Cholesterol and its functions
Cholesterol is the substance of life. Alexander Yuryevich in his blog talks in detail about why it is needed, how “good” cholesterol differs from “bad”, which organs produce it, and also provides information on the metabolism of cholesterol in the body.
This substance performs the following functions:
- present in all metabolic processes;
- serves as a building material for cells, as it is contained in their membranes;
- helps produce myelin, which conducts nerve impulses;
- many hormones are also produced from cholesterol, especially sex hormones.
The body cannot live without cholesterol, since most biochemical processes are associated with cholesterol metabolism. From this we can conclude that the more active and better the metabolism, the higher the cholesterol level will be. If metabolism is disrupted, then cholesterol levels decrease.
Advice:
To understand in more detail what cholesterol is and why it is needed, watch other videos on Dr. Shishonin’s blog.
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Cholesterol and baby
The child’s body is actively developing, new cells and hormones are formed, and the nervous system is strengthened. For all this you need a sufficient level of cholesterol.
A child's metabolism is always very active and fast, as this is normal for a growing body. The logical conclusion follows from this: a healthy child should have high cholesterol levels.
Important:
Low cholesterol levels in children are a reason to consult a doctor and determine whether there are metabolic disorders.
Elevated cholesterol levels in children are completely normal. Only with a high level of cholesterol will a child develop good nervous tissue, hormones, and cellular immunity. A high level indicates that the body is developing, and this is not a reason for panic, but quite the opposite.
High levels are not a disease. But when it is low, then there is a risk of developing many diseases, developmental delays, and metabolic disorders. This indicator should be a reason to consult a doctor.
Medical myths. All about cholesterol
Of all the biochemical compounds circulating in our body, cholesterol is one of the best known. As always happens in such cases, many different prejudices have accumulated around cholesterol, which we will take a closer look at today.
Cholesterol is an integral component of the cell membrane in higher animals; as such, it is synthesized by all cells. Despite its bad reputation, cholesterol is necessary and vital for any body. Problems begin only with its excess: increased concentrations of cholesterol in the blood increase the risk of cardiovascular diseases.
Along with other substances, such as fat or calcium, cholesterol accumulates to form plaques on the walls of the arteries. Over time, this can significantly narrow the lumen of blood vessels and lead to serious complications, including stroke and heart failure.
According to the Centers for Disease Control and Prevention (CDC), as of 2015-2016, at least 12% of Americans over 20 years of age had high blood cholesterol.
The World Health Organization (WHO) estimates that elevated cholesterol levels are a direct or indirect cause of 2.6 million deaths annually.
Given all this data, it is not surprising that there is a lot of misinformation regarding cholesterol. To separate fact from fiction, we enlisted the help of three subject matter experts:
— Dr. Edo Patz, cardiologist, vice president of medicine at the K Health health care network;
— Dr. Robert Greenfield, cardiologist, lipidologist and general practitioner at the Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California;
— Dr. Alexandra Lajoie, a specialist in non-invasive cardiology at Providence Saint John's Health Center, Santa Monica, California.
Cholesterol is always bad
As mentioned in the introduction, cholesterol is a vital component of cell membranes. In addition to this important structural function, cholesterol is also involved in the synthesis of steroid hormones, vitamin D and bile acids.
Yes, high cholesterol levels are a risk factor for many diseases. However, without cholesterol we simply could not exist.
As Dr. Greenfield figuratively explains, “cholesterol as such cannot be considered something bad. He is busy with his own business and is not to blame for the fact that at the present historical stage he is being treated so wrongly.”
“The human body is not designed to live in conditions of excess food supply, so when there is too much cholesterol, it begins to accumulate in our body. And if blood vessels become the depository center, we have problems.”
Dr. Robert Greenfield
In addition to the basic functions of cholesterol, the potential harm to health depends on the way it circulates in the body. Cholesterol is transported by lipoproteins, special substances whose composition simultaneously includes fats and proteins. There are two main routes of transportation.
Low-density lipoproteins (LDL) carry cholesterol from the liver into cells, where it participates in several processes. The concept of LDL as “bad cholesterol” has taken root because abnormally high levels of these compounds in the systemic circulation increase the risk of cardiovascular disease. In contrast, high-density lipoprotein (HDL) is often called “good cholesterol” because it returns waste cholesterol back to the liver, where it is eliminated from the body; thereby reducing cardiovascular risks.
I'm a healthy weight, so I can't have high cholesterol.
“How can he! – says Dr. R. Greenfield. – The balance of cholesterol depends on what exactly we eat and on our genetics. For example, you may be born with a genetic predisposition to process cholesterol inefficiently. This situation is called familial hypercholesterolemia and, according to the PubMed Central database, occurs in approximately every two hundred of us. Body weight is primarily a function of your genetic metabolism and the balance between calories in and calories out."
