Cholesterol

WHAT IS CHOLESTEROL?

A fat molecule that is white, insoluble and waxy
Essential for many metabolic processes
There are different types of cholesterol

HDL is the ‘good’ cholesterol
LDL is the ‘bad’ cholesterol
Triglycerides, a type of fat, also form part of the lipid profile
Eating foods rich in saturated fats will increase the amount of LDL cholesterol in the body, which is a risk factor in coronary heart disease
High triglycerides may contribute to hardening of the arteries or thickening of the artery walls

What is high cholesterol?
Where does the cholesterol in our bodies come from?
How is cholesterol transported in the body?
What is cholesterol needed for?
What are the risk factors for developing high cholesterol?
What are the different ways of measuring cholesterol
What would be considered as safe blood cholesterol levels
Examples of saturated fatty foods to avoid
Examples of cholesterol lowering foods
Treatment

WHAT IS HIGH CHOLESTEROL?

High cholesterol, or hypercholesterolaemia, is a condition in which the amount of cholesterol in the blood exceeds normal values
This may be due to genetic or lifestyle factors. If it is genetic, it is referred to as familial hypercholesterolaemia

WHERE DOES THE CHOLESTEROL IN OUR BODIES COME FROM?

Cholesterol comes from 2 sources:

Animal-based foods in our diets
Production by the liver and cells

Plant-based foods do not contain cholesterol

HOW IS CHOLESTEROL TRANSPORTED IN THE BODY?

Low-density lipoprotein (LDL) cholesterol – carries most of the cholesterol that is delivered to cells. It is called the ‘bad’ cholesterol because when its level in the bloodstream is high, it can clog up your arteries
High-density lipoprotein (HDL) cholesterol – is called the ‘good’ cholesterol, because it helps remove excess cholesterol out of the cell

This explains why LDL is bad and HDL is good!

WHAT IS CHOLESTEROL NEEDED FOR?

We need a small amount of cholesterol because the body uses it to:
Build the structure of cell membranes
Make hormones, like oestrogen and testosterone
Help your metabolism work efficiently
Produce vitamin D
Produce bile acids, which help the body digest fat and absorb important nutrients

If cholesterol has so many important functions in the body, why should I eliminate cholesterol from my diet and worry about my cholesterol levels?

You don’t need to eat foods that contain cholesterol. Your body can produce all the cholesterol it needs by itself
Excess cholesterol is harmful. Atherosclerosis is a condition in which arteries become hardened and narrowed due to the deposition of excess cholesterol (cholesterol-rich plaques) in the artery walls. This can narrow or obstruct blood vessels, leading to heart attack and stroke

WHAT ARE THE RISK FACTORS FOR DEVELOPING HIGH CHOLESTEROL?

Being overweight
Incorrect diet, rich in saturated fats
Family history of high cholesterol
Excessive alcohol consumption
Smoking
Lack of exercise
Stress
Lack of fibre in the diet

WHAT ARE THE DIFFERENT WAYS OF MEASURING CHOLESTEROL?

Finger prick test that will show total cholesterol for screening and follow-up purposes, ranging from total cholesterol only, to a full cholesterol lipogram profile
Lipogram where blood is drawn and evaluated by a laboratory
Health authorities recommend that a lipogram be done at least once a year in high risk individuals

WHAT WOULD BE CONSIDERED AS SAFE BLOOD CHOLESTEROL LEVELS?

Health authorities recommend that cholesterol levels should be less than 5mmol per litre for total cholesterol and 3 mmol/l for LDL cholesterol if there are no other risk factors present.

WHAT ARE THE GENERAL GUIDELINES TO MANAGE HIGH CHOLESTEROL AND REDUCE THE RISK FOR CARDIOVASCULAR DISEASE?

The South African Heart Association’s guidelines for lifestyle modifications in this regard is summarised as follows:

Stop smoking and avoid exposure to smoke
Increase your physical activity
Achieve and maintain an ideal body weight
Reduce your intake of saturated fats,
Increase your intake of soluble fiber
Avoid refined carbohydrates and sugars
Consume alcohol in moderation
Avoid adding additional salt to food
Monitor your cholesterol levels on a regular basis

EXAMPLES OF SATURATED FATTY FOODS TO AVOID:

Fatty or processed meats like salami and sausages
Snack foods like chips
Most takeaway foods, especially deep-fried foods
Cakes, biscuits and pastries

EXAMPLES OF CHOLESTEROL LOWERING FOODS:

LDL cholesterol can be lowered by the following food types:

Oats and legumes and chickpeas
Garlic and onions
Apple polyphenols found in apples
Plant sterols (often incorporated into margarine these days)

TREATMENT

Is a healthy lifestyle on its own enough to combat high cholesterol?
For some people, diet and lifestyle changes alone are not enough, as High blood cholesterol levels often have a genetic component.
For these individuals, prescription medication such as statins may be required
Treatment of cholesterol should have a multi-approach:
(1) prevention of new formation of new cholesterol on the vessel walls
(2) removal of existing cholesterol
(3) decrease the complications that occur with the cholesterol increase

Please Note: This is an educational information leaflet only and should not be used for diagnosis. For more information on cholesterol, consult your healthcare professional.