Cholesterol: The good, bad and ugly

Understanding the relationship between cholesterol and weight can seem complicated, especially when you consider that there is good and bad cholesterol and that your body actually needs a small amount of cholesterol.

Many people have too much “bad” cholesterol, called LDL. This can happen when you eat too much saturated fat, found mainly in foods from animals. If your LDL levels are too high, plaque can build up in your arteries which can lead to heart disease. The “good” cholesterol, known as HDL, can help to clear LDL from the blood.

To boost HDL levels, people should exercise regularly, avoid smoking and maintain a healthy weight. Besides improving your HDL levels, avoiding obesity can reduce the risk for heart disease and many other health conditions.

While overweight people don’t all automatically have higher cholesterol, carrying extra weight can make you more likely to get high cholesterol as well as high blood pressure, and type 2 diabetes.

Dr Alkesh Magan, a specialist Physician/Endocrinologist at Sandton Medi-Clinic, confirms there is a definite link between belly fat and cholesterol, but says that while losing weight can help lower bad cholesterol levels, these levels may not normalise completely in all people.

Cholesterol is always linked to cardiovascular disease, which can affect many organs including the heart and the brain. Dr Magan also stresses that the biggest dangers of high cholesterol, especially when it is undetected, are heart attack and stroke.

Picture: iStock

“The take home message is that the more fat that is carried around the abdomen, measured by the waist circumference, the increased chances of having higher cholesterol,” says Dr Rosetta Guidozzi, a General Practitioner from Johannesburg.

The good news for anyone struggling with obesity is that it is preventable and it only takes losing 5% of one’s body weight to see significant health benefits. Waist circumference is also an important and useful measuring tool to assess obesity, with the criteria for clinical obesity being a waist circumference of more than 90cm in men and 85cm in women.

Dr Magan’s advice for people with high cholesterol includes adopting healthy lifestyle measures, and in those who have not been successful, medical therapy will be needed.

Picture: iStock

Healthy lifestyle measures to help get your cholesterol in check include:

• Adopting portion control
• Aiming for 5-9 helpings of fruit and vegetables per day
• Eating more fish and benefitting from increased omega-3s in your diet
• Choosing whole grain carbohydrates and opting for unsaturated fats
• Eating nuts, which lowers LDL but leaves HDL as they are
• Limiting stress and including regular exercise

High cholesterol usually has no symptoms. That is why it is important to have your cholesterol levels checked by your pharmacist or doctor, by a simple finger prick test. The American Heart Association recommends that all adults 20 or older have their cholesterol and other traditional risk factors checked every 4 to 6 years.

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