Cholesterol, Good and/or Bad
One Saturday after church a friend said to me, "is it good to have high levels of good cholesterol? If it is good as you - medical people say, why should there be a limit?".
Like my good
friend, there may be other people who are yearning for answers to these
questions and more. However, cholesterol is one of the most misunderstood topics
in health. In this reflection series, I will talk about cholesterol; where we get it from, how good or how bad it is, how to keep it under control and possibly how to prevent complications that come with it.
Cholesterol; what is it?
Cholesterol
is a waxy type of fat which is found in the blood and moves throughout the body.
Since fats do not dissolve in water, cholesterol does not dissolve in the blood
which is water-based, and for that matter it floats in the blood as it moves in the
blood vessels. This explains why it can be found everywhere in the body.
Cholesterol; where do we get it from?
It is important to know that the body produces the cholesterol it needs to function. The liver is the organ responsible for the production of cholesterol in the body. For this reason, there is no dietary requirement for it. That is, you don’t necessarily need to eat food rich in cholesterol to supply the body with the amount it needs.
The other sources of cholesterol to the body are animal food sources such as meat, egg, dairy, cheese, canned shrimps, organ meats (kidney, liver and heart), processed meat etc. Dietary sources of cholesterol are restricted to animals and animal products because it only occurs in animal cells as a result of biosynthesis. Plant based foods do not contain cholesterol.
As mentioned
earlier, cholesterol like all other fats in the body does not dissolve in the
blood. Therefore, it must bind to proteins in the body to form lipoproteins
before it can be transported around the body by the blood. Five different types
of lipoprotein with each one having a specific role to play in transporting
lipids around the body have been identified.
Chylomicrons are lipoproteins responsible for packaging
and transporting fats and cholesterol that have been introduced into the body
through food. They are manufactured in the walls of the intestine for this
purpose.
Very Low-Density
Lipoproteins (VLDL), Low-Density Lipoproteins (LDL) and Intermediate-Density
Lipoproteins (IDL) are responsible for transporting cholesterol and lipids from
the liver to the cells and tissues. These three (3) lipoproteins transport
cholesterol that has been produced by the liver to the cells and tissues.
High Density Lipoproteins (HDL) has a different role compared to the other types of lipoproteins. HDL is manufactured by the Liver and released into the blood to collect excess amount of cholesterol that exist in the cells and tissues, and transport them to the liver for recycling. This is why HDL is called good cholesterol.
Cholesterol; How good
Cholesterol
when produced in the right amount is beneficial to the body. It is an essential
component of the cell membranes (The structures/layers that protect the
contents of the cell by acting as the gatekeeper to what things can enter or
leave the cell). Without cholesterol, cells like the T-cells (a type of white
blood cell) would not maintain their cell membranes and lead to its rupture.
Cholesterol enables
the body to form bile acids, which are needed for the breakdown and absorption
(digestion) of fats in the digestive tract. Additionally, cholesterol must be
present for the skin to manufacture vitamin D, which plays a role in how the
body handles calcium and assists in maintaining bone density.
Cholesterol
is also needed for the manufacturing of certain hormones particularly sex
hormones like testosterone, oestrogen and progesterone. Other hormones produced
mainly by the adrenal gland, also require cholesterol for its production.
Aldosterone (the hormone that makes the kidneys retain water) and cortisol (the
hormone that is important in suppressing inflammation in the body) are two such
examples.
Cholesterol; How bad
High levels
of cholesterol in the form of Low-Density Lipoproteins (LDL) in the blood is
detrimental to the health of the individual. As it has been mentioned earlier,
LDL transports endogenous fat and cholesterol from the liver to the tissues. It
is considered “bad cholesterol” because LDL particles can build up in the walls
of the arteries (blood vessels that carry oxygen-rich blood away from your
heart to all other organs in the body) and make them narrower. These fatty
deposits form plaque that lines the arteries and may eventually block the free flow
of blood in the arteries. This build-up of plaque is called atherosclerosis.
Hypercholesterolemia (high cholesterol in the blood) does not typically produce symptoms. However, it may lead to complications such as coronary heart diseases, stroke, heart attack and peripheral arterial disease which will produce symptoms.
