Everything about cholesterol: the norm in the blood, tips and recommendations on how to lower it. Cholesterol - vital necessity - functions

Cholesterol is present only in animals, it is not found in plants. In the human body, cholesterol is found in the liver, spinal cord and brain, adrenal glands, sex glands, adipose tissue; is part of the membranes of almost all cells. A lot of cholesterol is found in breast milk. The total amount of this substance in our body is approximately 350 g, of which 90% is in the tissues and 10% in the blood (in the form of esters with fatty acids). More than 8% of the dense substance of the brain consists of cholesterol.

Most cholesterol is produced by the body itself (endogenous cholesterol), much less comes from food (exogenous cholesterol). Approximately 80% of this substance is synthesized in the liver, the rest is produced in the wall of the small intestine and some other organs.

Without cholesterol, the normal functioning of the vital organs and systems of our body is impossible. It is part of cell membranes, providing their strength and regulating their permeability, as well as influencing the activity of membrane enzymes.

The term " membrane" denotes a cell boundary, which, on the one hand, serves as a barrier between the contents of the cell and the external environment, and on the other hand, as a semi-permeable partition through which water molecules and some of the substances dissolved in it can pass. More than 95% of the membranes are composed of lipoproteins. They include phospho-, glycolipids and cholesterol, which performs not only a stabilizing, but also a protective function. It ensures the stability of cell membranes and protects intracellular structures from the destructive action of free oxygen radicals, which are formed during metabolism and under the influence of external factors.

The next function of cholesterol is its participation in metabolic processes, the production of bile acids necessary for the emulsification and absorption of fats in the small intestine, and various steroid hormones, including sex hormones. With direct participation cholesterol vitamin D is produced in the body (which plays a key role in the metabolism of calcium and phosphorus), adrenal hormones(cortisol, cortisone, aldosterone), female sex hormones (estrogen and progesterone), male sex hormone testosterone.

That's why cholesterol-free diets are harmful also by the fact that their long-term observance often leads to sexual dysfunctions (both in men and women).

In addition, cholesterol is essential for normal brain function. According to the latest scientific data, cholesterol directly affects the intellectual abilities of a person, as it takes part in the formation of new synapses by brain neurons, which provide the reactive properties of the nervous tissue. Thus, American scientists experimentally proved that a high content of HDL (“good” lipoproteins) in the blood reduces the risk of developing Alzheimer's disease, compared with people of the same age group with an average cholesterol level, by 30-40%.

And even LDL, "bad" cholesterol, is also necessary for our body, as it plays a leading role in the functioning of the immune system, including protection against cancer. It is low-density lyioproteins that are able to neutralize various bacteria and toxins that enter the bloodstream. Therefore, the lack of fat in the diet is harmful in the same way as their excess. Nutrition should be regular, balanced and meet the individual needs of the body, depending on living conditions, physical activity, individual characteristics, gender and age.

Very often people confuse dietary fats and adipose tissue of the body. That is why it is sometimes so difficult to convince patients not to eliminate fats from the diet. However, these are completely different concepts.

There are three classes of fats:

1. Structural fats- fats used as building materials for the synthesis of hormones and the formation of cellular structures.

2. Adipose tissue- a store of fat stored in fat cells in the form of triglycerides and playing the role of thermal insulation and an energy source in the body.

3. Dietary fats contained in food. Dietary fats of animal origin are structural fats and adipose tissue of animals. Vegetable oils and fats are fatty acids.

Dietary fats themselves are not able to turn into adipose tissue, as they do not stimulate the release of insulin. To create fat reserves, insulin is needed, which switches fat cells into reception mode. No matter how much pure fat you eat, it won't make your pancreas produce insulin. I emphasize: the human body is constantly updated, the processes of decay and synthesis are going on in it, and dietary fats play a key role in this process. As in the case of cholesterol, a dietary deficiency of fat results in; to metabolic disorders and accelerated metabolic aging. It is impossible to list all the diseases and disorders resulting from chronic fat deficiency, but here are just a few of the symptoms:

¤ brittle, brittle nails; ¤ cravings for carbohydrates and stimulants; ¤ constipation; ¤ dry, lifeless, thin hair; ¤ infertility; ¤ insomnia; ¤ reduction in lean body mass while increasing fat on the abdomen and waist; ¤ mood swings; ¤ peeling and itching of the skin.

If there is not enough dietary fat in the diet, then the body, among other things, receives less two essential (essential) fatty acids: linoleic and linolenic. These vital fatty acids cannot be synthesized in the body. Linoleic and linolenic acids serve as raw materials for the synthesis of many biochemical substances, including hormones of the class eicosanoids.

Recently, eicosanoids have received much attention in the popular medical literature, sometimes citing them as the most important hormones. This approach is wrong: there are no "more important" and "less important" hormones. All body systems are closely interconnected, and all hormones are equally necessary for normal life. What is important is not this or that hormone in itself, but the maintenance of hormonal balance.

The balance of eicosanoids is only one of the elements of the general balance of biochemical substances achieved with a good diet. You can look at this problem from the other side: any imbalance, whether it be thyroid disease, menopause or a lack of fat in the diet, leads to hormonal imbalances, including an imbalance of eicosanoids. It is necessary to take care not of one of the body systems, but of the whole organism as a whole.

With a deficiency of linoleic and linolenic acids, the body cannot produce enough eicosanoids, which leads to allergies, joint pain, heartburn, asthma, and other diseases.

To contribute to the cure of these diseases and the prevention of the emergence of new diseases, it is necessary to eat right, namely: do not give up healthy dietary fats. Saturated, monounsaturated and polyunsaturated fats found in natural foods are good for health.

Your diet should include enough fat and cholesterol. Try to diversify your sources of these nutrients as much as possible: eat butter, eggs, red meat, poultry, fish, seafood, olives, avocados, tofu, nuts, and seeds.

Cholesterol and fats are so important to normal life that the body has a redundant system for the production of these nutrients. I emphasize the fact that the body is able to synthesize the cholesterol it needs from carbohydrates. Read on for more details on this process.

Crossing the threshold of the office, even the most skeptical patients, as a rule, are already ready to agree with my opinion about the dangers of low-fat diets for health, as they have learned the truth from their own bitter experience. Chronic fatigue, obesity, high blood sugar and other health disorders have become the strongest arguments in favor of my words. Of course, agreeing with me in principle, every patient wants to be guaranteed that the inclusion of fats and cholesterol in the diet will not lead to cardiovascular disease.

The only way to save people from fear is to explain in detail how the body functions with regular good nutrition, as nature intended.

In order for the brain to function normally, a strictly defined amount of sugar must be constantly supplied to it. The supply of sugar for the brain is stored in the liver. After eating, blood sugar rises, but the liver prevents excess sugar from reaching the brain. Between meals, when blood sugar drops, the liver keeps a constant supply of sugar to the brain from its own reserves.

Let's take a look at what happens in the body after eating a nutrient-balanced meal. Food is digested in the stomach and intestines, and about 4 hours after eating, nutrients enter the portal vein that connects the small intestine with the liver. The liver is our sorting station. It sorts nutrients and determines how much sugar can be passed to the brain and body cells. With a balanced diet, the liver works most efficiently, providing a constant and tightly regulated supply of fuel and building materials to the body's cells.

However, if your diet is not balanced, then this process is significantly disrupted. To begin with, let's look at what happens in the body when carbohydrates are consumed.

Suppose you ate a piece of bread. In the small intestine, the complex carbohydrates that make up bread are broken down into sugar. Sugar is absorbed into the bloodstream and enters the portal vein, signaling the pancreas to start producing insulin. (If at this moment it was possible to take blood from the portal vein for analysis, then it would reveal elevated levels of insulin and sugar). Insulin and sugar go to the liver. By the amount of insulin, the liver determines how much sugar has entered the body.

