Cardiologist Alok Chopra recently argued that cholesterol has been unfairly demonised over the years. Speaking on Eisha Chopra’s podcast, he said, “Cholesterol has become a swear word…everybody thinks it’s evil. The moment the cholesterol goes around 200, everybody gets a pill. You must understand that cholesterol is essential for life… Where does cholesterol come from? I ask most of my patients, and they say it comes from food. I said (reply) not at all. 85% of cholesterol is made by our body. If something is made in our body, how can it be bad? Cholesterol is deeply linked to our immunity; it does a damn good job for that. Deactivating bacteria, controlling infections, protecting against damage, reducing the chances of AIDS, Alzheimers, recovery from illness, all that is done by cholesterol. So cholesterol varies over time, with levels increasing in winter and decreasing in summer. It increases after infections, after surgery, dental treatment, and even stress. And when we are relaxed, then the cholesterol comes down. I love cholesterol; I always tell people about my cholesterol. It’s 325…and I am still alive.”
Dr Chopra further pointed out that most cholesterol is naturally produced by the body and plays an important role in immunity, recovery, and overall functioning. He also noted that cholesterol levels can fluctuate with stress, infections, surgeries, and even seasonal changes.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
Is cholesterol really misunderstood?
According to Parin Sangoi, cholesterol is often misunderstood because people tend to classify it as simply “good” or “bad”. “Cholesterol itself is not the villain people think it is,” Dr Sangoi explains. “The body needs cholesterol to make hormones, vitamin D, and even to build healthy cells.”
However, the type and quantity of cholesterol matter. “LDL cholesterol is often called ‘bad’ because excess LDL can deposit inside artery walls and gradually narrow blood vessels,” he says. “HDL, on the other hand, helps clear some of that cholesterol from circulation.”
Wrong assumptions
According to Dr Sangoi, many people wrongly assume that eating certain foods alone directly causes heart disease. “What worries cardiologists is not one food item or one blood test, but a long-term pattern,” he says. “Poor diet, smoking, lack of exercise, diabetes, stress, poor sleep, and obesity together increase cardiovascular risk.”
He adds that blaming foods like eggs or ghee alone oversimplifies the issue. “Heart health is shaped by overall lifestyle and metabolic health, not fear of one nutrient,” Dr Sangoi says.
When should high cholesterol become a concern?
“Concern begins when cholesterol levels stay persistently high, especially LDL and triglycerides, because they can accelerate plaque formation inside arteries,” Dr Sangoi explains.
Story continues below this ad
Importantly, doctors do not interpret cholesterol readings in isolation. “A mildly elevated cholesterol reading in a healthy young individual may not carry the same risk as the same number in someone with diabetes, high blood pressure, smoking history, or family history of heart disease,” he says.
Genetics can also play a major role. “Some patients have genetically high cholesterol, where even a healthy lifestyle may not be enough and medication becomes necessary early in life,” he adds.
Can stress, illness, or surgery affect cholesterol readings?
Dr Chopra’s observation that cholesterol fluctuates after stress or illness is medically plausible, experts say.
“Yes, cholesterol readings can fluctuate more than people realise,” Dr Sangoi notes. “Acute illness, infections, surgery, physical stress, poor sleep, dehydration, rapid weight loss, and even certain medications can temporarily alter lipid levels.”
Story continues below this ad
Emotional stress can also indirectly influence cholesterol through hormonal changes and unhealthy lifestyle patterns.
“This is why one abnormal test should not create panic,” he says. “If a person has recently recovered from illness or undergone surgery, doctors may repeat the test after a few weeks before making long-term decisions.”
Why total cholesterol alone is no longer enough
Modern cardiology has moved beyond focusing only on total cholesterol levels. “Total cholesterol alone is not enough anymore,” Dr Sangoi says. “Today we look at LDL levels, triglycerides, HDL, waist circumference, blood sugar, blood pressure, inflammatory markers, and lifestyle habits.”
Two people with identical cholesterol numbers may still have vastly different cardiovascular risks. “A physically active person with balanced metabolic health may be at lower risk than someone with borderline cholesterol but uncontrolled diabetes, chronic stress, smoking, and abdominal obesity,” he explains.
Story continues below this ad
For deeper evaluation, cardiologists may also recommend advanced markers such as hs-CRP, serum homocysteine, Lipoprotein(a), ApoA, and ApoB. “These tests help identify hidden inflammation, genetic cholesterol risk, and particle-related cardiovascular risk that routine cholesterol reports may miss,” Dr Sangoi says.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.