What you need to know about cholesterol? How dangerous it is, when to get tested and how to eat properly

Cholesterol is a substance that our body absolutely needs. However, elevated cholesterol levels can be one of the causes of many diseases, so each of us has heard that we should control the level of this substance in the body. In this material we will tell you what you need to know about cholesterol, what it is like, when you need to get tested and how to properly plan your diet.

Cholesterol is a substance present in all cells of the body and involved in important metabolic processes. For example, cholesterol is a building material for cells and is necessary for the production of hormones (thanks to it, the synthesis of sex hormones occurs - estrogen, progesterone, testosterone, the hormone of the adrenal cortex - cortisol). To produce vitamin D, which is important for immunity and bone HEALTH, the body also needs cholesterol. Cholesterol produces acids that help digest food and break down fats. In addition, cholesterol is involved in lipid metabolism and is important for the synthesis of certain vitamins and minerals.

Our body (namely the liver) can produce cholesterol itself, but we consume a significant part of it through food. Animal products are especially rich in cholesterol.

Cholesterol is transported throughout the body thanks to particles in the blood called lipoproteins. There are two types of them.

The first is high-density lipoprotein (HDL). They are also called “good” cholesterol. HDL helps remove “bad” cholesterol from the bloodstream. It returns to the liver, where it is broken down and excreted from the body. You can increase the level of “good” cholesterol by enriching your diet with nuts, fatty fish, OLIVE OIL, legumes and plenty of vegetables. Maintaining healthy cholesterol levels is important to reduce your risk of developing cardiovascular disease.

The second type is low-density lipoprotein (LDL). They are called "bad" cholesterol because when transported, it can build up on artery walls, creating plaque, which increases the risk of heart attack and stroke. Bad cholesterol in the body increases with poor nutrition and ALCOHOL abuse. There is also a risk of increased bad cholesterol with some chronic diseases.

When blood cholesterol levels rise above normal levels, the risk of certain diseases increases. First of all, the cardiovascular system of the body is at risk. Below are several diseases that can be caused by high cholesterol levels.

Atherosclerosis. High levels of “bad” cholesterol (LDL) can lead to the accumulation of fatty deposits on artery walls. Because of this, they narrow, their walls become harder and the movement of blood flow through them is limited. The organs to which the artery delivered blood now do not receive enough oxygen and nutrients, and are therefore at risk.

Cardiac ischemia . This disease develops when the blood supply to the heart muscle is disrupted due to damage to the coronary artery. Reduced blood flow to the heart can cause angina, heart attack, myocardial infarction, or even cardiac arrest. The artery can be damaged, among other things, due to high levels of “bad” cholesterol, which collects on the walls and clogs it.

Stroke . High levels of cholesterol and plaque in the arteries can impair blood flow to the brain, which can cause a stroke . The tissues of our brain must constantly receive nutrition and oxygen; when the blood flow stops even for a few seconds, severe damage to the organ can develop.

Peripheral arterial diseases. They develop due to impaired blood supply to the extremities as a result of the formation of atherosclerotic plaques on the walls of the arteries. Tissues cease to receive sufficient nutrition and oxygen. Fatigue appears in the legs, a feeling of pain and numbness when walking and running, cramps, dry skin appears, it becomes paler, sometimes even cyanotic. The symptoms of this disease cannot be ignored because in extremely severe cases it can lead to the formation of ulcers and even gangrene.

However, high cholesterol often has no noticeable symptoms, and most people only become aware of the problem after having a blood test. But in some cases, signs may appear that directly indicate high cholesterol levels. For example, it is worth paying attention to xanthomas - these are fatty growths up to 5 centimeters in size that can form throughout the body in the tendon area. Along with them, xanthelasmas may appear, which look like fatty plaques and appear on the face in the eyelid area.

To reduce the risk of these diseases, it is important to maintain a healthy lifestyle, eat a balanced diet, do regular exercise, maintain a healthy weight, and give up bad habits.

To find out the level of cholesterol in the body, you need to do a lipidogram, or lipid profile analysis. This is a test that allows you to determine the level of fats in the blood, which will help identify lipid metabolism disorders. The analysis includes indicators such as total cholesterol, LDL cholesterol, HDL cholesterol, cholesterol not associated with high-density lipoproteins, triglycerides, etc.

