EVERYTHING YOU NEED TO KNOW ABOUT CHOLESTEROL: FROM HEALTH RISKS TO NATURAL WAYS TO LOWER CHOLESTEROL

What is cholesterol?

Cholesterol is a waxy, fat-like substance naturally found in our bodies and is essential for life. It is produced by the liver and is used to build cells and make vitamins and hormones. Cholesterol is a vital component of cell membranes, maintaining their flexibility, and it is involved in producing certain hormones and vitamin D. While the body produces most of the cholesterol it needs, some of it also comes from animal-based foods. Cholesterol travels through the bloodstream in protein-bound particles called lipoproteins. There are two main types of lipoproteins: Low-Density Lipoprotein (LDL) and High-Density Lipoprotein (HDL). LDL is often referred to as "bad" cholesterol because it can build up in the walls of arteries, forming plaques* that lead to narrowing and blockages. HDL is considered "good" cholesterol because it helps remove excess cholesterol from the blood and transport it to the liver for disposal. Maintaining a balanced cholesterol level is crucial for heart and artery health. However, excessive cholesterol, particularly LDL, can accumulate in the arteries, leading to serious health issues like heart disease, stroke, and arterial blockages. Cholesterol levels are influenced by diet, lifestyle, and genetic factors. Regular check-ups are important for early detection of potential risks.

*Plaque: These are structures that form inside blood vessels, narrowing them.

Why is high cholesterol dangerous?

High cholesterol, especially elevated LDL levels, poses significant risks to heart and vascular health. LDL cholesterol can adhere to the walls of blood vessels, leading to the formation of plaques. Over time, these plaques cause a condition known as atherosclerosis, where the arteries harden and narrow. Atherosclerosis increases the risk of cardiovascular diseases such as heart attacks and strokes. Narrowed arteries can restrict blood flow to the heart or brain. A heart attack occurs when a coronary artery becomes blocked, abruptly stopping the blood supply to the heart muscle. A stroke occurs when blood flow to the brain is reduced or cut off. Since these conditions often do not present symptoms, high cholesterol is considered a silent threat. The harmful effects of high cholesterol can go unnoticed for years, but complications like artery blockages can manifest suddenly with severe consequences. For this reason, preventing or managing high cholesterol is possible through healthy eating, exercise, and, if necessary, medication.

How can I find out my cholesterol level?

The most reliable way to know your cholesterol level is through a blood test conducted at a healthcare facility. This test, usually called a "lipid panel" or "lipid profile," measures the levels of different lipoproteins in the blood. The test results provide information on total cholesterol, LDL (low-density lipoprotein), HDL (high-density lipoprotein), and triglycerides. Cholesterol tests are often done after fasting because food can temporarily affect cholesterol levels. To ensure accurate results, your doctor may advise you to fast for 9-12 hours before the test. Regular monitoring of cholesterol levels, particularly for inpiduals over 40, is essential to assess the risk of heart disease. If there is a family history of heart disease or high cholesterol, testing may be recommended at an earlier age. Based on your test results, your doctor can recommend lifestyle changes or, if necessary, medications to help keep your cholesterol levels in check. Since high cholesterol often shows no symptoms, regular screenings are crucial for early detection of heart and vascular disease risk.

What should cholesterol levels be?

Cholesterol levels should be within certain ranges to maintain good health. Blood tests typically measure four main values: total cholesterol, LDL, HDL, and triglycerides.

• Total cholesterol: Less than 200 mg/dL is considered desirable for adults. Levels between 200-239 mg/dL are borderline, and levels above 240 mg/dL are high.
  
• LDL (bad cholesterol): Should be less than 100 mg/dL. Levels between 100-129 mg/dL are near optimal, 130-159 mg/dL is borderline high, and 160-189 mg/dL is high. Levels above 130 mg/dL increase the risk of heart disease.
• HDL (good cholesterol): Should be above 40 mg/dL for men and 50 mg/dL for women. The higher the HDL, the lower the risk of heart disease.
• Triglycerides: Should be less than 150 mg/dL. Levels between 151-200 mg/dL are borderline high, 201-499 mg/dL are high, and levels above 500 mg/dL are very high. High triglycerides also increase the risk of heart disease.

