Cholesterol: Everything You Need To Know
As we originally expected, cholesterol is a waxy substance, similar to fat or triglycerides, although chemically it is alcohol (which is why it was first called “cholesterol” and later renamed “cholesterol”).
By this time, everyone was more or less aware of the “dreaded” cholesterol, that blood lipid labeled as an anti-hero, capable of causing cardiovascular infarction almost by itself. Or so it seems, given the advice that “the lower the cholesterol, the better” is always emphasized in medical consultations and clinical practice guidelines.
What is cholesterol and what does it do?
As mentioned at the beginning, cholesterol is a waxy substance similar to fat or triglycerides, although chemically it is alcohol (which is why it was originally called “cholesterol” and later renamed “cholesterol”). Cholesterol, like fat, has always been essential to life. It is impossible to live without these two substances.
In the specific case of cholesterol, most of it is produced endogenously, that is, by the body itself, especially in the liver. In fact, we produce more cholesterol internally than we usually get from food: we synthesize about 10 mg per kilogram of body weight per day, while dietary recommendations suggest that we consume no more than 300 mg per day.
There are different subunits of cholesterol, depending on the type of transport protein that contains it. Since cholesterol is insoluble in water, it needs these “transporters” – lipoproteins. These are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).
The former is called “bad cholesterol” or “LDL cholesterol” and has the function of transporting cholesterol to using tissues such as arteries; on the other hand, “good cholesterol” or “HDL cholesterol” has the opposite function of picking up cholesterol from tissues and transporting it to the liver where it is excreted by the bile.
There are many more subunits that carry cholesterol, but we will focus on the latter two, as they are the most widely used in medicine today.
In general, we know that cholesterol, as a molecule, is necessary to build the body’s cell membranes and to make bile in the liver, and it is also part of several hormones such as sex hormones. Therefore, a life without cholesterol could not be more obvious, even though an excess of cholesterol is dangerous.
Why cholesterol is important in medicine
Currently, dietary recommendations suggest that blood cholesterol should not exceed 200 mg/dL, and for this reason, several food groups are recommended and discouraged, some good and some reaching catastrophic nutritional points.
Initially, all these recommendations were based on the obsession of an American physiologist, Ancel Keys, whose “Seven Countries Study” and other related works began the general persecution of cholesterol and fat. Later, in 1997, Case himself corrected himself, even asserting that “dietary cholesterol has a limited effect on the human body”. But the damage has been done.
The reality is that ingested cholesterol does not go directly into the arteries and consuming dietary cholesterol does not have such adverse effects. In fact, as we have already mentioned, the human liver itself is capable of synthesizing twice as much cholesterol as is normally recommended in the diet.
It could be assumed that levels of “LDL cholesterol” above 150 mg/dL or “HDL cholesterol” below 35 mg/dL are detrimental to health, and that both levels, if insufficient, increase the risk of heart attack. However, this is far from reality.
How is cholesterol treated?
Currently, in medicine, the use of drugs known as statins functions to lower blood cholesterol levels when it exceeds the well-known 200 mg/dL of total cholesterol, or when LDL cholesterol exceeds 150 mg/dL, as long as there are other associated risk factors, such as having type 2 diabetes, obesity, hypertension, alcoholism or smoking. In fact, depending on the associated risk factors, or if a heart attack or stroke has already occurred, clinical medical guidelines recommend, when possible, a greater reduction of total cholesterol, especially LDL cholesterol, recommending that the latter should be below 70 mg/dl in some cases. for its part, an increase in HDL cholesterol is generally recommended, although there are no drugs specifically for this purpose. In fact, some recent studies claim that an excess of good cholesterol or HDL increases the risk of infection and premature death.
How to treat cholesterol
While medical and nutritional advice recommends stopping certain foods, the reality is that these foods are outdated. Some of the “not recommended foods” are high-fat cheeses or eggs, both of which are high in saturated fat and cholesterol, factors that we have already explained do not have a direct effect on blood cholesterol as previously thought.
In fact, recent work not only points out that eating more than one egg a day is not harmful, but that even one egg a day will protect the heart.
On the other hand, it has also been officially recommended to reduce the consumption of nuts because of their high fat content, but we now know that nuts are beneficial and can increase satiety. The danger comes when they are salted or fried, because not only do we consume too much of them (any excess, even of good food, is bad), but we also consume a higher caloric density due to the super additives of frying.
On the other hand, more recent research suggests that we shouldn’t take the buildup of arterial plaque or fat in our arteries so seriously because we still know a lot about it and how and when it can harm us. In fact, a 2017 study showed that intense exercise doubles the amount of fatty plaque, while exercise likely has a protective effect. Researchers believe that exercise can actually “stabilize plaque,” though more research is needed.
Statins, on the other hand, have been shown to give users a “halo effect”: “While I’m on the drug, I can eat less well and it won’t raise my cholesterol.” And cholesterol alone is not responsible for all the ills of modern medicine.
The reality is that diet and exercise, in short, a healthy lifestyle in and of itself will be more effective than any medication we want to use. a 2009 study published in the journal Circulation stated that diet trumps any medication as a factor in preventing cardiovascular risk. And it’s not only important to eat healthy (with a smile “real food”), but also to eat in moderation: a good diet, but one that is high in calories, can be harmful.