For analysis, blood is taken from a vein. Before taking it, preparation is required. It is necessary to donate blood on an empty stomach; it is necessary to exclude any physical activity before blood collection, as well as stress. You should not eat food for 12 hours before the test; you can only drink still water. Smoking is prohibited before the study.

It is recommended that adults over 20 years of age without health problems have their cholesterol levels checked at least once every 5 years. However, it is recommended to get tested more often if there are risk factors - heart disease, poor diet and low physical activity, or a hereditary predisposition to high cholesterol. People with heart disease and other chronic illnesses may need to monitor their cholesterol levels more frequently.

A lipidogram is done not only to determine blood fat levels, but also so that the DOCTOR can assess the possible risks of developing cardiovascular diseases, to monitor lipid-lowering therapy, monitor patients with diagnosed vascular and heart diseases, as well as other diseases, which can be affected by cholesterol.

For adults, total cholesterol should not exceed 5.2 mmol/l. However, this value is an average, and in each individual case the indicator may be different. Interpretation of tests and determination of values ​​is carried out exclusively by the attending physician based on individual risk factors, medical history and general health.

Cholesterol plaques are formations on the walls of a vessel, which consist of cholesterol, calcium and fibrous tissue. They are considered the main symptom of atherosclerosis - a disease in which, due to the accumulation of plaques, the arteries narrow and the delivery of nutrition and oxygen to tissues and organs through them is reduced or stopped.

Over time, cholesterol plaques can increase in size, thickening the vessel wall and narrowing the lumen of the artery. This restricts blood flow and can lead to ischemia of the tissues and organs that are supplied with blood through these arteries. If the plaque ruptures, it can cause a large blood clot to form, which will further block blood flow. This can lead to a heart attack or stroke.

Cholesterol plaques increase unevenly; growth may stop and then resume again. Narrowing of the artery begins when the plaque occupies more than 40% of its lumen. Most often, plaques form in the arteries of the heart, brain, lower extremities and intestines.

Preventing the growth of cholesterol plaques includes a diet low in saturated fats and increased consumption of foods that are rich in nutrients. It is also worth increasing the level of physical activity and giving up bad habits - smoking and drinking alcohol. Severe cases may require medications or surgery.

The normal cholesterol level in lipid profile studies in men and women may differ slightly. However, hormonal levels influence health and cholesterol levels the most.

In women, estrogens tend to lower total cholesterol and increase good cholesterol, which may provide additional protection against cardiovascular disease up to a certain age. Androgens, in turn, increase total cholesterol levels. Therefore, at a young age, women have a lower risk of cardiovascular disease than men.

After menopause, when estrogen levels decrease and the amount of “good” cholesterol decreases, the level of “bad” cholesterol increases. This increases the risk of developing cardiovascular diseases. Therefore, women after 45 years of age need to undergo examinations more often. For men, regular examinations can begin earlier, especially if they are at risk - they have a hereditary predisposition, lead an unhealthy and sedentary lifestyle, or have bad habits .

By the way, cholesterol levels also increase during pregnancy. After birth, the indicators should return to normal.

It is important to note that regardless of gender, controlling cholesterol levels is a key factor in preventing cardiovascular disease, so both women and men should strive to live a healthy lifestyle and regularly check their cholesterol levels.

Expert commentary. Irina Kurstak, laboratory diagnostics doctor, candidate of medical sciences, associate professor, answers questions

- Men in Belarus die more often from heart disease. Is it possible to determine predisposition to such diseases in a laboratory way?

- This is true. If we talk about predisposition, let's start with the simplest. Heart disease is primarily a disorder of lipid metabolism.

The following indicators are responsible for lipid metabolism in a conventional biochemical analysis, which is available to every person at the laboratory level of a public clinic: cholesterol, high-density lipoproteins, low-density lipoproteins and triglycerides. Of the listed indicators, cholesterol and low-density lipoproteins are important for us. Because low-density lipoproteins are responsible for transporting cholesterol from the liver to the blood vessels. If there are a lot of them, then atherosclerotic plaques will form on the periphery, in the vessels, including the vessels of the heart.

Therefore, the main task is to monitor cholesterol and low-density lipoprotein levels.