With an excess of carbohydrates in the diet, the pancreas produces a lot of insulin. High insulin levels tell the liver that too much sugar has been taken into the body. To prevent excess sugar from entering the bloodstream and from there to the brain, the liver converts some of the sugar into energy or stores it as glycogen. If at the moment the body does not have an urgent need for energy, and there are already enough glycogen reserves, then excess sugar turns into cholesterol - a building material for hormones and cellular structures, and triglycerides - fatty acids used to create fat reserves. The amount of sugar entering the brain remains unchanged.

The conversion of some of the sugar into cholesterol and triglycerides under the action of insulin is a natural and normal process. However, it fails if your diet lacks fat and cholesterol while having an excess of carbohydrates, and also if your lifestyle and bad habits cause increased production of insulin in the pancreas.

When you don't have enough cholesterol in your diet, your body decides it's times of famine. In this case, the body has a backup system: insulin activates a liver enzyme called HMG Co-A reductase. Under the action of this enzyme, increased production of cholesterol from carbohydrates from food begins. It is this cholesterol that is deposited on the inner walls of the arteries in the form of atherosclerotic cholesterol plaques, causing heart attacks, strokes and other diseases. This is why people on diets low in fat and cholesterol, while having an excess of carbohydrates that cause insulin levels to rise, eventually increase blood cholesterol levels and develop atherosclerosis of blood vessels, which eventually (as happened to Robert) can lead to a person to the operating table.

Reducing the intake of dietary cholesterol while increasing the amount of carbohydrates in the diet is a sure guarantee of overproduction of cholesterol in the body.

Dietary cholesterol, unlike carbohydrates, does not increase cholesterol production in the liver. Essentially, as paradoxical as it may sound, the only possible "low cholesterol diet" is a complete diet that contains enough dietary cholesterol. The only way to "turn off" the enzyme HMG Co-A reductase is to include foods containing dietary cholesterol in your diet. The intake of cholesterol with food gives the body a signal that the hungry times are behind us. Dietary cholesterol blocks the action of HMG Co-A reductase, and without this enzyme, the liver cannot synthesize cholesterol from sugar. In other words, getting enough dietary cholesterol stops the production of cholesterol in the body.

More than once I have heard from patients: “Well, if the body is able to synthesize cholesterol, then what are cholesterol-rich foods for? I will eat as before, without cholesterol, and let the body produce as much of it as it needs.” He will work out something, but there will be no health benefits from this. An excess of carbohydrates causes an overproduction of insulin, and an overproduction of insulin starts the processes leading to the formation of cholesterol plaques on the walls of blood vessels. It is equally important to know that carbohydrates, unlike dietary cholesterol, are not able to signal to the body in time that there is already enough cholesterol in the body and it is time to stop its synthesis. This causes the body to produce more cholesterol than it needs.

If you ate scrambled eggs and a sandwich with butter for breakfast, then your body has received enough cholesterol, and the liver does not have to synthesize it. If your breakfast consists of a bowl of cereal with skimmed milk, fruit and orange juice, then the body does not get cholesterol, but gets too many carbohydrates. The mechanism of internal synthesis of cholesterol is launched, while, as just mentioned, too much of it is produced. Excess cholesterol settles on the walls of blood vessels, increasing the likelihood of atherosclerosis and cardiovascular disease.

Pharmaceutical companies have developed drugs to reduce the synthesis of cholesterol in the body. The action of these drugs is based on blocking the enzyme HMG Co-A reductase. The development of new, more effective drugs continues. But it would be much easier to explain to people that it is necessary to include foods containing cholesterol in the diet, and at the same time reduce the consumption of carbohydrates and stimulants. Drinking enough dietary cholesterol- the only possible healthy way to reduce the production of cholesterol in the body and normalize cholesterol metabolism.

It is extremely important to emphasize that insulin plays a critical role in the overproduction of cholesterol. Whatever causes insulin levels to rise, be it stress, drastic diets, caffeine, alcohol, aspartame, tobacco, steroid hormones, lack of exercise, drug use, excessive or unnecessary thyroid hormone intake, medications, or an unbalanced diet high in carbohydrates lack of fats and proteins, the body will always respond to this by overproduction of cholesterol. Next, three diseases will be consecrated, the most common today - cardiovascular diseases, cancer and type II diabetes. You will learn why the main cause of cardiovascular disease is not high blood cholesterol levels, but chronically elevated insulin levels, which caused an overproduction of cholesterol.

Fifty-five-year-old Joel tried to do everything he could to lower his total blood cholesterol levels. Like many of our contemporaries, Joel had no doubt that in this way he could reduce the risk of cardiovascular disease.

What are lipoproteins?

The total cholesterol level is the sum of three indicators, each of which characterizes the level of one of the groups of special proteins - lipoproteins("lilo" means "fat"): high density lipoproteins(HDL), low density lipoproteins(LNP) and very low density lipoproteins(LONP). Cholesterol and triglycerides(fats) are insoluble in water, so they are transported through the blood vessels in a "package" of water-soluble proteins (as you know, blood is mostly water).

A blood test for cholesterol measures triglycerides, total cholesterol, and HDL, LDL, and VLDL levels. These quantities are mathematically related as follows:

Total cholesterol = HDL+LDL+VLDL.

VLDL = triglyceride level: 5.

Total cholesterol = HDL + LDL + (triglyceride level: 5).

The value of HDL is inversely proportional to the level of VLDL. In other words, blood triglyceride levels contribute to total cholesterol levels; the higher the level of high density lipoprotein, the lower the level of very low density lipoprotein, and vice versa.

As you can see, the total cholesterol level is just the result of the arithmetic addition of three different indicators. High, low and very low density lipoproteins act on the body in different ways, so their amount alone will not say anything about your health. Therefore, it is incorrect to talk about "normal" and "abnormal" total cholesterol levels. Moreover, you can get a heart attack with absolutely "normal" total cholesterol and live a long life with "elevated" total cholesterol.

My patient Joel was just one of those who worries about individual numerical indicators (test results), not being able to look at his health as a whole. Hoping to lower his total cholesterol levels, he eliminated fat from his diet, but after that, his total cholesterol levels became even higher. Joel decided that his disorder was hereditary, and therefore he would have to come to terms with it. The patient was wrong: his health could and should be helped.

Joel: I went on a diet even before the whole world started talking about the dangers of cholesterol. As a teenager, my whole face was in terrible acne. At the time, doctors believed that acne was diet related, so I kept hearing, “No chocolate, no fat, no dairy!” I remember doctors telling me: “You can do without dairy products. Why do you need a lot of calcium, because you are no longer a child and no longer grow!

I took the advice and cut out dairy, but other than that, my diet was quintessentially American. Candies? Please. Desserts? As much as you like. No one could even imagine that the whole trouble was in sugar.

Nobody thought about cholesterol at that time. I found out that I had high cholesterol at the age of twenty-five when I signed a life insurance contract. The doctor who sent me for the physical said, “Why didn't you tell me you had a problem? However, you should not worry too much: your tests are almost within the normal range. Then my total cholesterol, in my opinion, was somewhere around 260-270 mg%.

I remember that at that time I immediately decided to change my diet and find a diet that would lower my cholesterol. That's when I read somewhere that fat is bad for health. At that time, I was just starting to gain weight little by little, and therefore I refused fat, being sure that fat would make you fat.

Every time I heard someone's advice (on the principle of "do this, don't do that"), I tried to put it into practice. The result was a completely crazy diet of my own design, which had its own do’s and don’ts, and I followed it for many years.

I tried to do everything that was considered healthy. Every morning I drank a large glass of fresh orange juice, ate a large bowl of porridge with skim milk. What American is not sure that porridge is a wholesome and healthy food? And I wanted to be very healthy and added berries or fruits to the porridge. My breakfast ended with a cup of coffee. By dinnertime, I felt tired and as hungry as a wolf. Since I wanted to stay lean, my lunch consisted of fruit juice, and by the middle of the day I was again like a squeezed lemon. I had to go home for an hour or two nap and then go back to work. In the evening, when I came home from work, I was so exhausted that I opened a home bar and mixed myself two or three, or even all four glasses of a cocktail in order to somehow cheer up and cheer myself up.

