Dr. Jekyll and Mr. Hyde for our metabolism is characterized by cholesterol, because on the one hand it is an irreplaceable structural component of cell membranes, but on the other hand, when its concentration is increased, it accelerates atherosclerosis and the risk of heart attack.
Cholesterol, or more correctly, cholesterol, is quite high in a large percentage of Greeks, which poses a threat to their cardiovascular health.
Approximately half of all adults in our country are estimated to have high cholesterol., according to data from the Hellenic Cardiology Foundation based on a sample of 50,000 residents.
Most importantly, however, the 50% ignores this, which makes the risk to his heart even greater.
The reason is that high cholesterol, specifically «bad» LDL, increases the risk of atherosclerosis, and consequently the risk of heart attack and stroke.
Let's start from the beginning...
Bad cholesterol
What is cholesterol, which has been part of our everyday vocabulary and diet for decades?;
It is a soft fat found in animal foods, but it is also produced by our bodies, mainly by the liver..
Although we have learned to think of it as harmful, the truth is that is essential for many functions, such as the synthesis of cell membranes, the production of bile acids, hormones, and vitamin D.
However, problems arise when the balance of lipoproteins that transport it in the blood is disrupted.
Simply put, when bad LDL cholesterol increases and good HDL decreases. Excess bad cholesterol is deposited on the arterial wall, constituting one of the most important cardiovascular risk factors.
Experts explain that High cholesterol (hypercholesterolemia) increases the likelihood of atherosclerotic plaques forming on the walls of the arteries., which gradually impede the smooth flow of blood, thereby increasing the chances of developing cardiovascular diseases such as myocardial infarction and stroke.
One of the mechanisms available to the body for removing excess cholesterol from the bloodstream is good HDL cholesterol, a beneficial lipoprotein.
We must not fail to mention the less popular but dangerous triglycerides.
These are fats found in our bodies, and there is growing evidence of their role in the development of coronary artery disease.
Particular caution is required for patients with high triglyceride levels, low HDL cholesterol levels, and diabetes mellitus.
These individuals have a significantly increased risk of developing atherosclerotic disease.
Dangerous prices
When it comes to dangerous LDL, values below 100 mg/dL are considered ideal, while values between 100 and 129 mg/dL are considered almost normal. LDL is considered borderline high when it ranges between 130 and 159 mg/dL. A value above 160 mg/dL is considered high. According to the latest guidelines, in high-risk individuals (i.e., those with multiple predisposing risk factors such as hypertension, diabetes, smoking, obesity), LDL should be below 70 mg/dL. In patients with cardiovascular disease (heart attack, stroke), the goal is to reduce LDL below 55 mg/dL.
Finally, good HDL is considered ideal when it is above 60 mg/dL, while below 40 mg/dL is considered low. It is recommended to check lipid levels every 3-5 years, and annually for those with borderline high levels.
The valuable exercise
Walking is perhaps the most economical and effective way to control blood lipid levels.
Also, engaging in any moderate-intensity aerobic exercise such as running, swimming, and cycling is considered effective for regulating lipids.
The recommended goal is 30 minutes of aerobic exercise five times a week.
Before starting an exercise program, you should make sure you are healthy, especially if you are over 40 years old.
So be sure to consult your doctor.
When you start exercising, begin slowly and gradually increase the intensity.. Never rush or overdo it—give your body time to adjust.
The crucial role of nutrition
Although many of the factors that affect cholesterol are interrelated and interact with each other, proper nutrition, exercise, and maintaining a healthy weight remain the primary means of preventing and treating high cholesterol.
In fact, combining exercise with diet is much more effective than adopting a single measure (e.g., diet alone or exercise alone).
Also A proper diet to combat cholesterol is not possible unless you first reduce your body weight.. Losing weight significantly reduces cholesterol levels.
What we should pay attention to regarding our diet
Our main concern is to avoid foods rich in saturated fats, such as meat, full-fat dairy products, butter, and sweets.
Also, avoid trans fatty acids found in many processed and packaged foods.
The Mediterranean diet plays a decisive role in regulating the lipid profile.
