Cholesterol, Health & Lifespan

by Dr. David Minkoff June 07, 2023 9 min read

Cholesterol, Health & Lifespan

As this is the Longevity Series, I have to talk about cholesterol. Because cholesterol is very firmly associated with lifespan. Just not in the way most people think.

In fact, according to newer research, levels of cholesterol in the ranges of 210-240 are associated with longer lifespans.

And lower levels of cholesterol lead to lower levels of energy, overall health and hormonal deficiencies among testosterone, estrogen and others.

In this article we cover how cholesterol actually operates in the body, what it actually has to do with high blood pressure and how it’s not quite the villain it’s been made out to be, but a vital part of our body’s proper functioning.


In an earlier article we covered the truth about cholesterol and heart disease.

It covers what’s called the cholesterol hypothesis — and it is only that, a hypothesis (a proposed explanation made on the basis of limited evidence as a starting point for further investigation).

This hypothesis states that higher levels of cholesterol, particularly LDL Cholesterol, are associated with higher rates of Heart Disease due to high blood pressure.

And that this high blood pressure is due to cholesterol clogging our arteries, thus narrowing the blood vessels so that our heart has to increase pressure rot push the blood through.

And that, to prevent heart disease, we must lower our cholesterol intake and take drugs known as statins, which lower our liver’s ability to produce cholesterol.

However, over the last decade or so, more and more scientists and doctors have been raising an eyebrow at this idea for one very glaring reason: there is actually no evidence to support the hypothesis.

In fact, the only studies we have on the matter not only refute it, but actually show that more often than not, the situation is the opposite.

Mortality from Cardiovascular Disease among those 60 and above actually increases as cholesterol is lowered, and decreases as cholesterol levels are raised. The same was seen in all-cause mortality rates.

And, in a study of 12.8 million adults, it was found that the lowest risk of heart disease, and highest potential of survival, was in the 200 to 240 levels of total cholesterol, levels that have been considered very high.

You can learn more about what cholesterol actually is (a vital component of about a third of your hormones, and each one of your cells) in this article.

But, while the idea that cholesterol intake causes heart disease may be a myth, heart disease itself is quite real.

And the actual cause of it also affects our ability to build muscle, lose fat, keep high energy levels and overall health, keep our hormones in balance, and slow aging.

So let’s see what’s actually happening here and how we can help to lower the risk of heart disease, increase our ability build muscle, and raise our overall levels of energy and health.


We know we need oxygen to survive. But more specifically, our cells need oxygen to survive.

After about 5 minutes of low or no oxygen, cells begin to die.

This is because of something called ATP (Adenosine Triphosphate), the energy, or “food”, our cells live on.

ATP is made within the cell by combining oxygen with glucose (sugar), or ketones (from fat), or amino acids (from protein).

ATP is made by tiny organelles within the cell called mitochondria. There are about 1000-2500 mitochondria in each cell.

They take the oxygen and food source, and produce ATP which the cell then uses as energy to fuel itself.

And, as the cells are always working, they need a constant source of ATP to carry on.

So if we remove oxygen, they can’t make ATP, don’t have the fuel they need to work, and they die.

Or, if our oxygen levels are low, they produce less ATP, and have less energy.

And, so, as our bodies are nothing but cells, we have less energy.

But we also have less ability to repair cells or build new ones.

Your cells need energy to do this, and if energy levels are low, they conserve it for the most necessary of actions.

Cell turn-over rates decline. Cell replication, which is obviously needed for muscle building and replacing of old cells, declines.

So it becomes harder to build new muscle, our energy levels drop and, as our cells are not being replaced as often, we “age” as there are fewer new cells, even for our skin.

Obviously amino acids, fats and other nutrients are needed to produce new cells as well, but this point of oxygen is key, because it will slow things down faster than anything else.

And when working out or exercising, they need even more energy. More work is being given to them, our muscles are contracting faster and working harder. They need more ATP and more oxygen to do this.

So our breathing increases, to bring in more oxygen, and our heart rate increases to push oxygenated red blood cells through our bodies to the cells, where the oxygen is removed.

And this is where high blood pressure comes in.


When our cells need more oxygen to produce ATP, our breathing and heart rate increase, oxygen is transported to our cells by red blood cells, and they make ATP.

But these red blood cells have an exact size. They’re about 6-8 microns in diameter (a micron is 1/1000th of a millimeter).

