By Doc Willie Ong

How are cholesterol and triglycerides produced?

The liver gathers fat, sugar, and protein as raw materials in order to produce cholesterol.  Afterward, the liver converts some of the cholesterol into bile acids which go on to break down fats during digestion and carry away waste. Cholesterol can’t move around the blood by itself. Instead, it’s carried by lipids wrapped in protein which are called lipoproteins. 

The lipoprotein family name is shared by several particles which bring fatty acids and cholesterol to cells. Very low-density lipoprotein or VLDL carries a form of fat called triglycerides.  Some of the fat we consume is not immediately burned for energy. These are converted into triglycerides. They serve as a storage of energy for our cells to use later on.  Cells around the body can catch and hang onto VLDL to extract the fats within. 

As more fatty acids are extracted from very low-density lipoprotein, it degrades and transforms into intermediate-density lipoprotein or IDL.  The smaller intermediate-density lipoprotein (IDL) particle carries fewer triglycerides along with some cholesterol.  Some IDLs are quickly absorbed by the liver. Others continue along the bloodstream. 

What is cholesterol used for?

As cells continue to extract fatty acids from IDL, they convert into low-density lipoprotein or LDL.  Having lost most of the fatty acids, LDL carries pure cholesterol.  Cells hold onto LDL to absorb cholesterol. Despite its bad reputation, cholesterol is in fact a necessity and can be found in each and every cell. 

Cholesterol serves as a raw material for the formation of cell membranes which control what can enter and leave a cell.  Skin cells make use of cholesterol to make vitamin D from sunlight.  This vitamin is then used by the bones which allow for better calcium absorption.  Our glands use cholesterol to produce hormones like cortisol, estrogen, and testosterone.

Why is cholesterol bad?

Most cholesterol in the body is carried by low-density lipoprotein or LDL. At normal levels, LDL performs a necessary function. However, an unhealthy lifestyle and certain foods can raise levels of LDL cholesterol in our blood.  Bad LDL cholesterol, triglycerides, and other substances can combine to form plaque deposits that accumulate along the walls of arteries in the heart.  This makes arteries less elastic and slows down blood flow. 

If the blood cannot bring enough oxygen to the heart, chest pain or angina results. To make things worse, plaque deposits can break away, form a clot, and entirely block the flow of blood to the heart.  This results in a heart attack.  Even more worrisome, this process can happen without producing noticeable symptoms. 

Therefore, undiagnosed cholesterol can become a quick and silent killer.  As such, LDL has gained notoriety as the bad cholesterol.  Be sure to check the LDL cholesterol after taking a blood test.  Doctors recommend checking cholesterol levels starting at age 9 and rechecking every five years after.  Persons from age 45 to 65 should check every two years.  Those over age 65 should check yearly.          

Is there good cholesterol?

To maintain balance, the liver and small intestines also produce high-density lipoprotein or HDL.  It’s characterized by more protein in its composition.  HDL travels the bloodstream, collects excess cholesterol, cleans the walls of our arteries to prevent damage, and transports cholesterol back to the liver.  Finally, the liver gets rid of cholesterol.  As such, HDL has a well-deserved reputation for being good cholesterol. 

Proper Cholesterol Levels

According to the Center for Disease Control and Prevention, 94 million people in the United States have high cholesterol levels.  Listed below are the accepted levels of cholesterol.  Notice how the normal levels can also vary according to age.  Non-HDL cholesterol corresponds to LDL and the other remaining cholesterol.

Cholesterol    Anyone 19 & below    Male aged 20 & up      Female aged 20 & up
total cholesterol   Less than 170 mg/dl    125–200 mg/dl       125–200 mg/dl
non-HDL   less than 120 mg/dl   less than 130 mg/dl       less than 130 mg/dl
LDL   less than 100 mg/dl   less than 100 mg/dl       less than 100 mg/dl
HDL   more than 45 mg/dl   40 mg/dl or higher       50 mg/dl or higher

Symptoms of people with high cholesterol

  1. Chest pain or angina
  2. Cold Extremities
  3. Fatigue
  4. High blood pressure
  5. Nausea
  6. Numbness
  7. Shortness of breath
  8. Slurring of speech

Causes of High Cholesterol

  1. Diabetes – Having type 2 diabetes can decrease good HDL cholesterol levels.
  2. Unhealthy Diet – a diet high in saturated fat and trans fat from fatty meat, butter, coconut oil, palm oil, cream, ice cream, fast food, fried food, biscuits, cakes, and cookies causes high cholesterol. 
  3. Low fiber diet
  4. Kidney disease
  5. Family history of high cholesterol – Check if you have a male family member with heart disease before age 55 or a female family member with heart disease before age 65.  You can inherit a rare disease called familial hypercholesterolemia which causes high cholesterol even at a young age.
  6. Being obese
  7. Lack of exercise
  8. Smoking – damages the blood vessels making it more likely they’ll collect fatty deposits. It also lowers good HDL cholesterol.
  9. Menopause – LDL levels can rise after women have menopause.
  10. Age – Men aged 45 or older and women aged 55 or older have an increased risk of high cholesterol
  11.   Alcohol increases cholesterol and triglycerides.  Drinking also causes kidney disease, liver disease, and hypothyroidism.
  12.   Medicines can also increase cholesterol levels.

