Understanding “Good” and “Bad” Cholesterol

Cholesterol sources

Cholesterol is often labeled as a heart health villain, but it is actually a complex and essential molecule crucial to our bodies. While it is often associated with negative health outcomes, cholesterol plays a significant role in our overall well-being.

Produced by the liver, cholesterol is vital for the structure and function of cell membranes. It is also a precursor for synthesizing key compounds like hormones and Vitamin D. However, when cholesterol levels in the bloodstream become too high, it can lead to health problems, underscoring the importance of maintaining a balance.

Cholesterol comes from two main sources:

Endogenous production: The liver produces cholesterol internally to meet the body’s needs. This process is tightly regulated to ensure balance.
Dietary Intake: Cholesterol is also absorbed from the foods we eat, especially from animal-based products like meat, dairy, and eggs.

The importance of cholesterol for health

Cholesterol plays a crucial role in maintaining overall health, particularly cardiovascular and brain health. While it often gets a bad rap due to its association with heart disease, cholesterol is indispensable for numerous bodily functions.

Cholesterol and cardiovascular health

Cholesterol is fundamental to cardiovascular health. Maintaining optimal cholesterol levels is essential for preserving heart health and preventing conditions like atherosclerosis, heart attacks, and strokes. Balancing “good” (HDL) and “bad” (LDL) cholesterol levels is key to minimizing the risk of cardiovascular disease.

Cholesterol’s role in brain health

Beyond its impact on the heart, cholesterol is vital for brain function. It is a critical component of cell membranes in the brain, contributing to synapse formation, neural communication, and overall cognitive function. Adequate cholesterol levels are necessary for optimal mental performance and cognitive health. However, imbalances can negatively impact brain function, potentially leading to mental health issues. This makes cholesterol management not just a matter of heart health but a holistic concern for overall well-being.

Cholesterol’s broader impact on health

Balanced cholesterol levels are integral to both physical and mental well-being. Cholesterol is involved in producing hormones, aiding digestion, and maintaining cellular structure throughout the body. Ensuring that your cholesterol levels remain within a healthy range supports these essential processes, contributing to overall health.

Given its importance, individuals must be proactive in managing their cholesterol levels through diet, exercise, and regular health check-ups to support their long-term health and well-being.

Understanding HDL and LDL cholesterol and their levels

HDL (High-Density Lipoprotein) Cholesterol: The "Good" Cholesterol	LDL (Low-Density Lipoprotein) Cholesterol: The "Bad" Cholesterol
HDL cholesterol is often referred to as “good” cholesterol because of its positive effects on health. It plays several important roles in the body, including: Reverse cholesterol transport: HDL helps remove excess cholesterol from the bloodstream, transporting it back to the liver for excretion. This process helps prevent plaque buildup in the arteries. Anti-inflammatory properties: HDL exhibits anti-inflammatory effects, which reduce the risk of atherosclerosis and heart disease. Cardiovascular protection: Higher levels of HDL are associated with a lower risk of heart disease, making it a protective factor for cardiovascular health.	On the other hand, LDL cholesterol is often labelled as “bad” cholesterol due to the health risks associated with high levels. While LDL has a role in the body, excessive amounts can be harmful, leading to: Atherosclerosis: Elevated LDL levels can contribute to the buildup of plaque in the arteries, increasing the risk of atherosclerosis. Heart Disease: High LDL levels are a significant risk factor for coronary heart disease, making it crucial to keep these levels in check.
Desirable: Above 1.55 mmol/L or 60 mg/dL Undesirable: Below 1.03 mmol/L or 40 mg/dL	Optimal: Less than 2.59 mmol/L or 100 mg/dL Near optimal: Between 2.59-3.35 mmol/L or 100-129 mg/dL Borderline high: Between 3.36-4.13 mmol/L or 130-159 mg/dL High: Between 4.14-4.90 mmol/L or 160-189 mg/dL Very High: Above 4.91 mmol/L or 190 mg/dL
Total cholesterol level Normal: Less than 5.17 mmol/L or 200 mg/dL Borderline high: Between 5.17-6.19 mmol/L or 200-239 mg/dL High: Above 6.21 mmol/L or 240 mg/dL

Managing cholesterol levels

Dietary intake	Incorporating certain foods into your diet can help lower LDL (bad) cholesterol and support overall heart health. For example, oats are rich in soluble fibre, which can reduce LDL cholesterol. Nuts like walnuts and almonds are packed with healthy fats that also contribute to lowering LDL levels. Additionally, fruits and vegetables are high in antioxidants and fibre, both of which are beneficial for heart health. Including fatty fish such as salmon, bluefin tuna, sardines, herring, and anchovies in your diet is another smart choice, as these fish are rich in omega-3 fatty acids—healthy fats that lower the risk of heart disease and reduce triglycerides.
Physical activities	Aim to exercise at least 150 minutes a week. You can start off with brisk walks and cycling.
Quit smoking	Smoking damages the blood vessels and contributes to inflammation, which can accelerate the process of atherosclerosis (the buildup of plaque in the arteries). By quitting smoking, your HDL cholesterol levels begin to rise, improving the balance of cholesterol in your body and reducing inflammation in the body, reducing the risk of plaque buildup in the arteries.
Limit alcohol intake	Excessive alcohol consumption can lead to elevated triglyceride levels, a type of fat found in the blood that contributes to high cholesterol and increases the risk of heart disease. By limiting alcohol intake, you help prevent spikes in triglyceride levels, maintaining a healthier cholesterol profile.
Medications	Sometimes, lifestyle modifications may not be sufficient to manage cholesterol levels. As such, specific medications may be prescribed to individuals at high risk of heart disease or those who do not respond well to dietary and lifestyle changes.
Regular monitoring	Regular cholesterol screenings are crucial for everyone, particularly those with risk factors like a family history of high cholesterol or heart disease. Routine lipid profiles—blood tests that measure HDL, LDL, and total cholesterol—enable early detection and intervention, helping to reduce the risk of complications.

Make an appointment at Gleneagles Hospitals

For health screening appointments, please contact the Health Screening Centre at your nearest Gleneagles Hospitals. We offer a wide range of screening programmes and packages that are specifically designed and can be customised based on every individual’s needs.

You may also get in touch with us to book an appointment today for a consultation or find out more about our Cardiology Services at your nearest Gleneagles Hospital.