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Cholesterol Confusion
The Stakes Are High, Knowing The Basics Is Important

May 28st, 2004

By Ken McGrath : eCureMe Contributor
May 27th, 2004 : Physician Reviewed

Cholesterol is one of the hardest topics to get accurate, concise advice on. An alphabet of terms - HDL "Good" cholesterol, LDL "Bad" cholesterol, monounsaturated, trans-fats, triglycerides - all compete for your attention. And every new report that comes out seems to contradict the last one. Case and point: researchers have recently found that antioxidant vitamin supplements, which were previously thought to guard against heart disease, may increase the amount of bad cholesterol in the body. In a similar turnaround, eggs, previously assailed by many doctors and scientists as nothing more than tiny cholesterol bombs, have been shown not to affect an individual’s risk of cardiovascular trouble. It’s enough to make you want to give up on cholesterol all together, eat what you like, when you like and hope for the best. But heart disease is America’s top killer, topping even cancer, and the one certainty is that too many fatty compounds in your system puts you at a higher risk. Trying to figure out what you’re up against is more than worth the effort.

Cholesterol Confusion

What is Cholesterol?

Chances are you’ve heard the term cholesterol so many times it has become an abstract concept more than a concrete reality. Though you know what it is, generally, you might not be able to define it, explain what it does in the body and how it can be harmful. That’s why it helps to get down to basics.

Cholesterol is a soft, slippery substance that’s found in the bloodstream. Contrary to what you hear about cholesterol being so bad for you, your body needs it to function. Without cholesterol, your body couldn’t properly make cells or synthesize certain hormones. Your liver makes about 80% of the cholesterol in your body, only 20% is dietary cholesterol: cholesterol that comes from the food (typically animal fats) you consume.

In and of itself, the cholesterol isn’t the problem. Like most fats, cholesterol can’t dissolve in the bloodstream. In order for it to move around the body, it has to latch onto certain proteins and, in effect, be carried around by them. There are two important cholesterol-carrying proteins: low-density lipoprotein (LDL, LDL cholesterol or "bad" cholesterol) and high-density lipoprotein (HDL, HDL cholesterol or "good" cholesterol). LDL carries cholesterol from the liver to cells throughout the body. HDL carries cholesterol from the blood back to the liver, where it’s filtered out of the system. LDL transports most of the cholesterol in the body. HDL handles anywhere from a quarter to a third. When too much LDL cholesterol is circulating in the blood, it drops out and builds up on the inside of the blood vessels. The buildup, known as plaque, is mixture of LDL cholesterol and other substances from the blood. As the plaque accumulates, it can choke off the blood flowing past it, like a clogged drain chokes off the flow of water. If a blood clot happens to flow into the clog, it can stop up the artery completely and whatever organs the vessel was leading to will be starved for the oxygen the blood carries. If the clot / plaque occur near the brain, this reaction is known as a stroke. If it’s near the heart, the result is a heart attack.

What To Watch

In this process of cholesterol build up, scientists have hashed out several simple facts. The more LDL cholesterol you have in your blood stream, the greater the chance you’ll suffer a heart attack. Since HDL moves cholesterol away from the arteries and towards the liver, the more you have of it, the less risk you’re at. Some researchers believe that HDL can even pick up cholesterol from artery walls and bring it back to the liver, thus slowing the progress of heart disease where it already exist.

This dual action can get confusing when you think about measuring your cholesterol level. Often, it’s common to assume that your risk for heart disease is linked to the total amount of cholesterol in your system (LDL and HDL measured together). While that can be a good indicator, it’s more important to break it down and examine how much "good" and how much "bad" cholesterol you’ve got. If your LDL level is above 160 mg/dl and your HDL is below 40 mg/dl, you’re going to want to work on lowering the bad and upping the good.

Lowering Confusion

Lowering your cholesterol, if your levels are off kilter, can also be a baffling process. Diet and exercise are the two most important changes you’ll need to make. Exercise is fairly straightforward. More physical activity is associated with higher levels of HDL. Diet is somewhat trickier. In general, you need to reduce the amount of fat - especially animal fat - you consume. However, there are many kinds of fats - saturated, poly- and monounsaturated and trans fats. Not all of them are created equal, and cutting down on the wrong kind could be counterproductive.

Trans fats are among the most damaging and most difficult to control. When vegetable oil is heated around hydrogen (a process known as hydrogenation) the chemical reaction generates trans fats. So any food that has been, or contains ingredients that have been hydrogenated, will contain them. The real problem is that hydrogenation plays a role in the preparation of popular processed foods. Everything from potato chips to french fries to margarine contains dangerous amounts of trans fats. Trans fats are dangerous because in addition to increasing the amount of LDL in the bloodstream, it lowers the HDL. Any food product that lists ingredients as "hydrogenated" or "partially hydrogenated" should raise a red flag.

Saturated fats are unhealthy as well, though they’re easier to spot. Saturated fats occur naturally in animal products like fatty meats, whole milk, cheese, ice cream and poultry skin. Coconut milk and oil are also high in saturated fat. Like trans fats, saturated fat raises the amount of LDL in the system. However, that increase is partially offset by the fact it also increases levels of HDL.

When you substitute "good fats" for saturated and trans fats, studies have shown that HDL climbs while LDL falls. "Good fats" are unsaturated ones, and can be broken down into monounsaturated and polyunsaturated fats. Monounsaturated fats come from more organic sources like olives, olive oil, canola oil, nuts and avocados. Polyunsaturated fats are similar, and can be found in corn, soybean products and fish.

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