Diet, Cholesterol, and Lipoproteins Clarified
In the realm of heart health, lipoproteins play a crucial role. These spherical molecules, responsible for transporting fat in the body, come in various types, each with distinct effects on cardiovascular health and atherosclerosis.
High-density lipoproteins (HDL), often referred to as 'good' cholesterol, facilitate reverse cholesterol transport—removing cholesterol from plaques and arterial walls and carrying it back to the liver for excretion. This process typically protects against atherosclerosis and cardiovascular disease.
On the other hand, low-density lipoproteins (LDL), or 'bad' cholesterol, contribute to atherosclerosis by depositing cholesterol in arterial walls, leading to plaque formation and increased cardiovascular risk. Apolipoprotein B (apoB), a structural protein found in LDL and other atherogenic lipoproteins, is considered an even better predictor of cardiovascular events than LDL cholesterol alone.
A third type, Lipoprotein(a) [Lp(a)], is a genetically determined lipoprotein similar to LDL but with an additional apolipoprotein(a) component. Elevated Lp(a) levels are independently associated with increased risk of atherosclerotic cardiovascular events such as heart attack, stroke, peripheral artery disease, and restenosis after vascular procedures.
Maintaining optimal blood lipid levels is essential for heart health. For adults aged 20 years and over, these levels should be as follows: triglycerides under 150 mg/dl, LDL cholesterol under 100 mg/dl, HDL cholesterol at least 40 mg/dl for males and 50 mg/dl for females, total cholesterol 125-200 mg/dl, and non-HDL less than 130 mg/dl.
Increasing physical activity, cutting out processed meats, choosing healthy fats, limiting added sugar and processed foods, and maintaining a high-fiber diet can all help maintain healthy blood lipid levels and decrease heart disease risk. Reducing excess body fat can also increase HDL levels and decrease LDL and triglyceride levels.
Taking an omega-3 supplement may further reduce LDL and triglyceride levels and increase HDL levels. However, anyone considering using a new supplement should speak with a healthcare professional to ensure the supplement is safe to use.
Statins can help lower cholesterol levels, particularly LDL, and are often prescribed for those at high risk of cardiovascular disease. A doctor can help someone with high blood lipid levels or low HDL cholesterol levels to make a treatment plan that suits their specific needs.
In summary, LDL and Lp(a) are key therapeutic targets to reduce cardiovascular risk, while HDL is generally viewed as protective. Elevated Lp(a) represents a significant residual risk factor independent of traditional LDL cholesterol levels, underscoring the importance of monitoring and novel treatments for Lp(a)-associated risk.
- High-density lipoproteins, often referred to as 'good' cholesterol, facilitate reverse cholesterol transport, typically protecting against atherosclerosis and coronary artery disease.
- A third type, Lipoprotein(a) [Lp(a)], is a genetically determined lipoprotein similar to LDL but with an additional apolipoprotein(a) component, and elevated Lp(a) levels are independently associated with increased risk of coronary artery disease and other cardiovascular events.
- Maintaining optimal blood lipid levels is essential for heart health, with specific guidelines for triglycerides, cholesterol, and non-HDL levels.
- Adopting a healthy diet can help maintain healthy blood lipid levels and decrease heart disease risk, including increasing physical activity, choosing healthy foods, limiting processed foods, and maintaining a high-fiber diet.
- Reducing excess body fat can also increase HDL levels and decrease LDL and triglyceride levels, contributing to overall heart health.
- Taking an omega-3 supplement may further reduce LDL and triglyceride levels and increase HDL levels, but it is recommended to consult with a healthcare professional before starting any new supplements.
- Statins, therapies and treatments for lowering cholesterol levels, are often prescribed for those at high risk of cardiovascular disease, and a doctor can help create a personalized treatment plan to address specific needs in heart-and-wellness, fitness-and-exercise, and medicare.
