Friday, July 13, 2018

Cholesterol 101: What Your Levels Mean?

What is Cholesterol?
Many associate cholesterol with fatty foods, but most come from a waxy substance that is made by our own bodies.  The liver produces 75% of the circulates in our blood; the other 25% is from the food we eat.  When at normal levels, cholesterol plays an important part in helping the cells do their job.  Cholesterol levels are high in more than 100 million Americans.
Symptoms of High Cholesterol
There are generally no symptoms, but there can be damage deep within the body.  Over time, too much cholesterol can lead to buildup of placque in the arteries, known as artherosclerosis.  This is when the arteries become to narrow for available blood flow and can trigger heart disease.  But the good news is that high cholesterol can be easily detected by several ways and can be brought down. 
Cholesterol Testing
It is recommended that people over 20 have their cholesterol levels checked at least once every 4 – 6 years.  You can do this with a simple blood test called a fasting lipoprotein profile.  It measures the different forms of cholesterol that circulates in our blood after avoiding food for 9 – 12 hours.  The results give the levels of bad cholesterol, good cholesterol, and triglycerides.
Bad Cholesterol
Most  of the cholesterol that the blood carries protein through the body is call low density lipoproteins (LDL).  It combines with other substances that clog the arteries.  A diet high in saturated and trans fats raises the level of LDL cholesterol.  For most people, the LDL score should be below 100 to be healthy, but those with heart disease should be even lower.
Good Cholesterol
1/3 of the blood that cholesterol is carried through the arteries is called high-density lipoproteins (HDL).  The good cholesterol helps remove the bad cholesterol by preventing buildup to the arteries.  The higher level of HDL cholesterol, the better.  But people with too little HDL may develop heart disease.  Healthy fats, like olive oil, boost HDL cholesterol levels.
Triglycerides
The body converts excess calories, sugar, and alcohol into triglycerides, the fat that is carried in the blood and stored as fat cells in the body.  People who are overweight, inactive, smoke, heavy drinkers have high levels of triglycerides and also those who eat a high-carb diet.  A triglyceride score of 150 or higher runs the risk of metabolic syndrome—that is linked to heart disease and diabetes.
Total Cholesterol
This measures the combination of LDL, HDL, and VLDL (very low density lipoprotein) in the bloodstream.  VLDL is a precursor of LDL, the bad cholesterol.  A total cholesterol score under 200 is healthy in most cases; but people in the high range have an increased risk of heart disease than those under 200.
Cholesterol Ratio
To calculate the cholesterol ratio:  divide the total cholesterol by HDL cholesterol. 
Example:  total score 200/HDL score 50 = Cholesterol ratio 4 to 1.
Doctors recommend maintaining a ratio of 4 to 1 or lower; the smaller the better.  It is useful in estimating heart disease risk, but not important in guiding treatment.
Cholesterol in Food
Cholesterol-rich foods, like eggs, shrimp, or lobster are no longer forbidden as research shows that cholesterol eaten is a small effect in the blood cholesterol levels for most people.  Few people “respond” to blood levels that spike after eating eggs.  Saturated or trans fats are the bigger concerns.  A daily cholesterol limits 300 milligrams for healthy people, and 200 milligrams for those at higher risk.
Cholesterol and Family History
There are two sources for cholesterol:  the body and food, that contribute to high cholesterol.  Some people can inherit the genes that trigger too much cholesterol produced.  Saturated fats in cholesterol are found in animal-based fats like meat, eggs, and dairy products made from milk.  In many cases, high cholesterol comes from a combination of diet and genetics.
What Boost Your Risk?
There are several factors that can boost your risk:
·          A diet that high in saturated fats and cholesterol.
·         A family history high in cholesterol.
·         Aging.
Cholesterol and Gender
Women usually have a lower total cholesterol level than men of the same age, that is until menopause.  Women tend to have higher levels of HDL cholesterol, the good kind; and for good reason—estrogen, the femal e sex hormone raises the level of HDL cholesterol.  But estrogen peaks during childbearing and drops after menopause.  After 55, the risk of developing high cholesterol increases.
Cholesterol and Children
There is evidence that cholesterol can start clogging the arteries in childhood, increasing the risk of artherosclerosis and heart disease later in life.  The American Heart Association recommends children and teenagers take necessary steps to bring down high levels of cholesterol.  The total cholesterol should be below 170 for ages 2 – 19.
