Over the last few decades, the word cholesterol has assumed a different connotation. It has come to be known as a silent killer that spells doom for health. However, what we need to realize is that a certain amount of cholesterol is essential for the proper functioning of the body. The liver produces about 85% of the cholesterol that is required by the body normally. The ever changing food habits have introduced a lot of processed foods that are loaded with saturated fats. Along with this, reduced physical activity has led to accumulation of cholesterol in the blood.

The types of cholesterol are based on the density and we have 2 types of density that is Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL). LDL is more dangerous than HDL, called as bad and good cholesterol respectively. In addition, the triglycerides and lipoprotein are also critical indicators of overall cholesterol levels. Depending on a person's age, height and weight, normal levels are derived for each of these four.

Because of their density of the cholesterol molecules, as they are circulating in the blood stream, they tend to get sluggish and settle down along the walls of the blood vessels, referred to as plaque. This plaque attracts more and more cholesterol from the blood and the layer gets gradually thicker. This reduces the thickness of the blood vessels and in severe cases even completely blocks blood flow to important organs like the brain and heart, leading to severe conditions like stroke and heart attack respectively.

However, it is not always that all cholesterol is bad. It is one of the essential things for the proper body functions with the main functions listed below.

1. Each cell in the body requires it to form the cell membrane, the protective layer around the cells
2. Synthesis of vitamin D is done with the help of cholesterol, which is very essential for skin health
3. It also helps in hormone formation. In addition to steroids, other hormones like testosterone, estrogen, cortisol require cholesterol as a main ingredient
4. Formation of neurotransmitters and overall nerve function requires cholesterol. This ensures optimal neurological functioning.

So, as noted above, there are, both good and bad aspects to cholesterol. It is not all that dangerous a thing that it is made out to be. The trick is to maintain a good level of cholesterol so that the body's requirements are met, and at the same time, the harmful effects are kept at bay. Some important parameters to manage, include the percentage of bad cholesterol in the blood and the ratio of triglycerides to HDL in the blood. These are considered fair indicators of heart health and if need be, lifestyle changes and/or medications can be undertaken to manage overall health and reduce risk of heart disease and stroke.

Cholesterol: Good and Bad of It

Cholesterol is a vital component, which helps the body to make healthy cells. This wax like component is found in the lipid of the blood. An increased cholesterol count elevates the risk of heart diseases in a person. It thickens the vessels of the arteries resulting in less oxygen flow in the heart. This, in turn, increases the chances of a stroke. High cholesterol can happen from lifestyle habits and inheritance. It is completely treatable and preventable.

What causes high cholesterol?
The blood carries the cholesterol which is attached to the proteins. The combination of cholesterol and protein is known as the lipoprotein. Primarily there are two different kinds of cholesterol that the lipoprotein carries:

    Low-density lipoprotein: LDL is the bad guy that carries all kinds of cholesterol present in the body. It eventually rests on the walls of the arteries, making it narrow and hard.
    High-density lipoprotein: This is the good guy which scans the excess cholesterol and take them back to the liver.

Ideally, the body should have low LDL and high HDL. But often the reverse happens, resulting in high cholesterol and cardiac diseases. Factors such as unhealthy diet, inactivity for most of the day and obesity is responsible for the same. Even the genetic set up can play a hand in a high count of LDL in the body. There is nothing that can be done in this case except to seek medical help.

6 factors that put you at risk:

    Poor diet: Cholesterol levels are dramatically increased when baked products and saturated fats are consumed in an excess amount. Other high cholesterol food products include dairy products, processed fats and red meat. Refraining from this food items will drastically reduce the chances of getting high cholesterol in the body.
    Obesity: Obesity results from too much of fat storage in the body. It not only fatigues a person faster, but puts a person at high risk of getting cholesterol. The body mass index should be always lesser than 30 to abstain the risk of cholesterol.
    Waist circumference: A waist circumference of more than 40 inches in men and 35 inches in women can increase the risk of cholesterol.
    Diabetes: This is one of the major causes of high cholesterol. It not only damages the artery lining, but results in higher LDL and lower HDL.
    Less workout: Leading a life which is devoid of exercise and jogging can increase the chances of getting high cholesterol. Exercise boost HDL count in the body and mitigates the risk of low HDL.
    Smoking: The blood vessel walls get damaged with smoking. The blood vessels start accumulating fatty acids thereby increasing the chances of getting high cholesterol.

