Decoding lipids – The good, bad and ugly

The lipid profile throws some numbers and jargon at you that are often confusing. The total cholesterol is still understandable but we often think what is LDL and HDL. LDL cholesterol is the bad cholesterol or simply the one that clogs the arteries supplying oxygen to vital organs causing heart diseases and stroke while the HDL is good cholesterol which carries the excess cholesterol to the liver for excretion. So, obviously LDL should be low and HDL should be high. The total cholesterol reflects a sum of LDL and HDL cholesterol and although maintaining normal range is important, within the total – the ratio of HDL should be higher than LDL. We can call total cholesterol as the ugly one as high numbers are not appreciated as they hardly ever due to an elevated HDL.

What causes an increase and decrease in the numbers?

Many factors can affect the cholesterol levels in your blood. While some of them are modifiable, some other biological ones are not.

Modifiable  factors:

Diet: We had discussed in our earlier blog that dietary cholesterol does not have an effect on blood cholesterol. But rather other types of fats such as saturated and trans fats lead to an increase in cholesterol in blood.

Saturated fat which is sound in red meats, baked products prepared using dalda / butter/ margarine and other deep fried and processed foods directly causes oxidation of the LDL cholesterol making them dangerous for the arteries.

Similarly, Trans fatty acids (trans fats) present in the solid fats such as margarine, butter,  and products such as cookies, crackers, biscuits, khari, rusks, etc prepared using the same also causes an increase in LDL cholesterol. It also lowers the good (HDL) cholesterol.

On the other hand, there are foods which can lower cholesterol by simply not letting them get absorbed. These are usually the high fiber foods which bind the cholesterol and take them out along with the waste products. Besides these, there are other foods rich in antioxidant activity that can prevent oxidation of the LDL to the deadly artery-clogging form. Antioxidants come from  fresh fruits and vegetables and foods rich in omega 3 fatty acids such as fish and flaxseeds.

Physical Activity

Increasing physical activity also has immense benefits in improving lipid profile.

• Exercise helps to reduce LDL cholesterol
• It increases the HDL cholesterol
• Lowers weight which in turn decreases production of LDL cholesterol

Smoking

Smoking independently lowers good (HDL) cholesterol. Also, studies have shown that individuals who smoke have poor capacity to work-out/ exercise due to compromised lung function. So smokers find it harder to lose weight and thereby lower LDL cholesterol.

Non-modifiable factors:

Heredity

High cholesterol levels may run in families known as a familial hypercholesterolemia. This genetic disorder cannot be totally cured but can be well managed with medication alongwith the right diet and exercise

Age and Sex

With age, LDL cholesterol levels tend to increase in both men and women. Men tend to have lower HDL levels as compared to women. In women, after menopause the LDL cholesterol levels are higher than men due to loss of estrogen hormone.

Largely, maintaining a healthy normal body weight can help to maintain normal cholesterol levels. But sometimes even apparently lean individuals, especially with big belly or smokers, may have high LDL cholesterol and very low HDL levels.  Hence, the current recommendation suggest that everybody above age 20y should get a complete body profile done including lipids. It is better to take the preventive approach as far as heart disease risk is concerned.

 

References:

https://www.nhlbi.nih.gov/health/health-topics/topics/hbc/causes