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Cholesterol is much more than just a popular topic. Its a vital compound that is required for numerous functions, which is why it can be produced by just about every cell in the body.
It is a structural and functional element of cell membranes, a major lipid in the brain and central nervous system, and a precursor to all steroid hormones, vitamin D, and bile salts.
Most importantly, cholesterol is essential to nerve transmission and neural function cell membrane fluidity and permeability growth and development digestion and absorption vitamin D synthesis stress response blood pressure and fluid and salt balance.
Your Test Results: A Preview
Your test results will show your cholesterol levels in milligrams per deciliter of blood . Your total cholesterol and HDL cholesterol are among numerous factors your doctor can use to predict your lifetime or 10-year risk for a heart attack or stroke. Your doctor will also consider other risk factors, such as age, family history, smoking status, diabetes and high blood pressure.
Lipid profile or lipid panel is a blood test that will give you results for your HDL cholesterol, LDL cholesterol, triglycerides and total blood cholesterol.
How Do You Prepare For A Cholesterol Test
In most cases, youll need to fast for nine to 12 hours before the test. Make sure you tell the person drawing your blood how long it has been since you ate or drank anything that wasnt water.
There are some cases when a cholesterol test is done without fasting. This is true for tests done at health screenings and may be true for people younger than 20 or for people who are unable to fast.
Some medical societies believe that fasting is not necessary to get a true picture of lipid levels in the blood, while other associations stand by the belief that fasting gives a better idea of a persons heart disease risk. You should be clear on whether or not you need to fast, and for how long, before you go for the blood test.
What Is High Cholesterol
Cholesterol is a waxy substance that is made by the liver and obtained through the diet. It can be found in the fats in your blood. High cholesterol is when you have high amounts of cholesterol in the blood.
Cholesterol is essential in order for your body to continue building healthy cells, however having high cholesterol can increase your risk of heart disease. This is because it can lead to a build-up of fatty deposits in your blood vessels, which overtime can make it difficult for enough blood to flow through your arteries and consequently to your heart.
What Else To Know About Cholesterol
Optimal LDL-lowering therapy alone fails to avert the majority of heart disease. Its well known that lowering LDL cholesterol does, indeed, lower your risk for heart disease. But a sad fact is that despite the effectiveness of statin drugs for reducing heart disease risk, even optimal LDL-lowering therapy alone fails to stop 60% to 70% of coronary heart disease cases. Clearly, theres more to heart disease than LDL cholesterol!
Luckily, by looking beyond just total and LDL cholesterol, you can use your cholesterol ratio from your standard cholesterol test to tell you a lot about your risk for developing heart disease and having a heart attack or stroke. To improve your ratio, either increase your HDL or lower your total cholesterol, or both. Achieving this ratio of 3.5 or less is quite doable for most people using natural healing therapies.
Ingelsson E, Schaefer EJ, Contois JH, McNamara JR, Sullivan L, Keyes MJ, Pencina MJ, Schoonmaker C, Wilson PW, DAgostino RB, Vasan RS. Clinical utility of different lipid measures for prediction of coronary heart disease in men and women. JAMA. 2007 Aug 15 298:776-85.
Zhang L, Qiao Q, Tuomilehto J, et al DECODE Study Group. The impact of dyslipidaemia on cardiovascular mortality in individuals without a prior history of diabetes in the DECODE Study. Atherosclerosis. 2009 Sep 206:298-302.
This post originally appeared in 2012 and is regularly updated.
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What Are Cholesterol Levels
- LDL cholesterol is often referred to as “bad” cholesterol because too much of it can build up in your arteries and form plaques, which increases the risk of heart disease .
- HDL cholesterol is often referred to as “good” cholesterol as it carries cholesterol to the liver to be broken down and excreted.
Since your total cholesterol is a combination of your LDL cholesterol and your HDL cholesterol, ideally you want to keep your LDL levels low and your HDL levels high. There are many factors that can influence your cholesterol, including, diet, exercise, weight, genetics, and other health conditions.
