As the saying goes that excess of everything is bad, it also holds true in the case of cholesterol in our body. An increased level of cholesterol invites various health-related disorders. Our liver produces a good amount of fatty substance called cholesterol that is sufficient to meet the functional requirements of the body. Foods having high- trans fat content stimulates the liver to produce more cholesterol. This article throws some light on the health issues related to cholesterol, and how to lower cholesterol.

Cholesterol and its Types

Cholesterol produced by the liver is an essential component as it provides flexibility to the body cells and forms an essential component of hormones. There are two types of lipoproteins that act as a carrier of cholesterol in the body (1):

1. Low-Density Lipid Cholesterol

LDL is generally considered as bad cholesterol because it contributes to fat accumulation in the arteries. LDL is a major cause of cardiovascular issues like heart stroke and peripheral artery disease as a result of atherosclerosis.

2. High-Density Lipid Cholesterol

HDL is the good cholesterol as it scavenged the LDL from the arteries, thereby preventing fat accumulation. HDLs are believed to return LDL to the liver for further breakdown and elimination.

High Cholesterol and Health issues

Health issues are related to the increased levels of low-density lipid (LDL) in the body. It can affect the functioning of various organ systems of the body. Some of the commonly observed conditions due to high cholesterol levels is as follows:

1. Cardiac Issues due to High Cholesterol

The deposition of fat in the arteries makes them stiff with time and this condition is known as atherosclerosis. When the arteries become rigid, the blood flow is obstructed and the heart has to compensate for it by pumping hard. This puts extra pressure on the pumping organ.

With the passage of time, the fatty accumulation turns into permanent plaque. The plaque settled in the walls of the coronary arteries disrupts the oxygen flow to the heart muscles. It results in chest pain called angina. Although angina is not a heart attack, it is an indication that your risk of cardiac stroke is high.

Plaque can pose another threat if a piece of it breaks off from the arterial wall and forms a clot. The clot will narrow down the artery, and further drop-in the blood flow to the heart will lead to a heart attack. If the plaque blocks the vessels supplying blood to the intestinal tract and the hind limbs, the condition is known as Peripheral Arterial Disease(2).

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2. Cholesterol Associated with Diabetes

People suffering from diabetes often observe a disbalance in the levels of their High-density lipid cholesterol and low-density lipid cholesterol. Diabetes patients are more susceptible to plaque formation in their arterial walls as compared to a normal person.

The low-density lipid particles in the blood of a diabetes patient exhibit an increased tendency to attach to the arterial walls. This is attributed to the fact that diabetes patients have high glucose content in their blood that easily attaches to the cholesterol or lipid particles.

A sugar-coated cholesterol particle has more life duration in the bloodstream and also has high chances to form a plaque. It increases the risk of a heart attack and arterial damage in diabetic patients (3).

3. Cholesterol Associated with the Digestive System

Cholesterol is important for the proper functioning of the digestive system. Bile is a vital enzyme that breaks down and emulsifies the fat from the food. Cholesterol is a component of the bile that helps to absorb the nutrients from the intestine and assimilate them into the bloodstream.

When the level of low-density lipid cholesterol increases significantly in the bile, it starts converting the excess amount into crystals. These crystals take the form of hard stone on the accumulation and get stored in the gallbladder.

When a large number of stones are deposited in the gallbladder, it causes inflammation, pain, and swelling. Gallbladder stones are treated by removing them surgically (4).

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4. Cholesterol Associated with the Nervous System

Our Brain consumes around 25% of the body’s total supply of cholesterol. The fat content of cholesterol is important for the nourishment of brain cells and to facilitate their coordination with the rest of the body parts. But if the cholesterol level rises, it adversely affects the brain.

High cholesterol level is associated with brain strokes, as they cause damage to some parts of the brain. The damage to the brain cells leads to loss of memory, hampered movement, difficulty while swallowing food, slurred speech, etc.

An increased amount of cholesterol in the blood catalyzes the generation of beta-amyloid plaques. These plaques are sticky protein depositions that cause Alzheimer’s disease (5).

5. Cholesterol Associated with Blood Pressure

People with high cholesterol levels in their blood are likely to face the problem of hypertension. It is due to the fact that the artery becomes hard with the continuous accumulation of plaque and calcium. To cope up with the reduced blood supply from narrow arteries, the heart faces a strained condition as it beats at a faster rate. All these factors contribute to a spike in blood pressure (6).

Treatment options for High Cholesterol

While the change in lifestyles and dietary habits remains the first line of defense for high cholesterol patients, medication is also available to treat the condition. Some of the common medicines are as follows:

1. Statins: Statins like atorvastatin, simvastatin, lovastatin, pitavastatin, rosuvastatin, and simvastatin inhibit the limit from making extra cholesterol (7).
2. Cholesterol absorption inhibitors: A drug named ezetimibe used to cease the absorption of cholesterol from the small intestine into the bloodstream. It is also used in combination with statins (8).
3. Bile acid-binding resins: Bile formation takes place with the use of cholesterol. Drugs like cholestyramine, colestipol, and colesevelam bind the bile with cholesterol. It reduces the cholesterol level in the body as now the liver is compelled to use excess cholesterol for some acid production (9).
4. Injectable drugs: The new class of drugs known as a PCSK9 inhibitor helps the liver to absorb low-density lipid cholesterol from the blood. It leads to a drop in the level of circulating cholesterol and thus prevents atherosclerosis.

