Myth: All Cholesterol Is Bad For You
Fact: Some types of cholesterol are essential for good health. Your body needs cholesterol to perform important jobs, such as making hormones and building cells. Cholesterol travels through the blood on proteins called lipoproteins. Two types of lipoproteins carry cholesterol throughout the body:
- LDL , sometimes called bad cholesterol, makes up most of your bodys cholesterol. High levels of LDL cholesterol raise your risk for heart disease and stroke.
- HDL , or good cholesterol, carries cholesterol back to the liver. The liver then flushes it from the body. High levels of HDL cholesterol can lower your risk for heart disease and stroke.
When your body has too much LDL cholesterol, it can build up in the walls of your blood vessels. This buildup is called plaque. As your blood vessels build up plaque over time, the insides of the vessels narrow. This narrowing can restrict and eventually block blood flow to and from your heart and other organs. When blood flow to the heart is blocked, it can cause angina or a heart attack.
What Is A Healthy Blood Cholesterol Level
For people who have plaque in their arteries or who have other factors that put them at risk for cardiovascular disease, doctors recommend an ideal LDL level well below 70 mg/dl. For those without risk factors who have an LDL level at or above 190 mg/dl, the recommendation is to get this level down to below 100 mg/dl. People age 40 to 75 who are living with diabetes and whose LDL is at 70 or above may need medication.
What Are The Different Types Of Cholesterol
Cholesterol can be attached to two different types of lipoproteins: high-density lipoprotein or low-density lipoprotein . The two differ in how much of the molecule is made up of cholesterol and how much is made up of protein.
HDL cholesterol is considered to be beneficial, or good cholesterol. This is because it removes harmful LDL cholesterol from your bloodstream. To do this, HDL brings excess LDL cholesterol to the liver , delivering it away from your heart and other organs. Because of this powerful ability, higher levels of HDL are associated with a lower risk of heart disease.
LDL cholesterol, however, carries cholesterol to cells and can accumulate on the walls of your blood vessels, narrowing the passageways your blood uses to travel throughout the body. This can become dangerous: narrow vessels make it hard or impossible for blood, oxygen, and nutrients to travel to the heart and brain and can lead to a heart attack or stroke. LDL is thus considered bad cholesterol, and higher levels of LDL can increase your risk of these severe health issues. Eating too much saturated fat can reduce how much LDL cholesterol your liver cells can remove from your blood.
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Treatment For High Cholesterol
Lifestyle changes are one of the first things your doctor will recommend for managing high cholesterol. All medications can cause side effects, including medications to lower your cholesterol, and many people can successfully lower their cholesterol without them. Your doctor will determine which treatment approach is best for you.
Lifestyle changes that can help lower your cholesterol include:
- Adenosine triphosphate-citrate lyase inhibitors
Metabolism Recycling And Excretion
Cholesterol is susceptible to oxidation and easily forms oxygenated derivatives called oxysterols. Three different mechanisms can form these: autoxidation, secondary oxidation to lipid peroxidation, and cholesterol-metabolizing enzyme oxidation. A great interest in oxysterols arose when they were shown to exert inhibitory actions on cholesterol biosynthesis. This finding became known as the “oxysterol hypothesis”. Additional roles for oxysterols in human physiology include their participation in bile acid biosynthesis, function as transport forms of cholesterol, and regulation of gene transcription.
In biochemical experiments radiolabelled forms of cholesterol, such as tritiated-cholesterol are used. These derivatives undergo degradation upon storage and it is essential to purify cholesterol prior to use. Cholesterol can be purified using small Sephadex LH-20 columns.
Although cholesterol is a steroid generally associated with mammals, the human pathogen Mycobacterium tuberculosis is able to completely degrade this molecule and contains a large number of genes that are regulated by its presence. Many of these cholesterol-regulated genes are homologues of fatty acid-oxidation genes, but have evolved in such a way as to bind large steroid substrates like cholesterol.
