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Cholesterol. The Good, the Bad, and why we Can’t Live Without it

cholesterol

Our bodies need cholesterol. It is present in every cell in our body and we cannot survive without it. So why does it have such a bad reputation?

What is Cholesterol?

Cholesterol is a waxy fat-like substance created by the liver and intestines. It is an integral part of cell membranes, vitally important for brain health and essential for the healthy functioning of the nerves and skin. 

In women cholesterol assists in the production of oestrogen and progesterone, and in men it is associated with higher testosterone levels. Cholesterol aids in bile synthesis in the liver, and when your skin is exposed to sunlight the UVB interacts with a form of cholesterol to create vitamin D3. 

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Cholesterol belongs to a type of blood fats known as lipids. Our liver and intestines make most of the cholesterol our bodies require, with animal products such as meat and dairy making up around 20%. 

To enable cholesterol and other lipids to move around our body they are transported through the bloodstream attached to proteins, forming complex particles known as lipoproteins. So when people think of types of cholesterol they are really thinking of lipoproteins, of which there are two main types:  

Bad Cholesterol

LDL cholesterol – low density lipoprotein – is known as the ‘bad’ cholesterol, because it contributes to the build-up of fatty deposits called plaques in the arteries (atherosclerosis). This narrows the arteries, reducing blood flow and increasing the risk of a heart attack or stroke.

Good Cholesterol

According to the American Heart Association, HDL cholesterol – high density lipoprotein – is considered the ‘good’ cholesterol because “a healthy level may protect against heart attack and stroke.” It does this by absorbing the bad cholesterol from your bloodstream and carrying it back to the liver, where it is broken down and flushed from the body. While HDL cholesterol cannot completely remove LDL cholesterol, it does help to reduce atherosclerosis. 

Triglycerides

Triglycerides are the third type of cholesterol we need to be aware of, and the most common type of fat in the body. Triglycerides store excess energy in our body’s fat cells and raised levels are linked with being overweight and a diet high in sugary and fatty foods. A combination of high triglyceride levels or high LDL (bad) cholesterol and low HDL (good) cholesterol will contribute to increased cardiovascular risk.

Unfortunately, there are no obvious signs or symptoms of high levels of good or bad cholesterol. The only way to detect cholesterol levels is with a blood test or a finger prick test. Typically, your doctor will run a complete cholesterol test, also called a lipid profile or panel. This test will measure the total amount of cholesterol in your blood, the levels of HDL and LDL, and the triglycerides. 

Your doctor or nurse will assess your results and tell you what your levels you should be, based on factors including your family history, blood pressure, height and weight, and your age, sex and ethnicity. While high cholesterol is a known risk factor for heart attacks and coronary heart disease, it can be effectively managed with medication. 

Lifestyle and Diet Impact on Cholesterol

Lifestyle and diet can also have an extremely positive impact on HDL and LDL cholesterol. High levels of bad cholesterol can run in families, so it is important to find out if you have a family history of high cholesterol. 

Lifestyle factors – a diet high in foods associated with raised cholesterol levels such as processed meats, saturated fats, baked goods; inadequate exercise; smoking and excessive alcohol use; and being overweight all contribute to increased risk for heart attacks or coronary heart disease. It is however possible to reduce ‘bad’ LDL cholesterol naturally with regular exercise and a diet rich in fruits, vegetables, whole grains, plant proteins, fatty fish and vegetable oils.

Sources

American Heart Association, https://www.heart.org/

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