2023 / 6 / 9


Is LDL cholesterol really bad? LDL Excess NG ... Awareness of proper LDL levels protects the body
True bad ➔ "small dense LDL cholesterol"


For the transport of lipids in the blood it’s realized by the binding of long-chained fatty acid and albumin. Short/medium chain fatty one has a high affinity and it’s dissolved easily in blood. Long chain fatty one shows hydrophobic and it can be transferred in blood as water-soluble lipoprotein complex like the other fat, phospholipid, cholesterol, ester and lipid soluble vitamin.

Cholesterol can be separated by the particle number, the particle size/nm, subclass as follows. CM/chylomicrons (1, 90 >, CM), VLDL (3~5, 64.0~44.5, L), VLDL (6, 36.8, M), VLDL (7, 31.3, S), LDL (8, 28.6, L), LDL (9, 25.5, M), LDL (10, 23.0, S), LDL (11~13, 20.7~16.7, VS), HDL (14~15, 15.0~13.5, VL), HDL (16, 12.1, L), HDL (17, 10.9, M), HDL (18, 9.8, S), HDL(19~20, 8.8~7.6, VS) are categorized into the four group of CM, VLDL, LDL and HDL.HDL-C (VL, L, M, S, VS) is well-known as good cholesterol to collect increased cholesterol in blood and to remove attached one on blood vessel wall for returning those into liver. LDL-C (L, M, S, VS) is basically contributing to produce hormone and cells if it’s controlled within standard volume. However, it can be causing inflammatory response related to cerebral infarction or myocardial one with arteriosclerosis by damaging vascular endothelial cells or deposition/accumulation on vessel wall if LDL-C exceeds the standard range in body.

The disease process by LDL is well-known today as functional mechanism and therefore LDL-C is called as bad cholesterol. The density of those lipoprotein g/mL are follows. There are CM: ~0.94 g/mL, VLDL: ~1.006 g/mL, LDL: 1.019~1.063 g/mL and HDL: 1.063~1.21 g/mL as general data. In some pre-disease state persons, IDL so called one of lipoproteins as remnant of CM or VLDL by hydrolytic degradation could be identifies and its density is 1.006~1.019 g/mL. (Wikipedia)According to MRFIT/Multi Risk Factor InTervention in US, the cholesterol can shorten life if its number is exceeding or shortage in body and the report is beyond the traditional understanding of the diseases’ process. The coronary artery death can drastically increase, if the total cholesterol TC is over 200 mg/dL. It can be stable without reduction under 180 mg/dL in Japan.

It could similarly match the results in EU or US. The epidemiological survey between 1986 and 1989 for 26,000 residents is well-known in Fukui City of Japan. It is driven by Dr. Shoichiro Shirasaki, the Fukui Public Health Center and it shows the high death number in man/male with low cholesterol and the similar results even in woman/female. They have the high correlation with the liver cancer when TC is lower than 160 mg/dL. It shows some correlation with gastric cancer in man/male but nothing special about woman/female under low TC. In Japan the decrease of TC has been reported in some white paper in Japan when colorectal cancer or advanced cancer is growing. In addition, the bad cholesterol is really “small LDL cholesterol” because it can be oxidized LDL as endogenous and make atheroma, according to the research group by Tsutomu Hirano in School of Medicine, Showa University.

From “National Cancer Center/NCC” “Development and Evaluation of Cancer Center Prevention Strategies in Japan” You can see the figure below of BMI vs mortality in Japan. In the past years you might have already known the correlation and the reason why.BMI is well-known to show the best healthy body or some risk of unhealthy degree for people in Japan.

It could show the higher mortality risk even if BMI is not high and lower than 20.0 possibly relating to weak side body. In that case, the albumin could often show the poor nutrition like less than 3.5 g/dL that means low immunity against diseases. It’s particularly strong for woman/female in Japan. In addition, recently it’s not a little number of pregnant women who is sensitive about her BMI and she knows very well that it’s not good for her fetus. Some MDs give a warning about the current mother/fetus way of thinking. Generally speaking, out range of 22.0 and 23.9 BMI is increasing the death risk of cancer, heart disease, cerebrovascular disease and others even if the number is not big or far for out of the sweet spot BMI. In case of senior persons, the sweet spot of BMI is slightly higher. It means it can be between 24.0 and 25.9 and much better zone as their QoL. The cancer risk of woman/female significantly increases when the BMI is higher than 30.0 clearly.

AXR recommends that BMI is important to show the degree of healthiness but you should check the other parameters.

Similarly, the figure below shows the annual changes of the death by cancer site. It is created by National Cancer Center Hospital based on the vital statistics of cancer death in Japan reported by MHLW/Ministry of Health, Labour, and Welfare.

Japan Lung Cancer Society started “No Smoking Declaration” anti-smoking campaigns in 2000. In 2020 the smoking rate was 17.8%/make: 29.0%, female: 8.1%) and it was drastically going down. The declining trend of smoking rate is similarly keeping going-down globally. However, the mortality by cancer is still high in Japan. The immune system could be happening by many reasons and it’s not easy to say for sure. Some researchers say over 20 years ago, “The mortality might increase against the no-smoking campaign because the immunity might be down without its stimulation in body against the expectation.” Of course, I was criticized so much by MDs and cancer association in Japan when I published a book about fake data of cancer & no-smoking correlation. Why the mortality by cancer is still increasing today even if we successfully reduced the smokers today.” We should think about how to protect individual’s healthiness and QoL and acquire the habits for healthiness or QoL learning what is good or bad for our body.