What Are The Types Of Cholesterol
Cholesterol in the blood doesn’t move through the body on its own. It combines with proteins to travel through the bloodstream. Cholesterol and protein traveling together are called lipoproteins .
Low-density lipoprotein and high-density lipoprotein are the lipoproteines that most of us have heard about.
Low-density lipoproteins, or “bad cholesterol,” can build up on the walls of the arteries. Cholesterol and other substances in the blood form plaque . Plaque buildup can make blood vessels become stiffer, narrower, or blocked. Plaque makes it easier for blood clots to form. A blood clot can block a narrowed artery and cause a heart attack or stroke.
Atherosclerosis , or hardening of the arteries, also leads to decreased blood flow to vital organs, including the brain, intestines, and kidneys.
High-density lipoproteins, or “good cholesterol,” carry cholesterol away from the arteries and back to the liver. In the liver, cholesterol is broken down and removed from the body.
High levels of LDL and low levels of HDL increase a person’s risk of heart disease.
Myth: I Dont Need Statins Or Other Medicines For My Cholesterol I Can Manage My Cholesterol With Diet And Exercise
Fact: Although many people can achieve good cholesterol levels by making healthy food choices and getting enough physical activity, some people may also need medicines called statins to lower their cholesterol levels. Guidelinesexternal icon also suggest that other medicines in addition to statins may be needed to help control cholesterol.2
People who may need statins or other medicines to manage cholesterol levels include the following:
- People with familial hypercholesterolemia or people with very high levels of bad cholesterol. FH is a genetic condition that causes very high LDL cholesterol levels beginning at a young age. If left untreated, cholesterol levels will continue to get worse. This greatly raises the risk for heart disease, heart attack, and stroke at a young age.
- People with cardiovascular disease . People with CVD may already have narrowed arteries because of too much plaque. Medicines that lower cholesterol may help reduce the risk for heart attack or stroke.
- People with diabetes.Type 2 diabetes lowers HDL or good cholesterol levels and raises bad cholesterol levels. This combination raises your risk of heart disease and stroke.
Other groups of people may also need medicines to manage their cholesterol, including people who have a high risk for CVD. Always talk to your health care provider about the best ways to manage your cholesterol.
How Fat Moves From Food To The Bloodstream
Fat and cholesterol cant dissolve in water or blood. Instead, the body packages fat and cholesterol into tiny, protein-covered particles called lipoproteins. Lipoproteins can transport a lot of fat they mix easily with blood and flow with it. Some of these particles are big and fluffy, while others are small and dense. The most important ones are low-density lipoproteins , high-density lipoproteins , and triglycerides.
- Low Density lipoproteins
Low-density lipoproteins carry cholesterol from the liver to the rest of the body. Cells latch onto these particles and extract fat and cholesterol from them. When there is too much LDL cholesterol in the blood, these particles can form deposits in the walls of the coronary arteries and other arteries throughout the body. Such deposits, called plaque, can narrow arteries and limit blood flow. When plaque breaks apart, it can cause a heart attack or stroke. Because of this, LDL cholesterol is often referred to as bad, or harmful, cholesterol.
- High-density lipoproteins
High-density lipoproteins scavenge cholesterol from the bloodstream, from LDL, and from artery walls and ferry it back to the liver for disposal. Think of HDL as the garbage trucks of the bloodstream. HDL cholesterol is often referred to as good, or protective, cholesterol.
In general, the lower your LDL and the higher your HDL, the better your chances of preventing heart disease and other chronic conditions.
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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.
Plant Sterols Can Lower Cholesterol Levels
Plant sterols are found naturally in plant foods including sunflower and canola seeds, vegetable oils and in nuts, legumes, cereals, fruit and vegetables. Some margarine and milks have concentrated plant sterols added to them. Margarines enriched with plant sterolslower LDL cholesterol in most people if the correct amount is eaten .
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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.
Do I Need To Cut Down On Dietary Cholesterol
Most people dont need to cut down on the cholesterol thats found in foods- so you can still enjoy eggs and shellfish.
Its much more important to cut down on foods which contain saturated fats. Thats because saturated fats affect how the liver handles cholesterol. So, eating saturated fats can raise your blood cholesterol. Try to replace saturated fats with unsaturated fats which are better for your heart.
For some people those with familial hypercholesterolaemia , those who have high cholesterol, and those who are at high risk of or have cardiovascular disease the recommendation is to limit cholesterol in food to no more than 300mg a day. In the case of FH, ideally less than 200 mg a day.
