Cholesterol: The Good and the Bad.

We often forget that without Cholesterol our nerve cells, brain and other vital structures just would not work.

So why is cholesterol the ‘Big Baddy’ when it comes to heart disease?

There are two main types of cholesterol checked in the cholesterol blood test.

The Good one is called HDL and the bad one, LDL.

There are other fat molecules that we also check but for simplicity I will talk about these two today.

The way I remember which one is good and which one is bad is you want the LDL to be Low-because it’s bad; the HDL to be High because it’s good.

For a long time in the modern era of medicine, it was thought that eating food high in saturated fat was the main way for cholesterol to get into the lining of your arteries. But actually there are other causes for narrowing of your arteries.

Inflammation affects the health of your arteries as does your genes and how you are programmed to age and deal with stress in the body.

Being overweight increases inflammation, eating high sugar foods and even processed fats such as polyunsaturates also promote inflammation

So cholesterol is not the only ‘Baddy’ out there.

What influences your cholesterol levels?

  • Your Genes

  • Your weight- If you’re overweight you’re more likely to have an abnormal cholesterol profile

  •  Diet

  •  Exercise: both lifting weight and getting strong muscles and walking and getting a fitter heart.

  •  Inflammation: affects how cholesterol is synthesised and often masked a raised cholesterol level

  • Other Diseases: thyroid disease can affect how cholesterol is produced in the liver

  • Medication: statins lower cholesterol and some drugs such as anti-epileptics increase total cholesterol

What can you do to help keep your cholesterol levels healthy?

 A healthy lifestyle really does influence your cholesterol levels:

  • Eating lots of vegetables, nuts, olive oil, fish and occasional chicken and meat; exercising regularly and maintaining low stress levels are associated with lower levels of LDL and higher levels of HDL.

  • Increasing your exercise level for example will increase good cholesterol and, in some cases, lower bad cholesterol.

  • Eating lots of foods rich in (soluble) fibre, such as oats, vegetables and some fruits will lower LDL, by reducing the absorption of cholesterol and bile acids after eating.

  •  Consuming tree-nuts, such as walnuts, almonds, pistachios five times a week will also lower LDL levels.

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These healthy lifestyles habits are not just associated with having good cholesterol, studies show that making these changes will cause changes in the cholesterol in a dose-dependent fashion i.e. the more you exercise the better your cholesterol ratio will be; and the more vegetables, nuts and olive oil you eat, the better your cholesterol will be.

 As you know food such as red meat, chicken skin and cheeses and coconut oil contain lots of saturated fats, and these foods are on the ‘danger list ‘ if you have high cholesterol.

A lot of doctors, nutritionists and scientists still can’t agree on whether saturated fats are really bad or whether it’s that most people eat too many sugary food and drinks.  The French Paradox is one example of people eating cheese and fatty meats, yet having low levels of heart disease.

This topic is for another day when I’ll talk about fats on their own. But for now avoid processed meats and try and eat olive oil as your fat source, along with nuts and seeds, both high in fats.

Some cardiologists believe eating olive every day is better than taking a statin-a medication used to lower bad cholesterol.


When should you have your cholesterol checked?

If you answer ‘Yes’ to one of these you should have a fasting blood test for Cholesterol

  1. If you are overweight with BMI>25.

  2. If someone in your family-first degree relative- had a heart attack or heart disease at age 55 or younger.

  3. If you have a family history of high cholesterol or a first degree relative has familial Hypercholesterolaemia.

  4. If you are >40 years of age.

  5. If you have an inflammatory condition such as rheumatoid arthritis, lupus, crohn’s disease.

  6. If you are taking steroids.


Summary

  • So, red meat and saturated fat aside, If you can eat more vegetables and nuts, more fibre from oats or psyllium husk, add olive oil to your food, eat seeds such as flax and sunflower, exercise more- both walking and lifting weights- then your cholesterol in your blood will look a lot healthier.

  • Get your blood checked for Cholesterol if you answer ‘Yes’ to any of the scenarios above.

  •  And finally, there’s alcohol. Ethanol is toxic, and drinks, like beer and wine contain a lot of sugar which in turn increases your insulin levels and background inflammation. Inflammation on its own increases your risk of heart disease.

So, if you can reduce your alcohol intake this will help.

Above all, when you’re ready to make changes to your diet try to pick the ones you think will be easiest to initiate and build from there.

Remember you can’t outrun a bad diet!