High cholesterol: causes and how to reduce it

The causes of high cholesterol can be of two types: genetic and environmental.

The genetic factor is not modifiable, however within environmental factors, diet together with medication, if the specialist considers it necessary, are essential to help reduce cholesterol levels. In this post we explain what factors can lead to high cholesterol levels and what you can do to reduce it.

What is cholesterol?

Cholesterol is a type of fat that our body produces naturally and that is also found in foods of animal origin. Cholesterol itself is not a negative substance, in fact it is part of various structures in our body, such as: 

  • hormones
  • Plasma membrane of our cells
  • bile salts 
  • Vitamin D

In short, cholesterol is a fat that we need! The problem arises when the levels rise above what is desired, since in that case the risk of cardiovascular diseases increases. The causes of high cholesterol may be lifestyle habits, but there may also be a genetic component. 

And it is that, in our DNA we find the instructions for our body to function correctly. For this reason, our genetics play a fundamental role in the predisposition we have to suffer from certain diseases, from hereditary cancer to hearing loss, passing, of course, cholesterol levels.

What types of cholesterol are there?

Before going into more detail about high cholesterol and its causes, it is important that you know what types of cholesterol there are. As you know, in general we talk about two classes: the “good” and the “bad”. But do you know what each one is and how they differ? Let’s try to clarify these concepts. 

First of all, you have to know that cholesterol is a fat-soluble substance, that is, it is not soluble in water, so to travel through the blood it needs to join proteins. This is something that also happens, for example, to fat-soluble vitamins.

When we say “good cholesterol” we are referring to HDL cholesterol, an acronym for High Density Lipoprotein , which means “high density lipoprotein”. It is a smaller and denser molecule, which is made up of more proteins than lipids, hence its name. 

HDL is responsible for collecting cholesterol from the arteries and taking it to the liver, where it is eliminated or reused. 

The “bad cholesterol” is the so-called LDL, an acronym for Low Density Lipoprotein, which means “low density lipoprotein”. Unlike HDL or “good”, LDL contains much more fat than protein in proportion. This molecule in itself is not bad, since its function is to transport lipids throughout the organism. The problem is that when it is found in values ​​above those considered “normal”, cholesterol can accumulate in the walls of the arteries and veins, favoring the appearance of atherosclerosis ( deposit of fatty substances inside the arteries). 

Triglycerides why are they important?

A concept that you will often hear linked to high cholesterol is that of triglycerides. These are a type of fat found in the blood. When you eat, the calories you don’t use are immediately converted into triglycerides, which are stored in fat cells. In this way, if in your usual diet you eat more calories than you burn, your triglyceride levels are probably high, especially if you eat many foods rich in carbohydrates. 

High levels of triglycerides are harmful because they contribute to the hardening of the arteries and, in addition, they can cause inflammation of the pancreas. In short, although they are molecules that provide energy to the body, in excess they do not help us at all. Sometimes having elevated levels is the consequence of other primary conditions, such as diabetes, hypothyroidism, and even obesity. 

What cholesterol levels are considered high? 

Do you know that if you take a cholesterol test in several laboratories, the same levels can be considered high in some and not in others? It’s not a lab error!

This occurs because the reference values ​​of each laboratory do not have to be exactly the same, that is, they can vary a little. In general, these are the HDL and LDL cholesterol levels and their implications for people without cardiovascular disease or diabetes.

What is atherosclerosis?

When we have high cholesterol we have a higher risk of developing atherosclerosis, but what is this?

Healthy veins and arteries are flexible and elastic. When cholesterol begins to deposit on its walls, a reaction begins that causes oxidation and inflammation and, as a consequence, damage to the vascular wall, in which the so-called “atheromatous plaque” forms. This plaque is made up of lipids, inflammatory and smooth muscle cells, and connective tissue. This cell accumulation generates a thickening of the vascular wall and loss of elasticity of the vessel, which narrows the arteries and reduces blood risk . Also, if the plaque dislodges there is a high risk of a clot developing that can block blood flow to the heart or other organs.

This pathological process is called atherosclerosis, and it develops gradually. Even if you have this pathology, you do not have to present symptoms until a complication occurs, that is, until a blood vessel narrows enough to stop blood flow. As you can see, it is certainly better to prevent. 

High cholesterol: what factors influence?

There are different factors that have been shown to be associated with high cholesterol levels:

  • Poor diet: if we regularly eat saturated fats or trans fats, it is likely that our cholesterol is high. The former are found in products of animal origin, and the latter in some cookies and industrial pastries. Regular intake of red meat or dairy products also increases cholesterol. It does not mean that we have to eliminate all these foods from our diet, but it does mean that we adjust our intake with healthy recommendations, taking into account whether or not we have other cardiovascular risk factors.
  • Overweight:  A body mass index (BMI) of 30 or more increases the risk of high cholesterol. Therefore, staying at a lower weight can help keep cholesterol at bay. Everything is adding up.
  • Sedentary lifestyle: exercise helps you increase HDL cholesterol levels (“good cholesterol”) at the same time allows you to reduce LDL cholesterol (“bad” cholesterol). Regular exercise is good for almost everything, and cholesterol is no exception.
  • Smoking: the harmful substances contained in tobacco cause damage to the walls of the blood vessels, which facilitates the deposition of fat and, therefore, favors the development of atherosclerosis. 
  • Age and sex: with age the level of cholesterol increases. In men, on average, it is usually higher up to age 50, compared to women of the same age. However, this difference ends with menopause, from which point cholesterol increases in women.
  • Diabetes: Patients with diabetes have elevated sugar levels above normal and also have increased LDL cholesterol and reduced HDL. Since blood sugar levels damage the wall of the arteries, both factors together add risk.

