WHY CHOLESTEROL MATTERS AND SHOULD MATTER TO ANYONE 20 YEARS OR OLDER
When the conversation over dinner with friends shifts to a discussion about cholesterol and statins you know you've entered a new chapter of life!
You know you’ve entered another stage of life when the conversation with friends over dinner shifts from the latest travel destinations or favorite new restaurants to a spirited discussion about who’s on a statin and comparing cholesterol numbers like they’re the latest stock market trends. Yes, welcome to the cholesterol club—where the highs and lows we’re talking about are more about our LDL and HDL levels than the rollercoaster of life. It’s a rite of passage that sneaks up on us, often served alongside a plate of pasta or a glass of wine, reminding us that the body we’ve been cruising around in has its own maintenance schedule. So, let’s dive into the world of cholesterol: what it is, why it matters, and how to manage it without sacrificing all the good things in life.
Cholesterol is a term often mentioned in conversations about health and diet, but its role in the body is frequently misunderstood. While many people associate cholesterol strictly with heart disease, it’s important to understand that cholesterol itself is not inherently harmful. In fact, it is a vital substance that our bodies need to function properly. However, managing cholesterol levels is crucial for reducing the risk of chronic disease, particularly heart disease.
Cholesterol is a waxy, fat-like substance found in every cell of the body. It is essential for the production of hormones, vitamin D, and substances that help digest foods. The liver produces all the cholesterol the body needs, but cholesterol is also present in animal-based foods, such as meat, cheese, and eggs.
Cholesterol travels through the bloodstream on proteins called lipoproteins. The two most important types are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL is often referred to as "bad" cholesterol because it contributes to the buildup of plaque in the arteries, which can lead to atherosclerosis, a condition characterized by hardened and narrowed arteries. This condition increases the risk of heart attacks and strokes.
On the other hand, HDL is known as "good" cholesterol because it helps remove LDL cholesterol from the arteries. I always remember it as H-for happy—happy cholesterol! It is often associated with physical activity—the more exercise you do—HDL goes up! Higher levels of HDL cholesterol can reduce the risk of heart disease. Triglycerides, another type of fat in the blood, are also an important factor to consider. High levels of triglycerides combined with low HDL cholesterol or high LDL cholesterol can increase the risk of heart disease. Your doctor needs to be looking at all these numbers!
Why Cholesterol Levels Matter
High cholesterol levels, particularly high levels of LDL cholesterol and low levels of HDL cholesterol, can lead to the development of cardiovascular diseases. When there is too much LDL cholesterol in the blood, it can combine with other substances to form hard deposits, or plaques, on the walls of arteries. These plaques can narrow the arteries, making them less flexible, a condition known as atherosclerosis. If a plaque ruptures, it can cause a blood clot, which may result in a heart attack or stroke.
Several factors can influence cholesterol levels. Diet plays a significant role; consuming high amounts of saturated fats, trans fats, and cholesterol can increase cholesterol levels. Lifestyle factors such as lack of physical activity, smoking, and being overweight can also negatively impact cholesterol levels. Additionally, genetics can play a role; some people inherit conditions that make their bodies produce too much cholesterol. Yes you can be thin and still have high cholesterol!
Familial hypercholesterolemia (FH) is a genetic condition that results in high levels of LDL cholesterol from a young age. This condition increases the risk of developing cardiovascular diseases early in life. It is important for individuals with a family history of high cholesterol or heart disease to get their cholesterol levels checked regularly and to manage their cholesterol through lifestyle changes and, if necessary, medication.
It is very important to note that many women experience an increase in cholesterol levels during menopause due to hormonal changes, particularly the decline in estrogen levels. Estrogen has a protective effect on the cardiovascular system and helps regulate cholesterol levels. Here are a few reasons why cholesterol levels often rise during menopause:
1. Decrease in Estrogen Levels: Estrogen helps maintain healthy cholesterol levels by increasing the levels of high-density lipoprotein (HDL) cholesterol, known as the "good" cholesterol, and lowering low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol. When estrogen levels decrease during menopause, LDL levels tend to rise while HDL levels may decrease, leading to a higher overall cholesterol level and an increased risk of cardiovascular disease.
2. Changes in Body Fat Distribution: Menopause often leads to changes in body fat distribution, with more fat being stored around the abdomen (central obesity). This shift in fat distribution is associated with increased insulin resistance and higher levels of LDL cholesterol and triglycerides, which can contribute to higher cholesterol levels overall.
3. Slower Metabolism; As women age, their metabolism often slows down, which can lead to weight gain. Increased body weight, particularly if it results in more visceral fat (fat around the organs), is associated with higher cholesterol levels and an increased risk of metabolic syndrome, a cluster of conditions that raise the risk of heart disease, stroke, and diabetes.
4. Lifestyle Factors: Menopause can coincide with other lifestyle changes that affect cholesterol levels. For instance, women might become less physically active, or their diets might change, contributing to weight gain and increased cholesterol levels. Additionally, some women may experience increased stress or sleep disturbances during menopause, both of which can negatively impact cholesterol and overall heart health.
5. Genetic Factors and Family History: Some women have a genetic predisposition to higher cholesterol levels that become more pronounced during menopause. If there is a family history of high cholesterol or heart disease, menopause can trigger an increase in cholesterol levels.
6. Hormonal Replacement Therapy (HRT): While some forms of hormone replacement therapy (HRT) can help manage menopausal symptoms and potentially have a favorable effect on cholesterol levels, not all forms of HRT are beneficial. The impact of HRT on cholesterol depends on the type of hormone, the route of administration, and the duration of treatment. Some HRT options can raise HDL cholesterol and lower LDL cholesterol, while others might have a neutral or even negative effect.
Furthermore, recent studies have highlighted the role of inflammation in heart disease. Inflammation is the body's response to injury, and chronic inflammation can lead to the formation of plaques in the arteries. Managing cholesterol is one aspect of reducing heart disease risk, but controlling inflammation is also crucial. A healthy diet that focuses on eating whole unprocessed foods, less sugars and alcohols, regular exercise, and stress management can help reduce inflammation and impact cholesterol.
Get Your Cholesterol Checked!
Regular cholesterol screenings are important for monitoring cholesterol levels and assessing the risk of heart disease. The American Heart Association recommends that adults aged 20 or older have their cholesterol checked every four to six years, and more frequently if they have a family history of heart disease or other risk factors.
It’s essential to approach cholesterol management comprehensively, considering diet, lifestyle, and other health conditions. While medications can effectively lower cholesterol levels, they work best when combined with a healthy lifestyle. This comprehensive approach not only lowers cholesterol but also improves overall cardiovascular health. Maintaining a healthy balance of cholesterol in the body is crucial for long-term health, and making proactive choices today can lead to a healthier tomorrow.