How To Maintain Optimal Total Cholesterol Levels
- Fill up on fiber-rich foods like veggies, fruit, whole grains, and legumes, aiming to get 30-40g fiber each day.
- Limit refined carbs and added sugars, like those found in soda, chips, candy, baked goods, sweetened yogurt, and ice cream.
- Avoid trans fats and reduce saturated fat intake to < 10% total calories.
- Eat small, fatty fish at least twice a week. Salmon, sardines, and trout are all great choices.
- Get 30-60 minutes of physical activity most days of the week.
- Incorporate plant sterols and stanols daily in the form of food or a supplement.
- Lose weight if you are overweight or obese.
- Quit smoking if you currently smoke.
- Achieve and maintain good blood sugar control if you have diabetes or prediabetes.
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How Can A High Ldl Level Raise My Risk Of Coronary Artery Disease And Other Diseases
If you have a high LDL level, this means that you have too much LDL cholesterol in your blood. This extra LDL, along with other substances, forms plaque. The plaque builds up in your arteries this is a condition called atherosclerosis.
Coronary artery disease happens when the plaque buildup is in the arteries of your heart. It causes the arteries to become hardened and narrowed, which slows down or blocks the blood flow to your heart. Since your blood carries oxygen to your heart, this means that your heart may not be able to get enough oxygen. This can cause angina , or if the blood flow is completely blocked, a heart attack.
Why Cholesterol Affects Women Differently
In general, women have higher levels of HDL cholesterol than men because the female sex hormone estrogen seems to boost this good cholesterol. But, like so much else, everything changes at menopause. At this point, many women experience a change in their cholesterol levels total and LDL cholesterol rise and HDL cholesterol falls. This is why women who had favorable cholesterol values during their childbearing years might end up with elevated cholesterol later in life. Of course, genetics and lifestyle factors can play big roles, too.
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Whats Your Cholesterol Level Anyway
A standard lipid blood test usually measures the concentration of total cholesterol, HDL cholesterol, and triglycerides levels. The LDL-cholesterol level is typically estimated from these numbers using a well-established formula that has been more recently revised and improved by researchers at Johns Hopkins.
So what are your target numbers? According to Michos, an ideal LDL cholesterol level should be less than 70 mg/dl, and a womans HDL cholesterol level ideally should be close to 50 mg/dl. Triglycerides should be less than 150 mg/dl. As Michos notes, total cholesterol levels well below 200 mg/dl are best.
Find Out Your Heart Age With The Heart Age Tool
Once you have your cholesterol results you can work out your risk of developing heart disease over the next 10 years using the NHS Heart Age Tool. You will get a more accurate result if you know your blood pressure numbers too. The heart age tool is designed for people aged 25 to 84.
Adults age 40-74 are also invited for NHS Health Checks which includes other simple tests to look at your heart health.
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Reducing Ldl Cholesterol Levels
The liver produces enough cholesterol to meet all of the bodys needs. Any cholesterol a person consumes through food and drink is excess.
Changing the diet is an effective way to lower LDL cholesterol levels. Reducing the consumption of trans fats can be an important first step in bringing cholesterol levels down.
If a person consumes 2,000 calories per day, they should only take in 1113 grams of saturated fats per day.
Other dietary and lifestyle changes that can help people reach optimum cholesterol levels include:
- eating fewer full fat dairy products, such as whole milk, butter, cream, and cheeses
- eating less red meat, pork, lamb, and poultry with skin
- avoiding heavily processed foods
- exercising regularly
- addressing related medical conditions, including diabetes and high blood pressure
Keeping a food diary can help a person identify room for improvement and develop healthier habits.