To maintain healthy cholesterol levels, a balanced diet, regular exercise, avoiding smoking, and losing excess weight are critical. Lowering LDL is especially important to protect heart and vascular health. For those at higher risk, doctors may also recommend medication. Regular cholesterol checks help identify potential risks early on.

What is the difference between HDL and LDL cholesterol?

Cholesterol is carried in two main forms: HDL (good cholesterol or high-density lipoprotein) and LDL (bad cholesterol or low-density lipoprotein). The functions and effects of these two types of cholesterol on health are quite different. HDL is known as "good" cholesterol because it removes excess cholesterol from blood vessels and carries it to the liver, where it is processed and excreted from the body. High HDL levels can reduce the risk of cardiovascular diseases as it helps clean blood vessels and prevent blockages. LDL, on the other hand, is referred to as "bad" cholesterol because high levels can cause cholesterol to stick to artery walls, forming plaques. These plaques gradually narrow arteries and can lead to diseases like atherosclerosis. Atherosclerosis can result in serious health conditions such as heart attacks, strokes, and peripheral artery disease. While high LDL is dangerous, maintaining high HDL levels is equally important in reducing heart disease risk. Therefore, cholesterol management should focus on both lowering LDL and increasing HDL.

How is high cholesterol detected?

High cholesterol is often called a "silent danger" because it typically shows no symptoms. Elevated cholesterol, especially LDL, causes the buildup of plaques in the arteries, a process that can go unnoticed for years. As a result, inpiduals may not realize their cholesterol levels are high until they experience serious conditions like heart attacks or strokes. The most reliable way to detect high cholesterol is through regular blood tests. In some cases, small fatty nodules (xanthomas) may appear on the skin due to cholesterol deposits. Yellowish fat deposits around the eyes can also indicate high cholesterol. People with a family history of high cholesterol are at greater risk, and high cholesterol may appear at younger ages due to genetic predisposition. If there is a family history of heart disease, heart attacks, or high cholesterol, it is advisable to have your cholesterol levels checked regularly. Testing before reaching a certain age is crucial to prevent the complications of high cholesterol at an early stage.

What lifestyle changes can lower cholesterol?

The most important lifestyle changes to lower cholesterol include adopting a healthy diet, exercising regularly, and managing weight. First, reduce the intake of foods rich in saturated and trans fats. Saturated fats are found in red meat, full-fat dairy products, and some processed foods. These fats increase LDL (bad) cholesterol levels, raising the risk of heart disease. Trans fats, found in margarines, packaged snacks, and fast food, both raise LDL and lower HDL (good) cholesterol. Therefore, avoiding trans fats entirely is recommended. Eating more fiber-rich foods, especially whole grains, vegetables, and fruits, can also help lower cholesterol by reducing its absorption in the intestines. Engaging in at least 150 minutes of moderate-intensity exercise per week can raise HDL levels and help lower LDL. Exercise also assists with weight control, as excess weight can negatively affect cholesterol levels. Additionally, quitting smoking and limiting alcohol consumption are essential for heart and vascular health. Quitting smoking raises HDL levels and improves heart health. As last, managing stress can positively affect cholesterol levels since chronic stress can indirectly raise cholesterol.

What are cholesterol medications?

The most common medications used to control cholesterol levels are statins. Statins lower LDL cholesterol by reducing cholesterol production in the liver. They can also help prevent plaque buildup on the inner walls of blood vessels, thereby reducing the risk of heart attacks and strokes. Other medications include ezetimibe and PCSK9 inhibitors. Ezetimibe reduces cholesterol absorption from the intestines, thereby lowering circulating LDL levels. PCSK9 inhibitors work by increasing the number of LDL receptors in the body, helping the liver clear more LDL cholesterol from the blood. These medications are often used in inpiduals with genetically high cholesterol levels. Bile acid sequestrants are also used to lower LDL cholesterol. These drugs prevent the reabsorption of bile acids in the intestines, leading the liver to use more cholesterol to produce bile acids, thus lowering LDL levels in the blood. Niacin and fibrates may also be used to lower triglyceride levels. However, all of these medications should be used under the supervision of a doctor, and potential side effects should be considered. Cholesterol medications are more effective when combined with lifestyle changes.