Dr. E. Patz agrees: “Even if you have an ideal weight, your blood cholesterol levels may be abnormal. Other factors include the composition of the daily diet, exercise habits, smoking and the amount of alcohol consumed.”
In addition, Dr. A. Lajoie adds, not only people with a healthy body weight may have high cholesterol, but, conversely, if they are overweight, their cholesterol may be within the normal range. “This is all influenced by genetics, thyroid function, medications, exercise, sleep and diet,” explains Alexandra Lajoie. “But you cannot influence some of these factors in any way, since you cannot change, for example, age or heredity.”
If I have high cholesterol, it will definitely affect my health
No, this is also a myth. Dr. Edo Patz: “In most cases, high cholesterol does not show any symptoms. By the way, this is why it is recommended to periodically take blood tests to monitor cholesterol concentrations. The age at which you should start this habit and the frequency of follow-up tests are determined by your individual risk factors.”
“The first noticeable signs of excess cholesterol may only appear in the later stages, when its accumulation leads to damage and blockage of major blood vessels, which in turn causes chest pain, heart attacks or even sudden death,” says Dr. R. Greenfield.
Dr. A. Lajoie also emphasizes that abnormally high cholesterol leads to the “silent” formation of plaque in the arteries, until the situation becomes so serious that it manifests itself in a stroke or severe heart attack.
If I eat a lot of cholesterol, then I will have a lot of it in my blood
This question is a little more complicated than you might expect. “The amount of cholesterol consumed does not necessarily have a direct correlation with blood cholesterol levels,” says Alexandra Lajoie. – Even if you carefully limit cholesterol as such in your diet, you can get cholesterolemia due, for example, to consuming sugars or simple carbohydrates. But people who are actively involved in physical exercise, with the same diet, will have lower cholesterol levels than people who lead a sedentary lifestyle.”
However, Dr. R. Greenfield clarifies: if we consume more cholesterol from food, then the likelihood of high cholesterol in the blood will still be greater for us. And he explains why: “Of course, you don’t go to the store specifically for a bag of cholesterol. But you buy red meat, cheeses, eggs. Red meat, in particular, contains saturated fat and cholesterol. In general, this is a substance of animal origin, and anything that contains saturated fat will increase the level of cholesterol in the blood, and specifically the “bad” cholesterol, that is, low-density lipoproteins that settle on the walls of our blood vessels.”
Everyone should strive for the same cholesterol level
“No, no,” says Dr. E. Patz. – The normal target cholesterol level for you depends on your individual medical history, for example, diagnosed heart disease, strokes, etc. Additionally, risk factors include advanced age and high blood pressure.”
Dr. R. Greenfield also calls the concept of a “universal norm” of cholesterol false, citing research from the American Heart Association, the American College of Cardiology and the National Association for Lipid Research. “For those of us who have not had any cardiovascular problems,” the expert explains, “LDL (i.e., “bad”) cholesterol should not exceed a concentration of 100 mg per deciliter. However, if there is a history of cardiovascular disease, especially in the setting of diabetes, then the target LDL cholesterol level should be in the range of 70 mg/dL, or even lower.”
Only men should care about cholesterol levels
This is one of the rather strange but persistent myths. From the response of Dr. E. Patz: “According to the CDC, during the period 2015-2018, the prevalence of cases of elevated total cholesterol in the US adult population was 11.4%. If we take statistics by gender, then high cholesterol is observed in 10.5% of men and 12.1% of women.”
Dr. R. Greenfield agrees: “...besides, the risk of developing heart disease is the same for both sexes. After women lose their natural estrogen protection at a certain age, their cardiac risk begins to increase and is compared with that of men. In general, since women live longer and their cardiac pathology develops, on average, later, more heart attacks are recorded annually in the female population.”
Added to this is that women are more likely to have unfavorable outcomes, and their risk of dying from a heart attack still ranks first, even ahead of breast cancer.
Nothing can be done about high cholesterol levels
Fortunately, this statement is wrong. Edo Patz: “In addition to taking special medications to lower your blood cholesterol levels, you can normalize your cholesterol levels by maintaining a healthy body weight, eating right, exercising regularly, and not smoking or drinking too much.”
Robert Greenfield says the same thing: “There are a lot of things that can be done to make cholesterol levels safe! Diet and exercise should always be the first step, which is really very important. As for special drugs - statins - they have been widely used since 1987; the modern generation of these drugs has become much more effective and safe compared to the first formulas, and there are much fewer side effects.”
At the same time, development continues. The new injectable PCSK-9 inhibitors lower cholesterol levels to levels not previously achieved with little risk of side effects, Dr. Greenfield said.
Since I take statins, I can eat whatever I want.