Foods to avoid for people with high cholesterol

  1. Butter.  One tablespoon has already 30g of cholesterol.  This is 10% of the daily allowable cholesterol consumption.  Baked cakes, cookies, and pastries made with plentiful amounts of butter will increase your cholesterol. 
  2. Biscuits, creamy candy, doughnuts, fast food, microwave popcorn, and pizza have unhealthy trans fats which can raise cholesterol.
  3. Caviar
  4. Fast foods.  A hamburger has 60 to 150 mg of cholesterol.  Chicken nuggets have 30 mg-50 mg of cholesterol
  5. Fried foods. Frying foods increase their calories.
  6. Canned foods and salty chips can be high in sodium.  Too much sodium increases blood pressure.
  7. Duck.
  8. Egg yolks have 1,234 mg of cholesterol per 100 grams.  This is 4x the daily allowance of cholesterol.
  9. Sugar causes diabetes, heart disease, and obesity.  Avoid sodas, iced tea, candy, and ice cream.  Anything with sucrose, dextrose, fructose, lactose, maltose, brown sugar, corn syrup, and corn sweetener.
  10. Red meat. Lamb, beef, and pork have a lot of saturated fat. Hamburgers, pork chops, and ribs have the highest amount of fat. Choose pork loin or sirloin cuts.  Eat beans, chicken breast, and fish.
  11. Processed meats like bacon, hot dogs, and sausages are high in cholesterol.  Just one piece of bacon has 9 mg of cholesterol and 5 mg of fat.  Eating processed meats is linked to heart disease and colon cancer.  In a study with 614,000 people, eating 50 grams of processed meat a day increased the risk of heart disease by 42%.
  12. Shellfish like clams, crabs, oysters, lobsters, and mussels raise cholesterol.
  13. Shrimp.  Low in fat but high in cholesterol.  100g of shrimp constitutes 65% of the daily allowable cholesterol. 

Healthy foods that lower cholesterol

  1. Avocados
  2. Beans
  3. Berries
  4. Brussels sprouts
  5. Chia and grounded flaxseeds
  6. Citrus fruit
  7. Dark Chocolate but in moderate amounts
  8. Green and black tea
  9. Lentils
  10. Nuts
  11. Olive oil
  12. Oranges
  13. Red wine but in moderate amounts
  14. Salmon
  15. Soy
  16. Spinach
  17. Tuna
  18. Vegetables
  19. Whole grain. Get bread, cereal, and pasta made with whole grain.  Barley, oats, and quinoa have complex carbohydrates, fiber, and protein.
  20. Whey protein from dairy products can decrease bad LDL cholesterol, total cholesterol, and blood pressure.

Tips on lowering cholesterol

  1. Get 30-45 minutes of exercise daily. 5 times each week.  Exercise can add to good HDL cholesterol.  In 2019, a study made with the participation of 425 adults showed moderate and vigorous exercise lowered blood sugar, reduced blood pressure, and raised good HDL cholesterol.
  2. Add fiber to your diet by eating apples, brussels sprouts, eggplant, okra, kidney beans, oatmeal, and pears.  Every day, eat 20 to 35 grams of fiber.  5-10 grams from this total should be soluble fiber.  This type of fiber reduces the absorption of cholesterol by the blood thus lowering LDL cholesterol.
  3. Eat foods high in omega-3 fatty acids like salmon, mackerel, flaxseeds, and walnuts.  This can reduce triglycerides in the blood and improve blood pressure.
  4. Eat fruits and vegetables.  Eating at least four servings of fruits and vegetables a day can give a person 6% lower cholesterol than people who eat fewer than 2 servings of fruits and vegetables a day.
  5. Stop smoking.  After only 20 minutes, blood pressure and heart rate normalize.  In three months, circulation of blood and respiration in the lungs improve.  In a year, the risk of heart disease is cut in half compared to a smoker.
  6. Lose weight.  Losing 10 pounds can cut LDL by 8%. 
  7. Use olive oil instead of butter.  This can reduce cholesterol by 15%
  8. Eat garlic.  Eating half to a full clove of garlic can lower cholesterol by 9%
  9. Use allspice, cilantro, cinnamon, clove, dill, dried oregano, mint, marjoram, sage, and thyme.  These herbs and spices are high in antioxidants which lower cholesterol and reduce the formation of plaque in arteries.
  10. Have a good laugh.  Laughter can increase HDL.
  11. Avoid trans fats. Avoid partially hydrogenated oil or partially hydrogenated vegetable oil.  This was banned by the United States FDA in January of 2021.   It’s the same as trans fats. Biscuits, cakes, cookies, doughnuts, French fries, fried chicken, margarine, microwave popcorn, nondairy creamer, pies, pie crust, and frozen pizza have a lot of trans fats.  These foods increase LDL while lowering HDL.
  12. Eat unsaturated fats.  Avocados, fatty fish, olives, and nuts have unsaturated fats. Eating this in a span of 8 weeks can lower total cholesterol by 9% and reduce bad LDL cholesterol by 11%.
  13. Drink green tea.  In animal studies, green tea lowers cholesterol by limiting the liver’s creation of LDL and increasing its removal from the blood.  Drinking one cup of green tea a day can reduce the risk of heart attack by 20%.
  14. Eating soy can increase good HDL cholesterol and lower bad LDL cholesterol.
  15. Avoid sugars.  In one study, adults taking drinks with high-fructose corn syrup for two weeks had a 17% increase in LDL cholesterol.

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