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Why Do We Need Cholesterol
Cholesterol plays a vital role in how your body works. There is cholesterol in every cell in your body, and it’s especially important in your brain, nerves and skin.
Cholesterol has three main jobs:
- Its part of the outer layer, or membrane, of all your bodys cells
- Its used to make vitamin D and steroid hormones which keep your bones, teeth and muscles healthy
- Its used to make bile, which helps to digest the fats you eat
What Can Raise My Risk Of High Cholesterol
A variety of things can raise your risk for high cholesterol:
- Age. Your cholesterol levels tend to rise as you get older. Even though it is less common, younger people, including children and teens, can also have high cholesterol.
- Heredity. High blood cholesterol can run in families.
- Weight. Being overweight or having obesity raises your cholesterol level.
- Race. Certain races may have an increased risk of high cholesterol. For example, African Americans typically have higher HDL and LDL cholesterol levels than whites.
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Cholesterol And The Great Egg Debate
One source of confusion has long been eggs. A typical egg contains about 200 milligrams of cholesterol, but only 1.5 grams of saturated fat. When researchers first linked high bloodcholesterol levels to heart disease, eggs got a bad rap.
In fact, when researchers at Harvard Medical School analyzed data from almost 120,000 men and women, they found that eating the equivalent of an egg a day did not increase the risk of heart disease or stroke. A more recent Harvard Medical School study, published in 2008, also found that otherwise healthy men could eat up to seven eggs a day with little risk. The only danger showed up in men with diabetes, which is known to increase heart disease risk.
Indeed, studies suggest that only about 30% of people are particularly susceptible to the effects of dietary cholesterol on blood cholesterol levels.
And overall, the effects of dietary cholesterol are relatively small compared with saturated fat and trans fats.
In a review of studies in which volunteers were fed eggs, researchers found that lowering the amount of dietary cholesterol by 100 milligrams a day resulted in only a 1% reduction in blood cholesterol levels. Replacing saturated fat with unsaturated fat had a much more beneficial effect on cholesterol.
How To Lower Cholesterol
If you have high cholesterol, your doctor may recommend lifestyle changes, medications or both.
Here are some ways to manage your cholesterol.
Eat heart-healthy food
What you eat can make a big difference to your cholesterol levels.
Cut back on foods high in saturated fats like:
- oily fish.
Drink less alcohol
Drinking too much alcohol can increase your LDL cholesterol and triglycerides. So drinking less is a good way to lower your cholesterol.
The Ministry of Health recommends no more than 10 standard drinks per week for women and no more than 15 for men. One standard drink is equal to:
- a standard can of 4% beer
- a small glass of wine
- a small single shot of spirits
If you have high cholesterol or youve been diagnosed with a heart condition, you may need to drink less than this.
Smoking makes your LDL cholesterol stickier and reduces the amount of HDL cholesterol in your blood. It also damages the artery walls. This increases the build-up of plaque in your arteries and can cause risk of heart attack and stroke.
Quitting smoking is a great way to lower your cholesterol levels and reduce your risk of heart disease.
Sitting less and being more active are great ways to reduce high cholesterol.
This doesnt mean you have to join a gym or take up running it just means you need to move your body more throughout the day. Ideally you should do 30 minutes of activity a day.
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Myth: Eating Foods With A Lot Of Cholesterol Will Not Make My Cholesterol Levels Go Up
Fact: It can be complicated. We know that foods with a lot of cholesterol usually also have a lot of saturated fat. Saturated fats can make your cholesterol numbers higher, so its best to choose foods that are lower in saturated fats. Foods made from animals, including red meat, butter, and cheese, have a lot of saturated fats.
Instead, aim to eat foods with plenty of fiber, such as oatmeal and beans, and healthy unsaturated fats, such as avocados, olive oil, and nuts. Learn more about healthy diets and nutrition at CDCs nutrition, physical activity, and obesity website.
