High Cholesterol - What Does It Mean?

Cholesterol is a wax-like chemical which is found in every living creature from the simplest form of life to the most complex. It is an absolutely essential ingredient in the wall or outer "shell" of every living cell and it is used as a building block of many different chemicals in our bodies. Without cholesterol life as we know it could not exist.

And yet we hear everywhere that too much cholesterol is bad for one's health! How can this be so???

We make cholesterol in our liver and it leaves the liver via the bloodstream to go to every part of our body where it's used in various ways. If we have too much in our blood it can be deposited in the form of firm, yellow, waxy deposits in the lining of the blood vessels which carry the cholesterol thoughout our bodies. These deposits form very slowly over many years and the more cholesterol we have floating round in our bloodstream the quicker these deposits grow. And the deposits can grow so large that they can eventually completely block off the channel though which the blood normally flows. If this happens in a major blood vessel to an important organ and if there are no alternative ways for the blood to get to that organ then part of or all of that organ can die!!! This is one way that strokes and heart attacks can happen.

Having a high level of cholesterol in the blood doesn't make one feel different in any way and one may have absolutely no warning that a stroke or heart attack is going to happen until it actually starts to happen. This is one reason that it's so important to find out if one's cholesterol level is too high.

So why does the cholesterol level go up too high? Well, almost all the food in our diet comes from other living tissues - plants and animals - so that we cannot avoid eating some cholesterol in our diet. However some foods sources contain a lot more cholesterol than other sources and it is a general rule that food which comes from plants usually has very low levels of cholesterol in it while food from animal tissues or products usually contains a lot more cholesterol in it and some parts of animal's bodies are extremely rich sources of cholesterol. Cholesterol is a different chemical from fat but they are often found together in the same animal tissues!

In particular, red meat is very rich in cholesterol and fat; poultry is less rich in cholesterol and fat, and finally, fish is much lower in cholesterol. (Interestingly the fatty or oily deep sea fish have little cholesterol and the special types of fats they have in their bodies helps us make less choleseterol in our livers.) Dairy products are also quite rich in fats and cholesterol and similarly for eggs.

So if one eats too much cholesterol then that cholesterol will eventually find its way into our bloodstream and this will speed up the rate at which the deposits of cholesterol in our arteries enlarge and narrow the channels through which our blood flows.

Making too much cholesterol!

However the cholesterol found in our blood isn't entirely made up of cholesterol we eat in our diet. We also make cholesterol in our liver and the process of making cholesterol is usually very well controlled so that if we eat too much cholesterol we make less. Unfortunately for some people, the mechanisms which control how much cholesterol we make can go haywire especially if we inherit faulty genes from our parents. And this problem starts even before one is born! So it's possible to eat a diet which is very low in animal fat and cholesterol but still have far too much cholesterol in the blood.

This explains why apparently healthy athletes can suddenly die from heart attacks! They may eat very healthy diets, be slender, do lots of ærobic exercise and be non-smokers. However if they have high cholesterol levels (which doesn't give any warning feelings that something's wrong) they can suddenly block off a major blood vessel carrying blood to the heart or part of the brain and just drop dead without any warning!

So obviously it's pretty important to know if one has a high level of cholesterol in one's blood and if so then to do something about it!

What can be done about high cholesterol?

Firstly, one can eat a diet which contains less animal fat. This means eating less red meat, more lean poultry and better still more fish. If one does eat red meat one should eat it less often and have smaller helpings. The meat should be lean and any visible fat should ideally be trimmed off before it's cooked. One should cook in a way which doesnt add or retain fat. This means roasts and frying are out!!! Grilling is better but the very high temperature involved in grilling may generate lots of cancer producing chemicals (carcinogens) especially in the charred areas!

Ideally one would also eat lower fat dairy products or switch to soya-based substitutes (they take a bit of getting used to!) and also have no more than 1 or 2 eggs per week!

It takes a bit of time to change one's eating habits and it's all too easy to slacken off and slip back to the bad old eating habits, especially if one has to eat out a lot or rely on takeaway food because of the pressures of work.

Add to this the fact that lowering one's dietary intake of cholesterol and fat doesn't make one feel even the slightest bit better and it's easy to see why so many people who initially make an effort to eat a healthier diet eventually give it up!

However if one can prove by doing followup blood tests for cholesterol that a healthy diet lowers ones cholesterol level to a safer level then it's far safer and cheaper to eat a nearly vegetarian diet than to take tablets to lower one's cholesterol.

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So what can tablets do?

There are now many tablets available which, if taken regularly, will slow down the rate of cholesterol production in the liver. This can result in large drops in the levels of cholesterol in the blood within a few weeks of starting the tablets. By and large these tablets are safe although sometimes they can produce subtle and reversible changes in the liver which can be shown up in blood tests taken specifically to watch out for this side-effect.

Tablets work only while they are taken! If one stops taking them it's inevitable that the level of cholesterol will rise again and then one is back to square one!

Whats are LDL and HDL?

These are the two main types of cholesterol which add up to comprise most of the cholesterol in our bloodstream. The former (Low Density Lipoprotein cholesterol or LESS DESIRABLE cholesterol) is bad news while the latter (High Density Lipoprotein cholesterol or HEALTHY cholesterol) is very good to have floating around in one's blood. It protects one from the damaging effects of the LDL cholesterol and it is now known that the ratio of the bad to good cholesterol ie. the LDL:HDL ratio, is a very important factor perhaps even more important that the absolute amount of cholesterol in the blood!

So it's possible to have a high total cholesterol level but still be quite healthy if the LDL:HDL ratio is 2:1 or less. Conversely, if one's total cholesterol is low but the LDL:HDL ratio is high eg. 4:1 or more, then one's overall cardiovascular risk can be quite high.