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If someone tries to get information from the Internet about healthy eating, they will find the most inconsistencies on the issue of cholesterol. For example, no nutritional messiah thinks it's good to have a fasting blood sugar of 300, but there are some who scream on social media that there's nothing wrong with having a bad cholesterol of 300. On the other hand, there are many who believe that the Cholesterol drugs should be given to all of us after 30 because they have many benefits to offer. Let's take a look at what is true and what is not true.
What is cholesterol? Cholesterol is one of the most important molecules present in our body. It is so necessary for our health that all cells can synthesize what they need and even more.
What are LDL and HDL? Cholesterol, as it is a fat-soluble substance, i.e. it dissolves in fats and oils, it cannot dissolve in water. This means that if we put a drop of cholesterol in a glass of water, it will not dissolve. This creates a problem in its transport inside the body. The solution for transporting cholesterol, and the rest of the body's lipids, are certain complexes of lipids and proteins called lipoproteins. There are too many lipoproteins, but of all of them we have adequately studied only three: LDL, HDL, and the lipoprotein Lp(a). From the studies that have been done for decades we have come to the conclusion that for the best health of the vessels of the heart and the brain it is important that the lipoproteins LDL and Lp(a) are low, while for HDL we generally want them to be up, without to have clarified exactly where we want it to be. We will say more about this in a moment.
What levels should LDL be at? The guidelines require people who do not have heart risk factors, such as smoking, hypertension and diabetes, to keep their LDL below 115. If there are heart risk factors, then the LDL should be even lower. For example, if there is one risk factor, eg smoking, then the target should be 100, whereas if there are more risk factors, then maybe the target is 70 or even 55.
Can HDL allow us to have more LDL? According to the guidelines this is not allowed. I've heard some of my patients tell me that it's okay if someone has an LDL of 160 if their HDL is 80 because their ratio somehow protects them. According to the guidelines, this is not the case. We do not consider HDL when choosing to treat LDL.
How can LDL be lowered? According to the guidelines, if the LDL is not too high, then we try diet and exercise. If this is not enough to achieve our goals, then we add some of the available drugs. Unfortunately, most fellow doctors oversimplify the instructions and "jump" straight to drugs without recommending diet and exercise, or when they do recommend diet and exercise their instructions are vague and unworkable, such as "cut out the fats" or "cut out the sweets" and such, which are not actual medical instructions. Whoever has problem with cholesterol and wants to treat it with diet, then I am happy to help him in my practice. Come to me to help you nutritionally lower your cholesterol and possibly avoid medication.
If my HDL is elevated, am I not protected? As I said earlier, HDL is a bit of a mystery. A few years ago a drug was discovered that significantly raised HDL. The medical world was excited, because we believed we had found the drug that would protect the heart even more. Unfortunately, when the relevant medical studies were done we saw something unexpected. While the drug consistently raised HDL, we also saw an increase in heart attacks and strokes. My advice is don't waste too much time with HDL. Don't use it as an excuse to tolerate high LDL. If LDL is elevated then you must definitely do something to reduce it: proper diet, exercise and if these are not enough, medication.
Does the atherosclerotic index matter? The latest guidelines have made it clear that all the markers that have been suggested from time to time do not have a strong predictive value and suggest that doctors only concern themselves with LDL and its proper reduction.
Cholesterol remains the most important reversible factor in heart health. Fortunately for us, it can be modified with proper nutrition, regular exercise and lifestyle changes for the better. But even if these are done correctly and it is not possible for the cholesterol to go where it should, there is also the possibility of medication. But we must think about these long before evil finds us. Should not
that is, to start taking care of our health when it is too late. To be well after 50 you need to start taking care of your health after 30. Because after 50 it can be too late.
Something that can significantly affect cholesterol is the coffee we drink. Some coffees raise cholesterol while others do not.