Cholesterol: The Basics, Neurological Health, Alzheimer’s

In general, people are misinformed on the topic of cholesterol. For example, I am sure you have been told HDL is good cholesterol and LDL is bad cholesterol, and you want to keep them high and low, respectively, and keep your overall cholesterol level low. Surprisingly, the concept is incorrect. That is one example illustrating there are many misconceptions about cholesterol. In this article, I will give a structured explanation of cholesterol’s role, misconceptions, impacts, and how cholesterol relates to Alzheimer’s.

The Basics

Perhaps the most prominent misconception of cholesterol is that you want to keep it as low as possible. Cholesterol is a vital component for good health, and if one’s cholesterol is too low, serious adverse effects could occur.

This is because cholesterol is found in every cell throughout the body and is necessary for the production of cell membranes, every steroid hormone, and vitamin D, and bile acids which assist your body in digesting fat.

Additionally, cholesterol plays a vital role in the formulation of memories and brain function because of its vitality for neurological function [5]. Studies have shown there is a relationship between low levels of cholesterol and increased risk of impulse behavior, aggression, and suicide [1] [2] [3]. A 1993 study hypothesized this association exists because low cholesterol levels are associated with low serotonin levels in the brain, which can lead to a “poorer suppression of aggressive behavior” [4].

Dr. Perlmutter, a Board-Certified Neurologist and Fellow of the American College of Nutrition, supports the notion that cholesterol is vital for brain health. Perlmutter stated the following:

“Cholesterol is vitally important for brain function. While your brain represents about 2-3% of your total body weight, 25% of the cholesterol in your body is found in your brain, where it plays important roles in such things as membrane function, acts as an antioxidant, and serves as the raw material from which we are able to make things like progesterone, estrogen, cortisol, testosterone and even vitamin D.” [6]

In fact, a 2008 study found high cholesterol levels to be associated with better memory function [7]. This information raises the question: is there a link between cholesterol-lowering medication and memory degradation? Dr. Stephanie Seneff has done thorough research on the topic, and she concluded there is indeed a link between insufficient fat and cholesterol in your brain and the Alzheimer’s disease process, but there will be more on this later [8].

Cholesterol 101

In this section, I will explain the bare basics of cholesterol as described by Dr. Zoe Harcombe, a researcher in the fields of nutrition, diet, dietary advice, diet-related health and obesity with a Ph.D. in public health nutrition and will be supported with additional information and research [9]. There are six points I will make.

First, imagine you had no cholesterol in your body. That would mean you would have no cells, no bone structure, no muscles, no hormones, no brain function. I believe you get the picture. Because of this, it is almost impossible to understand and explain the full importance of cholesterol. Cholesterol is so vital to the body that the body makes most of it in the liver (about 80%) because it cannot entirely rely on external sources such as diet (about 20%) because if you stop eating and the body cannot make it, not so good things would happen. If you start receiving less cholesterol in your diet, your body will start producing more and vice versa.

Second, it is essential to understand the notion of good and bad cholesterol is misunderstood – cholesterol is cholesterol. The terms HDL and LDL do not stand for cholesterol but instead are terms for two types of lipoproteins; HDL stands for High-Density Lipoprotein, and LDL stands for Low-Density Lipoprotein. There are also forms of lipoproteins such as chylomicrons, VLDL, and IDL, but we will focus on HDL and LDL.

Third, because fat and cholesterol are not water soluble, they need to be carried throughout the body in something that will do their vital work. These fat and cholesterol carriers are called lipoproteins. Lipoproteins are essentially taxis for cholesterol, carrying cholesterol throughout the body. Therefore, LDL and HDL carry cholesterol, not cholesterol themselves.

In addition to cholesterol, LDL and HDL also carry other non-water-soluble substances such as triglycerides and phospholipids. LDL can be described as the taxi for fresh cholesterol, and HDL can be described as the taxi for recycled cholesterol.

Forth, when you go to the doctor to perform a cholesterol blood test, the blood test does not measure LDL – it estimates it. The fasting cholesterol test can only measure total cholesterol and HDL which are only two parts of the four-part cholesterol equation. As a result, there is a math equation to measure the other two parts of cholesterol, LDL and VLDL.

