Much confusion surrounds cholesterol and its effect on risk factors for cardiovascular disease. With the advent and widespread use of statin drugs, more and more people are trying to understand how to manage their cholesterol and whether they need medical intervention.
While your doctor should always be your primary source of health information and advice, it can be helpful to know the basics of cholesterol and to separate facts from fiction.
Benefits and Functions
Many people see cholesterol as strictly a bad thing, but cholesterol is a vital part of many key functions in the body, including hormone synthesis, cell membrane structure and neuron development. In fact, a study out of the University of Iowa found that common cholesterol-lowering drugs may impair brain function.
Misconceptions
As cholesterol has been demonized, the reasoning has followed that you should try to lower your cholesterol as much as you can. However, but a healthy range for cholesterol exists, and going above or below that range can increase your heart attack and disease risk.
Another myth related to cholesterol is that you should eliminate saturated fat from your diet to improve cholesterol and heart disease risk. A meta-analysis of available studies published in January 2010 found no correlation between saturated fat and cardiovascular disease. Because of the unfounded fear of saturated fat, many people have replaces fat with excess carbohydrates in their diets. That can cause more harm than good, as the American Heart Association advises that doing this can raise blood triglycerides, which are associated with a higher risk of heart disease.
Types
Cholesterol is commonly divided into two categories: good and bad. Good cholesterol is HDL, or high-density lipoprotein. Bad cholesterol is LDL, or low-density lipoprotein. However, it gets a bit more complicated than that, as LDL can be either good or bad as well, depending on the density. When looking at your total cholesterol number, you may think you are doing great because your total cholesterol is within the normal range, but if your ratio of HDL to LDL is bad, or your triglycerides are too high, you may not be getting an accurate picture of your disease risk.
A good alternative to getting a total cholesterol number is to have your doctor order a lipid profile, which will tell you how much of each type of cholesterol you have.
Considerations
Managing cholesterol is not just about lowering your total number. It's good for your health to raise the good cholesterol while lowering your bad cholesterol and triglycerides. You can do so by eating healthy fats such as omega-3 fatty acids, found in salmon and sardines; exercising; eating more fiber; and eliminating trans fats, alcohol and smoking.
Statins
Roughly 20 million Americans now take cholesterol-lowering drugs called statins, which have been shown to reduce the risk of heart attacks in people who already have heart disease, but the benefits to those without heart disease are less clear. Statins work by reducing your body's ability to make cholesterol, which is why some of the risks of statins are related to the important role that cholesterol plays in the healthy functioning of the body.
Before taking statins, it is important to talk to you doctor about risks and side effects. Besides the reduced brain function mentioned previously, statins also can cause liver damage or muscle pain.
References
- Neurology: Statins and cognitive function in the elderly
- "American Journal of Clinical Nutrition"; "Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease"
- "Time" Magazine: Who Should Take Statins? The Debate Continues
- Cholesterol and Health: Cholesterol functions
- American Heart Association: Triglycerides
