Cholesterol & Heart Health: Looking Beyond the Numbers

It’s February and all the stores are full of pink and red hearts…which is a great reminder for us to concentrate on heart health! Let’s look at some traditional and some not so traditional blood markers of heart health as well as some additional ways we can look into heart health from a nutrition perspective!

CHOLESTEROL AND HEART HEALTH

For years, cholesterol has been used medically as an indicator of cardiovascular health. However, cholesterol has many protective and important roles in the body including:

• Supporting the nervous system and brain health

  Cholesterol makes up approximately 50% of the nervous system and is a crucial component of brain tissue.

• Maintaining healthy cell membranes

  Cholesterol helps regulate the exchange of nutrients into cells and waste out of cells, supporting proper cellular function.

• Aiding digestion

  Cholesterol is an essential component of bile salts, which are required to digest and absorb fats and fat-soluble vitamins.

• Supporting vitamin D production

  Cholesterol is necessary for the conversion of sunlight into vitamin D in the body.

• Producing hormones

  Cholesterol is the foundation for steroid hormones, including cortisol, estrogen, progesterone, and testosterone.

  
  

So, when cholesterol increases, we must first ask ourselves why! What is the body trying to do? Since these functions are essential to health, elevated cholesterol is likely just the body trying to support these systems!

If you are a doubter, you may be thinking…but what about dietary cholesterol. I am glad you asked! Over 80% of the cholesterol in the body is synthesized by the liver and if you decrease the amount of dietary cholesterol, the liver will work even harder to make up the difference. So given the vitamin, mineral and omega 3 nutrient density of the egg…go ahead and eat some for your heart!

Let’s get back to the topic at hand, cholesterol and the heart. The famous Framington heart study showed that half of all heart attacks occurred in those who had LOW cholesterol. Furthermore, the thirty-year study showed that all causes of mortality increased as cholesterol decreased. This fact alone should create caution at the idea that lower cholesterol is the better way to health.

OTHER CARDIOVASCULAR MARKERS WITH NUTRITIONAL IMPLICATIONS

Since cholesterol doesn’t give us the whole picture of cardiovascular health, what other markers should you be looking at? We recommend that you check at least two additional markers, homocysteine and hs-CRP.

Elevated homocysteine is associated with increased risk for blood clots, heart disease and stroke.¹ However, with adequate Vitamin B12, Folate and Vitamin B6; homocysteine is naturally degraded by two pathways: the remethylation pathway and the transsulfuration process. Some people have genetic variations that require additional B vitamin supplementation to properly degrade homocysteine. In these cases, it is extremely important to use whole food B vitamins instead of synthetic sources.

Elevated hs-CRP is a sign of chronic inflammation and is associated with atherosclerosis.² A recent study has shown that those who eat the most ultra-processed foods have the highest levels of hs-CRP.³ Therefore, this is another independent cardiovascular risk factor that can be modulated using nutrition.

Greg Mitchell performing a Heart Sound Recording (left). Renee McCain administering a Ragland's test (right).

ADDITIONAL WAYS TO ASSESS HEART HEALTH

There are several objective ways that we evaluate heart health as nutritionists.

• Looking at a more comprehensive list of blood markers as mentioned previously.

• One simple in office test is known as the Ragland’s test. This test compares your blood pressure and heart rate to that of a second reading taken as you stand up. Your systolic pressure, diastolic pressure and heart rate should all go up by 8-10 points.

• We can use a special device known as the Heart Sound Recorder. This device listens to the heart sounds on the four heart valves and gives us a visual indicator of the heart’s nutritional needs. Another important way we assess the nutritional status of the heart is through functional blood chemistry.

  
  

ONE FINAL THOUGHT…

Your heart gets first dibs on the nutrients you ingest! Whole food nutrients through your diet and supplementation are the best way to support your heart. Make sure you evaluate and correct these things before jumping to cholesterol lowering medications for heart health!

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1.      professional CC medical. What is homocysteine? Cleveland Clinic. December 22, 2025. Accessed January 25, 2026. https://my.clevelandclinic.org/health/articles/21527-homocysteine.

2.      Randall ZD, Brouillard AM, Deych E, Rich MW. Demographic, behavioral, dietary, and clinical predictors of high-sensitivity C-reactive protein: The National Health and Nutrition Examination Surveys (NHANES). Am Heart J Plus. 2022;21:100196. Published 2022 Aug 27. doi:10.1016/j.ahjo.2022.100196

3.      Sajan K, Anthireddy N, Matarazzo A, Furtado C, Hennekens CH, Ferris A. Ultra-processed foods and increased high sensitivity C-reactive protein. Am J Med. 2025;138(12):1742-1745. doi:10.1016/j.amjmed.2025.08.016