Cholesterol: Is there such thing as Good Cholesterol ?

Good Cholesterol versus Bad Cholesterol

When talking about cholesterol, the first things that come to mind are “bad” cholesterol and its related diseases. However cholesterol is not necessarily bad. That’s why it is important to know what cholesterol is, how it works within the body and how it can affect human health.

Cholesterol is a lipid compound that functions as a structural component of cell membranes, as well as a precursor for steroid hormones (sex hormones and cortisol), bile acids, vitamin D and lipoproteins. Although cholesterol is found naturally in many foods, human cells (especially liver cells) are able to synthesize it from simpler precursors, so cholesterol is not an essential nutrient for the body.

Cholesterol travels in the bloodstream in small packages called lipoproteins, that have a hydrophobic lipid core of triglycerides and cholesterol esters (cholesterol bound to fatty acids), surrounded by a hydrophilic shell of phospholipids, free cholesterol and apolipoproteins (fat-binding proteins).

Where does Cholesterol go in the body?

There are two main types of lipoproteins: Low-Density-Lipoprotein (LDL) and High-Density-Lipoprotein (HDL). LDL serves as a source of cholesterol for most tissues of the body, where it performs the biological functions described above. However, when in excess, LDL-cholesterol can accumulate in the walls of arteries forming plaques or “atheromas” that reduce or even block blood flow through the arteries, potentially leading to myocardial infarction, stroke or other acute events associated with cerebral ischemia. That’s why LDL-cholesterol is known as “bad” cholesterol. On the contrary HDL serves as a scavenger of free cholesterol. It removes cholesterol from the blood and transports it to liver, where it can be eliminated from the body. That’s why HDL-cholesterol is usually known as “good cholesterol”.

According to this, above, it is clear that the ideal situation is to have low LDL-cholesterol (< 100 mg/dL) and high HDL-cholesterol (> 45 mg/dL), as well as a low total cholesterol. But how to achieve this goal? 

Heading for low LDL Cholesterol

Well, the cornerstone for preventing and treating high LDL-cholesterol is a healthy lifestyle. Most of all, it is important to adopt a healthy diet, that must be rich in fruit, vegetables, whole grains and legumes, with limited or no intake of cholesterol, saturated fats and trans fats. It has been clearly demonstrated that saturated fats (found in meat, dairy products, eggs and certain oils, such as palm and coconut oils) raise total blood cholesterol as well as LDL-cholesterol, while trans fats (found in margarine and some commercial snack foods) cause both LDL-cholesterol to increase and HDL-cholesterol to lower. Trans fats are therefore particularly bad for cholesterol levels.

Cholesterol and diet

Diet should be rich in nutrients that help lower LDL-cholesterol (polyphenols in olive oil), increase HDL-cholesterol (omega-3 fatty acids), or both (soluble fiber and omega-6 fatty acids). It has been shown that certain foods containing these nutrients are particularly effective in preventing high blood cholesterol. These include soluble-fiber rich foods (oatmeal, apples, bananas, prunes, barley, kidney beans), omega-6 rich foods (walnuts, almonds, pistachio nuts and peanuts), olive oil and certain fatty fishes.

Although healthy nutrition is the cornerstone for a healthy lifestyle, there are also other important lifestyle habits that can help control cholesterol levels, such as regular exercise, no smoking, managing stress and limiting alcohol use.

When diet and other lifestyle changes are not enough to address high cholesterol, medications (such as statins and fibrates) are indicated. However it is paramount to consult with one’s physician before starting any pharmacological treatment.

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