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Cholesterol

What is cholesterol?

A waxy, fat-like substance in every cell. It is essential for making hormones, vitamin D, and the bile acids that digest fat.

Source: about 80% is made by your liver, and about 20% comes from food — egg yolks, meat, full-fat dairy, cheese.

Types

  • HDL: high-density lipoprotein. The “good” cholesterol. It picks up excess cholesterol and carries it back to the liver.
  • LDL: low-density lipoprotein. The “bad” cholesterol. It can deposit in artery walls and form plaque.
  • VLDL: very low-density lipoprotein. Also “bad”. It mainly carries triglycerides, and contributes to plaque.

Main causes of high cholesterol

  1. Diet: saturated fats, trans fats, red meat, full-fat dairy, deep-fried and processed foods, excess chocolate.
  2. A sedentary lifestyle.
  3. Smoking: raises LDL and lowers HDL.
  4. Excess alcohol.

Risk factors

  1. Age: levels tend to rise as you get older.
  2. Sex: men often see increases between the ages of 20 and 39; in women, LDL rises after menopause as oestrogen drops.
  3. Genetics and family history.
  4. Health conditions: diabetes, chronic kidney disease, HIV, lupus.
  5. Medicines: steroids, some chemotherapy drugs, certain acne medicines.

Complications

LDL and plaque → the artery narrows or ruptures → clots. If a clot blocks the coronary arteries, that is a heart attack or angina. If it blocks the arteries of the brain, a stroke. If it blocks the arteries of the limbs, peripheral artery disease.

Management

  1. First line: diet, exercise and lifestyle. More fibre, oats, nuts, flax seeds, and vegetables like bottle gourd. Less saturated and trans fat. Quit smoking, limit alcohol.
  2. If it persists: statins are the standard group of drugs, along with continued lifestyle changes.

About 1 to 2 teaspoons of flax seeds and a few slices of raw bottle gourd in a salad help to decrease cholesterol. I have been eating them for the past 20 years.

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