Why High Cholesterol Matters
One major risk is Coronary Heart Disease, heart attacks, and strokes.  It also boosts the risk of Alzheimer’s Disease.  High cholesterol leads to buildup of placque and narrows the arteries.  This can be dangerous as it can restrict the blood flow and blood supply to the heart and brain can be cut off, resulting in heart attack and stroke.
Cholesterol Buster:  Eat More Fiber
Diet changes are a powerful way to fight high cholesterol.  Fiber is the reason cereals claim they are heart-healthy.  The soluble fiber in many foods reduces LDL, the bad cholesterol.  Some good sources of soluble fiber are whole-grain breads and cereals, oatmeal, fruits, dried fruits, vegetables, and legumes like kidney beans.
Cholesterol Buster:  Know Your Fats
It is recommended that no more than 35% of daily calories come from fats; but not all fats are equal.  Saturated fats, or animal fats and tropical oils raise the LDL cholesterol level.  Trans fats carry an even double whammy as they boost the bad cholesterol by lowering the good kind.  Examples are two bad fats like baked goods, fried foods like doughnuts, fries, and chips, stick margarine, and cookies.  Unsaturated fats like avocados, olive oil, and peanut oil, lower LDL if combined with a healthy diet.
Cholesterol Buster:  Smart Protein
While meat and fullfat milk have plenty of protein, they are major sources of cholesterol.  Try reduce LDL by switching to soy protein like tofu for some meats.  Fish, like salmon,  is also a great choice as they are rich in omega-3 fatty acids in improving cholesterol levels.  The American Heart Association recommends eating fish at least twice a week.
Cholesterol Buster:  Low-Carb Diet
Evidence has shown that a low-carb diet is better than a low-fat diet for improving cholesterol levels.  A 2-year study by the National Institutes of Health followed people who ate a low-carb diet had better HDL, (good cholesterol) than those who ate a low-fat diet.
Cholesterol Buster:  Lose Weight
If your overweight, talk with your doctor about a weight loss program.  Losing weight reduces triglyceride levels, LDL, and total cholesterol.  By shedding a few pounds, it can boost your levels of good cholesterol – and it goes up one point for every 6 pounds lost.
Cholesterol Buster:  Quit Smoking
Here’s a big reason for giving up smoking:  good cholesterol is improved by 10%; and you are successful if you combine several smoking cessation strategies.  Talk with your doctor about what options are best for you.
Cholesterol Buster:  Exercise
If you are healthy, but inactive, starting an aerobic exercise program can increase good cholesterol by 5% if started in the first two months.  Regular exercise lowers the bad cholesterol, so choose an activity that boosts the heart rate, like running, swimming, walking briskly—aim for 30 minutes most days of the week.  It doesn’t have to be 30 continuous minutes; 2 15-minute walks will work just as well.
Treatment:  Medications
If high cholesterol runs in your family, diet and exercise may not be enough to get cholesterol levels down.  For this reason, medication may be an option to help give cholesterol levels a nudge.  Statins are usually a first choice, as they block the production of cholesterol in the liver.  But other options , like cholesterol inhibitors, bile acid resin, and fibrates can be used.  Ask your doctor to recommend the best option. 
Treatment:  Supplements
There are certain dietary supplements that can improve cholesterol levels like flaxseed oil, fish oil, and plant sterols (beta-sitosterol).  Prescription niacin, a B-complex vitamin, raises the good cholesterol and reduces the bad cholesterol.  Niacin found in ordinary supplements is not used to lower cholesterol. 
Herbal Remedies
Studies have shown that garlic can also lower cholesterol by a few percentage points.  But garlic pills can have side effects that interact with medications.  Other herbs that can lower cholesterol include:
·         Fenugreek seeds
·         Artichoke leaf extract
·         Yarrow
How Low Should You Go?
Many people with lower cholesterol levels use a combination of medication and lifestyle changes.  But how low is enough?  For diabetes and high risk heart disease, the LDL score should be less than 100.  If you already heart disease and Coronary Artery Disease, it is recommended to reduce LDL to 70 or lower. 
Can the Damage be Undone?
It takes years for high cholesterol to clog the arteries with placque.  So evidence that atherosclerosis can be reversed to some degree.  Dean Ornish, MD, has published several studies that a low-fat vegetarian diet, stress management, and moderate exercise can chip away at the build-up inside coronary arteries.  And other research supports big drops of cholesterol by opening clogged arteries. 
Reference

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