High cholesterol: when to worry and how to eat

Bad guys aren’t always born evil. This is the case with cholesterol, which it is not dangerous in an absolute sensebecause it is a substance necessary to the good operation of the organism: for example, it is the main constituent of cell membranes and participates in the synthesis of some hormones, as well as vitamin D.

«The problem arises when cholesterol levels rise too much especially those of the LDL fraction, because these molecules tend to settle on the walls of the arteries to form plaques that obstruct the normal flow of blood like a “plug” », says Dr. Roberto Volpe, medical researcher of the Prevention and Protection Unit of the National Research Council of Rome. “In addition to preventing organs and tissues from receiving the right level of oxygen and nutrients, these plates risk breaking and their fragments they can break off, migrate into the arterial tree, and occlude distant arteries. The three districts most at risk are the brain, heart and lower limbs, where acute diseases such as stroke, myocardial infarction and ischemia of the lower limbs can occur, respectively, with very serious outcomes“.

When to worry about high cholesterol

For those who have never had a cardiovascular event (such as heart attack, stroke or angina), the alarm bell must start ringing when the value of total cholesterol exceeds 200 mg / dl and, in particular, when LDL levels exceed 130 mg / dl (but the bar for real prevention should already be set at 100 mg / dl).

«Less tolerance is granted instead to those who have already had acute events or suffer from particular pathologies, such as diabetes, or have a genetic-familial hypercholesterolemia. In this case, the LDL values ​​should be kept below 70 mg / dl », recommends Dr. Volpe.

How to calculate the LDL value if it is not found in the latest blood tests?

Just use the so-called Friedewald formula: total cholesterol – (HDL cholesterol + triglycerides / 5). On the web there are sites that allow a quick calculation, avoiding us to do too many operations if mathematics is not our strong point. “The only flaw: this formula loses accuracy when triglycerides are high, already over 250-300 mg / dl, because the LDL is” falsely “too low,” explains the expert.

What are the factors that raise cholesterol

Excess cholesterol can be caused by incorrect lifestyles, which include cigarette smoking, a sedentary lifestyle and an unbalanced diet characterized by the consumption of large amounts of saturated fat. “There can also be one genetic predispositionnever to be underestimated: about 16 per cent of women and 36 of men with familial hypercholesterolemia have a heart attack before the age of 50, because there are many more years of arterial accumulation behind them than in those who experience high cholesterol in old age ” , specifies Volpe.

“Suffice it to say that the diagnosis of familial hypercholesterolemia can already be made on the blood of the umbilical cord: if healthy children are born with an LDL cholesterol of about 40 mg / dl, in those with familiarity it could be around 80 mg / dl, albeit with the necessary individual differences “. However, we can do a lot: having high cholesterol from birth is not a “natural” fact, but it remains a negative factor to be countered immediately with a correct lifestyle.

Is it possible to lower cholesterol in no time?

Those who notice the high cholesterol problem would often want to repair quickly and without too much effort. «In reality, cholesterol does not pose risks overnight, but in the long run: this means that it is not necessary to give him a sudden scissor cut, which is impossible, ”admits Volpe.

“The only way to get results in a short time, already in 15-20 days, it is drug therapy: today we have several tools available, such as statins, ezetimibe and PCSK9 inhibitors, which should be chosen based on your individual situation and response “.

Instead, we often rely on do-it-yourself, independently purchasing supplements based on fermented red rice, perceived as natural and therefore less “dangerous” than medicines. “It is about products that contain an active substance, the monacolin K., which is in fact a statin and interferes with the production of cholesterol in the liver. Therefore, even the red fermented rice could cause muscle discomfort, stiffness and pain which are sometimes attributed to statinsbut which are actually quite rare events and are often confused with osteoarthritis pains“. Summing up: it must always be the doctor who advises and then supervise the therapy.

What to avoid at the table

Diet must limit saturated fats of animal origin (red meats, sausages, cheeses, whole milk, cream, butter, lard), while it is right to dispel a myth about eggs: “An egg brings 75 calories and contains 9 percent fat, of which only one third is saturated. Plus it contains lecithins, which promote the reverse transport of “bad” cholesterol from the arteries to the liver, enhancing the activity of the “good” cholesterol, HDL cholesterol. This means that we must not be relentless against this food, which is, among other things, very noble and rich in virtues. Two or three eggs a week are not harmful, the important thing is not to eat two together, worse if fried ». Better to avoid then, or in any case limit, even sweetsoften related only to the risk of diabetes, but in reality just as rich in more or less hidden fats.

What to eat with high cholesterol

How to start the day? With a cup of semi-skimmed milk or a tea and a source of whole grains: three servings of the latter (the equivalent of 50 grams) per day are enough to reduce cardiovascular risk by 20 percent. «A slice of wholemeal bread or four rusks correspond to a portion, as well as 80 grams of pasta or rice. So it doesn’t take much to reach the recommended quota ».

Another good morning habit can be hiring one yogurt with added phytosterols, molecules of vegetable origin that help to decrease the absorption of dietary cholesterol in the intestine (consumption can, alternatively, be moved to the end of lunch or dinner), without forgetting the important contribution of fibers, present for example in fruit. All healthy routines that can help us lower cholesterol by 5-10 percent, a small goal apparently, but still important to limit the damage in the long term ». On the other hand, those who prefer a savory breakfast can combine wholemeal bread with a few leaves of salad and tomato as well as turkey breast, bresaola, cooked or raw ham (deprived of visible fat) or speck.

Of course, yes to fruit which ensures a high intake of fibers, which help reduce the intestinal absorption of cholesterol and promote the sense of satiety, also helping to better control body weight. “In addition, fruit contains antioxidant vitamins that are essential for blocking the oxidation of LDL cholesterol in the arteries, considered the main pathogenic factor of atherosclerosis,” concludes the expert. «The same antioxidant action can be performed by green tea, vegetables, extra virgin olive oil, dark chocolate in moderate quantities and a glass of red wine a day ».

What are the cheeses you can eat

According to several studies, dairy products contain short- and medium-chain saturated fatty acids that cause an increase in LDL cholesterol, but they also increase the percentage of that HDL, although a diet should always be considered as a whole. Just follow the national guidelines, which turn on the green light on 50 grams of aged cheeses and 100 grams of fresh cheesesto be consumed twice a week.

“Obviously, priority must always be given to less fat cheeses, such as cottage cheese or cow ricotta, without being fooled by the less solid consistency of some types: for example, stracchino and robiola are respectively around 24 and 28 percent fat ».

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