Cholesterol is a lipid naturally found in your body. It has a waxy consistency, and it’s produced by your liver, because it’s important for keeping your organism healthy. Cholesterol helps form cell membranes, aids in the birth of certain hormones, but also boosts vitamin D production. Since it’s not water-soluble, cholesterol requires lipoproteins to travel through the blood, which are formed from proteins and fat. Some of these lipoproteins are good, while others are bad.
Types of cholesterol
Your body makes all the cholesterol it needs to stay healthy all on its own. Extra cholesterol deposits are the result of eating foods that are fatty and rich in cholesterol. Two main types of cholesterol travel inside your bloodstream:
- Low-density lipoprotein (LDL, for short), or “bad cholesterol” travels to your cells. When your blood has too much of this protein, it sticks to the walls of the arteries, causing them to become harder and narrower.
- High-density lipoprotein (HDL, for short), or “good cholesterol” tried to remove LDL cholesterol from your body, so the goal is to have as much of it as possible.
There is also a third type of lipid, triglycerides. While they have a different structure compared to cholesterol, they are still considered a form of bad cholesterol, because having too many of them causes health problems. Triglycerides can be considered a source of energy. As you consume calories, your body uses some on the spot, while conserving the excess for later use. To preserve calories, the body converts them to triglycerides, which are stored in your fat cells.
People who eat more calories than the recommended daily intake will end up having an elevated level of triglycerides in their body, which causes several different health problems, much like LDL cholesterol does.
The lipid profile
Also known as the lipid panel, a lipid profile helps determine what your current cholesterol figures are. The lipid profile will determine your total cholesterol, your HDL and LDL levels, and your triglycerides count.
The lipid panel test for high cholesterol screening requires a blood sample extracted through a needle injected into a vein in the arm. There are faster ways to draw blood, such as puncturing one of your fingertips, but the machines that test cholesterol are portable devices found in locations such as health fairs.
The general rule is to avoid food and drinks (except water) 12 hours before the test, but this really depends on what the laboratory requires. If you schedule a lipid profile test, you will be given instruction on fasting, if required.
Adults over the age of 20 who don’t have any diagnosed heart disease can take a cholesterol test once every five years. Children and young adults below this age should get tested at least once, particularly if they have a family history of high cholesterol.
Initially, the doctor may opt to perform the test for total cholesterol levels and, if the results are dubious, will run a full lipid profile. A person’s total cholesterol is the sum of the HDL and LDL cholesterol, plus 20 percent of triglyceride levels.
Another important figure given by the lipid profile is your cholesterol ratio — your total cholesterol, divided by your HDL level. For example, someone with a total cholesterol of 180 mg/dL and an HDL cholesterol of 60 mg/dL will have a cholesterol ratio of 3. The American Heart Association says that the best cholesterol ratio is below 5, with the ideal number being 3.5.
Naturally, interpreting the results of your cholesterol test are best left to a healthcare professional, but the optimal intervals for people who don’t have or are not at risk of heart disease are:
- Your total cholesterol level should be less than 200 mg/dL.
- The optimal HDL levels are below 100 mg/dL.
- The best HDL results should be of at least 50 mg/dL.
- Triglycerides levels should be below 150 mg/dL.
Consequences of high cholesterol
Even if high cholesterol doesn’t usually show any symptoms, treating elevated levels should be a priority, as the consequences of hypercholesterolemia can permanently damage your organs, and even be fatal in certain situations.
Cholesterol creates deposits on the artery walls, which means that is less free space available for blood to circulate inside the arteries. Less blood flow means that the organs that are attached to the narrow or blocked arteries won’t receive the supply they need, thus becoming prone to damage.
Naturally, high blood pressure is a consequence of high cholesterol, but that’s just the tip of the iceberg.
Coronary heart disease as a result of high cholesterol is probably the most well-known complication. This happens when the cholesterol deposits (called plaques) damage the arteries, preventing blood flow. Coronary heart disease can lead to a number of different other complications. You can experience angina, which is pain in the chest region. There are also greater chances of having a heart attack, as a blocked or narrow artery prevents blood from reaching the muscles of your heart, causing them to deteriorate in time.
As the heart is deprived of oxygen and nutrients, one can also experience heart failure, as this organ grows weaker and weaker. Abnormal heart rhythm is also a consequence of coronary heart disease, which is also known as arrhythmia.
The arteries just don’t supply the heart with blood. High cholesterol raises the risk of stroke, too, when the blood supply to your brain is low or cut off completely. When a person is having a stroke, they may start to experience sudden and severe headache, partial or total vision loss, blurred vision, dizziness, speech impairment, difficulty in speaking, confusion, and even numbness in the face, arms or legs. This requires immediate medical assistance.
