How dangerous is cholesterol?

Too much of it is harmful but there is much that can be done against increased cholesterol levels even without medication.

Cholesterol has a bad reputation particularly since there were a lot of bad things to read about it in the media. Too much of it in the blood can cause arteriosclerosis. The danger is especially high when other risk factors such as overweight, high blood pressure, smoking, diabetes or a tendency in the family for increased levels come into play. Increased blood fat levels are tricky. They don't hurt but they still cause harm. It often happens that overweight or obese people have increased cholesterol levels because they ingest too many fats, especially animal fats. It is often unclear to non-professionals that cholesterol is essentially a vital fat (lipid) in the body. On the occasion of the International Day of Cholesterol (22nd of June) the IFB AdiposityDiseases wants to contribute in bringing some light into this matter.

What is Cholesterol?
The lipid cholesterol is needed in all our body's cells and plays a central role in the building of brain and nerve cells as well as of certain hormones (steroid hormones). Furthermore bile acid and vitamin D are produced from this fat. Cholesterol gets into the body through food but the main portion is produced by the body itself - in the liver.

"Good" and "Bad" Cholesterol
Too high of an cholesterol level in the blood (Hypercholesterolemia; over 200 mg/dl) can lead to cardiovascular diseases. When the coronary vessels are affected (coronary heart disease) the risk to suffer a cardiac infarction or a stroke increases. Those diseases are the most common cause of death in Germany. The so-called "bad" LDL cholesterol (Low Density Lipoprotein) transports the fat from the liver through the vessels in all the body tissues. The LDL cholesterol can settle on the vessel walls and thus lead to arteriosclerosis. Diabetes and high blood pressure further benefit arteriosclerosis. LDL cholesterol might be produced in our own bodies but some people produce an excessive amount of it.

The "good" HDL cholesterol (High Density Lipoprotein) transports fat and thus cholesterol away from the tissue and the blood vessels back to the liver. A high HDL cholesterol level thus counters sedimentation of excessive fat in the vessels and protects us from heart diseases. Physical activity also lets the HDL cholesterol level rise.

Therapy in Case of an Increased Cholesterol Level
"The LDL level is especially important when it's necessary to decide on a therapy for the patient," explains endocrinologist Prof. Michael Stumvoll who scientifically leads the IFB AdiposityDiseases. "It depends on other risk factors in the patient such as overweight, smoking, diabetes or high blood pressure which target level we want to achieve. With an LDL level of less than 115 mg / dl (3,0 mmol/l) physicians assume a moderate risk for cardiovascular diseases, with less than 70 mg/dl they assume a very high risk. The HDL cholesterol level should be more than 40 mg/dl in men and more than 50 mg/dl in women. If a sufficient reduction of the levels is not achieved by a more healthy lifestyle so-called lipid lowering drugs (stanines) are used. Those, contrary to a healthier lifestyle do, however, include side effects. A consultation with your physician makes sense in this case. Many patients are also insecure because of deaths that occured in the context of lipid lowering drugs. (The respective drug was taken off the market in 2001).

Diet and lifestyle Influence the Cholesterol Level
It is a common misconception by many people that diet alone influences the cholesterol level. Apart from a balanced diet it is, however, essential to keep a normal weight and excercise in order to keep the cholesterol level in a normal area. The value can be influenced by 10 to 15 percent by diet and the LDL level can be reduced by about 10 percent by regular excercise. It is enough to regularly drive a bicycle, go swimming or walking.
Natural cholesterol can be found in some food such as eggs, liver and kidneys (food cholesterol). However, the type and quantity of ingested fats influence the cholesterol level in the blood more significantly than this food cholesterol. In food cholesterol there are saturated and nonsaturated fats. Most types of saturated fats lead to an increase of the total and LDL cholesterol. They are content in butter, lard, cocos or palm oil, meat, cream, cheese and sausage. Some nonsaturated are able to lower the LDL cholesterol level. Saturated fats should be replaced by nonsaturated ones in the diet if possible. Unsaturated fats are content of vegetable oils and spreads (e.g. rape oil, olive oil, soy spreads), fishes rich in oil (e.g. mackerel, salmon, herring), nuts and avocado. Most of the time, the part of saturated and nonsaturated fats can be found in the nutrition facts of food. A lot of fruits and vegetables as well as food that contain soluble fibers (e.g. whole grain products, oatmeal, lentils, beans and peas) contribute to a healthy cholesterol level. Industrially manufactured food that advertises with cholesterol lowering qualities, however, remain controversial.

The golden rule thus is the following: Eat the right kind of fat and don't eat to much fat anyway, reduce overweight and excercise sufficiently. Blood fat levels such as tryclycerides can also be influenced like that. When the healthier lifestyle doesn't have the desired effect, lipid lowering drugs can be prescribed.

Doris Gabel

Keywords: nutrition & diet