Talk with your health care provider about ways to manage your cholesterol. Learn more about medicines to lower cholesterol.
How And When To Have Your Cholesterol Checked
Getting your cholesterol levels checked is an important part of staying healthy. High cholesterol increases your risk for heart disease and stroke, two leading causes of death in the United States.
Knowing your cholesterol status can help you stay in control of your health. Learn about cholesterol screening and why it is important.
Cholesterol is a waxy substance that your body needs to make hormones and digest fats. Your body makes all the cholesterol it needs, but you can also get cholesterol from eating certain foods, such as egg yolks and fatty meats. Having high blood cholesterol can lead to plaque buildup in the arteries, putting you at risk for heart disease and stroke. High blood cholesterol doesnt have symptoms, which is why getting your cholesterol levels checked is so important.
Learn more about cholesterol screenings.
You should get your cholesterol checked at least every 5 years. If you have cardiovascular risk factors, talk with your health care team about getting tested more often.
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What Is The Difference Between Hdl And Ldl Cholesterol
Cholesterol doesnt dissolve in blood. To be transported in the bloodstream, cholesterol is packed into two types of carriers: low-density lipoproteins or high-density lipoproteins . LDL cholesterol, which is sometimes known as bad cholesterol, is necessary in limited quantities , but high LDL cholesterol levels can dramatically increase your risk of a heart attack. Thats because LDL particles can contribute to atherosclerosisor clogged arteries. HDL cholesterolsometimes called good cholesterolhelps clear LDL cholesterol from the arteries.
When doctors measure cholesterol levels, they first look at total cholesterol as a quick way to assess a persons risk. For a more exact guide, they divide the total level by the HDL level. Heart attack risk is minimized by having a lower total cholesterol and a higher proportion of HDL cholesterol. The ratio of total cholesterol to HDL should be less than 4 to 1.
Unfortunately, the average American man has a ratio of 5 to 1. Vegetarians, on the other hand, average about 3 to 1. Smoking and obesity lower HDL vigorous exercise and foods rich in vitamin C may increase it.
How Is High Cholesterol Diagnosed
There are usually no signs or symptoms that you have high cholesterol. There is a blood test to measure your cholesterol level. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:
For people who are age 19 or younger::
- The first test should be between ages 9 to 11
- Children should have the test again every 5 years
- Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke
For people who are age 20 or older::
- Younger adults should have the test every 5 years
- Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years
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How Often To Have A Test
The American Heart Association recommends that people without a family history of heart disease or other risk factors check their cholesterol levels once when they are aged 911 years and again when they are aged 1721 years.
After the age of 20 years, the AHA suggests that people recheck their cholesterol levels and other risk factors every 46 years, as long as the risk remains low.
Those with a family history of heart disease should speak with a doctor about how often they need a cholesterol test.
How To Lower Ldl Cholesterol
Lifestyle and diet changes are the main ways to prevent or lower high LDL. A trial of eating a low-fat diet, regular aerobic activity, maintaining a healthy weight, and smaller waist circumference is an appropriate first step. It is best to set a timeline to achieve your goals with your doctor. In some cases, if those lifestyle changes are not enough, your physician may suggest a cholesterol lowering medication, such as a statin. If you are considering over-the-counter herbal or ayurvedic medications for cholesterol, please discuss those with your physician first as well.
Rarely, very high LDL is genetic and passed down in families. This is called familial hypercholesterolemia and is caused by a genetic mutation that decreases the livers ability to clear excess cholesterol. This condition can lead to very high LDL levels, and heart attack or stroke at a young age in multiple generations. Those individuals may require special medical treatment for prevention and treatment of atherosclerotic cardiovascular disease.
Remember, knowledge is the first step. If you dont know your cholesterol levels, get tested. That will give you and your physician a starting point for lifestyle changes and medications if needed. In the meantime, adopt a heart-healthy lifestyle, and do it with friends and family no matter their ages. Theres no time like the present to prevent heart disease.
