Cholesterol Fact vs. Fiction For many of us the word cholesterol brings both a sense of fear, and a degree of uncertainty. Most of us have heard the word, yet what exactly is it about cholesterol that has gotten it such an infamous name?
Cholesterol is synthesized in virtually all cells, and significant amounts of it can be absorbed from the diet.
Most of the cholesterol in the body is synthesized therein; some is absorbed in the diet
Cholesterol is primarily synthesized from acetyl CoA through the HMG-CoA reductase pathway in many cells and tissues. About 20–25% of total daily production (~1 g/day) occurs in the liver; other sites of high synthesis rates include the intestines, adrenal glands, and reproductive organs.
Major dietary sources of cholesterol include cheese, egg yolks, beef, pork, poultry, and shrimp. 
Given the well-recognized role of cholesterol in cardiovascular disease, it is surprising that some studies have shown an inverse correlation between cholesterol levels and mortality in subjects over 50 years of age—an 11% increase overall and 14% increase in CVD mortality per 1 mg/dL per year drop in cholesterol levels.
In the Framingham Heart Study, the researchers attributed this phenomenon to the fact that people with severe chronic diseases or cancer tend to have below-normal cholesterol levels. 
This explanation is not supported by the Vorarlberg Health Monitoring and Promotion Programme, in which men of all ages and women over 50 with very low cholesterol were increasingly likely to die of cancer, liver diseases, and mental diseases.
Framingham studies and others have shown that the average LDL cholesterol of those that suffer from heart-disease is not much higher than the healthy.
Recall that triglycerides in the blood are primarily carried by VLDL, while cholesterol is primarily handled by LDL.
Thanks to a lipid metabolism specialist Ronald Krauss, we know there are actually seven discrete subclasses of LDL!
According to Krauss LDL can come in two varieties:
(Pattern A) A fluffy lipoprotein full of cholesterol.
(Pattern B) A denser LDL with less cholesterol.
He noted that only the densest LDL (Pattern B) seemed to be linked to heart disease, and it also was invariably linked to decreased levels of HDL (the ‘good’ cholesterol).
It seems that if the cholesterol that fills the LDL balloon was not in sufficient quantities, we would be at higher risk of heart diseases (and perhaps explains the inverse relationship seen between cholesterol and mortality in those over 50).
The Problem: Triglycerides & Carbohydrates, not Cholesterol
While we have seen that cholesterol is a very important molecule, the real problem lies in the fact that carbohydrate-rich meals result in the liver converting excess glucose into triglycerides.
Remembering the triglycerides are transported by VLDL, we would see an increase in VLDL by consuming carbohydrates. These particles then deliver the triglycerides throughout the body, and end their life as a smaller and denser LDL.
The result of seven trials of Krauss demonstrated that diets lower in fat and higher in carbohydrates resulted in smaller and denser LDL particles.
Some of the work by Professor Stephen Phinney, has also noted a statistically significant decrease in the size of LDL associated with carbohydrate-rich diets.
This explains how triglycerides, more so than cholesterol, is the determining factor in obesity.