Cholesterol and why you should know your levels.
Cholesterol is essential for the formation of bile acid, which assists in the digestion of fat. Everybody needs to have some cholesterol to be healthy, however it is when you have too much cholesterol that problems start to occur. This is often termed as hypercholesterolemia. High blood cholesterol is a major risk factor for coronary heart disease and stroke.
Cholesterol is transported in your bloodstream by lipoproteins. There are 2 types of lipoproteins: LDL (Low Density Lipoprotein) and HDL (High Density Lipoprotein). LDL is known as “bad cholesterol”. This is because when you have too much LDL circulating in your blood, it can build up the inner walls of heart arteries which leads to the formation of plaque. The plaque then narrows the arteries and increases your risk for having a heart attack or stroke. HDL on the other hand is known as “good cholesterol” because it helps keep cholesterol from building up in the arteries.
High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease.
Normative Data for Blood Total Cholesterol levels
| Parameter | Norm (mg/dl) |
| Total cholesterol | Low risk: <200 |
| Moderate risk: 200-240 | |
| High risk: >240 |
Normative Data for Blood LDL cholesterol levels
| Parameter | Norm (mg/dl) |
| LDL cholesterol | Low: <100 |
| Desirable: 100-129 | |
| Borderline: 130-159 | |
| High risk: 160-189 | |
| Very high risk: >190 |
Normative Data for blood HDL cholesterol levels
| Parameter | Norm (mg/dl) |
| HDL cholesterol | Very low risk: >75 |
| Average: 45 (men) 55(women) |
|
| High risk: < 25 |
Causes of High cholesterol
Many different factors can contribute to high blood cholesterol, including lifestyle factors like smoking, an unhealthy diet and lack of exercise, as well as having an underlying condition, such as high blood pressure or diabetes. Your lifestyle can increase your risk of developing high blood cholesterol. This includes:
- An unhealthy diet– some foods, such as liver, kidneys and eggs, contain cholesterol (dietary cholesterol), but this has little effect on blood cholesterol. It’s the total amount of saturated fat in your diet that’s more important to watch.
- lack of exercise or physical activity– this can increase your level of “bad cholesterol” (low-density lipoprotein, or LDL)
- Obesity– if you’re overweight, it’s likely that you’ll have higher levels of LDL cholesterol and triglycerides, and a lower level of high-density lipoprotein (HDL)
- Drinking excessive amounts of alcohol– regularly drinking large amounts of alcohol can increase your cholesterol and triglyceride levels
- Smoking– a chemical in cigarettes called acrolein stops “good cholesterol” (HDL) transporting cholesterol from fatty deposits to the liver, leading to narrowing of the arteries (atherosclerosis)
Risk factors
You may have high blood cholesterol because of your age, family history, or race. In terms of age, your body’s metabolism changes as you age. For example, your liver does not remove LDL cholesterol as efficiently as when you are younger. In terms of family history, genetic studies have shown that related family members tend to have similar levels of bad and good cholesterol. Lastly your race may also increase your risk of having high cholesterol. Compared to Caucasians, Africans have higher levels of HDL and LDL cholesterol levels.
Complications
High blood cholesterol leads to atherosclerosis, which is the build-up of plaque deposits in blood vessels throughout the body. This leads to complications such as coronary artery disease, coronary heart disease such as angina or heart attack, peripheral artery disease, and stroke.
Treatment
High blood cholesterol is treated with healthy lifestyle changes and medicines to control or lower high blood cholesterol.
The following lifestyle changes can help control or lower blood cholesterol levels:
- Healthy eating– Healthy eating includes limiting the amount of saturated and trans fats that you eat. It also includes consuming fish high in omega-3 fatty acids and vegetable oils that can help lower blood cholesterol levels and the risk of cardiovascular disease.
- Being physically active.There are many health benefits to being physically active and getting the recommended amount of physical activity each week. Studies have shown that physical activity can lower LDL cholesterol and triglycerides and increase good high-density lipoprotein (HDL) cholesterol.
- Aiming for a healthy weight.If you have high blood cholesterol and are overweight or obese, you can improve your health by aiming for a healthy weight. Research has shown that adults with overweight and obesity can reduce LDL cholesterol and increase HDL cholesterol by losing only 3 percent to 5 percent of their weight.
- Managing stress. Research has shown that chronic stresscan sometimes increase LDL cholesterol levels and decrease HDL cholesterol levels.
- Quitting smoking
Some medicines that will also be used in controlling or lowering high blood cholesterol include: statins, Niacin/Nicotinic acid, and Fibric acid derivatives.
Conclusion
High blood cholesterol is one of the major risk factors for heart disease. Thus it is important to know what your cholesterol numbers are, and if necessary, controlling high blood cholesterol by means of making lifestyle changes and/or taking drug therapy. Being physically active is one of the main lifestyle changes that we recommend because not only does it have direct effects such as lowering LDL and triglycerides, as well as increasing HDL cholesterol, it is also associated with indirect effects such as positive dietary habits and reducing adiposity (obesity).
Author: Taariq Patel
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References
Durstine, J.L., Moore, G.E. & Painter, P.L., 2016. ACSMs exercise management for persons with chronic diseases and disabilities, Human Kinetics
https://www.nhlbi.nih.gov/health-topics/high-blood-cholesterol