What is cholesterol and how it can harm our body? In this article, I’m going to tell you few important things about cholesterol, fat, triglycerides, trans-fats and your cholesterol numbers.
These topics could be overwhelming but I’m going to try my best to be as clear as possible.
Bear with me.
What is cholesterol?
Cholesterol is a sterol and an important part of the cell membrane and exclusively found in animals.
What is cholesterol good for?
Body uses cholesterol in the production of major hormones in the adrenal glands ( such as cortisol, testosterone, aldosterone and adrenaline).
Cholesterol is a precursor of bile salt. The liver produces bile salt and the gallbladder stores it.
Why do you need dietary fats?
You need energy to move, work, study, breathe and to stay alive.
Dietary fat in addition to carbohydrates and proteins are a major source of energy.
Cholesterol is the most prominent fat in our society but not the only fat metabolized inside of our body.
Triglycerides deliver the majority of the fat energy from your diet to your body.
However, because of the emphasis on cholesterol in recent decades, fewer people know about the harms of triglycerides and other forms of fat.
Fat provides almost 9 kcal per g energy and it’s essential for absorbing fat- soluble vitamins, such as vitamin A, D, E and K.
The difference between triglycerides and cholesterol
The are differences between the function of cholesterol and triglycerides as follows.
Cholesterol is part the cell membrane structure and used for the production of major hormones in the body.
Triglycerides are the major fuel of the body and absorbed through food and deposited in fat cells.
An elevated level of both could be harmful to your body.
Therefore, it’s important to have a balanced diet and to maintain the blood cholesterol and triglyceride levels within an acceptable range.
High cholesterol symptoms
An interesting question that I often receive is: “what are the symptoms of high cholesterol?” Is there any way to tell you if your blood cholesterol level is high, without having blood work? The simple answer is No.
The situation with high cholesterol level and high blood pressure is very similar.
It isn’t possible to tell who has high blood pressure and who doesn’t. This doesn’t pertain to those individuals who have extremely high blood cholesterol and blood pressure levels.
There is a small percentage of people who have had extremely high blood cholesterol levels for many years and present with cholesterol deposits under the skin and on their tendons.
That is why it’s important to know your family history and to have a baseline cholesterol level after consultation with your doctor.
Let me explain to you a little more about cholesterol numbers. When you look at blood cholesterol results , you’ll see several different numbers. I’d like to explain what those numbers mean.
However, before going any further, it’s necessary to understand the lipoproteins.
Lipids (fats) aren’t water soluble. For instance, if you add water to butter you will see that the fat remains separated and doesn’t mix with the water itself, even if you keep mixing it. The same thing is true when we look at the relationship of the blood and fat.
Therefore, to be able to transfer lipids from one location to another one, the body will require water soluble protein covered entities which can haul the water insoluble fat.
These water soluble structures are called lipoproteins, I’d call them containers. These containers carry fats such as cholesterol and triglycerides from one organ to another.
Lipoproteins are the carriers of fat, including triglycerides and cholesterol. Therefore, when you look at your blood work you’ll see numbers for total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides.
The commonly known lipoproteins include:
- Low Density Lipoprotein (LDL)
- High Density Lipoprotein (HDL)
- Very Low Density Lipoprotein (VLDL)
- Intermediate Density Lipoprotein (IDL)
These entities are large boxes that transport the dietary fat, in other words, the fat that you eat each time is packed into these carriers and transported from the intestine to other parts of the body. Chylomicrons incorporate mostly triglycerides and only a small amount of cholesterol.
Low Density Lipoprotein (LDL)
Most people know that LDL cholesterol is bad cholesterol. LDL cholesterol has been the focus of public and medical interest for many decades.
You should look at your recent blood cholesterol levels and locate your LDL cholesterol.
In most labs, LDL cholesterol is calculated by using the Friedewald equation,
([LDL-chol] =[Total chol] – [HDL-chol] – [TG]/5 ) and the concentrations are expressed in mg/dl.
Most physicians ask their patients to fast before going for blood work to check their cholesterol. This is because an elevated blood triglyceride level could affect the LDL cholesterol results.
There are also ways to check the LDL-cholesterol directly without the need to calculate it. This method will eliminate the interference of triglycerides on LDL cholesterol.
LDL cholesterol contains a larger amount of cholesterol and a small amount of triglycerides. This lipoprotein transports cholesterol from the liver to other organs. Cholesterol contributes to bile acid production in the liver and other hormones in the body.
Individuals with high blood LDL-cholesterol levels are at elevated risk for having cardiovascular events.