Meanwhile, total cholesterol levels were steadily creeping up. While undergoing a medical examination for a new insurance contract, I was shocked to see the results of a blood test. My. the food was better than ever (or so I thought), and the tests were the worst in my entire life! I resigned myself to this, deciding that it was all about bad heredity. Metabolism is to blame for everything, and nothing can be done about it. That's what I thought at the age of 45. I didn't realize how wrong I was.

Then my wife, who suffered from migraines for 28 years, heard about the endocrinologist Diana Schwarzbein and made an appointment with her. At the request of the doctor, two weeks before the visit, she began to monitor her diet, writing down everything she ate. My wife and I also went to the appointment to help her remember past illnesses and lifestyle habits in the past if necessary.

The doctor prescribed to his wife estrogen replacement therapy, and then she said: “Hormones alone are not enough, you will have to change your diet,” and began to explain why. I listened spellbound.

Dr. Schwarzbein, of course, had no idea why I listened to her with such enthusiasm and actively asked questions. When she said to my wife, “Now you will go to our nutritionist, and he will put together a therapeutic nutrition program for you,” I could not resist and exclaimed: “What about me?”

What about you? the doctor asked.

In general, everything is fine, except for very high cholesterol.

What you eat?

For breakfast - a large plate of porridge ... - and I told Dr. Schwarzbein about the low-cholesterol diet of my own invention, on which I sat all my life. - I can not understand why cholesterol is not reduced.

I talked about juice instead of dinner, and about fatigue, and about glasses of alcohol in the evenings.

We can handle that too,” the doctor said. - We will create a treatment program for you. In a week or two, we will begin to change cholesterol metabolism.

Diana Schwarzbein: Joel remembered well when doctors began to consider fat and cholesterol as the main risk factors for developing cardiovascular disease. In the early sixties, medical science began to be interested in ways to prevent a heart attack. The reason for this was the conclusion of scientists that the chemical composition of butter resembles cholesterol found in the blood, and waxy cholesterol plaques on the walls of arteries. This discovery has given rise to numerous searches for links between lifestyle and cardiovascular disease. Unfortunately, the researchers did not take into account all factors. Instead of discovering the true cause of cardiovascular disease, scientists blamed dietary cholesterol for everything.

Joel is not alone in his beliefs. Over the past 30 years, many people have come to believe that cutting back on cholesterol-containing foods or cutting them out completely will help prevent heart attacks. But this belief is wrong. The only way to prevent a heart attack is to evaluate your entire lifestyle with an open mind, and then make the necessary changes to it. It is very difficult for people to believe these words, because they constantly hear something completely different from doctors, the media and drug manufacturers.

The turning point from which the epidemic of fear of cholesterol began was the scientific article "The influence of diet and smoking on the development of coronary vascular disease" (published in the December issue of the Lancet, 1981). The most interesting thing is that the materials of this article actually only confirm my words about cholesterol, lifestyle and heart attack, which I address to all patients.

For 5 years, the researchers monitored the health of 1232 men - residents of the Norwegian capital Oslo, classified as at increased risk of developing coronary artery disease due to smoking and high blood cholesterol levels. All study participants were divided into two groups: experimental and control. Men from the control group continued to lead their usual way of life. Once a year, the researchers conducted a thorough medical examination of these people, but did not give them any recommendations about changing their lifestyle.

Much more attention was paid to the members of the experimental group. For those who were found to have high blood triglyceride levels, the researchers recommended quitting smoking, reducing sugar, alcohol, and cholesterol-containing foods. Every 6 months, scientists conducted conversations with the participants of the experiment, providing them with moral support in giving up bad habits. After 5 years, it was found that the number of cases of cardiovascular diseases (including fatal cases) in the experimental group is 47% lower than in the control group. The level of triglycerides in the blood of the members of the experimental group was on average 20% lower than in the control group, and the total cholesterol level was 13% lower.

Unfortunately, the results of the study were misinterpreted, and this was a real tragedy. During the 5 years of the experiment, the number of smokers in the experimental group decreased by 45% compared to the control group. However, at the time, scientists did not conclude a link between smoking and high blood cholesterol levels, although they considered the possible role of smoking cessation in the overall reduction in cardiovascular disease among the members of the experimental group. Simply put, the researchers brushed aside the obvious, recognizing that the only factor in reducing the incidence of cardiovascular disease in the experimental group was not a decrease in the number of cigarettes smoked, but a reduction in cholesterol consumption. This erroneous conclusion had a huge impact on physicians, setting off a vogue for limiting the amount of fat in the diet.

However, in fact, the results of the Norwegian study do not at all indicate that the reason for the decrease in the incidence of 47% in the experimental group was the reduction in cholesterol intake! By quitting smoking, the participants of the experiment contributed to lowering the level of insulin in the body, and after that, the levels of triglycerides and cholesterol in the blood decreased. Not only smoking cessation, but also any lifestyle change for the better, leading to the normalization of insulin levels, will contribute to health promotion, including the prevention of cardiovascular diseases.

Due to the misinterpretation of the results of the experiment, many, including Joel, began to emphasize the results of a blood test for total cholesterol and take measures to reduce this figure by refusing to eat cholesterol and fat.

People have been told that total cholesterol levels provide an estimate of the risk of developing cardiovascular disease, but in reality, based on this indicator, it is impossible to judge either the likelihood of having a heart attack or the likelihood of dying from it. According to medical statistics, the number of cases of myocardial infarction (including fatal cases) with a total cholesterol level not exceeding 200 is approximately the same as with a total cholesterol level above 200.

I knew that I would not be able to convince Joel in one visit, so I drew his attention to stress, alcohol and caffeine use, and nutritional imbalance. It was clear that giving up the most harmful habits would bring more benefit to the patient than a lecture about the low information value of the result of the analysis for total cholesterol. I sent Joel and his wife to our nutritionist for a therapeutic nutrition program.

Joel: It was like in the movies. It's like someone came to Earth and said, “So basically, eggs are good for your health, so eat them every day. Low fat milk? Come on, drink better cream. What was harmful yesterday suddenly became useful.

Robin, Diana Schwarzbein's nutritionist, suggested that we choose products not in the center of the supermarket, but along its edges. We had no idea that real, healthy products in supermarkets stand against the walls, and in the very center - two-thirds of solid chemistry. Robin gave us recommendations on what to eat and what not to, and we immediately and with great pleasure set about their implementation, going to have lunch at a cafe recommended by Robin. At the table, we rejoiced like children who have finally seized upon a forbidden delicacy. I remember then I said: “Listen, how wonderful it all is, how delicious, but I don’t believe for a second that my cholesterol will decrease from such a diet.”

Diana Schwarzbein: It was not high cholesterol that doomed Joel to premature death, but his lifestyle, which causes increased secretion of insulin - stress, alcohol, caffeine and an unbalanced diet with excess carbohydrates and a lack of fat.

I explained to Joel why cutting down on cholesterol wouldn't help prevent a heart attack. You can achieve your "ideal" cholesterol level by going on a low-fat diet or taking cholesterol-lowering drugs and still die of a heart attack. And all because the cause of a heart attack is not cholesterol, but an unhealthy lifestyle leading to increased secretion of insulin.

The root cause of all processes leading to the deposition of cholesterol plaques on the walls of blood vessels is the overproduction of insulin in the body. Research on the link between insulin and clogged arteries began in the 1960s. In 1961, the journal Circulation Research published an article, "The effect of intra-arterial insulin administration on cholesterol and fatty acids in the tissues of diabetic dogs," which reported the results of one of the most striking experiments of the time. The scientists injected insulin into the femoral arteries of laboratory dogs. As a result, in all experimental animals, the formation of cholesterol plaques on the walls of arteries.

Joel: I didn’t believe in vain, the treatment program helped me. I started exercising. Here, one thing is connected with the other: when you do not feel well, you are not up to physical education, and if you are inactive, then you do not feel well. Now I feel much healthier, my whole life has become much better, and I can swear that this is due to a healthy lifestyle.

