Clearing Up Cholesterol Confusion

August 02, 2019

"It’s critical to protect your heart! One of the most important ways you can do that is to keep cholesterol in check."

Cholesterol is a term that gets thrown around all the time: high cholesterol, low cholesterol, good cholesterol, bad cholesterol… it can be hard to keep it all straight! In today’s Inside Health, Dr. Keller Worthm, MD, will shed some light on this important molecule, which can cause some problems and provide some benefits as well. We’ll talk about the different terms that are used, how to know what your body needs, and some tips for how to get there. Get ready to talk the good, the bad, and the greasy when it comes to cholesterol.

Video highlights

  • 01:08: What is cholesterol?
    • 01:34: Cholesterol and inflammatino
    • 02:00: The Lipid Panel Test
    • 04:43: Causes of High Cholesterol
    • 08:09: Why is High Cholesterol So Dangerous?
    • 11:11: Best Steps to Lower Cholesterol 

    Cholesterol is actually very important for life, but if you have too much of it, it can lead to issues such as heart disease, heart attack, and stroke. With that much on the line, how do we figure out how to get the right amount of cholesterol — not too much, and not too little?

    Cholesterol is a waxy molecule that exists in the blood, and it’s responsible for the health of your cell membranes, it’s important in a lot of cellular functions, and it’s a building block for certain hormones like estrogen and testosterone (just to name a few), so it is a very crucial molecule. 

    Cholesterol and Inflammation

    When you get too much of this molecule, it can start to have an inflammatory effect on the body. It can inflame the inside of the blood vessels — called the endothelium — and can deposit there, creating plaques. This can be bad for the heart and blood vessels.

    The Lipid Panel Test

    How do you know if your cholesterol levels are good or bad? Luckily, this can be very easily determined with a blood test, or lipid panel. It’s a good idea to check your lipid panels every two years, or even more frequently if you have any risk factors that may be associated with high cholesterol, so make sure to have this conversation with your doctor or healthcare provider. 

    While cholesterol exists in the blood, it’s transported by a protein carrier module — or a lipoprotein. These lipoproteins are the way cholesterol moves around the body. There are different types of lipoproteins that come in different shapes and sizes, and some are better for your body than others. 

    One particular lipid protein, called LDL (Low Density Lipoprotein) is a larger one, and that’s what we commonly know as “bad” cholesterol. On the other hand, HDL (High Density Lipoprotein) is what we often refer to as “good” cholesterol. 

    LDL is considered bad because it’s more inflammatory to the blood vessels, and can deposit more plaque on the walls of the arteries, while HDL is considered good because it actually picks up the cholesterol from the artery walls, and carries it back to the liver where it can be excreted from the body via stool.

    So when your doctor draws a lipid panel, you’ll see values for total cholesterol, the portion of it that is LDL (bad), and the portion that is HDL (good). You’ll also see your triglyceride levels. Triglycerides are another fat that circulates through the body, which can also be quite inflammatory. It’s often related to your blood sugar levels, or the way your body metabolizes sugars. 

    Causes of High Cholesterol

    If you are diagnosed with high cholesterol, you may be wondering how it got there. In some people, it could just be a genetic issue. You don’t have to be consuming fats and cholesterol to get high cholesterol. Your liver makes its own cholesterol, and depending on your genetic makeup, your liver could be making a lot of cholesterol, leading to inflammation in the blood vessels.

    For most of us, however, high cholesterol is a result of lifestyle contributors. So let’s talk about some of the things that could increase our cholesterol levels.

    Sedentary Lifestyle

    If you don’t get a lot of physical activity — maybe you sit at a desk job, or you work in transportation and drive most of the time, that alone can start to raise cholesterol levels.

    A Diet High in Saturated and Trans Fats

    Saturated fats are typically animal fats, for the most part. If you’re eating a lot of red meat, or even other things like chicken and eggs, or fats from animal products like cheese and butter, these are high in saturated fats. Vegetable oils like Crisco, and Wesson, are also high in saturated fats. So if you find yourself consuming a lot of these, this can increase your LDL cholesterol levels.

    Trans Fats, are a kind of synthesized fat, made in a laboratory to preserve food better. It does preserve food well and keep it from spoiling, but it’s extremely bad for the arteries, causes inflammation in the body, and causes a faster hardening of the arteries. 

    Obesity

    A lot of these contributors we already mentioned can lead to weight struggles, and being overweight can also be a cause for cholesterol shifting to ratios that are not ideal.

    Smoking

    Smoking is really bad for cholesterol levels (as well as your lungs of course). Just the use of nicotine and burning of tobacco can drive good cholesterol down, and bad cholesterol up. 

    Diabetes

    Diabetes can increase triglycerides, as well as something called VLDL (Very Low Density Lipoprotein) which is even more corrosive and inflammatory to the arteries than LDL. 

    Why is High Cholesterol So Dangerous?

