You know that too much cholesterol is dangerous. But what is it? Where does it come from? Is it all bad? And why are women at risk?
Cholesterol is a waxy substance that is found in every cell in the body. It’s either made by the body or absorbed from food. Your body needs cholesterol to make important steroid hormones such as estrogen, progesterone and vitamin D. It’s also used to make bile acids in the liver; these absorb fat during digestion.
Some cholesterol is necessary — but bad cholesterol (LDL) is something you should limit. Excess bad cholesterol in the bloodstream can deposit into the body’s arteries. These deposits are called plaque and result in the hardening of the arteries (atherosclerosis). This is the major cause of heart attacks, strokes and other vascular problems that Australians face.
1) Low-density lipoprotein (LDL) – the ‘bad’ cholesterol. Low-density lipoprotein makes up most cholesterol and is bad because it can stick to the walls of arteries and cause a fatty build-up of plaque. Too much plaque leads to blockages that prevent blood from flowing properly to the heart.
2) High-density lipoprotein (HDL) – the ‘good’ cholesterol. High-density lipoprotein is healthy because it carries LDL away from the arteries and back to the liver to be broken down and then passed as waste
3) Cholesterol and Triglycerides
In addition to cholesterol, you might hear about your triglycerides which is another kind of fat found in the bloodstream. Women should pay particular attention to this because women’s cholesterol levels can fluctuate quite a bit after menopause and tend to increase with age, putting us at greater risk of heart disease and stroke. A high level of triglycerides seems to predict an even greater risk for heart disease in women compared with men.
When you take in more calories than you need, your body converts the extra calories into triglycerides, which are then stored in fat cells. Triglycerides are used by the body for energy, but people with excess triglycerides have higher risk of medical problems, including cardiovascular disease. Drinking a lot of alcohol and eating foods containing simple carbohydrates (sugary and starchy foods), saturated fats and trans fats all contribute to high triglyceride levels. High levels may also be caused by health conditions such as diabetes, an underactive thyroid, obesity, polycystic ovary syndrome or kidney disease.
Your cholesterol can be checked by a standard lipid test (a referral for a blood test can be provided by your GP) and it measures the concentration of your total cholesterol, HDL cholesterol and triglycerides levels.
For those people who don’t have heart or vascular disease, the goal is to get total cholesterol below 200 milligrams per deciliter (mg/dL), non-HDL cholesterol (total minus HDL) to less than 170 mg/dL, and LDL cholesterol to less than 100 mg/dL.
However for people with other risk factors for heart attack or stroke, then lower levels would be optimal. The people at highest risk should aim for LDL levels below 50 mg/dL.
Problems resulting from to high cholesterol develop over time. It’s a cumulative exposure effect, similar in that way to a smoker’s “pack-years” (a measure of how much and how long the person has smoked). It is best to watch your cholesterol levels earlier on in life and maintain a lifestyle that promotes healthy cholesterol levels.
In general, women have higher levels of HDL cholesterol than men because the female sex hormone estrogen appears to boost this good cholesterol. However, this can change during menopause.
During menopause, many women experience a change in their cholesterol levels — total and LDL cholesterol rise and HDL cholesterol falls. This is why women who had the suggested cholesterol values during their childbearing years might end up with elevated cholesterol later in life. Naturally, lifestyle factors and genetics play a role in this.
Women should also know about other risk factors that are specific to women, such as
· premature menopause (occurring before age 40); and
· certain pregnancy-related conditions, including pre-eclampsia, pregnancy-related hypertension, gestational diabetes, and preterm delivery.
Diet and lifestyle changes are very important to help maintain healthy cholesterol levels. Even for women who are recommended to take cholesterol-lowering medications, a healthy lifestyle assists these drugs to work better.
Here’s how to maintain a lifestyle that promotes healthy cholesterol levels:
· Maintain a healthy body weight
· Don’t smoke.
· Exercise for at least 30 minutes five or more days per week.
· Eat a diet rich in fruits, vegetables, lean protein and high amounts of soluble fiber such as beans and oats, which can reduce LDL.
· Avoid sugar-sweetened drinks and fruit juices — opt for water and unsweetened tea instead — and minimize your intake of other simple carbohydrates like baked goods and candy.
· Drink alcohol in moderation, especially if you have elevated triglycerides.
· Use olive oil (instead of butter) and spices (instead of salt).
· Eat monounsaturated and polyunsaturated fats — such as those found in olive oil, nuts and fatty fish like salmon. They can actually have a positive effect on cholesterol, by reducing the amount of LDL in the blood and reducing inflammation in the arteries, especially when they replace saturated fats in the diet.
High cholesterol generally doesn’t have obvious symptoms, but it can increase the risk of serious health conditions if left untreated.
Women with high cholesterol should be proactive in their approach to this issue. Knowing the higher the level, and the older the individuals, the higher the risk.
That’s why it’s important to get a blood test and have regular check-ups with a GP. While nobody wants to have high cholesterol, there are plenty of ways to keep it in check if you are told you do have a higher level than suggested. If you are concerned about your cholesterol or are going through menopause, book an online consultation with one of our doctors and a referral for the appropriate blood tests can be arranged. And pay attention to what you eat each day as it is possible to manage your cholesterol and blood fats to keep your heart healthy.