Dis­cover the new facts about your choles­terol

Great Health Guide - - CONTENTS - Dr He­lena Popovic

Choles­terol has re­ceived more me­dia at­ten­tion than most other bi­o­log­i­cal mol­e­cules. This con­tro­ver­sial lipid has ap­peared not once but twice on the cover of Time mag­a­zine. The first ar­ti­cle in Time con­demned choles­terol as a har­bin­ger of heart at­tack. A few years later, choles­terol was ex­on­er­ated with the ex­hor­ta­tion to bring back the ba­con. It’s time to re­veal the pri­vate life of this pub­lic diva. For decades choles­terol has been im­pli­cated as a ma­jor risk fac­tor for heart dis­ease and most peo­ple try to keep their blood choles­terol as low as pos­si­ble. But is this the best way to lower your risk of heart at­tack and stroke? And are drugs or diet the way to go about it? Older peo­ple with higher choles­terol lev­els ac­tu­ally tend to live longer and have a lower risk of Alzheimer’s dis­ease than do peo­ple with low lev­els of choles­terol. This is not what we have be­lieved for decades.

What do we now un­der­stand about choles­terol?

1. Choles­terol is essen­tial to life and each cell in the body can make it through a 37-step process. It’s a com­po­nent of cell mem­branes and a pre­cur­sor for mak­ing oe­stro­gen, pro­ges­terone, adrenal hor­mones, Vi­ta­min D and bile acids.

2. Choles­terol is also a vi­tal part of the myelin sheath that en­ables sig­nal­ing be­tween brain and nerve cells.

3. It plays many and var­ied roles in the body and is car­ried around in the blood by lipopro­teins of vary­ing size, weight and den­sity.

4. The choles­terol within each lipopro­tein is the same - it is the car­rier molecule that dif­fers. The higher the pro­tein to fat ra­tio, the denser the lipopro­tein. Hence the terms HDL (High Den­sity Lipopro­tein) and LDL (Low Den­sity Lipopro­tein).

How­ever, the pic­ture is far more nu­anced than that.

HDL and LDL are only two of many lipopro­teins in­volved in choles­terol trans­port.

In de­creas­ing or­der of den­sity there are also:

• in­ter­me­di­ate Den­sity Lipopro­teins (ILD),

• very Low-Den­sity Lipopro­teins (VLDL)

• chy­lomi­crons.

• each lipopro­tein is de­signed to carry its choles­terol to a dif­fer­ent lo­ca­tion in the body to be used for a dif­fer­ent pur­pose.

And here is where the con­tro­ver­sies start.

Tra­di­tional meth­ods of mea­sur­ing blood choles­terol were not able to dif­fer­en­ti­ate be­tween the dif­fer­ent lipopro­teins that trans­port choles­terol. We now un­der­stand that this is of crit­i­cal im­por­tance.

• In the 1980s, we be­lieved that the only thing that mat­tered was your to­tal blood choles­terol level. This was a big mis­take.

• In the 1990s, we be­lieved that HDL-C (High Den­sity Lipopro­tein-Choles­terol) was good (pre­vented heart dis­ease) and LDL-C (Low Den­sity Lipopro­tein-

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