Cholesterol

and its effects

on the body
Jayden Gevao
WHAT IS CHOLESTEROL
Cholesterol is a natural fatty substance in your blood. It’s produced
in the liver and it's also in some of the foods we eat. We need a
small amount of blood cholesterol because the body uses it to build the structure
of cell membranes, make hormones like oestrogen, testosterone and adrenal
hormones, help your metabolism work efficiently, for example, cholesterol is
essential for your body to produce vitamin D.

Although cholesterol is good for our bodies, too much of it - especially non-HDL
cholesterol (next slide) - If you don’t take steps to lower high
cholesterol, you can develop fatty deposits in your blood vessels.
Eventually, these deposits grow, making it difficult for enough
blood to flow through your arteries. Sometimes, those deposits
can break suddenly and form a clot that causes a heart attack or
stroke.
Types of
cholesterol
When cholesterol and proteins combine, they're called lipoproteins. There are
two main types of lipoproteins. One is good for your health; the other is bad.

High-density lipoproteins or HDL is known as ‘good’ cholesterol. It gets

rid of the ‘bad’ cholesterol from your blood by taking cholesterol you don’t
need back to the liver, where it is broken down and removed from your body.

LDL used to be the main measure of harmful types of cholesterol (and was what
known as 'bad cholesterol'), but we now know that other forms of non-HDL
cholesterol can also affect your health.

Non-high-density lipoproteins or non-HDL - known as 'bad' cholesterol. Too

much non-HDL leads to a buildup of fatty deposits inside the walls of the
blood vessels (channels that carry blood throughout your body) increasing
the risk of a heart attack or stroke. , but even a little non-HDL cholesterol is
needed. An example of a useful non-HDL is LDL which transports cholesterol
to tissues in the body.

Our blood also contains a type of fat called triglycerides (that the body uses
for energy if the body is low on glucose), which can also contribute to
narrowed arteries (contributing to heart attacks and strokes). Having excess
weight, eating a lot of fatty and sugary foods or drinking too much alcohol
can cause high triglyceride levels.

If you have had results from a lipid profile (a test that looks at all aspects of your
cholesterol), you may see your triglycerides level – your doctor will be able
to tell you if it's too high.

You can have a normal level of HDL and non-HDL cholesterol but still have a high
triglyceride level. If you are found to have this, you may wish to speak to
your GP to discuss what it means for you as a high triglyceride level is as
serious as high cholesterol levels.
 •Things that cause high cholesterol which you can't
control:

• Your age, biological sex and ethnic background:

• getting older – having higher cholesterol is more likely

as we age

•
•Things that cause high if your biological sex is male (you were assigned male
at birth) – males are more likely to have high

What cholesterol which you can cholesterol

control: • your ethnic background – if you are from a

south Asian background, you are more likely to have
high cholesterol.

effects • Your lifestyle:

• eating too much saturated fat –
•

•
Your genes:

Genes carry the information that determine your

cholester
features or characteristics that are passed on to you
this reduces the liver’s ability — or inherited — from your parents.
to remove cholesterol, so it • Familial hypercholesterolaemia (FH), is an inherited
builds up in the blood condition, meaning you were born with it. It's often

ol
passed down through families in faulty genes and can
lead to very high levels of cholesterol, even if you do
• being physically inactive – not have other risk factors.

being active raises the level of • Lipoprotein (a), or LP(a), is made in your liver and
carries fats around the body. High LP(a) is a condition
‘good’ cholesterol and reduces that can cause heart problems like heart attack and
stroke. This is because LP(a) is ‘sticky’ and can build
the level of ‘bad’ cholesterol up in your arteries. It's usually an inherited condition
but there are other causes. Find out more through
Heart UK.
• smoking - this can lead to high
• Your general health:
cholesterol levels and it causes
tar to build up in your arteries, • kidney disease - when your kidneys aren’t working
well, it also changes the way your body handles
making it easier for cholesterol cholesterol, which can lead to high cholesterol

to stick to your artery walls. • liver disease – an important job of the liver is to both
produce cholesterol and clear it from the body, but if
the liver isn’t working well it struggles to do this,
increasing your risk of high cholesterol

• if you live with excess weight, especially around your

middle

• if you have type 2 diabetes, you are at greater risk of

having high cholesterol

• having an underactive thyroid (hypothyroidism – when

your body doesn’t make enough thyroid hormone)

• growth hormone deficiency (when not enough of the

 often a hidden risk factor which means it can happen without us knowing until it's
too late. That is why it's so important to get your cholesterol level checked.
However, if you have familial hypercholesterolemia, you may have visible signs
symptoms of of high cholesterol. These include:
Tendon xanthomata - swellings made from cholesterol on the knuckles of your
high hands, your knees or the Achilles tendon at the back of your ankle.

cholesterol Xanthelasmas - small, yellow lumps of cholesterol near the inner corner of your
eye.

how to test for Corneal arcus - this is a pale white ring around the coloured part of your eye,
your iris.
cholesterol
and what are How to check cholesterol and triglyceride levels

healthy If you are concerned about any of these You can ask your GP to check your
cholesterol levels, which are measured using a simple blood test. It is
sometimes referred to as a ‘lipid profile’.
cholesterol You may be offered a finger-prick cholesterol test. This can be done in some
levels pharmacies, or as part of the NHS Health Check in England.

