What is cholesterol?

Cholesterol is a lipid (fat chemical) and is found in every cell of your body. Not all cholesterol is bad. Cholesterol is important to insulate nerve fibers and is involved with production of bile acids which are important for digestion and absorption of fats. It is needed to make up the structures of the outer layer of every cell in the body and it makes steroid hormones and sex hormones. However too much of it can lead to patches of atheroma (small fatty lumps) developing within the inside lining of blood vessels (arteries), otherwise known as atherosclerosis and ‘hardening of the arteries’. This can eventually lead to cardiovascular events such as narrowing of the arteries, heart attack, stroke and TIAs.

Different types of lipids:

Cholesterol does not mix well with water and therefore is transported around the body attached to lipoproteins.

There are two types of lipoprotein: Low-density lipoprotein (LDL) and High-density lipoprotein (HDL) which are also known as good fats and bad fats.

LDL is the main cholesterol transporter. It carries the cholesterol from your liver to the cells that need it. If there is too much cholesterol it starts to build up in the blood and sticks to the artery walls and the heart leading to cardiovascular disease.

HDL transports cholesterol away from the cells and back to the liver where it is broken down and passed through the body as waste produce.

There is another fat called Triglycerides. These are used by the body for energy and come from the fatty foods that we eat. What the body doesn’t use for energy is stored as fatty tissue. Too much triglyceride in the body also adds to heart disease.

Recent research in the Endocrine Society’s Journal of Clinical Endocrinology and Metabolisism indicates that high cholesterol is linked to infertility.
An article published in JAMA Neurology shows that cholesterol plaques are linked to Alzheimer’s and if LDL and HDL are unbalanced it can affect dementia health.

Normal cholesterol levels:

• It is recommended that cholesterol levels should be less than 5mmols/l.
• Low density lipoprotein (LDL) cholesterol after a 12 hour fast should be 3.0 mmol/L or less.
• High-density lipoprotein (HDL) cholesterol should be 1.2 mmol/L or more.
• TC/HDL ratio should be 4.5 or less. That is, your (TC) total cholesterol divided by your HDL cholesterol. This reflects the fact that for any given TC level, the more HDL, the better.

Risk factors
Everyone has some risk of developing atheroma. However, some situations increase the risk. These include:

• Lifestyle risk factors that can be prevented or changed:

o Lack of physical activity (a sedentary lifestyle).
o Obesity.
o Smoking.
o An unhealthy diet – including eating too much salt.
o Excess alcohol.

• Treatable or partly treatable risk factors:

o High blood pressure.
o Diabetes.
o High triglycerides
o High cholesterol.
o Kidney diseases that affect kidney function.

• Fixed risk factors – ones that you cannot alter:

o A strong family history. This means if you have a father or brother who developed heart disease or a stroke before they were 55, or in a mother or sister before they were 65.
o Age. You are more likely to develop atheroma as you get older.
o Being male.
o An early menopause in women.
o Ethnic group- People who live in the UK/Ireland whose family came from Pakistan, Bangladesh, India, or Sri Lanka have an increased risk.

However, if you have a fixed risk factor, you may want to make extra effort to tackle any lifestyle risk factors that can be changed.

Note: Some of these risk factors are more dangerous than others. High cholesterol level and smoking probably cause a greater risk to health than obesity on its own. Also, risk factors interact. So, if you have two or more risk factors, your health risk is much more increased than if you just have one.

Therese Nolan, RGN
Practice Nurse at Griffith Family Practice.

Therese is a Practice Nurse at Griffith Family Practice. Despite the distance she has been attending our Physiofit Woman clinic since 2013. Therese completed our exclusive 4 week Physiotherapy Postural Programme followed by a 6 week Pilates-Physiotherapy course to reduce her lower back pain and improve her posture. She also attended our Reflexology treatments and her maintenance plan includes homework exercises and regular massages with our therapists. Therese is a regular contributor on our Women Expert’s Corner.