A transient ischemic attack is also known as a mini-stroke, and occurs when the blood supply to the brain is temporarily cut off. While the transient ischemic attack shows signs similar to a stroke, it usually lasts for about five minutes, and doesn’t damage the tissue permanently.
However, since most people are unable to tell the difference between a stroke and a transient ischemic attack, seeking medical attention is required either way. A person who suffered a transient ischemic attack is considered at risk of having a stroke.
Arteries also pump blood to your kidneys, your stomach, your arms and legs. As plaque builds up and clogs these arteries, you can have peripheral artery disease, or chronic kidney disease because of high cholesterol.
Peripheral arterial disease usually has some clear symptoms, causing pain when walking or trying to lift heavier things. The more this disease progresses, the most visible the symptoms become, and can include: gangrene (a condition that expresses death tissue caused by an interruption in blood supply), a burning sensation in your toes, leg cramps, leg ulcers (with wounds that don’t heal or heal very slowly), and painful feeling in the skin.
Medication for cholesterol
While doctors usually recommend making lifestyle changes in order to improve your cholesterol levels, you may sometimes receive a medical prescription to speed up the process, or when the dietary changes aren’t sufficient for any improvement.
There are different types of cholesterol-lowering meds, some of which raise HDL cholesterol, while others lower LDL cholesterol and triglycerides.
Some of the most common medications for lowering cholesterol include:
- Statins for high cholesterol work inside your liver by blocking the substance that it needs to make cholesterol. They can also push the liver into absorbing cholesterol deposits for your artery walls, so they are widely recommended to people on the verge of coronary artery disease. Some of the most common types of statins are simvastatin, pitavastatin, lovastatin, atorvastatin, and fluvastatin.
- Resins for high cholesterol, also known as bile acid sequestrants, will literally bind to bile acid, a substance your body uses for digestion. Because resins eliminate bile acids, your liver will automatically make more, using up more cholesterol and resulting in reduced levels.
- Cholesterol absorption inhibitors work on your small intestine to prevent it from absorbing cholesterol coming from your food. That means less cholesterol in your bloodstream. A type of inhibitor is ezetimibe, which is sometimes combined with statins. Some doctors may prescribe ezetimibe alone, and recommend their patients combine it with a low-fat diet.
- PCSK9 inhibitors for high cholesterol are a novel option currently being tested. It is the most expensive kind of cholesterol drug currently on the market, so doctors will only prescribe it when other types of medication have failed to yield good results. These injectable inhibitors raise your HDL levels.
- Niacin to treat high cholesterol prevents your liver from making more LDL. Not a lot of doctors prescribe niacin, as it has been linked to the stroke and liver damage. Even more, the benefits of taking a niacin-based treatment don’t outweigh those of a statin-based treatment.
- Fibrates to manage high cholesterol are prescribed to people who need to lower their triglycerides. However, fibrates can sometimes interact with statins and increase the risk of side effects.
Foods that lower cholesterol
A lot of people freak out when they hear the word “diet”. Leading a healthy lifestyle and having a cholesterol-lowering diet doesn’t mean you will have to give up every delicious food on Earth. It just means that you will have to replace some foods with others that are low in fat and cholesterol, which requires learning what to eat and avoid with high cholesterol.
Some good dietary recommendations to lower your cholesterol, but also to improve your overall health, include:
- Fish is the healthiest type of meat that you can choose. It has plenty of omega-3 fatty acids, which help reduce triglyceride levels and improve high blood pressure. Even if they don’t impact your LDL levels, two servings of fish per week will keep your heart healthy. The ones with the richest omega-3 fatty acids contents are salmon, mackerel, trout, herring, and tuna. Fish oil helps reduce high cholesterol, too.
- Because fried foods are bad for your health, people assume it’s all about the oil. Oil can actually be good for your health, especially olive oil.
- Foods that are high in fiber are nutritious and healthy. It can be anything from apples to kidney beans, as long as its soluble fiber, which absorbs the amount of cholesterol in your bloodstream.
- Whole grains are also a very healthy addition to your diet, particularly oats and barley.
- You can still eat meat, as long as it’s lean. Remove as much fat from meat before cooking them, and always opt for a cooking method that doesn’t involve frying.
- Consider adding a daily serving of nuts to lower your cholesterol, They are an amazing treat, but can also serve as an ingredient for salads, and makes a delicious dessert when combined with some low-fat yogurt.
- No matter what you do, avoid trans fats and eat less sugar to lower cholesterol. Sugar means a lot of calories, and calories mean a lot of triglycerides. Trans fats are made through a process which involves adding hydrogen to unsaturated fats, which is a bad idea for any diet.