** Symptoms of Coronary Heart Disease include chest pains, angina, nausea, extreme fatigue, numbness or coldness in the feet and hands, shortness of breath and pain in the neck, jaw, upper abdomen, or back.
** Stroke produces symptoms such as sudden loss of balance and coordination, sudden dizziness, facial asymmetry (drooping eyelid and mouth on just one side), inability to move unaided (particularly affecting just one side of the body), confusion, slurring words, severe headache and eye problems (blurred vision, blackened vision and double vision).
** Symptoms of Heart Attack include tightness, squeezing, fullness, pain, or aching in the chest or arms, difficulty breathing, anxiety or a feeling of impending doom, dizziness, nausea, indigestion or heartburn, excessive fatigue.
** Symptoms of Peripheral Arterial Disease (PAD) includes cramping, achiness, fatigue, pain in the legs during activity or exercise and discomfort in the legs and feet. As PAD progresses, symptoms occur more frequently and can occur when at rest. Later symptoms that may occur because of reduced blood flow include thinning, paleness, or shininess on the skin of the legs and feet, tissue death (gangrene ulcers), leg pain that doesn’t go away when at rest, burning in the toes, leg cramps, thick toenails, reduced hair growth on the legs, and decreased temperature of the affected leg compared to the other leg.
Cholesterol; Diagnosis
Hypercholesterolemia
is diagnosed by a laboratory test called lipoprotein profile or lipid panel.
Before the blood sample is taken for the test, the person is expected to fast
for 10 to 12 hours. The table below provides the normal and abnormal values.
Credit: healthy-ojas.com
Cholesterol; how to keep it under control
** First of
all, you must reduce the consumption of animal food. This is because cholesterol
can only be found in animals hence the more animal foods you eat, the more
cholesterol you introduce into your body.
** Limit the
consumption of fatty meats including sausages and other foods rich in saturated
fat.
** Eat more
plant-based foods including fresh fruits, vegetables and wholegrain.
** Avoid alcohol
consumption since alcohol raises the level of lipids in the blood.
** Avoid
smoking because smoking increases the ability of LDL cholesterol to get into
the artery cells and cause damage.
** Exercise
regularly (for example, at least 30 minutes of brisk walking daily). Exercise
increases HDL levels while reducing LDL and triglyceride levels in the body.
** If you
have been diagnosed of high cholesterol, kindly take your medications and
follow the treatment plan of your qualified medical professional.
Conclusion
To conclude,
cholesterol is very beneficial to the normal functioning of the body. The liver
produces the right amount the body needs and so there is no need to introduce
more into the body through our diet. High cholesterol in the body can cause
many serious medical problems including stroke, heart attack and coronary heart
diseases.
I will
encourage everyone to cut down on the amount of animal foods they eat and consume
more plant-based diets. The more plant-based diet you eat, the less cholesterol
you will introduce into the body. God in His infinite wisdom knows that
consuming animal foods will put us at risk of high cholesterol, that is why He gave
humans plant-based food to eat after creation.
And God said, “See, I have given you every herb that yields seed which is on the face of all the earth, and every tree whose fruit yields seed; to you it shall be for food
(Genesis 1.29 NKJV)
It is
therefore important to go back to the Genesis plan so that we can live healthy
and live long like Adam and his generation who lived for more than 900 years. By
following the Genesis plan, we can be free from cholesterol.
REFERENCES
2. Peate, I. British Journal of Healthcare Assistants 2(3): 115-8. 2008.
3. Higgins C. Understanding Laboratory Investigations for Nurses and Health Professionals. 2nd edn. Blackwell Publishing, Chichester. 2007.
4. Maxfield FR, Tabas I. Nature. 2005; 438(7068): 612-21
5. Carton J, Daly R, Ramani P. Clinical Pathology. Oxford University Press, Oxford. 2007
6. Underwood JCE, Cross SS. General and Systematic Pathology. 5th edn. Churchill Livingstone. 2009
7. Holick MF. N Engl J Med. 2007; 19(3): 266-81
8. https://www.independentnurse.co.uk/clinical-article/the-role-of-cholesterol/63612/
9. https://my.clevelandclinic.org/health/articles/11920-cholesterol-numbers-what-do-they-mean
Written by James Mckeown Amoah and edited by Philomina Donkoh
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