High Density Lipoprotein (HDL)
HDL are commonly known as “good cholesterol”. The reason is that the HDL particles gather cholesterol from peripheral tissues and haul it back to the liver. They clean up the excess cholesterol from the body.
Therefore, having more HDL cholesterol is better than less HDL cholesterol. You can find out more about HDL by reading the following article “What is HDL?”.
These lipoproteins originate from the liver and contain larger amounts of triglycerides. VLDL is converted to LDL and is mainly involved in so-called diabetes dyslipidemia.
Diabetic patients usually have high levels of triglycerides, low levels of HDL cholesterol and higher levels of small LDL cholesterol.
Triglycerides make up the majority of ingested fats. And an elevated blood triglyceride level could reduce the blood HDL(good)-cholesterol level.
Triglyceride rich lipoproteins can result in elevated levels of inflammation and can be harmful to vascular health. I’d suggest to read my following article “Triglycerides: A Seldom-Acknowledged Part of Lipids” to learn more about triglycerides.
IDL is somehow between LDL and VLDL. This lipoprotein contains more proteins and cholesterols but fewer triglycerides than VLDL.
When you look at your blood work, one of the numbers you will see is your total cholesterol. This number will tell you approximate amount of cholesterol in three major lipoprotein classes Including: LDL, HDL and Vldl (very low density lipoprotein). IDL (intermediate lipoproteins) and lipoproteins (a) contain smaller amounts of cholesterol as well.
Total cholesterol is a sum of your bad and good cholesterol.
You shouldn’t panic, if you see an elevated total blood cholesterol level before you look at your amount of good cholesterol. An elevated good cholesterol will also result in a higher total cholesterol level.
Thus, relying on total cholesterol to estimate an individual’s cardiovascular risk could be misleading.
Normal blood cholesterol level
Many people would like to know what a normal blood cholesterol level is. This is a difficult question to answer because it depends on the person and our definition of normal.
Therefore, a person with a family history of early heart disease, high blood pressure and diabetes will have a different acceptable range, compared to someone who has no major health issues.
In general, bad cholesterol should be as low as possible and good cholesterol (HDL cholesterol) should be as high as possible. It should be at minimum more than 40 mg/dl in men and 50 mg/dl in women.
Optimal blood triglyceride level
This question is easier to answer for triglycerides. In general, it’s recommended that your blood triglyceride level should be less than 150 mg/dl.
This level increases in patients with diabetes and individuals with an impaired metabolism.
Trans fatty acids
In recent decades, changes in food processing techniques have added significant amounts of trans fatty acids to common processed foods.
Adding hydrogen to vegetable oil produces trans-fatty acids.
This process transforms a fluid with a solid product at room temperature. Trans fatty acids shown to increase LDL cholesterol levels and raise the cardiovascular risks.
The main purpose of the introduction of trans fatty acids is to increase the shelf life of the products.
Main sources of trans- fatty acids
Most people consume the following foods containing Trans fatty acids:
- Cakes, cookies, crackers
- Stick margarine
- Frozen pizza
- Coffee creamer
- Fried foods
- Potato chips
- Microwave popcorn
Have you consumed any of these products recently?
You’re probably familiar with the statins. These medications lower blood LDL cholesterol and prescribed to millions of patients. Currently the U.S. Food and Drug Administration has approved seven brands of statins.
- atorvastatin (Lipitor)
lovastatin (Mevacor, Altocor)
simvastatin (Zocor )
In recent decades, the number of patients dying from heart disease and stroke has declined significantly. Many experts suggest that statin treatment is a major contributor to this reduction.
Statins are great medications but they’ll never replace your responsibility for your physical and mental health.
That is why I encourage you to learn about your body and mind. If you start working on disease prevention, you can begin to get healthier today. I’m certain that your efforts will pay off and your general reliance on medications will go down, as you start these changes early.
Keep reading and learning,
Have a great healthy day.
H. Leon Daneschvar, MD
Must read articles
- Familial Hypercholesterolemia (High Blood Cholesterol): Too Often Ignored and Untreated
- Lowering Cholesterol through Diet- Plant Sterols
- Lowering LDL-cholesterol and Triglycerides through Diet-Fish Oil
- Lowering LDL-cholesterol and Triglycerides through Diet-Fiber
- Lowering LDL-cholesterol and Triglycerides through Diet-Red Yeast Rice
- Foods High in Cholesterol
- 3 Ways that Dietary Fiber Can Make You Healthier
- What is HDL?
- What is Cardiovascular Disease?
- Simvastatin: Review & Analysis
- What is Cholesterol Ratio?
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