Good Cholesterol versus Bad Cholesterol
When talking about cholesterol, the first things that come to mind are bad
cholesterol and its related diseases. However cholesterol is not necessarily
bad. That's why it is important to know what cholesterol is, how it works within
the body and how it can affect human health.
Cholesterol is a lipid compound that functions as a structural component of cell
membranes, as well as a precursor for steroid hormones (sex hormones and
cortisol), bile acids, vitamin D and lipoproteins. Although cholesterol is found
naturally in many foods, human cells (especially liver cells) are able to
synthesize it from simpler precursors, so cholesterol is not an essential
nutrient for the body.
Cholesterol travels in the bloodstream in small packages called lipoproteins,
that have a hydrophobic lipid core of triglycerides and cholesterol esters
(cholesterol bound to fatty acids), surrounded by a hydrophilic shell of
phospholipids, free cholesterol and apolipoproteins (fat-binding proteins).
Where does Cholesterol go in the body?
There are two main types of lipoproteins: Low-Density-Lipoprotein (LDL) and
High-Density-Lipoprotein (HDL). LDL serves as a source of cholesterol for most
tissues of the body, where it performs the biological functions described above.
However, when in excess, LDL-cholesterol can accumulate in the walls of arteries
forming plaques or "atheromas" that reduce or even block blood flow through the
arteries, potentially leading to myocardial infarction, stroke or other acute
events associated with cerebral ischemia. That's why LDL-cholesterol is known as
"bad" cholesterol. On the contrary HDL serves as a scavenger of free
cholesterol. It removes cholesterol from the blood and transports it to liver,
where it can be eliminated from the body. That"s why HDL-cholesterol is usually
known as "good cholesterol".
According to this, above, it is clear that the ideal situation is to have low
LDL-cholesterol (< 100 mg/dL) and high HDL-cholesterol (> 45 mg/dL), as well as
a low total cholesterol. But how to achieve this goal?
Heading for low LDL Cholesterol
Well, the cornerstone for preventing and treating high LDL-cholesterol is a
healthy lifestyle. Most of all, it is important to adopt a healthy diet, that
must be rich in fruit, vegetables, whole grains and legumes, with limited or no
intake of cholesterol, saturated fats and trans fats. It has been clearly
demonstrated that saturated fats (found in meat, dairy products, eggs and
certain oils, such as palm and coconut oils) raise total blood cholesterol as
well as LDL-cholesterol, while trans fats (found in margarine and some
commercial snack foods) cause both LDL-cholesterol to increase and
HDL-cholesterol to lower. Trans fats are therefore particularly bad for
cholesterol levels.
Cholesterol and diet
Diet should be rich in nutrients that help lower LDL-cholesterol (polyphenols in
olive oil), increase HDL-cholesterol (omega-3 fatty acids), or both (soluble
fiber and omega-6 fatty acids). It has been shown that certain foods containing
these nutrients are particularly effective in preventing high blood cholesterol.
These include soluble-fiber rich foods (oatmeal, apples, bananas, prunes,
barley, kidney beans), omega-6 rich foods (walnuts, almonds, pistachio nuts and
peanuts), olive oil and certain fatty fishes.
Although healthy nutrition is the cornerstone for a healthy lifestyle, there are
also other important lifestyle habits that can help control cholesterol levels,
such as regular exercise, no smoking, managing stress and limiting alcohol use.
When diet and other lifestyle changes are not enough to address high
cholesterol, medications (such as statins and fibrates) are indicated. However
it is paramount to consult with one"' physician before starting any
pharmacological treatment.
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