I lost weight 8 south without any effort. For the first 3 months I did not drink a drop of alcohol, and now I can drink a glass from time to time, but I always know when to stop.

If you try to lower your total cholesterol levels, you will get depressed and tired, as I did. I ate absolutely nothing fatty, felt disgusting, spoiled the immune system, in fact, starved myself, and what was the result? Cholesterol did not decrease, but increased!

Diana Schwarzbein: Normalization of cholesterol levels is just one of the consequences of normalizing diet and lifestyle. Thanks to a balanced diet and the rejection of bad habits, insulin levels normalize, and after that other indicators, including cholesterol, return to normal, and for different people the normal value of total cholesterol will be different: for someone less than 200, for whom something - more. What you eat and what lifestyle you lead will determine your well-being and health. Ignore your cholesterol test results and make every effort to switch to a healthy diet and lifestyle, and you will increase your chances of living a long and healthy life.

Perhaps, in response to my words, you will say: “Well, let the total cholesterol level not be an indicator. What about “good” and “bad” cholesterol? If I have not convinced you yet, read on - and you will understand that you should not worry just because of certain specific indicators, no more than because of your total cholesterol level.

Life is not about numbers

We all tend to give too much importance to numbers. We worry about the magnitude of cholesterol levels, blood pressure, weight and chronological age. The truth, however, is that if you focus solely on getting your numbers back on track, you will damage your health and develop a set of chronic degenerative diseases and disorders. This is exactly what happened to my patients whose stories are given here. Trying to lower his cholesterol levels, Robert almost starved himself to death, suffered two heart attacks and heart surgery, ruined his digestion. Elisabeth and Vicki, whom you will meet a little later, were too focused on weight loss, which caused them to suffer from Stine-Leventhal syndrome, early osteoporosis, anorexia, bulimia and depression. To protect himself from a heart attack, Joel did not eat anything fatty, but in the end only increased the risk of a heart attack, getting chronic fatigue, anxiety, excess weight and depression.

I urge everyone, without exception, not to look at the arrow of the scale and stop considering the results of the analysis for cholesterol as a decisive factor indicative of the state of health or the degree of risk of developing a heart attack. Neither weight nor cholesterol levels in and of themselves do not say anything.

All body systems are closely interconnected, and the concept of “health” cannot be reduced to one or more indicators. A blood test for cholesterol is just one of the health assessment tools. “Normal” cholesterol levels do not guarantee you will not have heart disease. Don't look at the numbers, but take a closer look at your lifestyle. Maybe you don't eat right, live under a lot of stress, use stimulants and drugs, or don't exercise?

Miriam, like Joel, was also afraid of a heart attack, because her father died of a heart attack at a relatively young age. But if Joel was worried about too high total cholesterol, then Miriam was worried about not having enough “good” HDL (high-density lipoprotein) cholesterol. Miriam came to me with a long history of vegetarianism. Through a low-fat, vegetarian diet, she hoped to increase her "good" cholesterol levels.

Miriam: When my father had his first heart attack, I decided to watch my diet: I gave up red meat, ate only chicken, low-fat cheeses and other low-fat diet foods. For breakfast, instead of scrambled eggs, she began to eat oatmeal, because everyone around said: "Don't eat eggs, they are unhealthy."

In 1982, at the age of 68, my father died of a massive heart attack. His death greatly frightened me, because I inherited my father's genes. Just at that time, the Pritikin diet came into fashion: no fat, no butter. I decided: “Okay, Pritikin is Pritikin. I'll try and see if it helps."

At the age of 41, I had my first blood test for cholesterol. The result was quite normal: total cholesterol, I think, 136, HDL somewhere around 50. I thought it would be nice to raise the “good” cholesterol a little more, because the higher the HDL, the better.

The doctor was also quite satisfied with my analysis, but he said that HDL could be higher, however, he did not pay special attention to this, he only mentioned in passing that there is fat in chicken too. After that, I gave up chicken and became almost a vegetarian. My diet consisted of cereals and legumes, pasta, vegetables, fruits and a small amount of fish. Some time later, I decided to tighten up my diet and stopped eating fish.

I regularly took a blood test for cholesterol. The results were not encouraging: the HDL level fell lower and reached almost 30. I got scared and stopped taking tests, realizing that I would be even worse from excitement and fear.

By 1995, I was practically a vegan, believing I was getting enough protein from legumes.

By the age of 49, my anxiety had crossed all limits. Since my periods had not yet stopped at that time, the doctors decided that everything was in order with me. It is known that most doctors prescribe hormone therapy to women only a year after the cessation of menstruation. The doctors wanted to prescribe a sedative, but I was so reluctant to take the pills that I waved my hand and was torn with unreasonable anxiety for several months. Finally, one of my friends advised me to contact Diana Schwarzbein.

I first came to Dr. Schwarzbein in October 1995. I was tormented by fears, my nerves were completely shattered. I was scared of menopause, low HDL and everything that is possible. The doctor sent me for a checkup. I asked not to be told the results of my cholesterol tests. On the test form, they wrote: “Do not report the result to the patient.” I didn't want to know how bad it was. When it gets better - that's when they let them know.

Diana Schwarzbein: Like Joel, Miriam considered dietary cholesterol to be the sole cause of her heart attack. But these fears are unfounded. As you learned earlier, dietary cholesterol does not cause a heart attack.

I explained to Miriam that to prevent a heart attack, you need to eat fats. Saturated fats (such as butter) increase blood levels of HDL. (High-density lipoproteins are considered "good" because they transport cholesterol from the bloodstream back to the liver, which is thought to help protect blood vessel walls from plaque formation.)

Due to an unbalanced diet (too much carbs and too little fat), Miriam's body wasn't producing enough estrogen to keep her HDL levels high. In addition, such nutrition increases insulin levels, which contributes to the formation of cholesterol plaques!

I told the patient that there was nothing to think about how to reduce the level of cholesterol in the blood to zero, since normal life of the body is impossible without cholesterol, and I recommended eating foods containing healthy fats and cholesterol. She was also put on hormone replacement therapy.

Miriam: The doctor told how to increase the level of HDL with the help of proper nutrition. Of course, at first I took her words with disbelief, but they sounded logical, and I decided to try.

The doctor said: “You need: olive, linseed, rapeseed, butter and nuts. These are healthy fats that are essential for health.”

I am a perfectionist by nature, and if I take on something, I will definitely bring it to the end. The very next morning after a visit to Dr. Schwarzbein, I started eating in a new way. My relatives decided that I was completely crazy: I was reading sermons about the dangers of fats, and now I suddenly started talking about the benefits of eggs!

Sister said:

You are crazy! Do you even understand what you're doing?

Maybe I don’t understand something, but I will eat eggs. The doctor explained why it is impossible to do without them, and I agree with her. I answered.

Now I try to eat a balanced diet, I eat a lot of soy products, fish, nuts, that is, everything that I previously refused.

Diana Schwarzbein: Many of my patients, like Miriam, don't eat meat because, Firstly, are very afraid of saturated fats, and Secondly, are sure that the meat contains hormones that were added to livestock feed.

Indeed, many products are far from natural and, in fact, are fake. Whenever possible, try to buy “village” meat of animals and birds grown not in stalls at fattening complexes, but on free pasture, without the use of hormones, antibiotics and other chemical additives. But, on the other hand, the complete rejection of animal products weakens the body's immune system, depriving it of protection. In our time, it is difficult, if not impossible, to find absolutely natural, environmentally friendly products. In such conditions, it is very dangerous to leave your body defenseless.

Miriam: My HDL has gone up to 55. Not bad. True, I would like him to reach 60 or even 70: I said that I like to bring everything to perfection. Let's see what will happen next.