What is a cholesterol diet?

A cholesterol diet is a nutritional plan aimed at lowering cholesterol levels by reducing LDL (bad) cholesterol while increasing HDL (good) cholesterol. The key principles of this diet include reducing the intake of saturated and trans fats, consuming more fiber-rich foods, and opting for healthy fats. Saturated fats are commonly found in red meat, butter, and full-fat dairy products and can raise cholesterol levels. Trans fats, found in processed and packaged foods, not only raise LDL but also lower HDL, and should therefore be avoided. Healthy fats, derived from foods like olive oil, avocado, fish, and nuts, help increase HDL, supporting vascular health. Omega-3 fatty acids found in salmon, mackerel, and similar fish are also an essential part of a cholesterol-lowering diet. Fiber-rich foods, such as oats, barley, beans, fruits, and vegetables, help reduce cholesterol absorption in the intestines, promoting its elimination from the body. Whole grains and leafy green vegetables also support heart health and help lower cholesterol levels. When following a cholesterol diet, it's important to carefully read food labels and avoid processed foods. A healthy diet, along with regular exercise and weight control, can naturally help lower cholesterol levels. Please consult your dietitian for more information.

How much can I lower my cholesterol with diet?

Lowering cholesterol levels through diet is possible, but the results can vary from person to person. Research shows that a healthy diet can reduce LDL cholesterol by 5% to 15%. However, these figures depend on lifestyle factors, genetic predisposition, and current cholesterol levels. A cholesterol-lowering diet typically involves consuming foods rich in fiber and low in saturated fats. Fiber-rich foods such as oats, barley, legumes, and whole grains reduce cholesterol absorption in the intestines, promoting its elimination from the body, which helps lower LDL cholesterol. Additionally, replacing saturated fats with healthy fats (e.g., olive oil, avocado) can increase HDL cholesterol. Fish rich in Omega-3 fatty acids, such as salmon and mackerel, play a key role in cholesterol management by reducing triglyceride levels. However, the reduction in cholesterol levels through diet may be limited for some inpiduals, and medication may be required. The process of lowering cholesterol through diet is a long-term effort, and results are typically seen within 3 to 6 months. Regular exercise and weight loss can further improve cholesterol levels. Please consult your dietitian for personalized advice.

Do cholesterol levels increase with age?

Yes, cholesterol levels generally increase with age. This is mainly due to a decline in the body's ability to process cholesterol efficiently and a slower metabolism. In younger inpiduals, the body uses cholesterol more efficiently, but as people age, the likelihood of cholesterol accumulating in the bloodstream increases. LDL (bad) cholesterol levels tend to rise with age, while HDL (good) cholesterol levels may decline. For women, a more rapid increase in cholesterol levels is observed after menopause. This is linked to the decrease in estrogen, a hormone that helps regulate cholesterol levels. Before menopause, estrogen keeps LDL levels lower in women, but after menopause, LDL levels may increase, raising the risk of heart disease. Therefore, regular cholesterol checkups become more important with age. Maintaining a healthy lifestyle can help manage cholesterol levels as one ages. Nutrition, exercise, and medication, if necessary, are important for balancing age-related cholesterol increases.

Does stress raise cholesterol?

