Cholesterol – why is it so important?

About 80% (approx. 3 mmol per day) of the required cholesterol is synthesized by the body itself, more specifically, in the liver. Only 20 % (about 0.8 mmol) is consumed through nutrition . Animal products, especially, contain a lot of cholesterol. Intake from the intestine is actively regulated. In the liver, special receptors (LDL-cholesterol-receptors) on liver cells regulate the concentration of cholesterol in the blood circulation.

Cholesterol is a blood fat and not soluble in aqueous solutions. For transportation it is, thus, combined with proteins and packed into small particles called lipoproteins. These lipoproteins differentiate in density . We distinguish between Low-Density-Lipoproteins (LDL) and High-Density-Lipoproteins (HDL). Low-Density-Lipoproteins transport cholesterol from the liver to body cells to be further processed. High-Density-Lipoproteins transport surplus cholesterol back to the liver where it can be degrade d.

Where does the bad reputation of LDL come from? So if cholesterol is crucial , how come it has such a bad reputation? HDL-cholesterol is commonly called “good cholesterol” whilst LDL is called “bad” cholesterol.

The reason is that LDL-cholesterol can cause vascular diseases and facilitate plaque build ups (deposits in the vessels). The amount of LDL-cholesterol is reportedly linked to the risk of suffering from a heart attack and stands in relation to increased mortality due to cardiovascular diseases. If there are too many LD-lipoproteins or too little cholesterol receptors, macrophages absorb surplus cholesterol and move into the walls of the vessels where the cholesterol is deposited . These plaques can narrow the vessels and eventually block them. Plaques also facilitate inflammatory reactions harming the walls of the vessels. This increases the risk of blood clots that arise when a plaque breaks down and thrombocytes accumulate. This often causes strokes or heart attacks: most of these plaques occur in the coronary vessels.

What are causes for high cholesterol levels? Genetic predispositions for high LDL cholesterol figures are possible. A common example is the genetic defect causing heritable hypercholesterolemia. These patients already have LDL-blood value s of over 190 mg/dl at a young age and often suffer from arteriosclerosis and heart attacks. The genetic defect can be passed on by both parents (homozygous) or by one (heterozygous). A sedentary lifestyle with a diet based on animal products can also increase the LDL-cholesterol level.

How much a patient’s cholesterol level should be reduced depends on the overall risk of diseases that can be caused by elevated LDL cholesterol. The higher this risk, the more useful it is to reduce cholesterol levels and the more often these levels should be checked.

Healthy people without risk factors should aim for LDL levels below 115 mg/dl. Healthy people at moderately increased risk should have levels below 100 mg/dl. Patients at high risk should not have LDL levels above 70 mg/dl. Total cholesterol levels should remain below 200 mg/dl. To determine blood lipid levels even more accurately, the ratio between LDL and HDL cholesterol, the LDL/HDL quotient, is calculated. Since cholesterol is vital, its level must not fall below a critical threshold, otherwise important bodily functions are endangered.

How can we counteract these high levels? Therapy mainly focusses on reducing the amount of LDL-cholesterol in the blood. Drugs such as statins have proven effective in this regard. Statins inhibit an enzyme needed to produce cholesterol. As the body needs the cholesterol, it takes up the surplus cholesterol from the blood vessels.

Dietary changes can have a positive effect on lowering LDL cholesterol levels. Since animal products contain the most cholesterol, a vegan diet reduces the cholesterol intake effectively.

Exercise can also help increase HDL cholesterol (protecting the vessels). This lowers LDL cholesterol, as HDL cholesterol is able to absorb and remove LDL cholesterol that has already been deposited. Exercise that advances stamina is very effective. Smoking reduces the amount of HDL cholesterol and increases the risk of cardiovascular diseases. Therefore, quitting smoking can also improve cholesterol levels. In short, it is important to regularly monitor cholesterol levels, especially if there is a known family predisposition.

EXERCISE:

1. Animal products contain almost no cholesterol. A. True B. False

2. Low-Density-Lipoproteins transport cholesterol from the liver to body cells to be further processed. High-Density-Lipoproteins transport surplus cholesterol back to the liver where it can be degraded. A. True B. False

3. Plaques facilitate inflammatory reactions harming the walls of the blood vessels. This increases the risk of blood clots. This often causes strokes or heart attacks, especially, since most of these plaques occur in the coronary vessels. A. True B. False

You‘ll find the answer below.

BIBLIOGRAPHY 1. http://dict.leo.org 2. www.dict.cc 3. www.herzstiftung.de 4. www.lipid-liga.de 5. www.nhs.uk 6. www.webster-dictionary.org

CARMEN LOBITZ Carmen Lobitz ist freie Trainerin, Lehrerin und MTA. Sie gründete 1998 in Berlin lobitz seminare, die unter anderem Englischseminare für Health Professionals anbieten. Kontakt: mail@lobitz-seminare.de www.lobitz-seminare.de

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Lösung für Exercise:

1. B)

2. A)

3. A)

Cholesterol – why is it so important?

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