Diana Schwarzbein: Even if Miriam would really like her HDL level to rise even higher, it may well be that the ideal value for her body is exactly 55. I repeat again and again: you should not think about certain numerical indicators, but about your lifestyle in in general. It was not her HDL levels but Miriam's eating habits that posed a health risk, increasing her risk of cardiovascular disease. No need to worry either because of the total cholesterol level, or because of individual indicators. These are just a few of the many indicators of potential risk for cardiovascular disease.

You can eat too many carbohydrates, drink alcohol, smoke, use artificial sweeteners and destructured fats, drink caffeinated drinks, live in conditions of constant stress and do not exercise, and the cholesterol test will be completely fine (of course, for the time being). But such a lifestyle will gradually destroy the body at the cellular level, although a blood test will not say anything about it. Bad habits lead to an overproduction of insulin, an overproduction of insulin leads to an overproduction of cholesterol and triglycerides in the body, and a blood test due to the work of the liver will be ideal. Remember that when insulin levels are elevated, the liver converts excess sugar into fat, storing it in reserve for later use as an energy source. Therefore, a blood test will not immediately reveal that something is wrong in the body.

An abnormal cholesterol profile is a late indicator of abnormal cholesterol metabolism in the body. The destruction of the body at the cellular level under the influence of excess carbohydrates and stimulants can last for years, until, finally, negative changes become so obvious that they are found in a blood test. By this time, serious damage may have been done to the body.

To see the pointlessness of fixing attention solely on the results of the analyzes, let's look at a few examples.

Example 1. What do you think is the best cholesterol test? Analysis 1: Total Cholesterol 240 = HDL 80 + LDL 140 + VLDL 20. Analysis 2: Total Cholesterol 240 = HDL 40 + LDL 170 + VLDL 30.

When evaluating lipoprotein levels, an analysis showing a higher HDL level and a lower VLDL level is considered good. With the transition to a healthy lifestyle and a balanced diet, HDL increases, and VLDL decreases. The result of the first analysis is much better than the second one. Please note that the total cholesterol level in both cases is the same - 240. So, the total cholesterol level does not mean anything.

Example 2. Which cholesterol test do you think is better?

Analysis 1: Total cholesterol 240 = HDL 60 + LDL 160 + VLDL 20; triglycerides = 100.

Analysis 2: Total cholesterol 180 = HDL 60 + LDL 80 + VLDL 40; triglycerides = 200.

It is desirable that the level of VLDL (very low density lipoprotein, the "worst" cholesterol) and triglyceride levels are low, even if total cholesterol and LDL levels are higher. Therefore, the first analysis is better than the second.

However, only on the basis of the results of the analysis for cholesterol, it is impossible to draw a conclusion about the degree of risk of developing cardiovascular diseases. The last example will show how easy it is to make mistakes and misinterpret the results of the analysis.

Example 3. Before you - the results of blood tests for cholesterol, taken from two different people. Which analysis do you think is better?

Patient 1: Total cholesterol 180 = HDL 60 + LDL 100 | LONP 20.

Patient 2: Total cholesterol 180 = HDL 60 + LDL 100 + VLDL 20.

Without knowing anything about the lifestyle of these people, about their dietary style, it is impossible to draw a correct conclusion about which of them is more at risk of getting a heart attack. It is very likely that doctors will classify both patients as a low-risk group. However, you already know that the degree of risk of developing cardiovascular diseases does not depend on the results of a blood test, but primarily on whether accelerated metabolic aging occurs in the body, and this is due to lifestyle and nutrition.

Perhaps you will agree with my words. But, on the other hand, you may well have seen from your own experience that reducing fat intake in combination with physical exercise improves cholesterol test results. What's the matter here?

The role of cholesterol in the human body is difficult to overestimate. This substance, belonging to sterols and fatty alcohols, performs many functions and serves as a building material for many hormones and biologically active substances.

To know for sure what cholesterol is for and how high the biological role of cholesterol is, it is enough to open any textbook on biochemistry.

Cholesterol (cholesterol) is a fat-like substance that is vital for a person

Molecule Features

The molecule of this substance consists of an insoluble part ─ the steroid nucleus and an insoluble side chain, as well as a soluble ─ hydroxyl group.

The dual properties of the molecule provide its polarity and ability to form cell membranes. In this case, the molecules are arranged in a certain way ─ in two rows, their gyrophobic parts are inside, and the hydroxyl groups are outside. Such an arrangement helps to provide the unique properties of the membrane, namely its flexibility, fluidity and, at the same time, selective permeability.

Functions in the body

The functions of cholesterol in the body are multifaceted:

• It is used to build the body's cell membranes.
• Part of it is deposited in the subcutaneous fat.
• Serves as a basis for the formation of bile acids.
• Necessary for the synthesis of steroid hormones (aldosterone, estradiol, cortisol).
• Needed for the formation of vitamin D.

Exchange features

Cholesterol in the human body is formed in the liver, as well as in the small intestine, skin, sex glands, adrenal cortex.

Its formation in the body is a complex multi-stage process - the sequential transformation of some substances into others, carried out with the help of enzymes (phosphatase, reductase). Enzyme activity is influenced by hormones such as insulin and glucagon.

Cholesterol, which appears in the liver, can be represented in three forms: in the free form, in the form of esters or bile acids.

Almost all cholesterol is in the form of esters and is transported throughout the body. To do this, its molecule is rearranged so as to become even more insoluble. This allows it to be transported through the blood stream only with the help of specific carriers ─ lipoproteins of various densities. A special protein on the surface of these transport forms (apoprotein C) activates the enzyme of adipose tissue, skeletal muscle and heart cells, which allows them to be saturated with free fatty acids.

Scheme of cholesterol metabolism in the body

Metabolism of cholesterol formed in the liver:

• In the liver, cholesterol esters are packaged into very low density lipoproteins and enter the general circulation. They transport fats to muscles and adipose tissue cells.
• In the process of circulation, the return of fatty acids to cells and the oxidative processes occurring in them, lipoproteins lose part of the fat and become low-density lipoproteins. They are enriched with cholesterol and its esters and carry it to the tissues by interacting with receptors on their surface with the help of apo-100 apoprotein.

Cholesterol obtained from food is transported from the intestines to the liver with the help of large carriers ─ chylomicrons, and in the liver it undergoes transformations and enters into the main cholesterol metabolism in the body.

Excretion from the body

There are high-density lipoproteins, they can bind free cholesterol, take excess from cells and its transport forms. They perform the function of a kind of "cleaners" and return cholesterol to the liver for its processing and excretion. And extra molecules in the composition of bile acids are excreted with feces.

Dangers of lipid metabolism disorders

In violation of lipid metabolism, in particular cholesterol, usually means an increase in its content in the blood. And this leads to the development of a disease such as atherosclerosis.

Atherosclerosis leads to the formation of cholesterol plaques in the lumen of blood vessels throughout the body and causes many terrible complications, such as strokes, heart attacks, damage to the kidneys and blood vessels of the extremities.

The amount of calories obtained from fat should not exceed 30% of the daily requirement.

There are many theories about how exactly cholesterol is deposited on the vascular wall:

• Plaques form at the site of fibrin deposits on the vascular endothelium (it has been observed that atherosclerosis is often combined with an increase in blood clotting).
• The opinion of other scientists spoke of the reverse mechanism ─ the accumulation of transport forms of cholesterol in the vessel caused fibrin to be attracted to this zone with the formation of an atherosclerotic plaque in this place.
• There is an infiltration (impregnation) of the vessel wall with lipids, in the process of circulation of lipoproteins in the blood.
• Another theory is that the oxidation that occurs within lipoproteins after the transfer of already oxidized fats to the cells causes cell damage and predisposes to cholesterol deposits at this site.
• Recently, more and more adherents of the theory of damage to the endothelial cover. It is believed that the normal inner layer of the vascular wall ─ the endothelium is a protection against the development of atherosclerosis. And damage to its wall, due to various factors, causes the accumulation of various particles there, including cholesterol carriers, which means that it occupies the walls of arteries at the sites of damage.

