Posted on October 25, 2018 by Emily Forbes
October is National Cholesterol Awareness Month. Maybe you, a family member or a friend suffer from high cholesterol. Everyone and everything is telling you to reduce your cholesterol. But what exactly is cholesterol? What does it do? And should you be worried about it? Up your knowledge with these cholesterol facts.
What is cholesterol?
- A lipid (fat) found in the blood and cells of humans and animals.
- Cholesterol is synthesised and recycled in the liver. To be transported around the body in the blood, cholesterol binds to proteins where it is known as a lipoprotein. Two common lipoproteins are HDL (high-density lipoprotein) and LDL (low-density lipoprotein).
What does cholesterol do?
- Despite all the negative press around cholesterol, it is essential for optimal health.
- Cholesterol is a key component of cell membranes and is required for the production of vitamin D, sex steroid hormones (oestrogen and testosterone) and bile for digestion.
- HDL shuttles cholesterol out of the blood, away from the cells to the liver where it is broken down. This is why HDL is known as our “good cholesterol”. LDL carries cholesterol to cells where it is needed but can accumulate if there is too much. LDL, “bad cholesterol” can cause damage and inflammation in arteries which leads to the build-up of atherogenic plaque. This plaque deposit narrows the artery walls, restricting blood flow which increases our risk of Cardiovascular Disease (CVD).
Should you be worried about cholesterol?
- It is because of this CVD risk that there is so much scare around cholesterol. Unless you get tested, then the first signs of high cholesterol may be something serious like a stroke or heart attack. So should you be worried? Yes and no.
- Obviously, anything which increases disease risk should be a slight worry.
- LDL and total cholesterol are often used as markers for disease risk but it is not that simple. Ratios of LDL to HDL also important. So you could have high cholesterol but greater HDL to LDL which would have protective effects. HDL and LDL are only two lipoproteins but there are many others and their ratios affect risk too. There are also particle numbers and blood lipids which can complicate things. Therefore, things are still unclear in this area.
- Early research on cholesterol was done in animal models with very skewed diet profiles which do not translate well into real-life human scenarios. Trans-fats are known to increase CVD risk and original data grouped this with saturated fats which is where the hype to reduce saturated fat came from.
- Unfortunately, there are some things we can’t change which increase our risk of CVD; genetics, age, gender, ethnicity and Type 1 diabetes.
- Good news, there are many modifiable behaviours which you can do to help reduce your risk.
How to reduce cholesterol and CVD risk
- Statins. These are prescribed by the doctor and help to reduce LDL cholesterol. In the UK it is recommended to prescribe them to anyone who has a 10% risk of heart disease within a decade. But on average, statins only increase end of life by 3.1-4.2 days for every year you are on them. They can also have many side effects including muscle pain (myopathy), cataracts, liver dysfunction, diabetes, fatigue and memory loss. So 30 years on statins may only be worth a few extra months of life; is it worth it?
- Lose weight. Obesity and overweight is a high-risk factor.
- Improve your diet. Eat less processed and junk food, and replace with more vegetables, healthy fats and greater food variety. And don’t be scared off eggs!
- Increase physical activity, stop smoking and reduce stress levels.
- Take a fish oil (omega-3 supplement).
- Moderate alcohol intake.
It’s the same advice you will hear time and again but it really is the best advice to live life in optimal health, there are no magic pills.