Cholesterol: Is It Fat?
You may have heard the words “lipid” and “cholesterol”. The truth is a little more complicated than that.
Lipids are fat-like molecules that circulate in the blood. They are also found in cells and tissues throughout the body.
There are many different types of lipids, but the best known is cholesterol.
Cholesterol is actually made up of part lipid and part protein. This is why the different types of cholesterol are called lipoproteins.
Another type of lipid is triglycerides.
Functions of lipids in the body
You need certain fats to stay healthy. For example, cholesterol is found in all of your cells. Your body makes the cholesterol it needs.
- Certain hormones
- Vitamin D
- Digestive enzymes
- Substances needed for cell function
You can also get cholesterol from foods of animal origin in your diet.
- Egg yolks
- Whole dairy products
- Red meats
- Bacon
Cholesterol in the human body is safe to consume in moderation. Hyperlipidemia is a condition known as hyperlipidemia or dyslipidemia, which increases the risk of heart disease.
LDL vs HDL
There are two main types of cholesterol: low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
LDL Cholesterol
LDL is considered “bad” cholesterol because it can form waxy deposits called plaque in the arteries.
Plaque can harden arteries. It can also block arteries and reduce blood flow. This process is called atherosclerosis. You may have also heard the term “atherosclerosis.
Plaque ruptures and dumps cholesterol and other fats and waste products into the bloodstream.
In response to the rupture, blood cells called platelets fall into place and form a clot to help contain the foreign material now in the blood.
If the clot is large enough, it can completely block blood flow. When this happens in one of the arteries of the heart, called a coronary artery, the result is a heart attack.
If the clot blocks an artery in the brain or an artery that carries blood to the brain, it can lead to a stroke.
HDL cholesterol
HDL is called the “good” cholesterol because its main function is to remove LDL from the blood and return it to the liver.
When LDL is returned to the liver, the cholesterol is broken down and excreted; HDL only accounts for about 1/4 to 1/3 of the cholesterol in the blood.
High LDL levels increase the risk of heart attacks and strokes. On the other hand, high HDL levels reduce the risk of heart disease.
Triglycerides
Triglycerides help store fat in the cells and can be used as a source of energy. Eating too much and not exercising can cause triglyceride levels to rise. Excessive alcohol consumption is also a risk factor for high triglycerides.
As with LDL, high triglyceride levels appear to be associated with cardiovascular disease. This means they may increase the risk of heart attacks and strokes.
Measuring Your Blood Lipid Levels
A simple blood test can determine your HDL, LDL and triglyceride levels. The results are measured in milligrams per deciliter (mg/dl). These are typical targets for lipid levels.
However, instead of focusing on a specific number, your doctor may recommend some lifestyle changes to reduce your overall risk of heart disease.
The traditional way to calculate LDL cholesterol is to subtract triglycerides from HDL cholesterol from total cholesterol and divide by 5.
However, researchers at Johns Hopkins University found that this method was not accurate for some people, making their LDL levels appear lower than they actually were, especially if their triglycerides were higher than 150 mg/dL.
Since then, researchers have developed more complex formulas for calculating this.
It is recommended that you have your cholesterol levels checked every two to three years, unless your doctor recommends more frequent checks.
If you have already had a heart attack or stroke, you may want to have your cholesterol checked annually or more frequently.
It is also recommended if you have any of the following risk factors for a heart attack
- High blood pressure
- Diabetes
- A history of smoking
- A family history of heart disease.
If you have recently started taking medication to lower your LDL levels, your doctor may check your cholesterol regularly to make sure the medication is working.
LDL levels rise with age; HDL levels do not. A sedentary lifestyle can cause HDL levels to fall and LDL and total cholesterol levels to rise.
Treatment
Dyslipidemia is a serious risk factor for heart disease, but for most people, it is treatable. In addition to diet and lifestyle changes, people with high LDL levels usually need medication to keep their LDL levels in a healthy range.
Statins are among the most commonly used medications for cholesterol control. These medications are generally well tolerated and very effective.
There are several types of statins on the market. Each works slightly differently, but they are all designed to lower LDL levels in the blood.
If you are prescribed a statin and experience side effects such as muscle pain, tell your doctor. Lowering the dose or switching to a different statin may work better and reduce side effects.
You may need to use a statin or cholesterol-lowering medicine for the rest of your life. You should not stop taking your medication unless your doctor tells you to, even if you have reached your cholesterol goal.
Other medications that may help lower LDL and triglyceride levels include
- Bile acid-binding resins
- Cholesterol absorption inhibitors
- A combination of cholesterol absorption inhibitors and statins
- Fibrates
- Niacin
- Combination of statins and niacin
- PCSK9 inhibitors
With medication and a healthy lifestyle, most people can successfully control their cholesterol.
Cholesterol Management Tips
In addition to taking statins and other cholesterol-lowering medications, you can improve your blood lipid profile by making the following lifestyle changes
- Eat a diet low in cholesterol and saturated fat, including lean meats, fatty meats and whole-grain dairy products. Try to eat more whole grains, nuts, fiber and fresh fruits and vegetables. A heart-healthy diet is also low in sugar and salt. Your doctor can refer you to a dietitian if you need help developing this type of diet.
- Exercise most, if not all, hours of the week. The American Heart Association recommends at least 150 minutes of moderate-intensity exercise, such as brisk walking, each week. Increased physical activity is associated with lower LDL levels and higher HDL levels.
- Follow your doctor’s recommendations for regular blood tests to keep an eye on your lipid levels. Test results can vary greatly from year to year. Eating a heart-healthy diet, exercising regularly, limiting alcohol, quitting smoking, and taking prescription medications can help improve cholesterol and triglyceride levels and reduce the risk of heart disease.
