Cholesterol: The good, the bad and the ugly

Often, patients are confused by their cholesterol readings. What exactly are LDL, HDL and triglycerides? Does the total cholesterol matter? How high is high? Let us guide you through all these.

 

The good.

High-Density Lipoprotein (HDL) is known as the “good” cholesterol. It is good because it actually carries the “bad” cholesterol (that clogs the arteries) back to the liver to be processed and passed out from the body. It has been shown in studies that low levels of HDL are associated with heart diseases, and the converse is also true. Therefore, high levels of HDL are desirable. With that said, high levels of HDL will not erase all the bad cholesterol in your body. It is only able to help flush out about a quarter of the bodies’ bad cholesterol, although this does make a difference.

The normal value for HDL should be MORE than 1.03mmol/L (40mg/dL) for males and 1.3mmol/L (50mg/dL) for females.

Find out more about how about HDL and how to raise its levels here (COMING SOON).

The bad.

Low-Density Lipoprotein (LDL) is the “bad” cholesterol. It causes a process known as atherosclerosis where fatty deposits build up in the arteries. The narrowing of arteries will slow/obstruct the transport of oxygenated blood around your body which increases the risks of heart attacks, strokes, and peripheral arterial disease.

Therefore, it is advisable to have lower levels of LDL to prevent atherosclerosis and its associated diseases. For those with low risks for heart diseases, LDL levels of LESS than 4.12mmol/L (160mg/dL) is desirable while those with higher risks should refer to our detailed discussion on LDL here  along with tips on how to reduce LDL levels.

If you are wondering what your risk for heart disease is, we have an article with a risk calculator here.

 

The ugly.

Triglycerides are not exactly cholesterol, but rears its ugly head along with LDL in increasing risk for atherosclerosis, stroke and heart diseases. It is another type of fat and is often measured along with cholesterol to assess a person’s risk for heart diseases. Extremely high levels of triglycerides are a risk factor for pancreatitis (inflammation of the pancreas).

Ideal levels of triglycerides should be LESS than 1.7mmol/L (150mg/dL).

Detailed explanation on triglycerides can be found here (COMING SOON).

 

Fast food with many fried components usually contain high amount of cholesterol

Total cholesterol.

Total cholesterol is the sum of HDL, LDL along with intermediate-density lipoprotein (IDL) which is usually not measured. Total cholesterol should be LESS than 5.2mmo//L (200mg/dL).

 

Recent myths.

Recently, it has been heavily circulated on social media and messaging platforms that cholesterol has been reduced from the “naughty” list. This story is true, but grossly misunderstood by members of the public.

The actual report stated that cholesterol was removed from the “naughty” list of foods. This means that foods rich in cholesterol is no longer classified as a “nutrient of concern” and reclassified as “safe”. The previous guideline recommending a daily consumption of LESS than 300mg of cholesterol was retracted following the revelation by recent studies that there is no appreciable link between consuming high cholesterol foods and high cholesterol levels in the body.

This, however, has been misinterpreted by some members of the public that high levels of cholesterol in one’s body is no longer a threat to one’s health. This cannot be further from the truth. Strong scientific evidence still points to the fact that high cholesterol levels in the body is associated with atherosclerosis, heart diseases and stroke.

If you are still in doubt, always feel free to speak to your pharmacist or doctor for more details.

Table 1: Summary of Cholesterol goals

 

References

  1. Patient education: High cholesterol (The Basics) [Internet]. Uptodate.com. 2018 [cited 18 January 2018]. Available from: https://www.uptodate.com/contents/high-cholesterol-the-basics
  2. Kasper D, Harrison T. Harrison’s Principles of internal medicine. New York: McGraw-Hill Education; 2015.
  3. Barr N. Cholesterol Is Finally Officially Removed From ‘Naughty’ List [Internet]. Uk.style.yahoo.com. 2018 [cited 18 January 2018]. Available from: https://uk.style.yahoo.com/blogs/icymi/cholesterol-is-finally-officially-removed-from–naughty–list-122559246.html
Pou Wee Gan
Pou Wee Gan

M.Pharm, MBBS, BCPS, R.Ph

A pharmacist first, then a medical doctor. An avid tea drinker and an occasional poet.

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