Cholesterol, Inflammation, and Women’s Heart Health: What the Science Reveals
When I turned my attention to heart health, I used to fear cholesterol. Like many women, I believed that keeping cholesterol low was the key to avoiding heart disease. But after years of research and listening to experts like Professor Bart Kay and Dr. Paul Mason, I learned that the old story about cholesterol is outdated and scientifically weak.
Your body makes about 80% of its own cholesterol because it is essential for life. Cholesterol builds hormones, supports brain function, and maintains cell membranes. It is not the problem. The real issue lies in what damages your arteries in the first place—inflammation.
The Truth About LDL
Low-Density Lipoprotein (LDL) has been called “bad cholesterol” for decades, but that label is misleading. LDL is not a type of cholesterol—it’s a transport vehicle. Its job is to carry cholesterol, triglycerides, and fat-soluble vitamins from the liver to the cells that need them. Every cell in your body depends on this process to repair membranes, make hormones, and maintain healthy function.
The confusion started when scientists noticed LDL cholesterol levels in people with heart disease and assumed it was the cause. But association is not causation. Later studies showed that many people with normal LDL levels still developed heart disease, while others with high LDL lived long, healthy lives.
The key difference lies in LDL particle quality, not quantity. When the body is healthy and inflammation is low, LDL particles are large and buoyant. They move easily through the bloodstream without causing harm. But when inflammation is present, caused by high blood sugar, processed foods, and insulin resistance, LDL particles become small and dense. These smaller particles are more likely to oxidize—meaning they react with free radicals—and this oxidation can irritate the artery walls.
That irritation triggers the body’s repair response. The body sends more cholesterol to the site to heal the damage. So when doctors see high LDL in the blood, they’re often seeing evidence of a repair process, not a cause of disease.
Professor Bart Kay puts it simply: “Blaming LDL for heart disease is like blaming firefighters for a fire.” LDL shows up because something is already burning—inflammation, poor diet, and metabolic dysfunction.
In other words, if you reduce the inflammation, you remove the need for the “firefighters” to be there. A low-carb diet helps do exactly that by keeping blood sugar and insulin low, improving LDL particle size, and supporting the body’s natural repair mechanisms without unnecessary damage.
Inflammation is the body’s response to damage. Chronically high blood sugar and insulin levels cause that damage over time. When you eat a diet high in refined carbohydrates and sugar, your blood sugar spikes. This leads to insulin resistance, which raises blood pressure and causes microscopic tears in artery walls. The body then sends cholesterol to repair those tears.
This repair process is not the problem—it’s a survival mechanism. But when inflammation persists, the repair never stops. This ongoing damage leads to arterial sclerosis, the hardening of arteries that increases the risk of heart attack and stroke.
Why Low-Carb Diets Improve Heart Health
A low-carb or ketogenic diet lowers insulin and stabilizes blood sugar. This reduces inflammation at the root level. Over time, many people see their triglycerides drop and HDL (“good” cholesterol) rise, both signs of improved heart health.
What some notice, however, is a rise in LDL. This often causes fear, but context matters. If inflammation markers are low, triglycerides are normal, and HDL is high, the rise in LDL may simply reflect the body’s healthy use of fat for fuel. Dr. Paul Mason explains that in low-carb individuals, cholesterol particles become larger and less dense, which makes them far less likely to cause damage.
Monitoring What Really Matters
Instead of focusing only on cholesterol tests, pay attention to markers of inflammation and metabolic health. Ask your doctor to check:
High-sensitivity C-reactive protein (hs-CRP)
Fasting insulin
HbA1c (for long-term blood sugar control)
Triglyceride-to-HDL ratio
These numbers tell a clearer story about your risk than total cholesterol alone.
The Statin Question
Statins are one of the most commonly overprescribed drugs in the world. They work by blocking an enzyme in the liver that produces cholesterol. This lowers total and LDL cholesterol levels on blood tests, which may look reassuring, but the real issue is what happens inside the arteries.
Statins do not stop the inflammatory process that damages artery walls in the first place. They simply reduce the amount of cholesterol your body can make. Since cholesterol is essential for hormone production, vitamin D synthesis, and cell repair, reducing it will create new problems—especially for women.
Many women report side effects from statins such as muscle pain, fatigue, joint stiffness, memory problems, and mood changes. Some also experience hormonal imbalances because cholesterol is the raw material for estrogen, progesterone, and other steroid hormones. When you suppress cholesterol production, you interfere with the body’s ability to maintain those hormones naturally.
There is also growing evidence that lowering cholesterol with medication does not always translate into fewer heart attacks or longer life, particularly in people without existing cardiovascular disease. Large studies have shown that in older women, high cholesterol often correlates with better survival, not worse.
Dr. Bart Kay and other metabolic health experts argue that the focus should shift away from cholesterol levels toward identifying and reducing chronic inflammation. If inflammation, insulin resistance, and oxidative stress are not corrected, the underlying damage continues regardless of how low your cholesterol goes.
Statins may have a place for some people with advanced arterial disease, but for many women, the wiser path is to address root causes—diet, blood sugar, insulin control, and inflammation. As Dr. Bart Kay says, “We don’t have a cholesterol problem, we have an inflammation problem.” The real solution starts with food, not pharmaceuticals.
The Bottom Line
Cholesterol is not your enemy. Sugar, processed foods, and chronic inflammation are. Your body produces cholesterol because it needs it for survival. When you eat real food, reduce carbohydrates, and balance your insulin, your arteries heal naturally.
Do not fear your cholesterol numbers. Learn what they mean in context. Understand your body’s physiology. Most of all, remember that you have the power to support your heart through informed choices, not fear-based prescriptions.
Disclaimer: The content shared here is for informational and educational purposes only and should never be taken as medical advice.
In writing this blog post, my goal is to distill research findings into a clear, approachable format that encourages critical thinking and empowers you to make informed decisions about your health.