The Freidewald cholesterol equation is as follows:

Total Cholesterol = LDL + HDL + (Triglycerides/5)

I am going to do my best to explain this equation, so this will get a little mathy. Because there are four variables in this equation and only two are known, you have to either have another equation for one of the two remaining unknown variables or you have to know one of the two remaining variables.

Generally, there are two equations or assumptions doctors use to solve the equation

  • LDL will rise if a) total cholesterol rises and/or b) is HDL falls and/or c) triglycerides fall


  • LDL will fall if a) total cholesterol falls and/or b) is HDL rises and/or c) triglycerides rise


Therefore, there is an inverse relationship between HDL and LDL. More interestingly, this equation also means if you have a fall in triglycerides (which is generally welcomed by doctors), you will experience an increase in LDL (which is not welcomed by doctors).

That is how scientific the measurement of cholesterol is – not scientific at all in my opinion.

Fifth, statin drugs stop the body from producing cholesterol, meaning they prevent one of the body’s natural processes. Dr. Zoe Harcombe gave a quick view of statins:

“The intelligent view on statins is that in the very limited arena where they appear to have some ‘benefit’ (men over 50 who have already had a heart attack), they ‘work’ by having anti-inflammatory properties and that the fact that they lower cholesterol (by stopping the body from being able to produce this vital substance) is a very unfortunate side effect. (Drug companies should work on developing something that has the anti-inflammatory benefit without this huge and damaging side effect – it’s called aspirin).” [9]

My sixth and final point regards the relationship between cholesterol in one's diet and its relation with cholesterol levels in one's blood. Ancel Keys, an American physiologist who studied the influence of diet on health, spent decades examining the relationship between consuming animal foods and cholesterol levels in one’s blood. Keys concluded his research in saying that eating animal foods, and diet in general, had no impact on blood cholesterol levels [10]. Newer research and studies have also shown there is a very weak relationship between the amount of cholesterol a person consumes and one’s cholesterol levels in their blood, and whether there is a relationship at all, even if weak, is still up for discussion [11] [12].

As a result of this information, Harcombe concludes “There is no need, whatsoever, to avoid liver, red meat, other meat, fish, eggs, dairy products, etc. for any cholesterol that they may contain. The body makes cholesterol. I worry about a number of things, but I don’t worry that my body is trying to kill me.”

If you would like to reduce your cholesterol level naturally without the use of statins, check out Healthmasters’ Cholesterol-X.

Cholesterol’s Influence on Neurological Function and Disease Risk

I will briefly digress to the association mentioned above regarding the importance of higher cholesterol levels for the prevention of neurodegenerative diseases such as Alzheimer’s and review studies which examine this relationship.

In 2014, researchers conducted a study entitled “Associations Between Serum Cholesterol Levels and Cerebral Amyloidosis,” and they concluded higher levels of HDL and lower levels of LDL were associated with a reduced risk for amyloid plaque deposits in the brain, and these results were independent of age and the presence of the APOE4 gene, a gene which can influence for the more common late-onset type of Alzheimer’s [13].

One of the researchers in the study, Charles DeCarli, a professor of neurology at the University of California (UC) Davis and director of the UC Davis Alzheimer’s Disease Center, commented on the results:

“If you have an LDL above 100 or an HDL that is less than 40 … you want to make sure that you're getting those numbers into alignment. You have to get the HDL up and the LDL down” [14].

Another researcher in the study, Bruce Reed, a professor of neurology at UC Davis and associate director of its Alzheimer’s Disease Center, gave a similar point:

“Our study shows that both higher levels of HDL - good - and lower levels of LDL - bad - cholesterol in the bloodstream are associated with lower levels of amyloid plaque deposits in the brain” [14].

Next, a 2008 study examining individuals who were not genetically predisposed to Alzheimer’s disease found that elderly individuals who had the highest cholesterol – including highest LDL levels – had the best memory [15]. Therefore, the debate on whether LDL is a significant risk factor is still incomplete.

Finally, a study conducted in 2018 gave a slightly more perplexing conclusion. Researchers found that having higher total cholesterol at midlife was associated with a reduced risk of cognitive decline after the age of 85 [16]. However, the researchers also found that those whose cholesterol levels increased between midlife and late life were at increased risk [16]. This newer information could suggest there may be additional, unknown variables.