High cholesterol: Causes and risk factors
High cholesterol is usually linked to an unhealthy diet and the lack of physical exercise. But those are not the only things that cause hypercholesterolemia. There are two main causes of high cholesterol: those that you can control, and genetic causes that you cannot alter.
There is a condition called familial hypercholesterolemia, which basically means that you’ve inherited a gene from one or both of your parents, which interferes with how the body normally processes cholesterol. People who have familial hypercholesterolemia are born with it. A genetic test can be performed to diagnose this condition, which can be kept under control through healthy lifestyle measures and medical treatment.
Other causes can be controlled, ranging from obesity to inactivity:
- An unhealthy diet influences cholesterol both directly and indirectly. The foods that you eat can contain trans fats and cholesterol, which naturally lead to elevated cholesterol levels in the bloodstream. Indirectly, eating improperly can lead to obesity, and people with a body mass index higher than 30 are at risk of developing hypercholesterolemia.
- Smoking raises your cholesterol. It is infamous for causing damage to the inner walls of the vessels. When this happens, it’s way easier for cholesterol build-up to get stuck to the artery walls, causing plaque and narrow arteries.
- Lack of physical exercise is more dangerous than you think. Exercising isn’t just useful for keeping the extra pounds under control; studies have shown that exercising can increase HDL levels, while also making LDL particles larger, and therefore less harmful.
- Diabetes can affect your cholesterol levels. It elevates the levels of VLDL in your body (which is where triglycerides come from), while lowering good cholesterol levels. When blood sugar levels are too high, the arteries are more exposed to damage.
Who should pay extra attention to cholesterol?
Even if high cholesterol is a threat to everyone who fails to follow a healthy diet and exercise path, certain categories of people are likely to have high cholesterol even if they carefully watch what they eat and how much they move:
- Age is a well-known risk factor for high cholesterol. With age, the body’s organs become less capable of performing their functions, and thus the liver finds it more difficult to remove bad cholesterol for the system.
- Aside from aging, in women, the menopause increases the risk of high cholesterol. A study of more than 1,000 women found a direct link between menstruation and cholesterol levels. As women age, their estrogen levels drop, which causes an increase in LDL cholesterol.
- Generally speaking, children don’t have high cholesterol (unless they are obese, in which case parents must immediately by monitoring cholesterol levels and imposing a strict and healthy diet). However, children with familial hypercholesterolemia have inherited the “bad cholesterol” gene. When this condition is not kept under control it can lead to heart disease from a very young age.
- Pregnant women have a flood of hormones that change their body to prepare them for the developing child. The topic of high cholesterol in pregnant women is very sensitive, because they are not allowed to take most medications that would normally be prescribed to people with hypercholesterolemia. Pregnant women will naturally have higher cholesterol levels compared to their pre-pregnancy numbers —cholesterol can rise by up to 50 percent during the third trimester. The occurrence is natural, as the body needs more steroid hormones for the fetus.
Cholesterol and physical exercise
Regular exercising isn’t just for keeping cholesterol under control: it’s a fool-proof way of increasing your life expectancy. It’s something that you have to squeeze into your weekly schedule if you want to be able to lower cholesterol without taking medication for an indefinite amount of time.
Studies suggest that the most efficient activities are strength-training exercises combined with aerobic sessions. The American Heart Association tells us that we need at least 150 minutes of weekly moderate-intensity exercise. If you want to take Saturday and Sundays off, that’s 30 minutes of exercising from Monday to Friday. Manageable, isn’t it?
Depending on your age and current health condition, some exercises might be more suitable for you than others:
- Walking or running are great if your joint health is optimal.
- Biking can require as much energy as jogging, but it’s best for people with joint pain.
- Lifting weights can be part of a good exercise program for lowering cholesterol, but they are best combined with aerobics.
- Swimming is one of the best sports for your overall health. It puts all the body’s muscles to good use; it’s easy on the joints, and also as efficient as an aerobic exercise session.
Remember that your body already produces the cholesterol it needs to stay healthy, so any extra cholesterol you consume is just bad news. Since eating virtually no cholesterol is extremely difficult, you need to seek out alternative foods that are low in fat, but also give you the nutrients you need for a healthy organism.
Typically, a diet that’s good for your cholesterol levels will contain a lot of fish, nuts, fruits, vegetables, legumes, low-fat dairy products, and lean meat. Aside from eating properly, you will have to exercise. Even if you don’t do it every day, exercising about three or four times per week reduces the risk of heart disease, but also helps the body stay in shape in the long run.Back to top