Cholesterol

What Is Cholesterol

Cholesterol is a lipid-based compound that travels through the bloodstream, serving as a key building block and regulator in your body. It preserves the structural integrity of cell membranes, acts as a precursor for hormones, including cortisol and sex hormones, supports Vitamin D synthesis, and helps generate bile acids for fat digestion. Your body manufactures most cholesterol internally, primarily in the liver and other tissues, while the remainder comes from dietary sources. Approximately 75 % of cholesterol is produced by your body, and 25 % is absorbed from foods such as eggs, dairy products, and red meat. There are two main types of cholesterol based on how they travel:

• Low-density lipoprotein (LDL): Known as ‘bad’ cholesterol, high levels of LDL can deposit cholesterol in artery walls, forming plaque and increasing the risk of heart disease.
• High-density lipoprotein (HDL): Called ‘good’ cholesterol, HDL removes excess cholesterol from cells and arterial walls, carrying it back to the liver for breakdown and elimination.

While cholesterol is essential for normal body functions, too much LDL cholesterol can be harmful. Over time, LDL-driven deposits can narrow arteries, restrict blood flow, and raise the likelihood of heart attacks and strokes.

Cholesterol levels

The only way to determine your cholesterol is through a fasting blood test. This test measures:

• LDL cholesterol concentration
• HDL cholesterol concentration
• Triglycerides, a type of blood fat that can also increase heart disease risk
• Total cholesterol, the overall cholesterol in your blood

Results are typically reported in milligrams per deciliter (mg/dL) and should be evaluated alongside other cardiovascular risk factors like age, family history, smoking, blood pressure, and diabetes. General guidelines provide target ranges, but your ideal levels depend on your individual risk profile. Consult your doctor to review your results, discuss lifestyle changes, such as diet and exercise, or consider medication if necessary. Adopting lifestyle measures, such as maintaining a healthy weight, exercising regularly, and avoiding tobacco, can also support healthy cholesterol levels.

High cholesterol

Elevated cholesterol levels are largely driven by what we eat. In particular, diets rich in saturated and trans fats and high in dietary cholesterol can push your levels up.

• Saturated and trans fats, present in various meats, dairy products, chocolate, baked goods, fried dishes, and many processed foods.
• Cholesterol, found in animal-based foods such as red meat and cheese.

Beyond dietary contributors, other conditions can also elevate your cholesterol:

• Diabetes, this metabolic disorder disrupts the balance between HDL and LDL cholesterol.
• Liver or kidney disease, impaired liver function reduces cholesterol removal, while chronic kidney disease often coincides with higher cholesterol.
• Polycystic ovary syndrome (PCOS), associated with insulin resistance, weight gain, increased triglycerides and lower HDL cholesterol.
• Pregnancy or other high-estrogen states, cholesterol rises naturally during pregnancy to support fetal growth.
• Hypothyroidism, an underactive thyroid hampers LDL clearance, resulting in elevated ‘bad’ and total cholesterol.
• Certain medications
• Genetic predisposition

Since most people with high cholesterol have no symptoms, routine testing is vital. Unnoticed arterial plaque buildup may suddenly manifest as chest pain, heart attack or stroke without warning.

Lowering your Cholesterol

If your lipid profile indicates high levels, your doctor will recommend the most suitable approach. The cornerstone of treatment is adopting healthy lifestyle habits:

Dietary adjustments

Choose foods that lower LDL and boost HDL:

• Increase intake of fresh fruits, vegetables and whole grains.
• Eat fish (fresh or canned) at least twice per week.
• Include sources of soluble fibre and beneficial fats, such as nuts, legumes and seeds.
• Opt for lean meats in place of fatty or processed cuts.
• Replace butter with polyunsaturated margarine.
• Select low-fat or reduced-fat dairy options and limit cheese and ice cream to twice weekly.
• Reduce overall fat consumption.

Physical activity

Aim for at least 30 minutes of moderate-intensity exercise (e.g. walking, running, dancing or cycling) daily to raise HDL and lower LDL.

Additional lifestyle changes

You can also make some lifestyle changes like:

• Limit alcohol to no more than two drinks per day and avoid bingeing.
• Quit smoking.
• Lose excess weight.
• Manage blood sugar levels if you have diabetes.

If these measures alone do not sufficiently lower your cholesterol, your doctor may prescribe cholesterol-lowering drugs. Among these, statins are the most commonly used to reduce cardiovascular risk. Your physician will discuss any possible side effects and monitoring requirements.