“Raw egg” by by jefras a.k.a Joăo Estęvăo A. de Freitas. Licensed under Public Domain via Commons

No other food related term can compete with the notoriety associated with ‘cholesterol’, right? We have all heard of ‘good’ and ‘bad’ cholesterol and have come across claims of various food product companies claiming ‘zero cholesterol’ in their products. But, what exactly is cholesterol and what harm does it do?

What is cholesterol, what are the good and bad cholesterol?

Cholesterol is a waxy substance found in the walls of cells in all parts of the body, from the nervous system to the liver to the heart. The body uses cholesterol to make hormones, bile acids, vitamin D, and other substances.

Two main kinds of lipoproteins carry cholesterol in the blood:

  • Low density lipoprotein, or LDL cholesterol, which also is called the ‘bad cholesterol’ because it carries cholesterol to tissues, including the arteries. Most of the cholesterol in the blood is the LDL form. The higher the level of LDL cholesterol in the blood, the greater your risk for heart disease
  • High density lipoprotein, or HDL cholesterol, which also is called the ‘good cholesterol‘ because it takes cholesterol from tissues to the liver, which removes it from the body. A low level of HDL cholesterol increases your risk for heart disease

How does cholesterol cause harm?

If there is too much cholesterol in the blood, some of the excess can become trapped in artery walls. Over time, this builds up and is called plaque. The plaque can narrow vessels and make them less flexible, a condition called atherosclerosis or “hardening of the arteries” and thus the blood supply to organs supplied by narrowed artery becomes compromised causing CVD and its complications

What are the ‘high cholesterol symptoms’?

There are no ‘high cholesterol symptoms’. High cholesterol combined with other heart risk factors leads to CVD, which can lead to heart attack or stroke eventually

Therefore it is better to go for routine health check up for blood cholesterol and other lifestyle risk factors, to detect them early and manage them within recommended levels

What Affects blood cholesterol levels?

Factors that you cannot change include:

  • Heredity:  High blood cholesterol can run in families. However, very few people are stuck with a high cholesterol just by heredity and everyone can take action to lower their cholesterol.
  • Age and sex: Blood cholesterol begins to rise around age 20 and continues to go up until about age 60 or 65. Before age 50, men’s total cholesterol levels tend to be higher than those of women of the same age—after age 50, the opposite happens.

Factors you can control include:

  • Diet:  Three nutrients in your diet make LDL levels rise: Saturated fat and cholesterol(fat found mostly in foods that come from animals) AND Trans fat (found mostly in foods made with hydrogenated oils and fats- vanaspati and margarine, used commonly in snacks and namkeens and in restaurant food such as french fries etc.
    Contrary to what you would expect, saturated fat raises your LDL cholesterol level more than anything else in your diet and not dietary cholesterol, which has a modest impact on blood LDL levels

Also, studies have established for overall heart health Trans fats are even more harmful than saturated fats and therefore you should replace ghee with vanaspati or butter with table margarine in your diet, rather should switch to vegetable oils all of which have zero cholesterol and most have low saturated fats (except coconut and palm oil)

The impact of Triglycerides (TGs) on raising blood cholesterol has brought a vigorous focus to limiting simple carbohydrates such as sugary drinks and snacks, syrups, honey, milled rice and maida (de husked wheat flour) containing food

  • Being Overweight: Excess weight tends to increase your LDL level. Also, it typically raises triglycerides, a fatty substance in the blood and in food and lowers HDL
  • Lack of exercise:  Being physically inactive contributes to overweight and can raise LDL and lower HDL

What are normal and high blood cholesterol levels and how to lower cholesterol?

Blood LDL cholesterol (bad cholesterol)

  • Ideal LDL level is <100 mg/DL for most people but for people with high heart risk < 70 is ideal
  • You should see your doctor regarding cholesterol lowering drugs, (most famous drugs being statins) if:
    • If your blood LDL cholesterol >190 mg/dL or total cholesterol is >300 mg/Dl
    • IF LDL>130 and CVD risk score is  high or very high
    • If your LDL> 160 and your CVD risk is low or moderate, you can do an intensive lifestyle modification trial of 3-6 months, if LDL still> 100 you should be put on drug(s)
    • If you are a diabetic over 40 years of age and LDL cholesterol is more than 70
  • You need to make lifestyle modifications to lower cholesterol if, your LDL cholesterol>100mg/dL or If LDL cholesterol> 70 and your CVD risk score is high or very high. These modifications include changes in diet, being more active, weight reduction, quitting smoking etc. and are summarized as TLC (Therapeutic Lifestyle Changes)

Get the FHI ‘TLC diet for high BP and cholesterol management’ NOW!

Check out: exercise for beginners

HDL cholesterol (good cholesterol)

  • Ideal HDL level for men is >40 mg/DL and for women> 50 is ideal
  • If HDL< 40 mg/dL for men and <50 for women, the interventions to lower LDL cholesterol would work in bringing HDL up as well

CHECK OUT: Our references for recommendation in heart risk management