What influences the development of atherosclerosis

Based on the pathogenesis of atherosclerosis, it is more likely to affect those vessels where endothelial damage occurs, so you need to know what causes this damage:

• Increase in blood pressure.
• Turbulent blood flow in some part of the arterial bed (for example, dysfunction of the heart valves, pathology of the aorta).
• Smoking.
• Infectious diseases.
• Autoimmune diseases that occur with damage to the vascular wall (for example, arteritis).
• Some drugs (for example, chemotherapy in oncology practice).

Why control cholesterol metabolism and lipid levels in the human body? First of all, to prevent atherosclerosis and inhibit its progression, as well as its reduction if necessary.

But we must also remember that a very low level of lipids in the blood is also unfavorable for the body. It has been proven that it can provoke depressive states, various diseases of the nervous system. Perhaps this is due to the fact that it is a component of the normal myelin sheath, without which adequate conduction of the nerve impulse is impossible. Therefore, it is important to ensure that lipid metabolism indicators are in the normal range, not higher and not lower.

It may surprise you, but cholesterol in the body is not at all as bad as it is commonly believed. In fact, it is just one of the substances that our body produces to maintain a healthy state. Another source of cholesterol is food, mostly of animal origin. But it is worth noting that our liver produces significantly more cholesterol if harmful trans fats are present in the diet.

What is cholesterol?

Cholesterol is a waxy, fat-like substance called sterol, which is found in the membranes of all cells of a living organism.

A person needs it for the production of hormones, as well as some enzymes. The highest concentrations of cholesterol are found in the cells of the liver and brain. By the way, gallbladder stones are also cholesterol. This fact explains the strange name of the substance, which in Greek means two words: "bile" and "solid".

The body is able to independently produce cholesterol for its needs (almost 75 percent of the total). In the body, this substance is produced by different cells. But most of all, almost a quarter of the total, is produced by the liver. In addition, sterol is synthesized in the intestines and in the layers of the skin.

In addition, sterol can enter the body with food. But, according to some researchers, the cholesterol in this variation is poorly absorbed by the intestines, therefore, obtained from products, it does not significantly affect the total amount of the substance in the blood. Although, we note right away that such a statement is only one of many theories.
Being an “oil-based” substance, cholesterol does not mix with blood, which is, so to speak, an aqueous solution, therefore it is transported through the vessels in small “packages” - lipoproteins. They are made up of lipids on the inside and proteins on the outside.

In the human body, they are represented by two types. The first type is low-density lipoprotein (LDL). Or, as they say, “bad” cholesterol with a modified molecular structure (it is this substance that is responsible for blockage of arteries, cardiac diseases, since it contributes to the creation of atherosclerotic plaques).

The second type is high-density lipoprotein (HDL) or "good" cholesterol. This substance, on the contrary, prevents the development of atheroma (blockage of blood vessels), since it works to remove "bad" cholesterol. In a rather primitive way, HDL elements capture the "bad" sterol and transport it to the liver, where these particles are processed and excreted from the body. The normal level of "correct" cholesterol is called an important factor for the prevention of cardiac diseases. It is found in healthy animal foods, is also produced by the body, and its excess is excreted.

Meanwhile, for the proper functioning of the body, it is important to maintain adequate levels of both types of lipoproteins.

Functions of cholesterol

This substance performs a number of functions that affect the life of the body. Here are just a few of them:

• support the structure of cell walls;
• affect the creation of bile acids;
• contribute to the production of vitamin D;
• support the production of certain hormones.

What is blood cholesterol level?

The definition of "high cholesterol" refers to an increased amount of a substance in the blood. But such a condition is not accompanied by any symptoms, which is why many do not even know about their bad tests. Meanwhile, people with elevated sterols are many times more likely to experience coronary artery disease. And the higher the cholesterol, the higher these chances. If a lipid clot blocks the artery that feeds the brain, a stroke occurs, and blockage of the vessels supplying blood to the heart causes a heart attack.

What affects sterol levels?

To a certain extent, the level of sterol in the blood can vary depending on the principles of nutrition. However (and doctors also agree), people on the same diet can have different levels of cholesterol in the blood. Although, if you refuse fatty foods, the indicators will undoubtedly decrease.

In some individuals, very high cholesterol can be genetically determined. This phenomenon is called familial hypercholesterolemia.

Risk factors and reasons for the increase

Cholesterol rise is provoked by two types of factors: modified and unmodified.

The easiest way to influence cholesterol levels is to stop eating too much fat. In particular, nutritionists recommend limiting foods that contain:

• trans fats;
• saturated fats;
• cholesterol (found in food of animal origin).

Excess weight is also a common cause of the increase in "bad" cholesterol, but regular exercise solves this problem. But perhaps the most serious "culprits" are genes.

In addition, abnormal sterol levels may appear against the background of certain diseases:

• diabetes;
• kidney and liver diseases;
• polycystic ovaries;
• hormonal disorders in women;
• thyroid dysfunction.

Anabolic steroids, corticosteroids, and progestins can increase LDL and lower HDL.

"Fatty" vessels: risk factors

Perhaps all people are at varying degrees at risk for the appearance of atherosclerotic plaques. But some circumstances can accelerate the process of formation of fat accumulations in the vessels. These include:

• unhealthy lifestyle (smoking, obesity, excessive alcohol consumption, physical inactivity, unhealthy diet with high salt intake);
• hypertension;
• high levels of triglycerides in the blood;
• diabetes;
• kidney dysfunction;
• increased concentration of "bad" cholesterol.

And if a person is still able to at least partially influence the above factors, then there are nuances that cannot be changed, and they can also cause atherosclerosis. It:

• genetic propensity;
• early menopause in women;
• male gender (men are more susceptible to the disease);
• age (the risk increases with age).

And most importantly, these factors interact with each other. The presence of two or more of these items is a reason to more carefully monitor your health.

Blood concentration: norm and deviation

Generally, the higher the LDL (“bad” cholesterol) level, the higher the health risk. And by the way, a blood test that determines only total cholesterol can be misleading. The overall high rate does not yet give a clue which of the lipoproteins is not normal. On the other hand, if total cholesterol is elevated , it is possible that in excess only HDL, which does not cause health problems. But, in order not to guess, but to be sure of the state of health, it is important to determine the levels of the substance of both groups.

How to calculate health risk?

Doctors often resort to using the so-called heart disease risk factor calculator. In this case, age, gender, bad habits, blood pressure and cholesterol levels are taken into account. This calculator was developed after many years of monitoring several thousand people. Today they talk about a fairly high accuracy of the results predicted by this method. After the analysis, the doctor determines the risk of diseases as a percentage. So:

• 20% and above - high risk of cardiological diseases for the next decade;
• 10-20% - moderate risk;
• less than 10% - low danger.

Can Diet Lower Cholesterol?

Cholesterol is both a friend and enemy of man. It is necessary for the normal functioning of the body, but if its level in the blood rises too much, there is a risk of a heart attack. Rejection of malnutrition and the transition to a healthy diet gives a good chance of reducing the "bad" sterol. In addition, healthy food will help regulate other indicators, such as the concentration of salts and sugar in the body.

Diet for people with high cholesterol

UK nutritionists have compiled a list of 6 superfood groups that help reduce sterol levels. It:

• soy products: milk, desserts, meat substitutes, beans, tofu (at least 15 g per day);
• nuts (a handful);
• oatmeal and barley;
• fruits and vegetables;
• foods rich in polyunsaturated fats.

In addition, the British also compiled a list of six foods that are most dangerous for people who have high cholesterol. It consists of:

• butter;
• ghee;
• margarine;
• fat;
• fatty and processed meat;
• milk fats.

Why is cholesterol dangerous?

Everyone seems to know that high cholesterol is a health problem. But how dangerous an excess of "adipose tissue" is and what causes such deviations from the norm, people without a medical education can rarely clearly explain. Bypassing heavy medical terminology, let's try to tell about it as intelligibly as possible.