White blood cells are even larger, about 30 microns.

And each cubic millimeter of blood contains about 4-6 million cells.

But the size of the blood vessels themselves can be smaller than the red blood cells.

Capillaries are the smallest blood vessels in the body, taking oxygenated red blood cells to each of our cells.

While they can be larger, the passage in most capillaries are about 3-4 microns in width, smaller than the blood cells that pass though them.

These red blood cells have to squish and elongate themselves to pass through these narrow passages. And they do so because of the pressure of the blood pushing them through.

That’s “blood pressure”.

But what happens when these capillaries become even more narrow?

What if they become 2 microns in width?

Then it’s harder for a blood cell to pass through them, so the heart has to beat harder, to raise blood pressure, to push them through.

Because they need to get through. Your cells will die without the oxygen they contain and your body is nothing but your cells.

If you’ve ever had a feeling of being out of breath, where you just can’t get enough air, you know what this is. It’s not that you’re not breathing enough, it's that your cells aren’t getting the oxygen they need fast enough.

If someone faints from over-exertion, this is their brain cells not getting oxygen fast enough.

But have you noticed that it’s easier for us to feel out of breath when running or working out, or even just walking, when we have more fat on our body?

This is because a good portion of the fat in our bodies isn’t just in our fat cells… but in our blood vessels, causing them to narrow.


I’m going to jump back to cholesterol for a moment here, not because high cholesterol causes high blood pressure, but because it does have a role, just not what you think.

As covered in this article, when the inside walls of our blood vessels are injured, much like a scrape on the knee, our body puts a scab on it, a bandage.

If you scrape your knee, the scab is made, largely, of special blood cells called platelets, which clump together and dry out, forming the scab.

But inside your blood vessels, that “scab” or bandage is made of… cholesterol.

And that’s where the confusion comes from.

Because this isn’t a point of you ate cholesterol, and then that cholesterol went and formed a scab.

No. There was an injury to the blood vessel caused by toxins, or high levels of sugar, or trans fats or something else in your blood, and cholesterol was brought in to bandage that injury.

It has to be bandaged. It’s blood vessel. What do you think happens if a hole starts to form there? Of course it needs to be fixed.

But that’s where cholesterol comes in. It doesn’t, on it’s own, build up in our blood vessels, it goes there as a reaction and solution to an injury that something elsecaused.

So the solution here isn’t to take away your body’s ability to bandage an injury, the solution is to remove the items that caused the injury which cholesterol was then needed to fix.

But this cholesterol does push out into the inside passage of the blood vessel and take up space, narrowing the passageway for blood cells to get through.

So our heart needs to raise blood pressure to push the blood cells through to get oxygen to our cells.

But there’s another culprit here. A larger one, in fact: triglycerides.

Triglycerides are the fats that fill our fat cells. But they’re not just in our fat cells.

They also build up inside of our blood vessels, narrowing the passageways.

About 90% of the “fat” in our body is triglycerides.

So when we have excess body fat, some of this fills our blood vessels. The more body fat we have, the more triglycerides we have in our blood cells, narrowing the passageways that oxygen-rich blood cells pass through to get oxygen to our cells.

This is why we feel out of breath when we’re “over-weight” and try to run or exercise. And why we have higher blood pressure.

Our heart has to pump harder to push these cells through, and it takes longer.

So our cells don’t get oxygen as fast as they need to.

When we remove this fat from our blood vessels, which occurs just by losing body fat in general, our blood pressure comes down and our energy levels rise, as our cells are getting the oxygen they need in order to do their work.

And muscle-building speeds up, as, along with amino acids, fats and vitamins, they now have what they need to replicate and build more muscle.


Triglycerides are a fat made from sugar and fatty acids.

When our diet is high in sugar, especially processed sugars, our body isn’t able to use them all. So it connects them up to fatty acids to make triglycerides which are then stored in our fat cells as “body fat.”

Or… in our blood vessels, narrowing the passageways.

To reverse this, we need to cut out the higher levels of sugar and, preferably, remove refined or processed sugars which cause the most triglyceride production.

This, along with a high protein and fat diet, and vitamins and minerals, will cause the excess body fat to be burned, removing it from our blood vessels, and allowing for more energy, greater cell turn over for an overall “younger” body, and greater ability to build lean muscle.

It seems simple because it is.

But it’s true and, more importantly, it works.


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