Cholesterol

What is cholesterol? Cholesterol is a waxy substance produced by the liver and found in certain foods, is needed to make vitamin D and some hormones, build cell walls, and create bile salts that help you digest fat. Actually, your liver produces about 1,000 milligrams of cholesterol a day, enough cholesterol so that if you never touched another cheese fry, you'd be OK. But it's hard to avoid cholesterol entirely because so many foods contain it. Burgers. Bacon. Cheese fries. What do they have in common (besides being some people's idea of delicious)? They're all high in cholesterol. the functions of cholesterol

It builds and maintains cell membranes (outer layer), it prevents crystallization of hydrocarbons in the membrane

It is essential for determining which molecules can pass into the cell and which cannot (cell membrane permeability)

It is involved in the production of sex hormones (androgens and estrogens) It is essential for the production of hormones released by the adrenal glands (cortisol, corticosterone, aldosterone, and others)

It aids in the production of bile It converts sunshine to vitamin D. Scientists from the Rockefeller University were surprised to find that taking vitamin D supplements do not seem to reduce the risk of cholesterolrelated cardiovascular disease.

It is important for the metabolism of fat soluble vitamins, including vitamins A, D, E, and K It insulates nerve fibers Cholesterol is carried in the blood by molecules called lipoproteins. A lipoprotein is any complex or compound containing both lipid (fat) and protein. The three main types are:

LDL (low density lipoprotein) - people often refer to it as bad cholesterol. LDL carries cholesterol from the liver to cells. If too much is carried, too much for the cells to use, there can be a harmful buildup of LDL. This lipoprotein can increase the risk of arterial disease if

levels rise too high. Most human blood contains approximately 70% LDL - this may vary, depending on the person.

HDL (high density lipoprotein) - people often refer to it as good cholesterol. Experts say HDL prevents arterial disease. HDL does the opposite of LDL - HDL takes the cholesterol away from the cells and back to the liver. In the liver it is either broken down or expelled from the body as waste.

Triglycerides - these are the chemical forms in which most fat exists in the body, as well as in food. They are present in blood plasma. Triglycerides, in association with cholesterol, form the plasma lipids (blood fat). Triglycerides in plasma originate either from fats in our food, or are made in the body from other energy sources, such ascarbohydrates. Calories we consume but are not used immediately by our tissues are converted into triglycerides and stored in fat cells. When your body needs energy and there is no food as an energy source, triglycerides will be released from fat cells and used as energy - hormones control this process. The two most important types of lipoproteins are high-density lipoproteins (or HDL) and low-density lipoproteins (or LDL). You've probably heard people call LDL cholesterol "bad cholesterol" and HDL cholesterol "good cholesterol" because of their very different effects on the body. Most cholesterol is LDL cholesterol, and this is the kind that's most likely to clog the blood vessels, keeping blood from flowing through the body the way it should. How can We Increase Our HDL and Lowering LDL Level? Aerobic exercise. Many people don't like to hear it, but regular aerobic exercise (any exercise, such as walking, jogging or bike riding, that raises your heart rate for 20 to 30 minutes at a time) may be the most effective way to increase HDL levels. Recent evidence suggests that the duration of exercise, rather than the intensity, is the more important factor in raising HDL choleserol. But any aerobic exercise helps. Lose weight. Obesity results not only in increased LDL cholesterol, but also in reduced HDL cholesterol. If you are overweight, reducing your weight should increase your HDL levels. This is especially important if your excess weight is stored in your abdominal area; your

waist-to-hip ratio is particularly importantin determining whether you ought to concentrate on weight loss. Stop smoking. If you smoke, giving up tobacco will result in an increase in HDL levels. (This is the only advantage I can think of that smokers have over non-smokers -- it gives them something else to do that will raise their HDL.) Cut out the trans fatty acids. Trans fatty acids are currently present in many of your favorite prepared foods -- anything in which the nutrition label reads "partially hydrogenated vegetable oils" -- so eliminating them from the diet is not a trivial task. But trans fatty acids not only increase LDL cholesterol levels, they also reduce HDL cholesterol levels. Removing them from your diet will almost certainly result in a measurable increase in HDL levels. Alcohol. With apologies to the American Heart Association, which discourages doctors from telling their patients about the advantages of alcohol: one or two drinks per day can significantly increase HDL levels. More than one or two drinks per day, one hastens to add, can lead to substantial health problems including heart failure -- and there are individuals who will develop such problems even when limiting their alcohol intake to one or two drinks per day.
Dangers of high cholesterol levels High cholesterol levels can cause: Atherosclerosis - narrowing of the arteries. Higher coronary heart disease risk - an abnormality of the arteries that supply blood and oxygen to the heart. Heart attack - occurs when the supply of blood and oxygen to an area of heart muscle is blocked, usually by a clot in a coronary artery. This causes your heart muscle to die. Angina - chest pain or discomfort that occurs when your heart muscle does not get enough blood. Other cardiovascular conditions - diseases of the heart and blood vessels. Stroke and mini-stroke - occurs when a blood clot blocks an artery or vein, interrupting the flow to an area of the brain. Can also occur when a blood vessel breaks. Brain cells begin to die.

