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A look at the real causes of heart disease and the role that cholesterol plays. Article gives lifestyle tips and evidence to support the role of diet, exercise and other lifestyle factors in both cholesterol lowering and heart disease prevention.

We all know that having raised cholesterol causes heart disease, right? And therefore reducing cholesterol by using prescription drugs is a sure way to prevent suffering a heart attack? It seems that the answer my not just be a simple “yes”. Lifestyle factors play a huge role in heart disease prevention and can be particularly effective for most people in lowering cholesterol levels, without medication. In addition, heart disease is a complex process that involves a number of risk factors with high cholesterol being just one of them. 

The Cause of Heart Disease

In essence a heart attack is an ischemic event in which the blood supply to the heart organ is cut off (in the case of a stroke it’s the brain’s blood supply that is blocked). The leading cause of heart disease is something known as atherosclerosis, or a hardening of the arteries.

Cholesterol build-up in the blood is one of the ways of blocking up an artery but not everyone with high cholesterol will suffer a blocked artery.

Smoking, high blood sugar and stress can damage blood vessels making them more susceptible to cholesterol build-up, and high blood pressure literally forces cholesterol onto the walls of the arteries.

What is Cholesterol?

Cholesterol is a fatty wax like substance, which is produced by the liver and used for many body functions. Cholesterol is also found in the food we eat. Meat, fish, chicken, egg yolks and dairy products are all sources of cholesterol. Too much cholesterol in the blood is the main underlying cause of heart disease. Some people genetically manufacture too much cholesterol, but most people get it from the diet.  

Cholesterol is transported in the blood via lipoproteins:

  • High-density lipoprotein (HDL or “good cholesterol”) transports cholesterol away from the tissues. High levels offer some degree of protection against CHD. Regular exercise and moderate alcohol consumption have been found to increase HDL levels.
  • Low density lipoprotein (LDL or “bad cholesterol”) transports cholesterol to the tissues where it can do harm by promoting atherosclerosis.

A high level of LDL cholesterol is associated with an increased risk of heart disease. People who have high HDL levels have some form of protection against heart disease. When assessing risk, both fractions should be taken into account.

Cholesterol is found in animal based foods.

All meat, chicken, fish and dairy contains some cholesterol.

Particularly high cholesterol foods include liver, egg yolk, meat, chicken, dairy, prawns, roe and squid. When it comes to which foods raise cholesterol, there is some degree of confusion. While animal based foods all contain cholesterol, however, it’s the types of fats in a food that have more impact on total blood cholesterol than cholesterol itself. Also, some high cholesterol foods, like eggs, also contain substances that lower cholesterol. For example an egg contains unsaturated fats and lecithin, which have a positive effect on cholesterol and seafood, is relatively low in fat in general.

While managing your intake of high cholesterol foods is important, certain so-called bad fats can be far more damaging to the body than cholesterol alone. Research has now shown that dietary cholesterol is not so much the culprit in CHD as are the presence of saturated fat and the lack of poly and monounsaturated fats in the diet.

The culprits are:

  • Saturated fatty acids are found in meat, chicken skin, butter, cream, full cream dairy, coconut and palm kernel oil and cocoa butter. Dietary saturated fats increase total cholesterol and LDL cholesterol.
  • Trans fatty acids are produced when fats are hydrogenated to produce commercial products such as margarine (except those listed as trans fat free), pies and certain baked goods. Trans acids increase LDL cholesterol.
  • Fried foods. Oils that have been exposed to heat become rancid


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