The following activities can boost a persons levels of HDL cholesterol:
- using oils with fewer trans fats, such as those from olives, sunflowers, canola, and corn
- eating more whole fruits and vegetables
- eating more whole grains and cereals
- replacing meat with plant-based protein sources, such as tofu and quinoa
- increasing their intake of dietary fiber
- drinking low fat milk or replacing milk with a dairy-free alternative
- getting regular exercise
Whats The Optimal Cholesterol Level
Written By Michael Greger M.D. FACLM on December 13, 2016
No matter where we live, how old we are or what we look like, health researchers from the Institute of Circulatory and Respiratory Health have discovered that 90% of the chance of having a first heart attack can be attributed to nine modifiable risk factors. The nine factors that could save our lives include: smoking, too much bad cholesterol, high blood pressure, diabetes, abdominal obesity, stress, a lack of daily fruit and veggie consumption, as well as a lack of daily exercise.
Dr. William Clifford Roberts, Executive Director of Baylor Heart and Vascular Institute and long-time Editor in Chief of the American Journal of Cardiology, is convinced, however, that atherosclerosis has a single causenamely cholesteroland that the other so-called atherosclerotic risk factors are only contributory at most. In other words, we could be stressed, overweight, smoking, diabetic couch potatoes, but if our cholesterol is low enough, there may just not be enough cholesterol in our blood stream to infiltrate our artery walls and trigger the disease. Thus, the only absolute prerequisite for a fatal or nonfatal atherosclerotic event like a heart attack is an elevated cholesterol level.
Normal cholesterol levels may be fatal cholesterol levels.
Its imperative for everyone to understand Dr. Roses sick population concept, which I introduced in When Low Risk Means High Risk.
Michael Greger, M.D.
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Lifestyle Tips To Cut Cholesterol
Changing some of your lifestyle habits may also help to reduce your cholesterol and triglyceride levels. Suggestions include:
- Cease alcohol consumption or reduce your alcohol intake to no more than one or two drinks a day. Avoid binge drinking. This may help lower your triglyceride levels.
- Dont smoke. Smoking increases the ability of LDL cholesterol to get into artery cells and cause damage.
- Exercise regularly . Exercise increases HDL levels while reducing LDL and triglyceride levels in the body.
- Lose any excess body fat. Being overweight may contribute to raised blood triglyceride and LDL levels.
- Control your blood sugar levels if you have diabetes. High blood sugars are linked to an increased risk of atherosclerosis , heart attacks and strokes.
Which Foods Can Help Lower Cholesterol
The American Heart Association has developed diet guidelines to help lower cholesterol levels. It may be a challenge to read the nutritional contents on food packaging and on restaurant menus or to do the math, but the benefit will decrease the risk of heart attack and stroke.
- Limit total fat intake to less than 25% to 35% of your total calories each day.
- Limit saturated fat intake to less than 7% of total daily calories.
- Limit trans fat intake to less than 1% of total daily calories.
- The remaining fat should come from sources of monounsaturated and polyunsaturated fats that are found in unsalted nuts and seeds, fish and vegetable oils.
- Limit cholesterol intake to less than 300 mg per day, for most people. If you have coronary heart disease or your LDL cholesterol level is 100 mg/dL or greater, limit your cholesterol intake to less than 200 milligrams a day.
Some food groups may be beneficial in directly lowering cholesterol levels and include foods with plant sterol additives, high fiber foods like bran, oatmeal, and fruits like apples and pears, fish, nuts, and olive oil. Some of these foods like nuts and fruits are also high in calories, so moderation is always advisable.
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Where Does Cholesterol Come From
The liver is responsible for managing the levels of LDL in the body. It manufactures and secretes LDL into the bloodstream. There are receptors on liver cells that can “monitor” and try to adjust the LDL levels. However, if there are fewer liver cells or if they do not function effectively, the LDL level may rise.
Diet and genetics both play a factor in a person’s cholesterol levels. There may be a genetic predisposition for familial hypercholesterolemia where the number of liver receptor cells is low and LDL levels rise causing the potential for atherosclerotic heart disease at a younger age.