Here are the healthy levels for different types of cholesterol:

• non-HDL cholesterol, 4mmol/L or below
• HDL cholesterol, 1mmol/L or above for men and 1.2mmol/L or above for
women
• LDL cholesterol, 3mmol/L or below
• total cholesterol, 5mmol/L or below
• total cholesterol to HDL cholesterol ratio, 6:1 or below
• fasting triglycerides, 1.7mmol/L or below
• non-fasting triglycerides, 2.3mmol/L or below.
How to Lower
cholesterol

There is lots you can do to help lower your

cholesterol:
• You can try ways of getting more active, which
will help lower your cholesterol
• You can cut down on alcohol and stop smoking
• You can enjoy trying healthy foods and
recipes that are good for your heart (next
slide)
Statins are the main type of medicine used to
reduce cholesterol. But there are other
treatments available. Your doctor will let you
know if you need to take any other drugs
which help control your cholesterol levels.
They may also refer you to a specialist called a
lipidologist.
Cholesterol friendly recipes (1)
Salmon & spinach with
tartare cream
Ingredients Method
• 1 tsp sunflower or vegetable oil • STEP 1
• 2 skinless salmon fillets Heat the oil in a pan, season the salmon on both sides,
• 250g bag spinach then fry for 4 mins each side until golden and the flesh
flakes easily. Leave to rest on a plate while you cook
• 2 tbsp reduced-fat crème fraîche the spinach.
• juice ½ lemon • STEP 2
• 1 tsp caper, drained Tip the leaves into the hot pan, season well, then
cover and leave to wilt for 1 min, stirring once or
• 2 tbsp flat-leaf parsley, chopped twice. Spoon the spinach onto plates, then top with
• lemon wedges, to serve the salmon. Gently heat the crème fraîche in the pan
with a squeeze of the lemon juice, the capers and
parsley, then season to taste. Be careful not to let it
boil. Spoon the sauce over the fish, then serve with
lemon wedges.
 Cholesterol friendly recipes (2)
-Crab linguine with chilli &
parsley
Ingredients Method
•400g linguine • STEP 1: Bring a large pan of salted water to the boil and add the
•4 tbsp extra-virgin linguine. Give it a good stir and boil for 1 min less than the pack
says. Stir well occasionally so it doesn’t stick.
olive oil
•1 red chili, deseeded • STEP 2: While the pasta cooks, gently heat 3 tbsp of olive oil with
and chopped the chili and garlic in a pan large enough to hold all the pasta
•2 garlic cloves finely comfortably. Cook the chili and garlic very gently until they start to
sizzle, then turn up the heat and add the white wine. Simmer
chopped everything until the wine and olive oil come together. Then take off
•1 whole cooked crab the heat and add the brown crabmeat, using a wooden spatula or
picked, or about spoon to mash it into the olive oil to make a thick sauce.
100g/4oz brown • STEP 3: When the pasta has had its cooking time, taste a strand –
crabmeat and 200g/7oz it should have a very slight bite. When it’s ready, turn off the heat.
fresh white crabmeat Place the sauce on a very low heat and use a pair of kitchen tongs
•small splash, about 5 to lift the pasta from the water into the sauce.

tbsp, white wine • STEP 4: Off the heat, add the white crabmeat and parsley to the
•small squeeze pasta with a sprinkling of sea salt. Stir everything together really
of lemon(optional) well, adding a drop of pasta water if it’s starting to get claggy.
Taste for seasoning and, if it needs a slight lift, add a small
•large handful parsley squeeze of lemon. Serve immediately twirled into pasta bowls and
leaves, very finely drizzled with the remaining oil.
drugs to help control blood cholesterol and triglyceride levels
for people who can’t control them through diet and exercise.

• Statins: These are the most commonly prescribed cholesterol-lowering medications. They work by inhibiting an enzyme involved in
cholesterol production in the liver. Examples include:
• Atorvastatin (Lipitor)
• Simvastatin (Zocor)
• Rosuvastatin (Crestor)
• Ezetimibe: This medication reduces cholesterol absorption in the intestines and is often used in conjunction with statins for additional
lowering of LDL cholesterol.
• Bile Acid Sequestrants: These drugs bind bile acids in the intestine, preventing their reabsorption, which can lower cholesterol levels.
Examples include:
• Cholestyramine (Questran)
• Colesevelam (Welchol)
• PCSK9 Inhibitors: These are newer injectable medications that significantly lower LDL cholesterol levels by enhancing the liver's ability to
remove LDL from the blood. Examples include:
• Alirocumab (Praluent)
• Evolocumab (Repatha)
• Fibrates: Primarily used to lower triglycerides, fibrates can also have a modest effect on raising HDL (good cholesterol). Examples include:
• Fenofibrate (Tricor)
• Gemfibrozil (Lopid)
• Niacin: This B vitamin can help increase HDL cholesterol and lower triglycerides, though its use has declined due to side effects and limited
benefit when added to statin therapy.
• Omega-3 Fatty Acid Supplements: Prescription formulations can help lower triglyceride levels, though they don’t typically affect LDL
cholesterol.
Always consult with a healthcare provider to determine the most appropriate treatment based on individual health needs and conditions.