The idea of “good” and “bad” cholesterol is incorrect – there is only one type of cholesterol. Lipoproteins carry cholesterol in the blood, and the terms HDL and LDL refer to the type of cholesterol complex formed when protein meets cholesterol. LDL complexes contribute to plaque buildup in arteries, while HDL tends to pick up stranded LDL and return it to the liver.
Most of the available literature addressing the link between high cholesterol and heart disease focuses on the distinction between “good” and “bad” cholesterol. This has led to the general belief that there are two main types of cholesterol: high-density (HDL) and low-density (LDL). These categories are sometimes further subdivided to include very low-density cholesterol (VDL) and other fats collectively called triglycerides. However, the idea that there are different types of cholesterol is actually incorrect. In fact, there is only one type of cholesterol and it is neither good nor bad.
Cholesterol is a fat produced in the body by the liver to perform a variety of biological functions. Since this wax-like material can be found in virtually every part of the body, it can be thought of as the “glue” that binds cells together. It is also used to make certain hormones and vitamin D, as well as bile acid to digest food. Because cholesterol is a fat, however, it naturally tends to separate from the blood, making it necessary to take a ride on a stable substance to navigate through the bloodstream. To accomplish this mission, the body sends out specialized proteins called lipoproteins to carry cholesterol to where it’s needed.
However, cholesterol doesn’t simply stick to passing proteins. In fact, exactly the opposite happens. When proteins enter the picture, they surround the cholesterol molecules to form a shield with which to keep the fat safely intact. Once packed in this way, the proteins circulate in the bloodstream, carrying the cholesterol with it. The “shuttles” created to facilitate this process are known as cholesterol complexes.
This means that when we refer to different types of cholesterol, what we really mean is how cholesterol is transported in the blood and where it goes. For that matter, classifying cholesterol as HDL or LDL simply identifies the type of lipoprotein that carries the substance and not the cholesterol itself since all cholesterol is the same. In fact, to be more precise, these terms refer to the type of cholesterol complex formed when protein meets cholesterol. In this regard, there are three different types of cholesterol complexes: HDL, LDL and VDL.
For example, high-density cholesterol has come to be known as such because it forms a complex involving high-density lipoproteins. However, low-density lipoproteins carry cholesterol in higher concentration, while very-low-density lipoprotein complexes contain even more. This is how good or bad cholesterol looks. Because LDL complexes contain more cholesterol than protein, they contribute to excess cholesterol deposits and plaque buildup in the arteries. Conversely, the formation of more HDL is considered beneficial as it tends to pick up stranded LDL and return it to the liver for recycling or elimination.
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