What Causes High Cholesterol? 6 Factors That Put You at Risk

Know Your Cholesterol 

Cholesterol is a waxy, fat-like substance that’s found in all cells of the body. The term cholesterol is often directly related to a heart condition. But the truth is that not all types of cholesterols are harmful for your body. It is important that one knows about the different types of cholesterol, having healthy levels of both types of lipoproteins is important, deal with them appropriately and lower the chances of having a stroke or getting a heart disease. Bad cholesterol levels can be high in people irrespective of them being thin, if it is genetic or if they are smokers.

Types of Cholesterol.

The Bad One:

LDL cholesterol sometimes is called “bad” cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. Lowering your cholesterol may slow down, reduce, or even stop the buildup of plaque in your arteries. It also may reduce the risk of plaque rupturing and causing dangerous blood clots.

The Good One:

HDL cholesterol sometimes is called “good” cholesterol. This is because it carries cholesterol from other parts of your body back to your liver. Your liver removes the cholesterol from your body and  is important for the body as it reduces the risk of heart attack, disease and strokes.

Cholesterol count of the body is counted by adding the two types of cholesterols (LDL and  HDL) along with body's triglyceride level. Triglycerides are a type of fat found in your blood. Too much of this type of fat may raise the risk of coronary artery disease.

The level of your cholesterol shows the level of risk your body is in, to have a stroke or a heart condition. Other factors which determine the risk are whether the person is a smoker, diabetic, has high blood pressure along with their age, sex and race.

Cholesterol levels are affected by:

1. Genetics: Genetics have a direct effect on your cholesterol level. If the levels have been high in the previous generations, you are automatically at higher risk of this condition.An inherited condition called familial hypercholesterolemia causes very high LDL cholesterol.

2. Age and Weight: Once we cross the age of 20, our cholesterol level starts to rise. Being overweight however is also a high risk factor of increased levels of bad cholesterol in the body as well as developing heart disease.

3. Lifestyle: Less or no exercise is another reason which reduces the good cholesterol in the body, as does being overweight. Regular exercise however reduces LDL and increases HDL in the body. Also a diet rich in saturated fats makes your LDL levels shoot up and puts you to higher risk.

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 Know Your Cholesterol: Good Vs Bad

Cholesterol is either ingested in the food (about 25% ) we eat and some of it is produced by our body (remaining 75%). Cholesterol is needed by the body to produce steroid hormones and bile acids. It is an aspect that is required by the body and if in too much quantity, the same can cause havoc in the body. The best is to maintain the right balance of cholesterol in our diet. The same requires lifestyle and dietary modifications.

The first step in creating your low cholesterol diet plan is to eliminate foods high in saturated fat and bad cholesterol.

Low cholesterol foods diet mainly includes:

1. High-Fiber Diet- Soluble fiber reduces bad cholesterol. Good food sources are oatmeal, fruits and vegetables.

2. Cooking oil- Fats makes about 30 % of your days intake. A combination of oils works the best. Foods rich in saturated fats are butter, ghee, cream, and cheese. These need to be taken in moderation or avoided. Avoid fried foods. Not more than 10% of total calories should be from Polyunsaturated Fatty Acids (PUFA) and the remaining should be from Monounsaturated Fatty Acids (MUFA). The best sources of PUFA are plant based oils, sunflower, corn, soybean, cottonseed and safflower. MUFA are found in the largest amounts in olive, canola, mustard, almond and peanut oils.

3. Avoid Trans fats- Read labels carefully and do not reuse oil used for frying.

4. Go lean- Choose lean meat and fish. Fish is a good source of omega-3 fatty acids. Foods high in omega 3 help you lower down the risk of cardiovascular disease. Tuna and salmon are a good source of omega-3 to name a few.

5. Eat a wide range of fruits and vegetables- This will help ensure that your body meets all the vitamins and nutrient requirement. Fruits and vegetables are relatively low in calories. Apples and pears are known for soluble fiber, which reduces bad cholesterol levels. It is best that you eat good quantities of the same.

6. Include low-fat dairy products- avoid ghee, cheese, cream, paneer and butter. Opt for lighter and healthier options.

7. Exercise well - Exercise at least 30 mins per day. Workout will help you burn extra fat resulting in lowering cholesterol levels.

Cholesterol - How To Manage It?

For a long time cholesterol in totality was seen as a bad thing for your body although the truth was a little more complicated than that. Cholesterol primarily is divided into two types, one of which can be categorized as bad cholesterol and the other as good cholesterol. Let's have an in-depth look at both the categories.

