OurHealth

The word cholesterol literally means hard solid in Greek. This is actually an extremely accurate term since when it is builds up in our blood vessels it becomes just that- a hard solid. Fighting high cholesterol levels is one of the most important things to do in order to prevent heart disease and stroke- two conditions that cause a lot of suffering in our communities.

 We all have cholesterol that circulates in our bodies. It is needed for some of the body’s basic functions – including making vitamin-D, making estrogen, and building protective layers around cells. But when cholesterol is present in excess amounts, major problems occur.

 Many of us know that there are good and bad forms of cholesterol. LDL is the bad form and HDL is the good form. But how are the two main types of cholesterol connected? And what role do triglycerides play in cholesterol being high and in heart disease?

Cholesterol in the body is similar to a factory. The process by which our bodies make, use and get rid of cholesterol is similar to a factory producing products and needing to get rid of and recycle waste.

 When we eat foods that contain fat, our body takes that fat and combines it with proteins while the fat is still within our stomach. The combination of this fat that we eat and proteins from our gut are called chylomicrons. The chylomicrons are then taken from the gut to the liver.

 If things work right, the chylomicrons are completely broken down by the liver and then sent out to our muscles and fat cells to make energy. The body is set up so that we should only eat enough fat to be used by our muscle and fat cells- just like an efficient factory. Because our bodies expect to completely use up fat from the foods we eat, the liver think that excess fat does not exist. The liver is then programmed to make its own set of cholesterol and fats. This is where triglycerides come in.

Triglycerides are the starting materials for cholesterol. The triglycerides that are made from the liver are then combined with proteins, called lipoproteins. The triglyceride-protein combination then leaves the liver to drop off fat throughout the body to give nutrients to muscles and fat tissues. So we have two ways to get energy (or triglycerides) to our tissues – through the fat we eat and through the fat the liver makes. Problems occur both of these systems work in overtime.

The triglyceride-protein combination made by the liver undergoes a lot of processing in the blood and become cholesterol. After dropping off triglycerides to our tissues, more protein is present than triglycerides. This is how we get cholesterol. Eventually this protein mixture turns into what is called bad cholesterol or LDL.

It takes only about 2-6 hours for LDL to form. The LDL then circulates in our bodies for about 2-3 days and is dropped off to cells that need cholesterol.

Excess LDL in the blood has to be handled, just like waste in a factory. The body has to decide how to remove it. The liver will take up most of it, but some LDL is taken up by special cells in the blood, called scavenger cells. The scavenger cells have the ability to stick to the inner walls of blood vessels and cause plaque formation. Sometimes, LDL will actually become smaller (or oxidized) while circulating in the blood.

The oxidized form is preferred by the scavenger cells and make it easier for plaque to form. Hence why LDL leads to heart disease.

The good cholesterol, HDL, works to recycle cholesterol waste. HDL is a combination of cholesterol with special proteins attached. It is the recycling team of the body. It goes to tissues in the body and takes up cholesterol that may be in excess and delivers the cholesterol back to the liver to be metabolized. The HDL system is set up to prevent excess cholesterol from occurring in the blood and being picked up by scavenger cells. This is why elevated HDL levels are so important to prevent heart disease.

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 Now that you know how high cholesterol happens, here are some tips to prevent it:

 1. Monitoring – Getting your cholesterol checked regularly.

     You are at risk for high cholesterol if, you:          

-          Eat a diet high in saturated fats

-          Sedentary Lifestyle – exercise is needed to keep HDL levels high

-          Family History                                 

-          Are a smoker

-          Have Diabetes

2. Lifestyle Changes

           -  Diet – eating lower fat and cholesterol diet.
                        Total daily fat intake should be  25- 30% of total daily calories.
                        Saturated fat should be less than 7% of total daily calories.

            - Exercise – will help keep your fat stores down and will
                                   increase HDL cholesterol

            - Stopping Smoking

3. Medications

            Statins – the most effective medicine for lowering LDL levels.
                            Some statins will also mildly increase HDL levels.

            Fibrates – will lower LDL and triglyceride levels

            Niacin – will increase HDL, lower LDL and triglyceride levels

            Fish Oil – will lower triglyceride levels