So, two types of lipoproteins “live” in the vessels. The “good” HDLs collect excess cholesterol and transport it to the liver. There, the substance is processed and excreted from the body. At the same time, there is a "harmful" sterol analogue. It travels through the body in a different direction - from the liver, and periodically sticks to the walls of blood vessels. Over time, this accumulation of "adiposity" narrows the patency of the arteries. This is how atherosclerosis occurs.

For people who already have cardiac problems or have been diagnosed with liver disease, the consumption of cholesterol food is important, if not reduced to zero, then at least minimized as much as possible. The same applies to people after operations. They should not consume cholesterol for at least two and a half months.

Cholesterol and heart disease

Atheroma spots resemble small fatty lumps that form inside the vessels. Atheroma is also known by other names - atherosclerosis or hardening of the arteries.

Over the years (in some cases, several months are enough for this process), atheroma areas can become larger and thicker. Subsequently, due to the accumulation of fats on the walls of blood vessels, the arteries narrow, and the blood flow weakens. Narrowing of the diameter of the coronary arteries is the cause of angina pectoris. Sometimes a blood clot (with thrombosis) can come across atheromas. This course of events ends with a heart attack, stroke, or other serious cardiac problems. Thus, atherosclerotic plaques can cause angina pectoris, heart attack, stroke, ischemic attacks, and peripheral arterial disease. By the way, diseases of the cardiovascular system caused by atheroma are the most common cause of death and poor health.

According to a 2013 study, imbalances between LDL and HDL affect not only heart health, but also brain function. A decrease in the concentration of "bad" sterol reduces the risk of developing Alzheimer's disease.

Scientists have also linked heart valve stenosis (an anomaly in which the valve narrows, restricting blood flow to the heart) with an increase in the level of "bad" cholesterol.

How to determine the level of sterol?

Maintaining adequate cholesterol levels is a great way to protect yourself from stroke and heart disease.

Many are interested in what symptoms causes elevated LDL. And that's where the rub is. None! Often only the occurrence of cardiovascular disease opens the patient's eyes to his cholesterol level. Therefore, doctors are increasingly recommending that people over 20 years old, as well as people at risk, check the concentration of “fat content” of the blood every 4-6 years.

Lab test results show cholesterol levels in milligrams per deciliter of blood (mg/dL). But in order to understand how safe indicators of “bad” and total cholesterol are for a person, doctors also analyze other factors (age, family history, smoking, hypertension).

Usually, the total cholesterol score is calculated by the formula:

LDL + HDL + 20 percent of triglycerides.

It is good for the body when there is more HDL than other lipids. With regard to triglycerides, this is the most common type of lipid (fat) in the body. Its level depends on age, gender and other factors. A high concentration of triglycerides in combination with elevated LDL and low HDL is an alarm signal. He can talk about the presence of fatty accumulations on the walls of blood vessels (atherosclerosis).

How to understand the numbers in the analyzes

LDL cholesterol:

• optimal: less than 100 mg/dl;
• near optimal: 100 to 129 mg/dl;
• borderline high: 130 to 159 mg/dl;
• high: 160 to 189 mg/dL;
• very high: 190 mg/dl.

• normal: less than 200 mg/dL;
• borderline high: 200-239 mg/dL;
• high: 240 mg/dl and above.

HDL cholesterol:

• low: below 40 mg/dL;
• high: 60 mg/dl and above.

Triglycerides:

• normal: 200 mg/dl or less;
• borderline normal: 200-399 mg/dL;
• high: 400-1000 mg/dl;
• very high: 100 mg/dl and above;
• high: 160 mg/dl and above.

Lipid-lowering therapy

Hyperlipidemia is a condition in which cholesterol and triglyceride levels are elevated.

Treatment in this case is determined individually, depending on the level of cholesterol. When it is in the range of 100-160 mg/dl, the so-called low level, but other risk factors are present, diet and exercise can lower the lipid concentration. At rates of 130-190 mg / dl, various drugs are already being used to correct the condition. Among the most popular:

• satins - interfere with the production of enzymes responsible for the production of cholesterol;
• folic acid - catalyzes the oxidation of lipids in the liver, which helps to reduce the concentration of LDL and triglycerides;
• bile acid-binding drug - slows down the production of cholesterol in the liver.

In addition, omega-3 fatty acids, nicotinic and folic acids, and help to reduce the level of lipoproteins. Also, substances that affect cholesterol levels are found in green tea, soy protein and garlic.

How to Lower Blood Cholesterol

But it's not just drugs that can lower your cholesterol levels. If you follow certain tips, you can also protect yourself from harmful fats.

For this:

1. Read food labels. It is important to give preference to foods that do not contain trans fats, as well as foods with low cholesterol levels.
2. Limit your intake of red meat, fatty dairy products. Instead of margarine, use natural vegetable oils. Avoid fried foods.
3. Eat more fiber. Tests have shown that with its help it is realistic to lower the concentration of sterol by 10 percent.
4. If high cholesterol is a genetic problem in your family, get active early and eat a healthy diet. Even if your laboratory lipid values ​​are normal.
5. Are you overweight? Get rid of it as quickly as possible, and your risk of atherosclerosis will decrease by almost 10 percent.

Is Sterol Deficiency a Problem?

Everyone is somehow used to the fact that cholesterol must be fought, by hook or by crook to reduce its concentration in the body. But it is important to know that in the “human-cholesterol” chain there are situations when the body, on the contrary, asks for additional portions of the substance.

Increasing the intake of sterol-rich foods is important when there is insufficient production of sex hormones and bile acid. Additional portions of cholesterol will also help restore damaged erythrocytes (red blood cells). Got a weakness? This may also be a reason for an increase in the concentration of lipoproteins. And now the most interesting. We are used to the fact that high cholesterol harms the arteries. But with its deficiency, the vessels also suffer - they become fragile. In this case, lipoproteins strengthen the damaged areas of the arteries with a kind of wax and fat patches.

Signals of a sterol deficiency can be bruising and changes in the blood count, fatigue and a decrease in pain threshold, as well as weakened immunity, depression, dysfunction of the reproductive system, or a decrease.

Sources of cholesterol

When compiling a nutrition program for weight loss and general well-being, it is important to know which foods contain especially high concentrations of cholesterol. Below is a table with the necessary information for this.

But this does not mean at all that you can (or should) refuse products containing cholesterol. Sterols are useful for humans, and in adequate doses they will only benefit. To confirm the above, we can recall the traditional menu of the inhabitants of maritime countries, which is especially rich in cholesterol, but is considered extremely useful. Since cholesterol in this menu is also from the category of useful.

food for cholesterol

The right diet is a sure helper in the fight against "bad" cholesterol. So, which foods are the most beneficial for health, what from our table will help reduce LDL levels and strengthen the cardiovascular system?

"Hercules"

Soluble fiber, which is contained in "hercules", is the best way to help reduce the concentration of "bad" cholesterol. In addition, soluble fiber should be looked for in beans, apples, pears, prunes and barley porridge.

Scientists have calculated that 5-10 grams of soluble fiber consumed daily significantly lowers blood lipid levels. And by the way, providing yourself with the recommended norms of this substance is not as difficult as it might seem. For example, one serving of "hercules" contains approximately 6 g of fiber. If you supplement the dish with fruits and vegetables, then its total amount will be approximately 10 g. And this is even more than the minimum norm.

nuts

A handful of nuts can affect cholesterol levels. Walnuts, almonds, hazelnuts, peanuts, pine nuts or pistachios - you can take any of those that you like. All of them contain mono- and polyunsaturated fatty acids that strengthen blood vessels. But when choosing nuts as a cure for cholesterol, it is important to give preference to natural products, without icing sugar or salt.

Avocado

This powerful source of nutrients is also able to reduce the concentration of LDL. Especially useful for overweight people.

Olive oil

Two tablespoons of olive oil a day is enough for the body to feel the benefits. A strong heart and normal cholesterol are the main benefits of this product. But you should not get too carried away with them, because, like avocados, they contain quite a lot of calories.