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Dietary Tips To Avoid Cholesterol
The most important thing you can do to reduce your cholesterol level is to maintain a healthy lifestyle. You should try to:
- Increase the amount and variety of fresh fruit, vegetables and wholegrain foods you have each day.
- Choose low or reduced-fat milk, yoghurt and other dairy products or have added calcium soy drinks.
- Choose lean meat .
- Limit fatty meats, including sausages and salami, and choose leaner sandwich meats like turkey breast or cooked lean chicken.
- Have fish at least twice a week.
- Replace butter and dairy blends with polyunsaturated margarines.
- Include foods in your diet that are rich in soluble fibre and healthy fats, such as nuts, legumes and seeds.
- Limit cheese and ice cream to twice a week.
Other storage fats that are transported in blood lipoproteins include triglycerides. When present in high concentrations in the blood, this fat is also a risk for heart attack. Some foods will affect the cholesterol level or the triglyceride level and some will affect both.
Urges Parents To Feed Their Children In Line With National Dietary Guidelines
Holven points out that we now have good, well-documented, national dietary recommendations on how to eat in order to prevent disease.
If you follow these guidelines, it will put your cholesterol on the right track. You can easily improve your level of cholesterol by changing your diet. For example, you can reduce the amount of saturated fat in your food and replace it with unsaturated fat.
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What Can We Do To Reduce Cholesterol Levels
The American Heart Association Diet and Lifestyle Recommendations include :
Make a variety of healthier food choices
- Include more fruits, vegetables, and legumes
- Go for fiber-rich whole grains when choosing grains
- Buy skinless poultry and fish
- Include a variety of fish at least two times a week, especially fish containing omega-3 fatty acids such as salmon, trout, and herring.
- Consider snacking on some mixed nuts as healthy snack
- Use non-tropical vegetable oils when cooking
- Select fat-free and low-fat dairy product
- Limit foods and beverages with add-sugars
Make healthier lifestyle changes
- Be active! Aim for at least 150 minutes of moderate physical activity or 75 minutes of vigorous activity each week
- Do not smoke tobacco and avoid second-hand smoke
Negative Impact Of High Cholesterol
Studying cholesterol in older adults is trickier than it sounds, Martin says. Many people who have high cholesterol die from complications of heart disease before reaching an advanced age. Those who live into their 70s or 80s despite high cholesterol might have other factors that increased their longevity. That bias could skew the research results.
If someone has made it to that age and hasnt had problems from their cholesterol, they may have gotten lucky with genes or other protective factors, he says. But that doesnt mean high cholesterol is harmless or that their luck wont run out.
In addition, high cholesterol is one of many factors that work together to contribute to cardiovascular disease, along with elements such as high blood pressure, diabetes, smoking and inactivity. Cholesterol might not always be the single most important factor, Martin says, but its a piece of the puzzle that patients and doctors should not ignore.
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Statins And How Statins Work
Doctors also prescribe, usually if lifestyle changes are falling short, drugs like statins. Brand names include Lipitor, Crestor, Mevacor, Pravacol, and Zocor. Statins have been clearly shown to reduce blood cholesterol and prevent atherosclerosis, or heart disease. They work by reducing the livers production of cholesterol. They block an enzyme called HMG CoA Reductase that the liver uses to make cholesterol.
But other things are happening in the liver that statins do not affect. In addition to producing cholesterol, the liver helps clear excess cholesterol from the blood. It has tiny receptors that capture LDL bad cholesterol particles that are floating around. Like vacuum cleaners, these receptors suck this excess cholesterol up and out of the blood, which means theres much less cholesterol seeping into our artery walls, building plaque.
The problem is, a diet full of saturated fats, trans fat, and dietary cholesterol reduces the number and effectiveness of these LDL receptors. And theres nothing statins can do to counteract this process.
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