When I started teaching in 2008, I said that the upper limit of normal cholesterol is the same for everyone: it should not be higher than 5.2 millimoles per liter. Low-density lipoproteins - the upper limit of normal is the same for everyone, they should not be more than 2.59 millimoles per liter.

Now there is a special scale for calculating the risk of developing complications from cardiovascular diseases, heart attack, stroke, which is called SCORE. The risk of developing a heart attack or stroke in a person is calculated depending on gender, systolic blood pressure, cholesterol and low-density lipoprotein levels. And based on these recommendations, we give completely different upper limits of normal levels for cholesterol and low-density lipoproteins. That is, the higher a person’s risk on this scale, the lower the recommended normal limits for lipid spectrum indicators are than the statistical average in the population for people without the risk of developing cardiovascular diseases.

- Is cholesterol a bad diet or not?

- It happens that the diet is incorrect. There is a hereditary disorder of lipid metabolism. These are the two main reasons that lead to lipid imbalance in a particular person.

After 50 years of age, the risk of developing diseases associated with high cholesterol increases. Primarily atherosclerosis, because with age the arteries become more vulnerable to the accumulation of cholesterol plaques.

Therefore, you need to pay more attention to your health. First of all, you need to get tested more often for your cholesterol levels, especially if you are at risk. After age 50, changes in the body can increase levels of “bad” cholesterol and decrease levels of “good” cholesterol.

Also, high cholesterol levels are dangerous for the cardiovascular system. There is a risk of developing coronary heart disease, heart attack and stroke.

After 50 years, you definitely need to monitor your diet and limit your consumption of foods high in saturated fats (dairy products, fatty meats , coconut oil ) and trans fats (cakes, MILK chocolate, fast food, mayonnaise ). In your diet, it is better to give preference to foods high in plant fiber; diversify your menu with fish, fruits and vegetables. Eating a healthy diet also helps you manage your weight, which reduces your risk of high cholesterol and heart disease.

As people age, their mobility decreases, which contributes to the accumulation of cholesterol plaques. Do not forget to regularly engage in physical activity that you are passionate about - this could be walking, Nordic walking , running , yoga, dancing. Sport helps increase the level of “good” cholesterol and improves overall health.

Reduce your stress levels as they can affect your cholesterol levels. Also, give up bad habits - as smoking reduces the level of “good” cholesterol.

It is also worth understanding your overall health and monitoring diseases that can affect your cholesterol levels (diabetes, high blood pressure). Even if you do not have obvious symptoms of high cholesterol, it is important to pay attention to any signs of cardiovascular disease and do not put off going to the doctor.

With high cholesterol, the entire diet should be aimed at reducing the consumption of animal fats, trans fats and simple carbohydrates, which can increase the level of “bad” cholesterol, and increasing the consumption of foods that can increase the level of “good” cholesterol.

It is necessary to give preference to products containing protein, fiber, polyunsaturated fats and complex carbohydrates.

If you have high cholesterol, it is not recommended to consume the following foods:

all animal fats,

goose and duck MEAT,

butter and ghee,

margarine,

offal (brains, liver, tongue),

sausages and frankfurters,

some dairy products (fat milk and sour cream, cream, cheese, cottage cheese with a high percentage of fat content),

ice cream ,

preserves, jams, cakes,

rich pastries,

White bread,

milk chocolate,

fast food,

carbonated sweet drinks,

alcohol .

The following products may occasionally be added to the diet:

lean meat 2-3 times a week,

fatty fish up to 2 times a week,

hard cheeses up to 2 times a week,

pasta from durum wheat no more than 2 times a week,

marshmallows or marshmallows once every two weeks.

Products that are allowed for consumption:

lean meat ( chicken , turkey, rabbit , veal),

lean fish,

vegetables (pumpkin, cabbage, zucchini, eggplant, carrots , beets , legumes, cucumbers, tomatoes , onions),

greens (spinach, arugula, parsley, basil, dill, salad mixes),

fruits and berries ,

buckwheat, quinoa, millet, oatmeal (in water),

low-fat cottage cheese,

rye, bran bread,

nuts,

seeds,

green and herbal tea,

fresh juices,

vegetable oils.

It is important to remember that changes in your diet should be made gradually and in accordance with your doctor's recommendations, taking into account your individual health characteristics.