Symptoms of high cholesterol do not exist alone in a way a patient or doctor can identify by touch or sight. Symptoms of high cholesterol are revealed if you have the symptoms ofatherosclerosis, a common consequence of having high cholesterol levels. These can include: Narrowed coronary arteries in the heart (angina) Leg pain when exercising - this is because the arteries that supply the legs have narrowed. Blood clots and ruptured blood vessels - these can cause a stroke or TIA (mini-stroke). Ruptured plaques - this can lead to coronary thrombosis (a clot forming in one of the arteries that delivers blood to the heart). If this causes significant damage to heart muscle it could cause heart failure. Xanthomas - thick yellow patches on the skin, especially around the eyes. They are, in fact, deposits of cholesterol. This is commonly seen among people who have inherited high cholesterol susceptibility (familial or inherited hypercholesterolaemia).

What causes high cholesterol? Lifestyle causes Nutrition - although some foods contain cholesterol, such as eggs, kidneys, eggs and some seafoods, dietary cholesterol does not have much of an impact in human blood cholesterol levels. However, saturated fats do! Foods high in saturated fats include red meat, some pies, sausages, hard cheese, lard, pastry, cakes, most biscuits, and cream (there are many more). Sedentary lifestyle - people who do not exercise and spend most of their time sitting/lying down have significantly higher levels of LDL (bad cholesterol) and lower levels of HDL (good cholesterol). Bodyweight - people who are overweight/obese are much more likely to have higher LDL levels and lower HDL levels, compared to people who are of normal weight. Smoking - this can have quite a considerable effect on LDL levels. Alcohol - people who consume too much alcohol regularly, generally have much higher levels of LDL and much lower levels of HDL, compared to people who abstain or those who drink in moderation.

Treatable medical conditions These medical conditions are known to cause LDL levels to rise. They are all conditions which can be controlled medically (with the help of your doctor, they do not need to be contributory factors):

Diabetes High blood pressure (hypertension) High levels of triglycerides Kidney diseases Liver diseases Under-active thyroid gland Risk factors which cannot be treated These are known as fixed risk factors: Your genes 1 - people with close family members who have had either a coronary heart disease or a stroke, have a greater risk of high blood cholesterol levels. The link has been identified if your father/brother was under 55, and/or your mother/sister was under 65 when they had coronary heart disease or a stroke. Your genes 2 - if you have/had a brother, sister, or parent with hypercholesterolemia (high cholesterol) or hyperlipidemia (high blood lipids), your chances of having high cholesterol levels are greater. Your sex - men have a greater chance of having high blood cholesterol levels than women. Your age - as you get older your chances of developing atherosclerosis increase. Early menopause - women whose menopause occurs early are more susceptible to higher cholesterol levels, compared to other women. Certain ethnic groups - people from the Indian sub-continent (Pakistan, Bangladesh, India, Sri Lanka) are more susceptible to having higher cholesterol levels, compared to other people There's a lot of variability in how high cholesterol treatments work in a given person. Treatment that did wonders for your spouse may do nothing for you. Some of it depends on your genes. You and your doctor will need to come up with a custom-tailored approach. For most people, the first high cholesterol treatment to try is three lifestyle changes:

Eating better Maintaining (or losing) weight Exercising more

Some people, if they already have other risk factors -- such as diabetes -- may immediately start medication as well. While lifestyle changes can really help bring your cholesterol down, Wong says that not enough people give them a real chance. "The problem is that both patients and their doctors like immediate results," he tells WebMD. "Lowering your cholesterol with exercise and diet is just not like that." So try to give high cholesterol lifestyle treatments time to work. If they do, you can avoid the hassle of being on a daily medicine for the rest of your life. Staton / Statin Statins are a class of medicines that are frequently used to lower blood cholesterollevels. The drugs are able to block the action of a chemical in the liver that is necessary for making cholesterol. Although cholesterol is necessary for normal cell and body function, very high levels of it can lead to atherosclerosis, a condition where cholesterol-containing plaques build up in arteries and block blood flow. By reducing blood cholesterol levels, statins lower the risk of chest pain (angina), heart attack, andstroke.

Several types of statins exist such asatorvastatin, cerivastatin, fluvastatin, lovastatin, mevastatin, pitavastatin, pravastatin, rosuvastatin, and simvastatin. Atorvastatin and rosuvastatin are the most potent, while fluvastatin is the least potent. These medicines are sold under several different brand names including Lipitor (an atorvastatin), Pravachol (a pravastatin), Crestor (a rosuvastatin), Zocor (a simvastatin), Lescol(a fluvastatin) and Vytorin (a combination of simvastatin and ezetimibe). Mevastatin is a naturally occurring statin that is found in red yeast rice.

Research over the last few years has uncovered other benefits linked to statins, apart from cardiovascular ones. Researchers from the Mayo Clinic carried out a study that found thatstatins may reduce people's risk of developing esophageal cancer (cancer of the gullet).

Alcohol consumption and cholesterol This is an interesting point and the first thing I would say is that a bottle of wine per day is excessive. One to two glasses per day is far more sensible and within the approved normal limits. At these levels it seems that wine particularly red wine is beneficial for the circulation by helping to reduce circulating levels of cholesterol in the blood. It appears to do this by both reducing the 'stickiness' of blood especially at mealtimes and also by improving the balance of 'good' and 'bad' cholesterol (lipoproteins). However, this does not mean the more you drink the better the effect! In fact, drinking more than four to five units of alcohol per day appears to increase cardiac health risks so there is a fine line between benefit and harm here.

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