Cholesterol's Identity as a Lipid and Its Functional Characteristics, Including Management Strategies
In the human body, triglycerides, the main type of fat, play a crucial role. These lipids are essential components of the body, responsible for various functions, including helping maintain cell membrane structure [1].
To monitor cholesterol levels, a lipid profile test is conducted, which measures several aspects, including total cholesterol, LDL and HDL cholesterol, and triglycerides. This blood test, performed by a doctor, is crucial in understanding an individual's cholesterol levels [2]. It's advisable for most adults to undergo this test every 4-6 years, although doctors may recommend more frequent testing for certain groups [3].
Cholesterol is not soluble in water and must bind to protein molecules to easily cross cell membranes, forming a lipoprotein. The two main types of cholesterol are high-density lipoprotein (HDL) and low-density lipoprotein (LDL). HDL, often referred to as "good" cholesterol, can help lower the risk of developing cardiovascular disease. It transports LDL cholesterol back to the liver, where it is broken down and removed from the body [4]. On the other hand, LDL cholesterol, or "bad" cholesterol, contributes to the fatty buildup in the arteries that can eventually lead to a blockage. Too much LDL cholesterol can increase a person's risk of developing several conditions, including heart attack, peripheral artery disease, and stroke [5].
Optimal levels for HDL cholesterol are more than 40 mg/dl for males and 50 mg/dl for females, while optimal levels for triglycerides are less than 150 mg/dl [6]. Optimal levels for total cholesterol are approximately 150 mg/dl [7]. An excessive amount of cholesterol can lead to a buildup in the arteries, known as plaque, which can block arteries and lead to potentially life-threatening conditions such as heart disease [8].
To manage high cholesterol levels, dietary changes are essential. Recommended changes include increasing intake of soluble fiber and healthy fats while reducing saturated fats, trans fats, and cholesterol-rich foods. Key recommendations are:
- Eat more soluble fiber-rich foods such as oats, barley, lentils, beans, apples, and citrus fruits. Soluble fiber helps bind cholesterol in the gut, reducing its absorption into the bloodstream [1][2][5].
- Include healthy fats by choosing monounsaturated and polyunsaturated fats found in avocados, nuts (like almonds and walnuts), seeds, olive oil, and fatty fish such as salmon, mackerel, and sardines. These fats can lower LDL ("bad") cholesterol and raise HDL ("good") cholesterol levels [1][2][3][5].
- Limit saturated fats, commonly found in red meat, pork, full-fat dairy products, and butter since they can raise LDL cholesterol levels [2][4][5].
- Avoid trans fats, typically found in processed and fried foods, which contribute to higher LDL cholesterol and lower HDL cholesterol. Although trans fats are banned in many products, some naturally occur in certain foods and should still be minimized [2][5].
- Adopt a Mediterranean-style diet emphasizing fruits, vegetables, whole grains, legumes, nuts, olive oil, and fish while limiting red meat and processed foods, which has been shown to improve cholesterol and reduce cardiovascular risk [3].
Incorporating plant sterols and stanols (found in some fortified foods) may help block cholesterol absorption [3]. Reducing added sugars and processed foods supports cholesterol management and overall heart health [4][5]. Lifestyle changes like regular physical activity and quitting smoking complement dietary efforts to improve cholesterol profiles [2][3].
Children and adolescents should undergo a lipid profile once aged 9-11 years and a second time aged 17-21 years [9]. In addition to medications, a doctor may recommend lifestyle changes such as a heart-healthy diet, increased physical activity, quitting smoking, and maintaining a healthy body mass index.
Niacin, available as a dietary supplement, should not be taken without a doctor's supervision due to potential side effects and risks of liver damage and failure [10]. Common types of cholesterol-lowering medications include statins, bile acid sequestrants, injectable medications like PCSK9 inhibitors, fibrates, and niacin (nicotinic acid) [11].
In summary, focusing on whole, plant-based foods rich in soluble fiber and healthy fats, reducing intake of saturated and trans fats, and following a Mediterranean-style eating pattern are the cornerstone dietary strategies for managing high cholesterol levels. A combination of medications and lifestyle changes is often necessary for effective treatment.
- The lipid profile test, an essential tool in understanding medical-conditions related to cardiovascular-health, measures not only total cholesterol and triglycerides but also HDL and LDL cholesterol in a person's body.
- Science has established that HDL cholesterol, often referred to as "good" cholesterol, can help lower the risk of several health-and-wellness conditions, such as cardiovascular-disease, due to its ability to transport LDL cholesterol back to the liver for removal.
- Nutrition plays a significant role in managing therapies-and-treatments for high cholesterol levels, with recommendations that emphasize increasing intake of soluble fiber, healthy fats, and plant sterols and stanols, while reducing saturated, trans fats, and cholesterol-rich foods.
- Fitness-and-exercise, combined with dietary efforts, can significantly improve cholesterol profiles and overall heart health, as recommended by medical practitioners for managing high cholesterol levels.
- Participating in Medicare as a senior adult provides access to necessary cardiovascular-health screenings, including lipid profiles and appropriate treatments and medications for cholesterol management.
- It's crucial for children and adolescents to undergo lipid profile tests as part of their healthcare routine, establishing vital health benchmarks for their cardiovascular-health growth and development.