Even though dietary cholesterol only has a small effect on blood cholesterol, people with high cholesterol and FH already have high levels of blood cholesterol, so it seems sensible not to eat too much cholesterol in food.
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Dietary Cholesterol May Not Impact Blood Cholesterol As Much As Previously Thought
The old thinking was that consuming dietary cholesterol added to the cholesterol that your body naturally produces, thus raising the amount in your blood. This was perceived to be risky, because too much blood cholesterol has been shown to up the risk of heart disease, the top killer of both men and women. One often-cited statistic is that every 1% increase in total blood cholesterol is tied to a 2% increase in the risk of heart disease.
For many years, the Dietary Guidelines for Americans recommended that dietary cholesterol should be limited to no more than 300 mg per day. To put that in perspective, one egg yolk contains about 185 mg, three ounces of shrimp contains about 130 mg, two ounces of 85% lean ground beef about 60 mg, and one tablespoon of butter about 30 mg. The brand new report eliminated this cap, however, because the committee believes that the research shows no substantial relationship between the consumption of dietary cholesterol and blood cholesterol levels. As such, they concluded, Cholesterol is not a nutrient of concern for overconsumption.
Food Supplements That Do Not Help With Cholesterol
Many extracts and supplements have been promoted for their overall health benefits and lipid-lowering effects, but do they work?
We reviewed the available scientific research and found that the following supplements had no good evidence to support those claims:
Selenium: Supplements may help lower cholesterol in people with low levels of selenium, but not in people with normal levels of selenium. There is not enough scientific evidence to say that selenium protects against cardiovascular disease.
Calcium: Results here are mixed, but the bottom line is calcium supplementation does not improve cholesterol levels.
Garlic supplements: Raw, powdered, and aged garlic supplements had no effect on cholesterol levels.
Policosanol: This substance, which is extracted from sugar cane wax, did not improve cholesterol.
Coconut oil supplements: There is mixed evidence about the cardiovascular benefits or harm of coconut oil. It is not an evidence-based alternative treatment for high cholesterol levels.
Coconut water: There is no high-quality data about coconut water improving cholesterol levels.
Resveratrol supplements: There is no evidence that these improve cholesterol levels in humans.
Soy isoflavones supplements: Taking supplements of soy isoflavones does not improve cholesterol levels.
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What Are The Different Types Of Cholesterol
Cholesterol does not travel freely through the bloodstream. Instead, it is attached or carried by lipoproteins in the blood. There are three types of lipoproteins that are categorized based upon how much protein there is in relation to the amount of cholesterol.
Low-density lipoproteins contain a higher ratio of cholesterol to protein and are thought of as the bad cholesterol. Elevated levels of LDL lipoprotein increase the risk of heart disease, stroke, and peripheral artery disease, by helping form cholesterol plaque along the inside of artery walls. Over time, as plaque buildup increases, the artery narrows , and blood flow decreases. If the plaque ruptures, it can cause a blood clot to form that prevents any blood flow. This clot is the cause of a heart attack or myocardial infarction if the clot occurs in one of the coronary arteries in the heart.
High-density lipoproteins are made up of a higher level of protein and a lower level of cholesterol. These tend to be thought of as good cholesterol. The higher the HDL to LDL ratio, the better it is for the individual because such ratios can potentially be protective against heart disease, stroke, and peripheral artery disease.
Very low-density lipoproteins contain even less protein than LDL. VLDL like LDL has been associated with plaque deposits.
Triglycerides may increase cholesterol-containing plaques if levels of LDL are high and HDL is low.
What Can I Eat On The Portfolio Diet
Dr Jenkins’ dietary portfolio involves eating one or more of the following four foods daily while sticking to a 2000-calorie diet low in saturated fat and salt and high in fibre, fruit and veg. If you eat the recommended amount of only one of the four food groups, research shows you could reduce your blood cholesterol by 5 to 10 percent, but this increases significantly if you eat all four in combination.
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Safe Blood Cholesterol Levels
Health authorities recommend that cholesterol levels should be no higher than 5.5 mmol per litre if there are no other risk factors present. If there are other cardiovascular risk factors such as smoking and high blood pressure or pre-existing cardiovascular disease, then the aim for the LDL levels would be less than 2 mmol/l. Approximately half of all adult Australians have a blood cholesterol level above 5 mmol/l. This makes high blood cholesterol a major health concern in Australia.