The Mediterranean diet is low in saturated fatty acids, i.e. animal fat, high in monounsaturated fatty acids, mainly due to the consumption of olive oil, high in complex carbohydrates from legumes and in fiber from vegetables and fruits.
What to eat and what not to eat
In practice Cut down on heavy, fat-rich sauces, mayonnaise, cream, creamy desserts, fried foods with butter, and sweets (especially chocolate and pastries). Also, remove visible fat from meat, chicken skin, turkey, lamb, and goat.
Consume milk, yogurt, and low-fat cheeses, and replace butter with olive oil when cooking. Also, adopt healthy cooking methods that limit fat, such as grilling and steaming.
Include fiber in your diet. These come from plant foods that have not been industrially processed and are found in legumes, whole fruits, and vegetables. It is important to enrich your diet with foods that provide 20-25 g of fiber per day..
Dietary cholesterol intake, That is, the amount contained in food should not exceed an average of 200-250 mg per day. Egg yolks, offal, bottarga, and lamb brains contain large amounts of cholesterol.
Look for polyunsaturated fats. Foods rich in polyunsaturated fatty acids include fatty fish (salmon, sardines, mackerel, etc.) and plant-based foods such as walnuts.
Seven reasons that raise cholesterol
The thyroid gland. It is possible that the increase in cholesterol is due to thyroid gland dysfunction. It is no coincidence that thyroid testing is one of the first things specialists recommend in cases of high cholesterol.
Genes. Experts point out that when cholesterol is elevated more than 20%-30% above the desired limits, hereditary predisposition is usually to blame. It should be noted that A small percentage of people are born with very high cholesterol (familial hypercholesterolemia) due to a genetic defect.. In this case, treating high cholesterol involves not only eating right but also taking medication.
The belly. When excess weight accumulates in the abdomen, the chances of developing high cholesterol, high blood sugar, elevated uric acid, and hypertension increase.
Elevated blood sugar. High levels of LDL and triglycerides are associated with metabolic diseases such as diabetes mellitus. Although the exact mechanism of action is not fully understood, a direct effect of type II diabetes mellitus on cholesterol metabolism has been observed.
Stress. Stress has been studied many times and it has been observed that there is a direct link between stress and increased cholesterol levels.
Smoking. Numerous studies have shown that smokers have higher cholesterol levels than non-smokers. Smoking reduces levels of good HDL cholesterol.
Alcohol. Although a small amount of alcohol (1-2 glasses of wine per day) contributes to an increase in HDL by up to 15%, increased consumption of alcoholic beverages has the opposite effect.
When medication is needed
Cardiologists point out that with diet, exercise, and smoking cessation, cholesterol can be reduced by 10%-20%.
Medication is prescribed when these measures have not been effective. However, if the patient already has atherosclerotic lesions, medication is prescribed immediately in combination with instructions for lifestyle changes.
The main medication used to treat high cholesterol is statins, which inhibit the synthesis of cholesterol in the liver.
However, cholesterol is essential for normal cell function, which is why the liver seeks it elsewhere.
This is how it binds and uses the cholesterol circulating in the blood. The result of this process is a reduction in blood cholesterol.
Statins, in addition to reducing cholesterol production, have been shown to have significant anti-inflammatory effects and are therefore an essential drug for the primary and secondary prevention of coronary heart disease.
However, when statins are administered in high doses, they may cause myalgia. Experts explain that myalgia must be treated promptly with specific tests, updated guidelines, and possible modification of the statin.
Ezetimibe, which prevents the intestinal absorption of cholesterol and is administered in combination with statins, is one of the newer lipid-lowering drugs.
Recently, injectable formulations for the treatment of hyperlipidemia have entered the pharmaceutical arsenal, monoclonal antibodies against PCSk9 receptors, aimed at removing LDL cholesterol from the bloodstream.
The use of these drugs leads to a reduction in LDL cholesterol levels and is mainly recommended
for individuals with familial hypercholesterolemia who are also at the highest risk of myocardial infarction.
In collaboration with cardiologist Emmanouil Kallieris, Director of the Cardiology Unit at Metropolitan Hospital, Member of the American College of Cardiology