Yes, stress can raise cholesterol levels. Chronic or prolonged stress affects the body's hormone balance, increasing LDL (bad) cholesterol levels while lowering HDL (good) cholesterol. During stressful situations, the body produces more cortisol and adrenaline, hormones that cause fatty acids and glucose to be released into the bloodstream to meet energy needs. Over time, this process can lead to elevated cholesterol levels. Additionally, inpiduals under stress often turn to unhealthy eating habits, overeating or consuming more saturated fats and sugars, which can further increase cholesterol levels. Unhealthy coping mechanisms, such as smoking, drinking alcohol, and reducing physical activity, also negatively impact cholesterol levels. Chronic stress can also disrupt sleep patterns, adversely affecting metabolism and raising cholesterol levels. Developing healthy strategies for managing stress is crucial to keeping cholesterol levels under control. Regular physical activity can reduce the harmful effects of stress on the body and boost HDL cholesterol levels. Relaxation techniques like meditation, yoga, and deep breathing exercises can also help manage stress. By reducing stress, you can improve your overall health and lower cholesterol levels. Additionally, a healthy diet and regular exercise can help mitigate the negative effects of stress, thus reducing the risk of heart disease.

What should I do if there is a family history of high cholesterol?

If you have a family history of high cholesterol, it's important to regularly monitor your cholesterol levels, as this condition may be hereditary. A genetic condition called familial hypercholesterolemia can cause cholesterol to accumulate in the blood and lead to abnormally high levels. This genetic disorder results in very high levels of LDL (bad) cholesterol, increasing the risk of heart disease. Inpiduals with familial hypercholesterolemia may have high cholesterol levels from a young age.

If your family has a history of heart attacks, strokes, or high cholesterol, it's important to assess your risk with healthcare professionals. In this case, more frequent cholesterol testing and early intervention can help prevent potential complications. Additionally, making dietary and lifestyle changes aimed at lowering cholesterol can help mitigate your genetic risk. In some cases, lifestyle changes alone may not be enough, and your doctor may recommend medications to control cholesterol levels.

If there is a family history of high cholesterol, adopting a healthy lifestyle becomes even more important. This includes regular exercise, healthy eating, quitting smoking, and managing stress. While genetic factors cannot be controlled, lifestyle changes can significantly impact cholesterol levels and the risk of heart disease.

What are triglycerides, and how are they different from cholesterol?

Triglycerides are another type of fat found in the blood and should not be confused with cholesterol. While cholesterol is used in cell membranes and hormone production, triglycerides serve as an energy reserve. When you eat, your body converts any excess calories into triglycerides and stores them in fat cells. Later, when the body needs energy, these triglycerides are used.

High triglyceride levels are associated with an increased risk of heart disease, especially when seen alongside high LDL and low HDL cholesterol levels. Elevated triglycerides can also lead to other health problems, such as pancreatitis*. Maintaining a healthy diet, exercising regularly, and managing weight are important for controlling triglyceride levels. Reducing the intake of sugar and refined carbohydrates can help lower triglyceride levels. Excessive alcohol consumption can also increase triglyceride levels, so limiting alcohol intake is beneficial. A blood test is required to measure triglyceride levels, and this test is often done alongside cholesterol tests.

*Pancreatitis: It is inflammation of the pancreas.

How can I naturally lower my cholesterol levels?

There are several lifestyle changes that can effectively lower cholesterol levels naturally. The most important step is to change your eating habits. Avoiding saturated and trans fats while consuming more fiber-rich foods can help lower cholesterol. Fiber-rich foods like oats, barley, beans, vegetables, and fruits reduce cholesterol absorption in the intestines, promoting its elimination from the body. Fish rich in Omega-3 fatty acids (such as salmon and mackerel) are excellent for lowering triglyceride levels. Please consult your dietitian for personalized advice.

Regular physical activity is another natural way to lower cholesterol. Engaging in at least 150 minutes of moderate-intensity exercise per week can increase HDL (good cholesterol) levels while lowering LDL (bad cholesterol). Additionally, losing weight can contribute to lower cholesterol levels in overweight inpiduals. Quitting smoking also raises HDL cholesterol levels and improves overall heart health. Limiting alcohol consumption is important for controlling cholesterol levels as well.

Some natural supplements may also help lower cholesterol levels. For example, fish oil, black seed oil, and fiber supplements can be used for this purpose, but it's important to consult your doctor or pharmacist before using these supplements. Lowering cholesterol naturally requires time and commitment. However, by making healthy lifestyle changes, you can not only control your cholesterol levels but also improve your overall health.