Ldl or low density lipoprotein aka bad cholesterol: cholesterol is a wax like chemical which is found all over the body and it has important functions to perform. Cholesterol is carried all over the body by lipoproteins. The low density lipoproteins are denoted as bad cholesterol as they can accumulate on the walls of the blood vessels and cause blockages resulting in many ailments. Ldl levels of 190 and above are considered dangerous. 

Some of the risks associated with it are:
1. Heart disease
2. Stroke
3. Atherosclerosis
4. Peripheral artery disease among many others

Hdl or high density lipoprotein aka good cholesterol - this is a form of cholesterol which is usually desired in higher quantities as it removes ldl from the system by dislodging it from the arteries and then carrying it through the bloodstream into the liver. The liver then breaks it down and removes it from the body. Thus, higher number of hdl cholesterol is always desirable. Some of the ideal numbers for hdl cholesterol within the body are:

For women - ideal: 60 mg/dl, dangerous: 50 mg/dl or lower
For men - ideal: 60 mg/dl, dangerous: 50 mg/dl lower

The role of triglycerides
Good and bad cholesterol levels also depend on the levels of triglycerides within the body and not just ldl or hdl cholesterol. Triglycerides are another type of fat which are used to store energy within the body, but can also affect your health. It is most associated with atherosclerosis when the levels of triglycerides are high within the body. 

Some habits that contribute to high levels of it are
A. Lack of physical activity
B. Obesity or being overweight
C. Excesses in alcohol consumption
D. Smoking
E. Bad diet and others

Thus the good cholesterol vs bad cholesterol war also includes other factors, most of which can be easily changed by making subtle changes in lifestyle and incorporating healthier habits. This will increase the good cholesterol and the other relevant elements and reduce the bad.

Good Cholesterol Vs Bad Cholesterol

Carotid artery disease occurs when an oily, waxy substance called plaque builds up inside the carotid arteries. These are arteries that supply oxygenated blood to your brain, face, scalp, and neck.
Carotid artery disease is very serious as it can cause a brain stroke. It, in fact, starts with damage to the inner layer of the carotid artery. To stem this damage your body starts a healing process and this leads to a build up of plaque at the point where the artery is damaged.

When this plaque ruptures, platelets are rushed in and these create an obstruction to the flow of blood to the brain. When the blood supply to the brain is cut off, which happens in carotid disease, the brain cells begin to die causing a stroke. This neural death impairs the parts of the body that these brain cells control. So, you can get paralyzed, become speech or vision impaired, have long  term effects like paralysis or even die due to a stroke.

Causes of carotid disease

Smoking
High cholesterol levels
High blood pressure
High levels of sugar in the blood due to diabetes
What s even more worrisome is that carotid artery disease may not cause any signs or symptoms until the carotid arteries are severely narrowed or blocked. And what usually happens is that a stroke becomes the first sign of the disease.

How scary is that?
So, the next question that comes to the mind is - Can this condition be cured? Let s learn more about management and prevention of the same-

Prevention
Lifestyle changes are key. Since hypertension, uncontrolled diabetes, sedentary lifestyles and imbibing too much fat are all risk factors, taking care of them minimizes the risk of carotid disease and strokes. Heart healthy lifestyle changes that include moderate exercise are a great way to prevent carotid disease.

Treatments
Treatments for carotid artery disease include:

Medicines: Sometimes lifestyle changes do not stem the rot. You need medicinal help. Doctors usually prescribe statin medications to control your cholesterol levels. These lower the bad cholesterol that can narrow your carotid arteries and cause brain strokes and damage. Statins are usually prescribed for people who have:

Heart disease
Those who ve had a stroke
Diabetes
High LDL or bad cholesterol levels
Medicines like Aspirin and Clopidogrel to prevent blood clots are the mainstay treatment if you suffer from carotid disease. They prevent platelets from clumping together inside your carotid arteries and forming blood clots. Apart from these, your doctor may also medicate you for conditions that can damage your carotid arteries and cause strokes. These medicines are for lowering your BP, blood sugar levels, preventing the formation of blood clots anywhere in your body including inside your heart, and preventing and reducing inflammation.

Medical Procedures
These are used to open narrowed or blocked carotid arteries.
The two common procedures are:
Carotid endarterectomy: It s mainly for people whose carotid arteries are blocked 50 percent or more. In this, the inner lining of the carotid artery that is blocking blood flow is removed.
Carotid artery angioplasty and stenting: Here, doctors use a procedure called angioplasty to widen the blocked carotid arteries and restore blood flow to the brain. A stent is inserted into your carotid artery to broaden the lumen. 

High Cholesterol Level - Can It Cause Carotid Disease?

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