Genetics: the types of genetic inheritance are decisive when it comes to predisposing us to certain diseases or conditions. Well, genetics inherited from parents can also increase the risk of high cholesterol. Familial hypercholesterolemia, a condition that is among the main inherited genetic diseases. Generally, people with very high cholesterol have a parent who also has high levels. In general, we can discriminate between two types of hypercholesterolemia related to genetic factors:

  • Familial hypercholesterolemia: around 100,000 people in Spain are affected by this pathology caused by gene mutations, which lead to an increase in LDL and total cholesterol levels. About 70-90% of cases of familial hypercholesterolemia are due to mutations in the APOB, LDLR, and PCSK9 genes. Each of us has two copies of these genes, one inherited from our mother and one from our father. If we only have one copy affected, we speak of heterozygosis , and cholesterol levels are above normal, but if both copies are affected, cholesterol levels are even higher and we speak of homozygosis.
  • Polygenic hypercholesterolemia : It is the most common form and is due to the interaction of various genes and environmental factors. 

How can I lower my high cholesterol?

If your cholesterol is high, that is, its levels are above normal, the specialist will probably evaluate this and other factors and recommend a change in your lifestyle and, if necessary, will prescribe a drug treatment that reduces the cholesterol. total cholesterol and LDL. These types of drugs are called hypocholesterolemic agents. 

However, if pharmacological treatment is recommended, you should not think that with the medication it is no longer necessary to take further measures. To reduce cholesterol effectively, drug treatment must always be accompanied by lifestyle changes that reduce cardiovascular risk. 

If the specialist considers that an approach through lifestyle habits is the most appropriate, here it is really important that you follow the indications strictly. In this case, you can resort to nutritional supplements such as red yeast rice , a supplement used in traditional Chinese medicine that has natural active ingredients that act in a similar way to cholesterol-lowering drugs and can help you reduce your LDL and total cholesterol levels. .

Here are seven dietary guidelines to avoid high cholesterol: 

  1. Avoid saturated fats : they are so called because at a structural level they do not have double bonds in their chain. This characteristic provides them with negative properties compared to so-called unsaturated fats, which do contain one or more double bonds. Saturated fat is usually solid at room temperature and is usually found in foods of animal origin, but beware! the famous palm oil or coconut oil, so fashionable lately, are of vegetable origin and contain saturated fats.
  2. Say goodbye to trans fats: these are the worst fats for health: they are a type of artificially unsaturated fatty acid, present above all in industrial foods that have undergone a hydrogenation process.
  3. Incorporate the famous Omega-3 into your diet: its properties help reduce cholesterol and triglycerides. Omega-3 encompasses a group of long and very long chain polyunsaturated fatty acids. It is found mainly in shellfish and oily fish such as salmon, herring, sardines, and tuna, in vegetable oils such as soybean oil, and in walnuts and flaxseeds.
  4. Add fiber to your diet: fiber consumption is essential in the diet. There are two types: soluble fiber, which helps control sugar and cholesterol levels and is found mainly in legumes, fruit and vegetables; and the non-soluble, which helps regulate intestinal transit and cholesterol levels. 
  5. Get moving!: physical activity helps you stay at your ideal weight, control blood pressure and keep your LDL cholesterol (bad cholesterol) at bay. It is not necessary to dedicate ourselves to running marathons, walking at a good pace for 30 minutes a day is enough.
  6. Forget tobacco: smoking only has negative health consequences, and one of them has to do with increased cholesterol. Nicotine increases LDL (bad cholesterol) levels and lowers HDL (good cholesterol) levels. It’s challenging for regular smokers, but it’s well worth the effort, on so many levels. Blood pressure and heart rate normalize within hours of quitting, and after a year of quitting the risk of heart disease is half that of a person who smokes.
  7. Start weighing yourself : Control your weight. Having extra kilos, even if they are not many, is one more factor that increases cholesterol. Simply cutting out soft drinks, swapping the potato side for salad, reducing the amount of sugar and trying to avoid bread can shave a few calories from your diet, just enough to lose some weight.

High cholesterol and personalized preventive medicine

Hypercholesterolemia is relatively common in the population, for this reason it is common to lose sight of the importance of this cardiovascular risk factor in our health. Cholesterol control through diet is essential even when there is a drug treatment, each small action in favor of your cardiovascular health adds up. Adopting some of the advice that we propose may not be excessively complicated and may be key to your health. 

We hope that after reading this article you are clearer about what cholesterol is, what are the causes of high cholesterol, and what you can do to reduce it. As you have seen, diet and lifestyle are environmental factors that influence cholesterol. Being under our control, they become powerful tools in our hands when it comes to taking care of our health and controlling high cholesterol, which can be the source of many health problems. 

If you have high cholesterol, it is also an option to find out if there is any genetic variant related to the increase in your cholesterol levels, since it is information that both siblings and children could also benefit from. Around 80% of cholesterol levels are determined by the genetics, age and physiological state of the individual, but through diet it is possible to control the remaining 20%.

Today medicine is increasingly preventive and personalized, knowing our genetic information allows us to take measures to prevent diseases and take care of our health. 

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