Milk serum

Scientists have proven that, contained in the whey of dairy products, is also able to influence the levels of LDL and total cholesterol downward. Therefore, you should not turn off natural dairy foods from your diet.

In addition to these foods, salmon, flaxseeds, plant-derived cholesterol, citrus fruits, and soy will help fight LDL. So do not immediately look for pills to lower cholesterol. Especially when the concentration of the substance is not very high.

But for any of the above products to actually benefit the body, it is important to reconsider the general principles of nutrition. First, eliminate trans fats from your diet completely. And this means giving up margarines, pastries and cakes from stores. Trans substances are usually labeled as "partially hydrogenated fats" on the label. But besides this, it is important to supplement the right diet with at least a little physical activity.

Special sport for special lipids

Exercise alone cannot lower cholesterol levels. But regular exercise “triggers” processes in the body, which as a result lead to a decrease in the concentration of LDL. In addition, it is already known that obese people tend to have high cholesterol, and losing weight helps to solve this problem. On the other hand, exercise stimulates the production of enzymes that help transport LDL to the liver. And the third reason in favor of sports: physical activity can affect the size of protein particles that carry cholesterol in the blood.

The fact that sport is good is already clear. But another question arises: how often and how long should training last in order to affect cholesterol? On this topic, researchers do not stop arguing, putting forward new theories. Some believe that 30 minutes a day is enough to start all the necessary mechanisms. Others argue that this is too little to feel changes in cholesterol concentration.

But, nevertheless, the researchers studied the trends in people who exercise intensively and in those who prefer moderate exercise. It turned out that both types of classes give a positive result, but in the first case, changes come faster.

And now, when we figured out the intensity of the classes, it's time to find out which sport is better to give preference to people with high cholesterol. Most experts agree that race walking is the best choice. Moderate exercise and pacing is suitable for everyone, even people with severe obesity. Regular running or jogging also helps lower cholesterol. And fans of pedaling can safely get on bicycles and begin to reduce their LDL levels.

The only rule for everyone, no matter what sport they choose, is to practice regularly. Only in this case, you can count on the improvement of blood tests. This does not mean that the fight against cholesterol should turn into daily several hours of training. You can make your own study plan and stick to it. The main thing is to move regularly.

But before you start exercising, it is extremely important to consult with your doctor, discuss together the intensity and duration of training. Especially if there is a history of heart problems.

Did you know about it?

1. There is no daily allowance for dietary intake of cholesterol. The liver is able to produce exactly as much as is necessary for the body. From this point of view, vegetarians, whose menu does not contain animal food, are doing very well.
2. High cholesterol can be inherited.
3. A high concentration of lipoproteins can even be in children. Atherosclerotic plaques begin to accumulate in childhood, especially against the background of congenital problems with the cardiovascular system.
4. Paradoxically, foods that do not contain cholesterol can increase the concentration of this substance in the blood. What's more, dietary cholesterol is not as bad for the body as saturated lipids and trans fats. If trans lipids make up only 2% of the total calories consumed, then rest assured, this will increase the concentration of lipoproteins by 20 percent.
5. Even minor weight loss will improve blood counts.
6. Generally, men are more prone to high cholesterol. But in women after menopause, LDL levels also rise sharply.
7. Skin bumps (xanthomas) can be a sign of elevated blood lipids. As a rule, such formations appear in the elderly on the elbows, knees or hands.
8. There is an opinion that too low a level of total cholesterol is no less harmful than raising the norm. Lack of lipids can increase the risk of cancer, depression, and cause premature birth and underweight newborns.
9. Cholesterol contributes to the production of sex hormones, which are responsible for libido, and also helps digestion.
10. Cholesterol is one of the building blocks of the body, or rather, an important component of cell membranes.
11. High cholesterol is normal. But such a statement is correct only for women during pregnancy, when their body needs additional portions of this substance. Some research suggests that "correct" cholesterol contributes to the formation of the brain in the fetus, and breast milk rich in cholesterol has a positive effect on the health of the child, especially on his cardiovascular system.
12. High cholesterol levels can be recognized ... by the eyes. A white border around the cornea and fatty lumps under the skin of the eyelids are a sign of high cholesterol.

When it comes to cholesterol, many people immediately think of fatty junk food and heart disease. But in fact, cholesterol in the right concentration is our assistant, without which many life processes would stop.

The functions of cholesterol in the body have long been a subject of scientific interest. Scientists' research is aimed at preventing atherosclerosis, a dangerous disease in the development of which cholesterol plays one of the main roles.

Despite the abundance of information, many people still consider cholesterol to be harmful substances. In fact, cholesterol helps maintain health by performing an important role in the body - ensuring metabolic processes.

The body's need for cholesterol is low. Only 10% of people have an increased concentration of the substance. Previously, there was an opinion that all cholesterol is harmful and leads to atherosclerosis.

High cholesterol is bad for the arteries, but its deficiency leads to increased fragility of the vessels. In this case, the damaged areas strengthen cholesterol patches.

Main functions of cholesterol

In the right concentration, cholesterol provides many life processes:

1. Maintains the shape and function of cell membranes: increases strength, regulates permeability. The membrane performs a barrier function between the contents of the cells and the external environment. At the same time, this semi-permeable partition is capable of passing water molecules and certain substances dissolved in it. Cell membranes are 95% built from lipoproteins, which include glyco-, phospholipids, cholesterol. Providing a stabilizing effect, it resists the damaging effects of free radicals.
2. Provides transportation of useful and harmful elements, regulation of the activity of enzymes that greatly accelerate biochemical reactions.
3. Takes part in the synthesis of sex hormones, maintains a normal hormonal background.
4. Participates in the synthesis of bile acids.
5. Supports the structure and growth of fetal cells. For bearing a fetus during pregnancy, the female body requires an increased amount of cholesterol. Mother's milk rich in cholesterol has a positive effect on the health of the child.
6. Ensures the normal functioning of the brain, protects against Alzheimer's disease. Scientific studies show a direct effect of cholesterol on mental performance.

The human body contains 140-350 g of cholesterol, 90% of which is in the tissues, and 10% in the blood. Insoluble in water, cholesterol dissolves in fatty media. It is transported to all tissues of the body by lipoproteins - complexes of proteins and fats.

There are several types of lipoprotein complexes of different density that determine the structure of cholesterol in the body:

• LDL - low density - 70%;
• VLDL - very low density - 9-10%;
• HDL - high density - 20-24%.

Low-density lipoproteins are called bad or bad cholesterol. Their source is only animal fats. LDL provides the delivery of cholesterol to cells that need it, replenish them with vitamins, and have a neutralizing effect on toxins.

Our body needs bad cholesterol, which supports the functioning of the immune system, including protection against cancer.

At the same time, LDL is the cause of the appearance of plaques deposited on the walls of blood vessels that can cause their blockage (atheroma).

As a result, atherosclerosis and a number of concomitant pathologies develop: peripheral arterial disease, ischemic attacks, angina pectoris, stroke, heart attack. The ailments caused by atheroma lead to poor health and most often cause death.

High density lipoproteins are synthesized by the liver. Their source is essential human fats of plant origin.

The structure of HDL is different from LDL. They have an anti-atherosclerotic effect, removing LDL from the cell walls and delivering them to the liver for processing and excretion from the body. As a result, the thickness of the plaque decreases, and the risk of atherosclerosis is reduced.

Obesity, diabetes mellitus, hepatosis of the liver are factors that increase the level of bad cholesterol and reduce the level of good.

Eating certain foods helps to optimize the ratio of cholesterol components in the blood:

• Carrots, Jerusalem artichoke, celery, cabbage, beets, bran, greens, citrus fruits, pears, apples containing insoluble fiber;
• Phytosterols that lower LDL levels: cereals, pumpkin, eggplant, zucchini, ginger, hibiscus, sesame, strawberries;
• legumes;
• Sea fish, fish oil, corn, olive, mustard oil;
• Red rice;
• Avocado and oil of this fruit;
• Onion garlic.