Cholesterol Myths And Facts
Cholesterol can be confusing! Learn answers to common questions about blood cholesterol.
What do your cholesterol numbers mean? Can the foods you eat change your cholesterol levels?
Learn the difference between cholesterol myth and fact. Then commit to getting your cholesterol checked this year so you know your numbers and your risk for heart disease and stroke.
Commit to getting your cholesterol checked this year so you know your numbers and your risk for heart disease and stroke.
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Eat A Variety Of Healthy Proteins
The best choices of protein are fish and seafood, legumes , nuts and seeds. You can eat smaller amounts of eggs and lean poultry but limit red meat to 1-3 times a week.
Flavour foods with herbs and spices rather than salt, and avoid processed foods as these contain a lot of salt too. Salt can lead to high blood pressure, which can increase your risk of heart disease.
Misconception: Diet And Physical Activity Dictate Your Cholesterol Level
Diet and physical activity do affect overall blood cholesterol levels, but so do other factors.
Being overweight or obese tends to increase bad cholesterol and lower good cholesterol . Getting older also causes LDL cholesterol to rise. For some, heredity may play a role.
So, a heart-healthy diet and regular physical activity are important to everyone for maintaining cardiovascular health.
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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.
Why Is High Cholesterol Dangerous
Elevated cholesterol levels are one of the risk factors for heart disease, stroke, and peripheral artery disease. The mechanism involving cholesterol in all three diseases is the same plaque buildup within arteries decreases blood flow affecting the function of the cells and organs that these blood vessels supply.
- Atherosclerotic heart disease or narrowed coronary arteries in the heart can cause the symptoms of angina, when the heart muscle is not provided with enough oxygen to function.
- Decreased blood supply to the brain may be due to narrowed small arteries in the brain or because the larger carotid arteries in the neck may become blocked. This can result in a transient ischemic attack or stroke.
- Peripheral artery disease describes gradual narrowing of the arteries that supply the legs. During exercise, if the legs do not get enough blood supply, they can develop pain, called claudication.
- Other arteries in the body may also be affected by plaque buildup causing them to narrow, including the mesenteric arteries to the intestine and the renal arteries to the kidney.
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Eating For Lower Cholesterol
Healthy eating can make a huge difference to your cholesterol levels and your heart health, whether your cholesterol has crept up over the years or you have a genetic condition. It will improve your health in other ways too, helping to lower your blood pressure, prevent diabetes and maintain a healthy weight.
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Medication May Be Needed
For some people, diet and lifestyle changes are not enough. High blood cholesterol levels often have a genetic component. Some people inherit altered genes that cause high cholesterol and this cannot usually be changed sufficiently by lifestyle or diet.
If you are at risk of coronary heart disease and your LDL cholesterol level doesnt drop after scrupulous attention to diet, your doctor may recommend medications to force your blood LDL levels down. Cell cholesterol levels, however, remain normal, so lowering blood cholesterol has no effect on most cell metabolic processes.
Some people get muscle aches from statins, which are the most commonly used medication to lower blood cholesterol. However, diet and exercise will still be important, even if you are taking medication. Your doctor may also refer you to a specialist who treats cardiovascular disease.
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Limiting Saturated And Trans Fats
Here are some ways to lower your intake of saturated and trans fats:
- Maintain a diet that emphasizes fruits, vegetables, whole grains, low-fat dairy products, poultry, fish and nuts. Also limit red meat and sugar-sweetened foods and beverages.
- Opt for naturally occurring unhydrogenated vegetable oils such as canola, safflower, sunflower or olive oil.
- Look for processed foods made with unhydrogenated oil rather than saturated fat or hydrogenated vegetable oils.
- Use soft margarine as a substitute for butter and choose soft margarines over harder stick forms. Look for 0 g trans fat on the Nutrition Facts label.
- Doughnuts, cookies, crackers, muffins, pies and cakes are examples of foods high in trans fat. Dont eat them often.
- Limit commercially fried foods and baked goods made with shortening or partially hydrogenated vegetable oils. These foods are very high in fat, and its likely to be trans fat.
- Limit fried fast food. Commercial shortening and deep-frying fats are still made by hydrogenation and contain saturated and trans fats.
Consider using a food diary to keep track of what you eat. Its a handy way to evaluate the healthy, not-so-healthy and unhealthy foods youre making a part of your everyday diet.