Cholesterol

Types of Cholesterol:

1. Low-Density Lipoprotein (LDL) – “Bad” Cholesterol:
   • LDL is often referred to as “bad” cholesterol because when you have high levels of LDL cholesterol, it can lead to the buildup of plaque in your arteries. Plaque is a thick, hard deposit that can clog your arteries, making it harder for blood to flow. This condition is known as atherosclerosis and increases your risk of heart disease, stroke, and peripheral artery disease.
   • The lower your LDL cholesterol, the better it is for your heart health.
2. High-Density Lipoprotein (HDL) – “Good” Cholesterol:
   • HDL is called “good” cholesterol because it helps remove LDL cholesterol from the bloodstream. HDL carries excess cholesterol from the arteries to the liver, where it can be processed and removed from the body.
   • Higher levels of HDL cholesterol are beneficial and lower the risk of heart disease.
3. Very Low-Density Lipoprotein (VLDL):
   • VLDL is another type of “bad” cholesterol. It is similar to LDL but primarily carries triglycerides, another type of fat. VLDL contributes to the buildup of plaque in the arteries, increasing the risk of heart disease.
4. Triglycerides:
   • While not technically a form of cholesterol, triglycerides are another type of fat found in the blood. Elevated triglycerides, often caused by obesity, excessive alcohol consumption, or high carbohydrate intake, can also increase the risk of heart disease.

How Cholesterol Works in the Body:

Cholesterol is vital for various bodily functions, including:

• Cell membrane structure: Cholesterol helps make cell membranes strong and flexible.
• Production of hormones: It is involved in the production of hormones such as estrogen, testosterone, and adrenal hormones.
• Vitamin D: Cholesterol helps produce vitamin D, which is essential for bone health and immune function.
• Bile production: Cholesterol is used by the liver to make bile, which helps digest fats.

However, when there’s an imbalance—especially when LDL is high and HDL is low—cholesterol can build up in the arteries and increase the risk of serious health problems.

Risk Factors for High Cholesterol:

Several factors can increase the likelihood of having high cholesterol:

• Poor diet: A diet high in saturated fats, trans fats, and cholesterol can raise LDL cholesterol levels. Processed foods, red meat, and full-fat dairy products are often culprits.
• Lack of physical activity: Inactivity can lead to weight gain, which may raise LDL levels and lower HDL levels.
• Obesity: Excess weight can lead to higher LDL cholesterol and triglycerides and lower HDL cholesterol.
• Smoking: Smoking lowers HDL cholesterol and damages the blood vessels, making it easier for plaque to accumulate in the arteries.
• Excessive alcohol intake: Drinking too much alcohol can raise triglyceride levels and contribute to weight gain.
• Age and gender: Cholesterol levels tend to increase as people age. Before menopause, women generally have lower total cholesterol levels than men, but after menopause, women’s LDL cholesterol levels often increase.
• Genetics: Some people inherit high cholesterol from their parents, a condition known as familial hypercholesterolemia. This can result in very high cholesterol levels at a young age.

Health Risks of High Cholesterol:

When there’s an excess of LDL cholesterol or triglycerides in the bloodstream, it can lead to atherosclerosis, which is the thickening and narrowing of the arteries. This can increase the risk of:

• Coronary artery disease (CAD): The buildup of plaque in the arteries that supply blood to the heart can lead to chest pain (angina), heart attacks, and heart failure.
• Stroke: Narrowed arteries can reduce blood flow to the brain, potentially causing a stroke.
• Peripheral artery disease (PAD): Atherosclerosis can also affect the arteries that supply blood to the limbs, leading to pain, numbness, and infection in the affected area.
• Aneurysms: Atherosclerosis can weaken blood vessels, leading to bulges (aneurysms) that may rupture and cause severe bleeding.

How to Test Cholesterol Levels:

Cholesterol levels are measured through a blood test called a lipid panel or lipid profile. This test checks the levels of:

• Total cholesterol
• LDL cholesterol
• HDL cholesterol
• Triglycerides

The American Heart Association (AHA) recommends that adults aged 20 and older have their cholesterol levels checked every four to six years as part of a routine check-up. If you have risk factors for heart disease or a family history of high cholesterol, your doctor may recommend more frequent testing.

What Are Healthy Cholesterol Levels?

The American Heart Association suggests the following target levels for cholesterol:

• Total cholesterol: Less than 200 mg/dL is considered desirable; 200-239 mg/dL is borderline high; and 240 mg/dL or higher is high.
• LDL (bad cholesterol): Less than 100 mg/dL is optimal; 100-129 mg/dL is near optimal; 130-159 mg/dL is borderline high; 160-189 mg/dL is high; and 190 mg/dL or higher is very high.
• HDL (good cholesterol): 60 mg/dL or higher is optimal. Less than 40 mg/dL for men and less than 50 mg/dL for women is considered a risk factor for heart disease.
• Triglycerides: Less than 150 mg/dL is normal; 150-199 mg/dL is borderline high; 200-499 mg/dL is high; and 500 mg/dL or higher is very high.

How to Lower Cholesterol:

1. Dietary Changes:
   • Eat more fiber: Foods high in soluble fiber, like oats, beans, lentils, and fruits, can help lower LDL cholesterol.
   • Limit saturated fats: Found in red meat, full-fat dairy products, and processed foods, saturated fats can raise LDL cholesterol levels.
   • Eliminate trans fats: Found in many processed and packaged foods, trans fats can significantly raise LDL cholesterol and lower HDL cholesterol.
   • Increase healthy fats: Unsaturated fats found in olive oil, avocado, and fatty fish (like salmon and mackerel) can help raise HDL cholesterol levels.
   • Choose lean protein: Opt for lean meats, poultry, and fish over fatty cuts of meat.
2. Exercise:
   • Regular physical activity can help raise HDL cholesterol, lower LDL cholesterol, and lower triglycerides. Aim for at least 150 minutes of moderate exercise per week or 75 minutes of vigorous exercise.
3. Weight loss:
   • Losing excess weight can help lower total cholesterol and improve other heart disease risk factors like high blood pressure.
4. Quit smoking:
   • Quitting smoking can improve HDL cholesterol levels and reduce your risk of heart disease and stroke.
5. Limit alcohol consumption:
   • If you drink alcohol, do so in moderation. Excessive drinking can raise triglyceride levels and contribute to weight gain.
6. Medications:
   • If lifestyle changes alone aren’t enough, your doctor may recommend cholesterol-lowering medications. These can include statins, bile acid sequestrants, cholesterol absorption inhibitors, and PCSK9 inhibitors.