Cholesterol is an important component of our cells and a basic building block of vital hormones. It also plays a crucial role in energy balance. Excessive cholesterol can damage blood vessels when it is deposited in the vessel wall. Arteriosclerosis develops. The vessels become inelastic, narrow and – in the worst case – impermeable. Cholesterol thus plays a major role in the development of arteriosclerotic diseases. The most important triggers for arteriosclerosis, in addition to elevated cholesterol levels, are high blood pressure, hereditary predisposition, poor diet, and also metabolic diseases such as type 2 diabetes and its precursor, insulin resistance. The dangerous thing: The larger the arteriosclerotic deposits in the vessels, the higher the risk of dangerous cardiovascular diseases. As with high blood pressure, those affected have no symptoms for a long time, so early diagnosis and thus the early start of therapy is often omitted.
Good and bad cholesterol
In the blood, cholesterol is bound to so-called lipoproteins. Here, physicians distinguish between two different lipoprotein fractions: LDL (low-density lipoprotein) and HDL (high-density lipoprotein).
LDL – “The Harmful Cholesterol.”
LDL (Low Density Lipoproteins) brings cholesterol to all the cells. Excess cholesterol can build up on the inner walls of blood vessels and lead to the dreaded hardening of the arteries. The risk of dangerous diseases such as high blood pressure, coronary heart disease, stroke or heart attack increases as cholesterol is deposited on the cell walls. Estimates suggest a one to two percent increase in the risk of coronary heart disease with a one percent increase in LDL cholesterol. The value should therefore not exceed 160 mg/dl without the presence of risk factors; if risk factors are present, the value should not exceed 130 mg/dl. Recommendation for lowering LDL cholesterol: drug therapy
The lower the LDL cholesterol – the better!
HDL – “The Useful Cholesterol.”
HDL (High Density Lipoproteins), on the other hand, brings cholesterol to the liver, where it is processed and broken down. Thus, it counteracts atherosclerosis and for this reason it is also called the “useful” cholesterol. The value should be above 40 mg/dl. The goal of successful therapy of elevated cholesterol levels should be both an increase in the HDL level and a decrease in the LDL level. Recommendations for increasing HDL cholesterol:
- Physical activity
- Abstinence from nicotine
- Hypocaloric diet / weight loss
The higher this blood value, the better.
Triglycerides (neutral fats).
Triglycerides are also called neutral fats. The fat molecules that we ingest with food consist, chemically speaking, of glycerol and three fatty acids each. The fatty acids are divided into monounsaturated, diunsaturated, polyunsaturated and saturated fatty acids. Saturated fatty acids are mainly found in animal fats and are rather unfavorable for the body. Vegetable fats and fish oils, on the other hand, contain the healthier unsaturated fatty acids. Triglycerides serve the body as energy stores. The triglyceride value should be below 200 mg/dl if possible. Recommendations for triglyceride lowering:
Therapy
In addition to drug therapy, in many cases those affected can do something themselves: Anyone suffering from a lipid metabolism disorder should in any case change their diet and increase their physical activity. The diet should consist of a high-fiber diet with a fat content of 30% (of which no more than 10% is saturated fat), less than 300 mg of cholesterol and a carbohydrate content of more than 50%. The consumption of plant sterols such as phytosterols, which are found in vegetable oils, seeds, nuts, vegetables and fruit, also has a positive effect on blood lipid levels. Weight loss, exercise, and abstinence from smoking and alcohol also have a positive effect on lipid metabolism, with small amounts of alcohol also leading to an increase in HDL cholesterol.In patients with genetic lipometabolic disorders, fat levels can rise to gigantic heights – LDL values of 500 to 1200 mg/dl are quite possible. These patients need special treatment.
