the foods that raise your cholesterol are butter, red meat, eggs, and cheese. Just eat less of them and your cholesterol will come down.
But as more research has come out, it’s shown that the connection between saturated fat and cholesterol is weaker than you were taught.
It’s even possible that eating more saturated fat barely moves the needle in raising your cholesterol.
And you want to know what raises your cholesterol more than saturated fat?
High blood sugar.
When your blood sugar stays elevated from sugar, refined carbs, and ultra-processed food, your liver gets overwhelmed. So it starts pumping out more cholesterol particles, more triglycerides, and storing extra fat right around the liver itself. This is where fatty liver comes from.
The cholesterol level you see on your blood test? It may not be coming from your breakfast…it's probably coming from your liver trying to manage too much sugar.
The other big driver is inflammation. Anything that keeps your body in a chronic state of stress (poor sleep, too much alcohol, sitting too much) feeds the same cycle. More fatty liver, higher cholesterol, and more cholesterol particles in your blood.
So when you keep cutting butter and eggs and your cholesterol still goes up…it's not that you're doing something wrong. You're just trying to fix the wrong problem.
The Part Nobody Tells You
Cholesterol isn't something foreign to your body, floating around causing problems.
Cholesterol is the building block of how your body produces hormones.
Estrogen, progesterone, testosterone, cortisol, vitamin D.
All of them start as cholesterol.
So can you guess what happens when you’re already losing estrogen and progesterone…and then you’re told to lower your cholesterol as much as possible?
Now your body is grasping at straws, trying to make hormones with even less to work with.
Naturally your energy drops, sleep gets worse, brain fog hits harder, mood crashes, and libido disappears.
Your cholesterol going up a bit during menopause isn't always a sign that something is broken. Sometimes it's your body trying to keep up with the hormonal cliff it just walked off.
The sad part is NO ONE talks about this part of women's health and it deserves a lot more attention.
“But What If It Runs In My Family?”
You might genuinely have a genetic reason for high cholesterol that has nothing to do with your diet.
There are a few different cases and the most common is called Familial Hypercholesterolemia. This affects about 1 in 250 people. If you've had high cholesterol since you were young, or you have a parent or sibling who had a heart attack before 55, this is worth getting checked.
The other one almost no one tests for is something called Lipoprotein(a), or "Lp little a." It's 90% genetic. Estrogen actually lowers it, meaning your Lipoprotein(a) levels naturally start climbing in your 50s as estrogen drops…regardless of genetics. The major cardiology groups now recommend getting it checked at least once in your lifetime, and most women have never even heard of it.
If either of these are part of your story, your plan is different. You still want to control your blood sugar and inflammation, but you also need to know what you're working with.
What To Actually Look At On Your Bloodwork
If you've ever gotten a cholesterol panel back, you probably looked at one number…total cholesterol. And if that number was over 200, you were told it was too high.
But only looking at total cholesterol is like getting your credit card statement, seeing $5,000 spent, and panicking. The number alone tells you nothing. What matters is what's actually in there.
Here's what to actually pay attention to:
Your total cholesterol to HDL ratio: This is already on your lab report (often called "Cardiac Risk Ratio") and gives you a more honest read than the total number alone, because it factors in how much protective HDL you have.
Your triglyceride to HDL ratio: This is one of the best signs of how well your body is handling sugar and insulin. Below 2 is great, above 3 is a yellow flag. Most labs will calculate it for you if you ask.
ApoB (if you can get it): Not every doctor runs this, but it's becoming the gold standard. It tells you the actual number of cholesterol particles in your blood, which matters way more than the total amount.
LDL particle size: Big, fluffy LDL is mostly fine. Small, dense LDL is the kind that causes problems. Worth asking about.
Marker | Optimal | Watch | Red Flag |
|---|---|---|---|
HDL (women) | 60+ | 50–60 | Under 50 |
Total Cholesterol / HDL ratio | Under 3.5 | 3.5–5 | Over 5 |
Triglyceride / HDL ratio | Under 2 | 2–3 | Over 3 |
ApoB | Under 70 mg/dL | 70–100 | Over 100 |
LDL Particle Size | Pattern A (large) | Pattern AB | Pattern B (small/dense) |
Lp(a) | Under 30 mg/dL | 30–50 | Over 50 |
Next time you get bloodwork done, push for more than just a total cholesterol number. You deserve a real picture of what's going on, not a single number with no context.
Remember this…
Cholesterol isn't the enemy, it's a messenger. And the message it's usually sending you is about your blood sugar, your inflammation, and your hormones…not about how many eggs you had for breakfast.
To be clear, I'm not a doctor and am not telling you to ignore your doctor or stop your medication. I’m just someone curious about helping you (and other women like my mom) feel more in control of your body. And the more I research, the more interesting, contradicting, and surprising information I find. And I want to share it all with you because the more you understand, the more control you have over how you feel.
Your friend and coach,
Ben Miknis
P.S. I’m hosting a free, live workshop next Wednesday at 7pm EST about:
How to Finally Feel Strong, Energized, and In Control of Your Body (Without a Gym, a Diet, or Starting Over Again)
