If you are reading this blog, then you probably care about your health and are concerned that your cholesterol is high. Know that this is already the first step toward a healthier life. Next, we will thoroughly explore the topic for you—why cholesterol is necessary in the blood and when high cholesterol becomes your enemy. Additionally, you will get effective recommendations for lowering high cholesterol.
What is cholesterol?
Cholesterol is commonly referred to as blood fat. In reality, it is a soft, waxy substance, 70% of which is produced by the liver, and 30% is obtained from food. In its essence, cholesterol is not bad. The human body needs cholesterol for building cells and for the production of sex hormones and vitamin D.
The problem arises when cholesterol levels in the blood remain persistently high, which is one of the most significant risk factors for cardiovascular diseases and is particularly dangerous because a person does not feel any symptoms.
What are the symptoms of high cholesterol?
Elevated cholesterol levels in the blood do not cause any direct symptoms but quietly and insidiously damage the cardiovascular system and are a risk factor for serious diseases such as heart attack and stroke.
Persistently high cholesterol over a longer period manifests itself as chest pain, particularly during physical exertion. Chest pain occurs because narrowed blood vessels can no longer transport sufficient oxygen to the heart. This results in ischemia, or oxygen deficiency, which develops into coronary artery disease.
Total cholesterol
Total cholesterol levels should remain below 5 nmol/L at all ages. Several different blood lipids contribute to total cholesterol, not all of which are dangerous for the heart and circulatory system. Therefore, it is not possible to assess the risk of arterial plaque formation based solely on total cholesterol levels.
In addition to total cholesterol, it is necessary to measure HDL and LDL cholesterol, i.e., good and bad cholesterol, as well as triglycerides in the blood. Total cholesterol norms:
- Normal: below 5
- Borderline: 5 to 6.5
- Elevated: 6.5 to 7.8
- Very high: above 7.8
Good (HDL) cholesterol
Good (HDL) cholesterol binds excess cholesterol in the blood and transports it to the liver, where it is processed or removed from the body. Thus, a sufficient amount of good cholesterol in the blood helps reduce the level of bad (LDL) cholesterol.
Good cholesterol levels in the blood should be above 1 nmol/L. The higher the good cholesterol level, the lower the risk of coronary artery disease.
Bad (LDL) cholesterol
Persistently high levels of bad (LDL) cholesterol are highly dense and tend to stick to the walls of blood vessels, making it a primary risk factor for arterial plaque formation. LDL cholesterol leads to plaque buildup in the arteries, narrowing them and reducing blood flow. If a plaque ruptures, a clot forms, blocking the artery and stopping blood flow.
It is important to know that arterial plaque formation occurs over decades and does not present symptoms until serious complications like heart attack and stroke arise.
In most cases, high LDL cholesterol in the blood is only discovered when symptoms indicating cardiovascular disease appear, such as chest pain or increased cold sensitivity in the extremities. Therefore, everyone should be aware of their blood LDL cholesterol levels.
LDL cholesterol in the blood should remain below 3 nmol/L for a healthy person. For individuals with accompanying conditions such as diabetes or high blood pressure, LDL cholesterol norms are stricter, with target values required to remain below 1.4 nmol/L.
Triglycerides
High triglyceride levels increase damage to blood vessels and, in combination with elevated LDL cholesterol, accelerate the risk of developing cardiovascular diseases. Triglyceride levels should remain below 1.7 nmol/L.
What are the risk factors for high cholesterol?
- Heredity
- Overweight
- Unhealthy diet
- Insufficient physical activity
- High blood pressure
- Diabetes
- Smoking
- Age: Women 55+ and men 45+
- Stress
How Often Should Cholesterol Levels Be Checked?
To prevent cardiovascular diseases, cholesterol levels should be checked every 5 years. The first cholesterol test should be done at age 30, or even earlier—starting at age 20, especially if there is a known family history of heart disease.
For those in risk groups, such as individuals with diabetes or high blood pressure, cholesterol should be checked annually along with other blood tests. Likewise, men over 40 and women over 50 should have their cholesterol levels checked once a year.
Blood test results provide a foundation for adjusting your diet and making necessary lifestyle changes.
Who Is at Risk for High Cholesterol?
If you have high cholesterol, know that it is not just a disease of older or overweight individuals. It often affects younger, normal-weight, and seemingly healthy people as well.
Cholesterol levels tend to rise in women after menopause. Cholesterol increases after menopause due to a drop in estrogen levels. This significantly raises the risk of developing heart disease.
What to Do If You Have High Cholesterol?
If cholesterol levels are not excessively high, they can be lowered to some extent through proper nutrition. Studies show that a consistent diet can reduce cholesterol by 5–15%, but no more. If cholesterol levels are significantly elevated, diet alone is not sufficient to normalize cholesterol levels.
The first recommendation for high cholesterol levels is to review lifestyle habits and dietary choices. If you have high cholesterol, cardiologists recommend the following for lowering it:
- More fish, less meat
- More plant-based, fewer animal-based fats
- More fresh fruits, fewer sweets
- The more colorful, the better
- More green tea, less coffee
- Use plant-based oils like olive or sunflower oil
- Whole grains instead of refined wheat products
- More herbs and spices instead of salt
- Reduce consumption of sugary drinks
- Adopt a Mediterranean diet
- Increase physical activity
The Mediterranean Diet Helps Lower Cholesterol
Did you know that people living in Mediterranean countries live about 10 years healthier compared to Estonians? The secret lies in their diet, which is rich in antioxidants from olives and olive oil, fish and other seafood, nuts, and fresh fruits and vegetables.
The Mediterranean diet emphasizes plant-based foods, with abundant fruits, vegetables, nuts, and seeds. For over 50 years, the Mediterranean diet has been considered one of the healthiest eating patterns.
To get an adequate daily dose of antioxidants, consume at least 200g of fruits and 200g of vegetables daily. Unfortunately, most people do not meet this requirement daily, let alone consume seafood or olives regularly. This is one of the main reasons why cardiovascular diseases claim lives too early in Estonia. Each year, approximately 2,000 people in Estonia die from cardiovascular diseases before the age of 65.
The Mediterranean Diet:
- Reduces bad (LDL) cholesterol levels
- Increases good (HDL) cholesterol levels
- Helps with weight loss
- Reduces the risk of stroke and heart disease
- Provides essential antioxidants
Medications Should Be the Last Resort
Cholesterol-lowering medications are not prescribed lightly, as they are a lifelong treatment. Additionally, prescription medications come with side effects. According to dyslipidemia treatment guidelines, statin therapy should not be the first choice but should be considered only in cases of high cardiovascular risk.
Before turning to prescription drugs, it is worth considering milder alternatives, such as red yeast rice supplements with antioxidants, which are available in pharmacies.
Keep your cholesterol levels in check, as your heart health depends on it!