    It all has to do with our cardiovascular system — the heart and blood vessels. Your heart is arguably your most vital organ! The heart has a really important job — it starts beating before you are even born, and it must continue beating every second for the rest of your life. It never gets to take a break, and it needs a constant supply of blood and oxygen to keep it functioning properly. It’s not like other muscles; if you get a cramp in your leg muscle, you can rest it, allowing it to relax while more oxygen reaches it. You don’t get to rest your heart. 

    The heart gets the blood and oxygen it needs from little arteries called the coronaries. But because they’re so small, they’re very susceptible to something called Atherosclerosis. Atherosclerosis basically means the hardening of the arteries. It happens when you get high cholesterol, or have a lot of inflammation in your diet. It starts to make the arteries inflamed, which causes them to become rigid. Cholesterol starts to deposit on the insides of them — it’s almost like the rusting of a pipe. Have you ever been told not to pour grease down the drain because it will coat the pipe and eventually clog the drain? That’s basically how cholesterol works in the arteries. You don’t want to clog the pipes that supply blood and oxygen to your heart!

    So if you get atherosclerosis, and it clogs the coronary arteries, the heart doesn’t get the blood and oxygen it needs, but it continues to beat anyway. This can lead to what is basically a muscle cramp of the heart — or a heart attack. This happens every day to thousands of people! Heart attacks and cardiovascular disease are the number one killer of men and women in the U.S. In fact, one out of four people in the country will die from some form of cardiovascular disease. So it’s critical to protect your heart! One of the most important ways you can do that is to keep cholesterol in check.

    Best Steps to Lower Cholesterol Levels

    If you go to the doctor and are diagnosed with high cholesterol, what can you do? In some cases, a doctor might prescribe you a medication, such as a statin, or other lipid-lowering drugs. But fortunately, there are also a lot of things you can do at home that will start to change cholesterol levels.

    Stop Smoking

    If you’re a smoker, please quit… today! It’s really hard, and we know that. It’s a powerful addiction. Seek out the help of your physician and online resources if necessary. There are medications, and support groups, and lots of tools available to help. A lot of people think (rightly so!) about the danger smoking poses to lung health, but it’s also incredibly bad for the heart and blood vessels. It really inflames the arteries and it changes the cholesterol from good to bad — lowering HDL and raising LDL. So quit smoking! Your heart will thank you.

    Exercise

    The heart loves exercise! It helps pump more blood through your body and to the heart. The heart gets more efficient, the coronary arteries get more flexible, and exercise is inherently good for your cholesterol levels. Just exercising for 30 minutes per day or even four times per week, will lower your total cholesterol levels, and start to raise HDL and lower LDL.

    Reduce Saturated Fats

    Again this refers to animal products — red meats, butter, cheese, and other products high in saturated fats. Reduce your intake of these things to lower cholesterol. This doesn’t mean you can never eat meat! If you do eat meat, opt for leaner options like chicken, and fish, which is high in healthy fats. Which brings us to our next point:

    Eat More Healthy Fats

    Healthy fats can actually lower cholesterol. They are found in things like salmon, and coldwater trout, as well as plant-based products like avocado oil, olive oil, avocados on their own, nuts, and chia seeds. These are all very rich in omegas, which are great for lowering bad cholesterol and triglycerides, as well as reducing inflammation that irritates the arteries.

    Increase Fiber

    Fiber is the molecule found in fruits and vegetables like kale, broccoli, and red bell peppers. There is also a lot of fiber found in grains (especially whole grains like farro) but you get the most bang for your buck in vegetables. When you eat fiber, it goes into your digestive system and helps pull cholesterol out of your blood, and helps you excrete it in your stool. So you can lower cholesterol by eating a lot of fiber. It helps keep you full for longer as well, so you end up eating less bad-for-you foods.

    Lower Alcohol

    While it’s true that in moderation alcohol can have a positive effect on the cardiovascular system, if you’re having too much of it — more than a drink per day for women, or two drinks per day for men — any benefits you might have gotten from it will go out the window. 

    Manage Stress

    Stress is very hard on the body. When you’re stressed, your cortisol levels go up. Cortisol is very inflammatory, and can also affect your cholesterol. So if you’re trying to protect your heart and blood vessels, you need to manage your stress. A lot of the things we talked about already can help with this, such as exercise, and eating well. Getting proper sleep is also a big one when it comes to managing stress. Take breaks, go for walks, listen to music, or do whatever helps you relax.

    All these things can help you get your cholesterol levels to where they need to be. And if you want some extra help reducing inflammation in the body, in addition to the foods we talked about, add some supplements. There are lots of natural supplements that can help, such as omega-3 oils, and curcumin, a natural inflammation fighter that is the bioactive ingredient found in turmeric. Add these to your diet to reduce inflammation, reduce the bad cholesterol in your body, and protect your heart. 

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