Do We Now Have Newer Information?

Amyloid precursor protein (APP) is strongly associated with Alzheimer’s. In 2019, researchers at Florida Atlantic University’s (FAU) Brain Institute and Vanderbilt University examined the relationship between APP and brain cholesterol levels. To summarize their study, researchers found APP was increased in the brain when there was a reduction in cholesterol levels [17]. This explanation is an extremely simplified conclusion to the study, so if you would like to read the full study, see reference [17]. This study is the first to examine this relationship, and it may be the pioneering study investigating a new, unthought-of relationship.

How to Protect Brain Health Through Diet

There is a lot of research examining the benefits of a high-fat, ketogenic diet as it relates to brain health.

In a 2012 study investigating the association between the proportions of macronutrients in total diet and incidents of mild cognitive impairment or dementia, the researchers found diets high in carbohydrates increase your risk of dementia by 89%, while diets high in fats lower it by 44% [18].

According to the authors, “A dietary pattern with relatively high caloric intake from carbohydrates and low caloric intake from fat and proteins may increase the risk of mild cognitive impairment or dementia in elderly persons” [18].

Positive Effects of a High-fat, Ketogenic Diet

Therefore, a ketogenic diet benefits your brain is many ways, and this next section will examine those ways.

A Ketogenic Diet Triggers Ketone Production

A ketogenic diet will help your body convert from a carbohydrate-burning mode to a fat-burning mode, and as a result, your body will produce more ketones, which are an energy source for the brain and have been shown to help prevent brain degradation and alleviate symptoms from Alzheimer’s [19] [20].

One study showed coconut oil, which is primarily consisted of medium-chain fatty acids (MCFA), may assist in preventing steps leading to Alzheimer’s disease because of how MCFA can be converted into ketones for the brain [19].

A Ketogenic Diet Improves Insulin Sensitivity

One study showed increased insulin resistance is associated with deteriorated memory performance, and the study also noted it could be constructive for individuals in their midlife to initiate treatments to improve insulin sensitivity [20]. A ketogenic diet is a perfect way to do that. Interestingly, the link between insulin resistance and Alzheimer’s is so strong, Alzheimer’s disease is sometimes referred to as Type 3 diabetes.

Studies have even shown a mild increase in blood sugar is associated with an elevated risk of dementia [21], as well as diabetes and heart disease [22].

In a 2018 study, researchers found that the higher an individual's blood sugar, the faster their rate of cognitive decline [23].

Additional studies have found the greater one’s insulin resistance, the less sugar they had in crucial parts of the brain – the parts of the brain typically corresponding to areas affected by Alzheimer’s [24] [25].

A Ketogenic Diet Reduces Free Radical Damage and Lowers Brain Inflammation

Ketones burn very efficiently and are the most superior fuel for your brain, but Ketones also generate fewer reactive oxygen species and produce less free radical damage. Studies have shown there is a link between free radical oxidative damage and Alzheimer’s disease [26] [27] [28].

The Importance of Phospholipid-Bound DHA in Alzheimer’s Prevention

Docosahexaenoic acid (DHA) is a type of fatty acid that is particularly important for brain health and the prevention of neurodegeneration. DHA is a marine-based fat found in fatty fish, fish oil, and krill oil.

In a 2019 study entitled “Role of phosphatidylcholine-DHA in preventing APOE4-associated Alzheimer’s disease,” researcher Rhonda Patrick, Ph.D. investigated DHA’s effect in reducing the risk of Alzheimer’s in those with the APOE4 gene, a pro-Alzheimer’s genetic disposition which is estimated to be present in one-quarter of the population [29].

Those with a single copy of the gene have two- to three-times the risk of Alzheimer’s, and those with two copies of the gene have up to fifteen times the risk of Alzheimer’s than those who do not have the gene.

Since in cases of Alzheimer’s individuals have reduced glucose transport in their brains, DHA supplementation is imperative because, according to Patrick, “DHA promotes brain glucose uptake by regulating the structure and function of special proteins called glucose transporters located at the blood-brain barrier, the tightly bound layer of cells that limits passage of substances into the brain” [30].