How to Lower Cholesterol?

As already mentioned, an alteration in the static lifestyle and eating habits is the best way to keep your cholesterol level in check. Let us discuss the things in detail that can be some to prevent health issues related to high cholesterol levels.

1. Lifestyle Changes

A sedentary lifestyle can lead your body to house various diseases. It is always good to get moving while you can.

2. Exercise

Exercise is the best way to attain physical wellness and a fit body. Generally, obese patients have a high level of cholesterol. A regular habit of exercising will also help to keep an eye on obesity.

Studies have shown that a combination of resistance and aerobic exercises if done for twelve weeks, significantly reduces the level of harmful low-density lipid cholesterol (10).

The aerobic workout should include walking and jumping jacks, while the resistant exercise should focus on low-intensity Korean dance and band training. Slow running or jogging also helps the condition by increasing the levels of high-density lipids. The duration and intensity if the exercises should be increased gradually to yield maximum benefits.

3. Quit Smoking

Smoking is always bad for health but it increases the risk of cardiac disorders in patients with high levels of cholesterol. Smoking adversely affects the immune cells of the body. The tobacco tar from smoking damages the immune cells, as a result of which they are not able to fetch extra cholesterol from blood vessels for metabolism in the liver.

It leads to the development of atherosclerosis at a very faster rate than in non-smokers. The dysfunctional cells of the immunity system clog the arteries and contribute to heart stroke. Passive smokers are also at a high risk as they too increase the bad cholesterol levels (11).

4. Release Stress

Many people are unaware of the fact that stressful conditions can cause their cholesterol levels to skyrocket. Several research results show that chronic stress acts as a major contributing factor to the high level of cholesterol in the body (12).

It is advisable to keep yourself free from stress and anxiety to keep your cholesterol level in check. The best way to overcome stress in daily life is to inculcate reading habits, start practicing yoga, start meditation, or socialize with your friends and family.

Laughter is the best medicine to keep feelings of depression and sadness at bay. It increases the HDL, so grab a comic book, or watch comedy shows, or you can become a member of the laughing club in your area.

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5. Lose Weight

A high level of low-density lipid is present in people who are overweight. It is a severe problem in people suffering from metabolic syndrome. Metabolic syndrome is a combination of risk factors including low high-density lipid levels, as well as high LDL levels.

The only way to combat the situation is to lose excess weight. A proper dieting regime under the supervision of a dietician is the best way to speed up the cholesterol metabolism in the body. A two-year weight-loss study was carried out in 90 adults to find out its effect on cholesterol levels.

A random weight loss plan was suggested to the volunteers. The outcomes revealed that weight loss helped to enhance the absorption of cholesterol from the blood, and also ceased the production of excess cholesterol in the body. In some people, weight loss has provided dual benefits. Weight management not only decreased LDL cholesterol but also significantly increased HDL cholesterol. This, in turn, lowers the chances of onset of heart disease and high blood pressure (13).

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6. Moderate Alcohol Consumption

People having a high cholesterol level must consume a moderate amount. A drink of one or two glasses in a week can actually lead to an elevation in the high-density lipid cholesterol. But it is advisable to refrain from alcohol if you are a non-drinker. For people who drink, it is important to be cautious, as a high amount of alcohol can speed up the onset of cardiac disorders and hypertension (14).

7. Dietary Changes

Diet plays an important role in the regulation of cholesterol levels in the body. Here are some dietary suggestions to keep your cholesterol level under control. You can practice a low cholesterol diet to keep the bad cholesterol in check.

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A. Increase Fiber Intake

Soluble fiber is a great addition to your eating habits. They increase the flora of probiotic bacterias in the intestine to prevent the formation of harmful low-density lipid cholesterol. If you are on statins, high fiber foods will help the working of the medicine. Foods like oats, lentils, psyllium, Brussel sprouts, kidney beans, apples, and pears are a good source of soluble fibers (15).

B. Cut down on Trans Fats

Trans fats are partially hydrogenated vegetable oils, generally present in processed and packaged foods. Trans fat is harmful to health as it increases LDL cholesterol while substantially decreasing the HDL (16). A globally conducted study on health patterns revealed that around 8% of death from heart disorders are a result of trans fat in the diet.

C. Include Fish in the Diet

Fishes are a rich source of polyunsaturated fats and omega 3 fatty acids. They reduce the risk of metabolic syndrome and diabetes, which eventually leads to dropping in coronary risk. The consumption of fish twice or thrice a week lowers the cholesterol level. Some common fishes that can be included in the diet are salmon, sardines, and tuna (16).

D. Switch to Monounsaturated Fats

Monounsaturated fats are healthy as compared to saturated fats. A diet plan containing monounsaturated fat has shown significant results to improve the level of HDL in the body. It reduces the oxidation of lipoproteins, thereby preventing the risk of artery-clogging. Some good sources of monounsaturated fats are olive oil, canola oil, avocados, etc (17).

E. Munch on Nuts

Nuts and seeds are rich in sterols, and have the same effect as fibrous food. They keep a check on cholesterol absorption in the body. You can munch on some almonds, walnuts, pecans, hazelnuts, etc (18).

F. Start using Spices

Spices like ginger, garlic, turmeric, black pepper, cinnamon, coriander, etc have numerous health benefits besides adding flavor and taste to the food. They help to improve the cholesterol level in the body and thus should be an integral part of your diet (19).

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