Without cholesterol, a human would not survive. Our bodies need it to maintain healthy cell membranes, synthesize hormones such as estrogen, testosterone, adrenal hormones, and vitamin D. We also need it to create bile acids that aid in digestion and for healthy brain function. So why is everyone afraid of it? Why are doctors, such as myself, always measuring it and advising patients on how to lower it? Is cholesterol really bad for you?
Cholesterol comes from two sources: the liver and our diet. The liver can synthesize all the cholesterol we need for healthy functioning, producing roughly 80% of total cholesterol; the remainder comes from our diet. Cholesterol is then taken out of the liver attached to carrier proteins called lipoproteins—the two major ones being HDL (good cholesterol) and the infamous LDL (bad cholesterol)—and delivered to multiple areas in our bodies. There are also triglycerides, another form of fat synthesized by the liver and diet, which, when in excess, are converted to fat and stored in our bodies. So why is cholesterol considered so bad when, without it, we would cease to function?
The answer lies inside our arteries, specifically the ones that supply our hearts and brains. Arteries normally have a silky endothelial lining through which blood easily passes, supplying our bodies with everything from nutrients and oxygen to immune cells and more. Roughly 2,000 gallons of blood circulate through our hearts and body daily, bringing with it everything we need to survive. Over time, however, high inflammation due to illnesses such as hypertension or diabetes, combined with excess stress, alcohol, and smoking, can damage arteries. What starts as a nick in the smooth vessel lining can develop into fatty streaks. If not controlled, these streaks can form plaques, some of which can become so large they entirely occlude and stop blood flow, like a dam or a pile-up of cars on the Long Island Expressway. These events can result in heart attacks and strokes, which can be devastating.
So, is cholesterol itself bad? Yes and no. Should it be lowered in high-risk individuals susceptible to heart disease and strokes? Yes. Preventative studies have shown that even lowering cholesterol by 10% leads to a significant reduction in heart attacks. Heart disease is the number one cause of mortality in this country, which is why doctors use the infamous statin drugs.
How can we lower our cholesterol naturally? By eating healthy foods such as fruits, vegetables, legumes, fish, nuts, and plenty of water. Eliminate processed foods, as well as foods high in trans fats and sugar. Reduce alcohol intake, never smoke, and reduce stress as much as possible. Lastly, exercise four to five times a week..again, if possible. Remember, elevated cholesterol by itself is only one risk factor for heart disease and strokes, and the above recommendations will help in all areas of prevention and lead to a better-balanced life.
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