It is also important to note there are two types of DHA: DHA in a triglyceride form and a phospholipid form. DHA in the phospholipid form seems to pass through the blood-brain barrier and enter the brain much more efficiently [30].

Patrick also notes individuals who have the APOE4 gene have an impaired DHA-transport system; however, those individuals can still transport the phospholipid form of DHA and taking the phospholipid form of DHA may lower the risk of Alzheimer’s in individuals who have the APOE4 gene more so than taking the triglyceride form of DHA [30].

Healthmasters’ HEMMLA is an excellent supplement of DHA in the phospholipid form.

What Does the Research Say About Alzheimer’s Prevention?

In this final section of this article, I will review some lifestyle strategies you can do to help support healthy brain function and possibly reduce the risk of Alzheimer’s.

  • Eat real, organic food. Processed and ultra-refined foods contain ingredients which are harmful to your brain including refined sugar, processed fructose, gluten, vegetable oils, GMO ingredients, and pesticides such as glyphosate. To read more on research surrounding glyphosate, click here. Most individuals will benefit from a gluten-free diet because gluten has been shown to make your gut more permeable in those with celiac disease or IBS, and in non-human studies, gluten has made the gut more permeable in general; however, that has not yet been proven in human subjects, so the research is still active [31] [32] [33] [34] [35]. Increased gut permeability allows proteins to get into your bloodstream where they sensitize your immune system and promote inflammation and autoimmunity, both of which play a role in the development of Alzheimer's [36] [37] [38].
  • Replace refined carbs with healthy fats. This point was made earlier in this article. I stated, “In a 2012 study investigating the association between the proportion of macronutrients in total diet and incidents of mild cognitive impairment or dementia, the researchers found diets high in carbohydrates increase your risk of dementia by 89%, while diets high in fats lower it by 44% [18]. According to the authors, ‘A dietary pattern with relatively high caloric intake from carbohydrates and low caloric intake from fat and proteins may increase the risk of mild cognitive impairment or dementia in elderly persons’ [18].”
  • Optimize your omega-3 level. Omega-3 supplements such as Healthmasters' Norwegian Omega 3 or Healthmasters' HEMMLA can help you optimize these levels.
  • Intermittent fasting. Intermittent fasting has been shown to increase insulin sensitivity, and as discussed in this article, insulin resistance is a primary contributing factor for Alzheimer’s [21] [22] [23] [24] [25] [39]. You can do this by compressing your eating window to six to eight hours.
  • Moving regularly and consistently throughout the day. One study suggests exercise can trigger how the APP if metabolized and can slow down the progression of Alzheimer’s [40].
  • Optimizing your levels of magnesium and vitamin D. It has been shown an increase of magnesium in the brain could lead to a decrease of neurodegenerative diseases [41] [42]. To read my article on magnesium, click here. Some studies show vitamin D may decrease the risk of Alzheimer’s and dementia, but the research is still inconclusive [43] [44].
  • Turmeric or curcumin supplementation. As noted in one of my previous articles (click here to read), turmeric and curcumin supplementation have been linked to reducing the risk of Alzheimer’s disease [45] [46] [47].
  • Avoid flu vaccinations and eliminate aluminum from your body. Most flu vaccines contain both mercury and aluminum. EDTA supplements such as Healthmasters’ Chelation Therapy can assist in this process of detoxification.
  • Optimize your sleep pattern. Insufficient sleep can lead to neuron degeneration, and simply sleeping in on the weekend will not reverse or prevent this damage [48] [49] [50]. Poor sleep has also been shown to accelerate one’s onset of Alzheimer’s disease [51].


Review and Conclusion

To review:

  • Cholesterol is generally misunderstood
  • LDL and HDL are not cholesterol; cholesterol is cholesterol
  • The measurement of cholesterol is not as scientific as one may think
  • There is a relationship between low levels of cholesterol and increased risk of impulse behavior, aggression, and suicide
  • There is a relationship between low levels of cholesterol and neurodegenerative disorders
  • A diet high in healthy fats can benefit you and your brain’s health through the production of ketones
  • Phospholipid-Bound DHA can play a critical and helpful role in preventing Alzheimer’s, specifically in individuals with the APOE4 gene
  • There are lifestyle activities you can do to decrease your risk of Alzheimer’s


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[52] This article was adapted from with information from additional research