In the diet, cholesterol comes from saturated fats that are found in meats, eggs, and dairy products. Excess intake can cause LDL levels in the blood to rise. Some vegetable oils made from coconut, palm, and cocoa are also high in saturated fats.
The goal is to have patients modify lifestyle and diet to maintain cholesterol levels within the normal range. It is important to remember that HDL may protect a patient from heart disease and it may be a treatment goal to raise a too low level of HDL.
Regulation Of Cholesterol Synthesis
Biosynthesis of cholesterol is directly regulated by the cholesterol levels present, though the homeostatic mechanisms involved are only partly understood. A higher intake from food leads to a net decrease in endogenous production, whereas lower intake from food has the opposite effect. The main regulatory mechanism is the sensing of intracellular cholesterol in the endoplasmic reticulum by the proteinSREBP . In the presence of cholesterol, SREBP is bound to two other proteins: SCAP and INSIG-1. When cholesterol levels fall, INSIG-1 dissociates from the SREBP-SCAP complex, which allows the complex to migrate to the Golgi apparatus. Here SREBP is cleaved by S1P and S2P , two enzymes that are activated by SCAP when cholesterol levels are low.
Cholesterol synthesis can also be turned off when cholesterol levels are high. HMG-CoA reductase contains both a cytosolic domain and a membrane domain. The membrane domain senses signals for its degradation. Increasing concentrations of cholesterol cause a change in this domain’s oligomerization state, which makes it more susceptible to destruction by the proteasome. This enzyme’s activity can also be reduced by phosphorylation by an AMP-activated protein kinase. Because this kinase is activated by AMP, which is produced when ATP is hydrolyzed, it follows that cholesterol synthesis is halted when ATP levels are low.
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How To Lower Cholesterol: Low
Low-carbohydrate diets may help improve HDL cholesterol levels. The National Institutes of Health conducted a study that found while both low-fat and low-carb dieters lost weight over the two-year study period, low-carb dieters also improved their HDL cholesterol levels. The problem with low-carb diets is that they may be difficult to adhere to. Consult your doctor about the best healthy eating plan to manage your cholesterol.
Getting A Cholesterol Test
A blood sample is taken that will be used to determine the amount of bad cholesterol , good cholesterol and other fatty substances in your blood.
You may be asked not to eat for 10-12 hours before the cholesterol test, usually including when youre asleep at night. This ensures that all food is completely digested and wont affect the outcome of the test.
Your GP or practice nurse can carry out the cholesterol test and will take a blood sample, either using a needle and a syringe or by pricking your finger.
A newer type of test that measures non-high-density lipoprotein is now sometimes used because its thought to be a more accurate way of estimating cardiovascular disease risk than LDL.
Non-HDL cholesterol is total cholesterol minus HDL cholesterol. Its also not necessary to fast before the test, so it is more convenient.
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What Is Familial Hypercholesterolemia
Familial hypercholesterolemia is an inherited condition that can cause a person to have high levels of bad cholesterol. FH can mean that a person is at a higher risk of conditions such as heart disease.
Cholesterol is a waxy substance that the body uses to make cells, vitamins, and hormones. A persons liver produces all the cholesterol their body requires. A person can also take in cholesterol from food.
A certain amount of cholesterol in the body is necessary for normal function. However, too much bad cholesterol can cause problems. A person with FH has high levels of bad cholesterol due to a genetic defect.
Read on to learn more about FH, including its symptoms, causes, and treatments.
FH is a genetic condition that causes a person to have high low-density lipoprotein cholesterol. LDL is what many people refer to as bad cholesterol.
The American Heart Association notes that about are living with FH in the United States. However, only around 10% of people with FH know they have it.
There are of FH that a person can have:
- Heterozygous FH: If one parent passes on a mutated FH gene, a person will have heterozygous FH.
- Homozygous FH: Homozygous is a rarer, more severe form of FH. Homozygous FH occurs when both parents pass on the mutated gene for FH.
who have FH experience no symptoms at all. If a person does have symptoms of FH, these can include: