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Understanding good cholesterol, bad cholesterol


Cholesterol is a waxy, fat-like substance that’s found in all the cells of the body. Most of the cholesterol in our body is made by the liver while rest of it comes from food. It is only found in foods that come from animals such as meat and dairy products. Cholesterol travels in the blood bundled up in packets called lipoproteins. Our body need some cholesterol to work properly but having too much cholesterol in the blood can put a person at higher risk of developing plaques in the arteries of the heart (Coronary Artery Disease).

Importance of Cholesterol in the Body

1.      Cholesterol is used by the liver to make bile, which helps the body to digest foods

2.      Cholesterol is also needed to make certain hormones like oestrogen, testosterone and adrenal hormones

3.      It contributes to the structure of cell membranes

4.      It allows the body to produce Vitamin D

5.      It helps the metabolism work efficiently

Types of Cholesterol:

  1. High Density Lipoprotein (HDL): HDL is considered as “Good” It is a healthy kind of cholesterol as it carries cholesterol to the liver where it can be removed from the bloodstream before it builds up in the arteries thus helps remove cholesterol from the arteries preventing the body from heart attack and stroke.
  2. Low Density Lipoprotein (LDL): LDL is considered as “Bad” It is a an unhealthy kind of cholesterol as it carries cholesterol directly to the arteries. This can result in atherosclerosis, a plaque blocking the arteries resulting in heart attack and stroke.
  3. Triglycerides: make up the third component of cholesterol and act as unused calories that are stored as fat in the blood. Triglycerides are carried in the blood from the food we eat. Extra calories, alcohol, or sugar are turned into triglycerides and stored in fat cells throughout the body. Eating more calories than we burn can cause triglycerides to build up in the bloodstream, increasing the risk for heart attacks.

Causes of High Cholesterol :

  • Consumption of cholesterol (present in animal foods, meat, and cheese), saturated fats (present in some meats, dairy products, chocolate, baked items, deep fried and processed foods) and trans fats (present in some fried and processed foods)
  • Excess weight or obesity can also lead to higher blood LDL levels. Genetic factors can contribute to high cholesterol. People with the inherited condition familial hypercholesterolemia have very high LDL levels.
  • Physical inactivity is a risk factor for heart disease. Regular physical activitycan help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also help to lose weight.
  • Diseases such as diabetes, liver or kidney disease, polycystic ovary syndrome (PCOD), pregnancy and other conditions that increase levels of female hormones, underactive thyroid gland and drugs that increase LDL cholesterol and decrease HDL cholesterol, such as progestins, anabolic steroids, and corticosteroids etc
  • Cigarette smoking lower HDL (good) cholesterol. HDL helps to remove bad cholesterol from the arteries. So a lower HDL can contribute to a higher level of bad cholesterol.
  • Age and sex: As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL (bad) cholesterol levels tend to rise.
  • Heredity: the genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
  • Race: Certain races may have an increased risk of high blood cholesterol. For example, African, Americans typically have higher HDL and LDL cholesterol levels than whites.

Effects of High Cholesterol on the Body :

The condition of high cholesterol can lead to some serious consequences :

·                  Heart Diseases: One of the most common effects of high cholesterol is the rise in heart-related issues. Too much cholesterol, when accumulated in the arteries, forms plaque that narrows them down. Because the arteries are narrowed, blood flow is reduced which can result in a angina (angina or heart attack) at some point if not addressed.

·                  Stroke: A stroke occurs when blood flow to the brain is disrupted. When blood doesn’t reach the brain, the brain is deprived of oxygen. Not everyone with high cholesterol can suffer from a stroke, but it does increase the chances.

·                  Diabetes: High cholesterol may lead to diabetes as we tend to gain weight and our body’s regular digestive function is disrupted. Also, too much of fat in the body impairs the body’s ability to produce enough insulin to regulate blood sugar. Uncontrolled diabetes can lead to a stroke, kidney disease and more.

  • Gall Stones: High cholesterol can create a bile imbalance and cause gallstones (stones in the gall bladder) in the body. Gallstones are painful but can be removed with surgery and medication.
  • Obesity: Too much of fat deposits in the body can make us overweight and lead to obesity. Obesity can be strenuous on the body and can lead to many lifestyle diseases. Being overweight puts a strain on the joints, and can eventually lead to severe joint pain.
  • Endocrine Disorders: Body’s hormone-producing glands use cholesterol to make hormones such as estrogen, testosterone, and cortisol. Hormones can also have an effect on body’s cholesterol levels. Research has shown that as oestrogen levels rise during a woman’s menstrual cycle, HDL cholesterol levels also go up, and LDL cholesterol levels decline. This may be one reason why a woman’s risk for heart disease increases after menopause, when oestrogen levels drop.

 Keeping Check on Cholesterol Levels:

Lowering cholesterol levels can save lives. Most of the time we may not experience or even show any of the symptoms on the outside, but a health check up will always give us the right information. With regular checkups, we can also check who may be leaning towards having a problem with high cholesterol and nip it in the bud.

A blood test called a lipoprotein panel can measure the cholesterol levels. Before the test, fasting (not eating or drinking anything but water) for 9 to 12 hours is needed. The test gives information about the total cholesterol, HDL, LDL, VLDL and Triglycerides.

  • 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

Prevention and Management of High Cholesterol :

  • Heart- healthy eating: A heart-healthy eating plan limits the amount of saturated and trans fats that we eat . Taking oats, barley and whole grains, beans, eggplant and lady finger, vegetable oil (canola, sunflower), fruits (mainly apples, grapes, strawberries, and citrus), soy and soy-based foods, fish and foods rich in fiber while as avoiding red meat, full-fat dairy, margarine, hydrogenated oils and baked goods has showing the good effect on the cholesterol levels.
  • Weight management: If overweight, losing weight can help lowering  LDL (bad) cholesterol.
  • Physical activity: Everyone should get regular physical activity (30 minutes on most, if not all, days).
  • Managing stress: Research has shown that chronic stress can sometimes raise LDL cholesterol and lower HDL cholesterol.
  • Quitting smoking: Quitting smoking can raise HDL cholesterol. Since HDL helps to remove LDL cholesterol from your arteries, having more HDL can help to lower  LDL cholesterol.
  • Drug Treatment: If lifestyle changes alone do not lower cholesterol enough, the cholesterol lowering drugs may be prescribed by the doctor.  While taking medicines to lower the cholesterol, one should continue with the lifestyle changes.

The writer is HOD at KTC Hospital & Research Centre, Kashmir BLS and ERTC Certified (Directorate of Health Services, Kashmir), PGC (Community Health) RCBS (University of Kashmir) and Life Member (Indian Red Cross Society). Email : [email protected]

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