“It would be nice if it were true,” says Dr. Greenfield. - But that's not true. If you start eating whatever you want without thinking, and the calories you consume exceed your actual energy expenditure, you will gain weight. And when you gain too much weight, especially in the abdominal area, you may develop a special type of metabolic syndrome, which is a pre-diabetic condition. And it is very important to understand that statins are not a drug for weight loss. They are designed to reduce the level of “bad” cholesterol, i.e. LDL, and your job is to respect your body, including when you sit down at the dinner table.”
I'm not yet forty, and I don't have to check my cholesterol levels yet.
“The debate about the age at which screening for high cholesterol should begin continues to this day,” explains Edo Patz. “However, keep in mind that many professional organizations, including the American Heart Association, recommend starting regular screening tests at age 20.”
Dr. R. Greenfield explains in more detail: “The longer your blood vessels are exposed to high concentrations of cholesterol, the higher your risk of developing cardiovascular disease in the future. Modern recommendations state that the first test for cholesterol levels should be carried out in adolescence, and even earlier if there is a family history.”
In cases of reliably confirmed homozygous familial hypercholesterolemia, such control should first be carried out at the age of two years.
Take note
“I always encourage my patients to ask questions and be interested in their own condition. But do not forget that there are many, so to speak, unclean resources and sources that mislead you or outright misinform. If something looks too good to be true or defies basic logic, you are probably being scammed. Look for information on reliable medical sites and trust the opinions of those who have dedicated their entire lives to treating cardiovascular diseases. Treat your body like a temple, not an amusement park.”
Dr. Robert Greenfield, cardiologist
Based on materials from Medical News Today
Causes of Low Cholesterol
Dr. Shishonin provides many arguments in favor of the fact that elevated cholesterol levels in children are a normal, healthy phenomenon. But what to do if the analysis reveals a reduced level of this indicator? This is a very alarming symptom, and it manifests itself for several reasons:
- Genetic predisposition. As you know, heredity can play a role in many characteristics of the body. There are cases when, due to genetic predisposition, low cholesterol levels in a child are normal, but in this case you should still see a doctor.
- Poor nutrition. For normal growth and development, a child needs a balanced diet. You can’t limit him in proteins, fats, carbohydrates and calories, but you should keep an eye on exactly what foods he eats. Include more dairy products rich in highly digestible fats in your child’s diet and limit fast food and other “junk” foods.
- Liver diseases. As you know, the liver is the main organ that produces cholesterol from fats. If the liver is not in order, it means that a sufficient amount of cholesterol, so necessary for the normal development of the child, does not enter the blood. The consequence is metabolic disorders and further complications.
- Thyroid diseases. It is necessary to constantly keep under control those organs that are responsible for the production of hormones, since hormonal disorders are difficult to reversible. Provide sufficient amounts of iodine-rich foods in your child's diet and do not forget to undergo regular examinations with an endocrinologist.
Important:
A low cholesterol level always indicates the presence of some kind of developmental disorder.
At the same time, the following are considered normal indicators for children:
- Newborn – 53–135 mg/l (1.37–3.5 mmol/l).
- Up to 1 year – 70–175 mg/l (1.81–4.53 mmol/l).
- From 1 year to 12 years – 120–200 mg/l (3.11–5.18 mmol/l).
- 13–17 years – 120–210 mg/l (3.11–5.44 mmol/l).
Thus, elevated cholesterol levels are normal for a child. The alarm should be raised only if this indicator decreases and goes beyond the normal range. This indicates the presence of metabolic disorders and cholesterol metabolism.
Treatment and prevention
Today, high cholesterol in children is not uncommon. If this pathological condition is identified during an examination, the fight against it must begin as early as possible. Normalizing high cholesterol in children is somewhat easier than in adults. Before the onset of puberty, hypercholesterolemia can be easily corrected by normalizing the diet physical activity (race walking, running, swimming, cycling, skiing) to the daily routine
Forming healthy eating habits is an important task for parents.
Sometimes, if the above recommendations are followed, serum cholesterol levels do not decrease. Then the need for drug treatment arises and the question arises: “Can I take statins?” The instructions for drugs in this group state that they are contraindicated for children under 18 years of age due to the fact that there is no data on their safety and effectiveness in this age group.
Pediatricians recommend medicinal treatment of high cholesterol in children using the drug “Policonazole”. It is made from natural raw materials - sugar cane stalks. The medicine helps eliminate the imbalance between LDL and HDL and reduce total cholesterol levels. To achieve the desired result, taking Polyconazole must be combined with proper nutrition and physical activity.
Prevention of hypercholesterolemia involves maintaining a healthy lifestyle. This requires a diet and nutrition that contains a minimum of harmful fats. It is also necessary to monitor children’s body weight and teach them to systematically play sports. It should be remembered that the foundation for most diseases that occur in adulthood is laid in childhood!
