Get to the heart of cholesterol
Mar 1 2004
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We must have cholesterol but we must not have too much of it. The key, says one Coventry expert, is balance.
Dr Michael Khan, a consultant with an interest in heart disease and diabetes, and head of molecular medicine at the University of Warwick, said: "Basically cholesterol is a lipid, a type of fat. It is found in most foods, sometimes in large quantities, sometimes not.
"It is also manufactured by our bodies in the liver. Cholesterol is actually an essential element in the body. It helps to maintain the structure of our cells and is used to manufacture certain proteins. We could not survive without it."
If that is the case, why does cholesterol get such a bad press and why does it appear to be so harmful? Because anything in abundance can be dangerous.
If our arteries contain too much cholesterol, they clog up, causing inflammation and obstruction.
Of course, if you start getting obstructions in your arteries it can be very bad news indeed. The blood cannot get through, your heart does not get enough oxygen - and you have a heart attack.
Dr Khan explained that part of the problem with abundant cholesterol was down to natural causes.
"Some organisms, particularly man, seem to have a high capacity to manufacture it internally.
"Humans tend to produce an abundance of cholesterol, which is fine if you are only living for 30 years or so, but in the long-term can be a concern.
"Our arteries, even in teenagers, contain streaks of fat and as we get older they form lumps, some of which bulge into the arteries.
"We make cholesterol in our own bodies and some people have a genetic predisposition to make more than others."
The other integral element is diet and lifestyle. Living a certain way and eating certain foods all increase our chances of having high cholesterol levels.
"As well as making cholesterol we also get it from food," said Dr Khan. "There are general rules of thumb which say cholesterol is fairly high in food groups such as red meat, dairy products, and pastry and crisps. Saturated fat is the component to watch out for."
It works like this. Foods which are high in saturated fats are transformed into cholesterol by the liver, which is then transported by proteins - lipoproteins - into the bloodstream.
Eventually this causes a narrowing of the arteries which, after years of abuse, takes its toll - and thousands die from a heart attack.
is diet the key for most of us who are lucky enough not to be overloading our own system with cloggy cholesterol?
You might think so, but it is not that simple. For one thing, it is not that easy for people to change the habits of a lifetime and give up foods they enjoy.
There also remains a lot of controversy over what kind of lifestyle changes are needed to make an impact on cholesterol.
Take the Atkins Diet, for example. Some people on this high-fat, high-protein regime discover their cholesterol levels fall, flying in the face of accepted dietary wisdom.
A worrying factor is that even if you do follow nutritional advice to the letter, there appears to be a surprisingly small pay-off.
"If the average person with a cholesterol level of 6 to 6.5 is put on a rigid diet, the most they are likely to do is reduce their level by 10 per cent, and we don't know why," said Dr Khan.
That is not to say we should ignore well-established dietary guidelines.
Increasingly we are learning that healthy eating can help reduce the risk of many illnesses and conditions and even a small reduction is better than none.
Cholesterol levels vary from nation to nation. In France and Mediterranean countries, levels are on average lower than in Britain.
Drinking red wine, which has antioxidants known to protect the heart, eating lots of fruit and vegetables, and using olive oil have been held up as the probable reasons.
"One of the things we are trying to understand is why Mediterranean people live longer," said Dr Khan. "It has been suggested that fats like olive oil and rapeseed oil may actually be better than other fats or may in some way be protective.
"So instead of saying 'do not take any fats', the suggestion is to use products such as extra virgin olive oil."
When it comes to food, there is a lot to be said for being more open about fat levels and the type of fats, present in our foods.
Nutritional labelling has improved in recent years but there is still a long way to go.
Dr Khan said : "We could do much more in terms of nutritional data available to the public, so they can see if they are buying foods high in cholesterol.
"Get to the heart of cholesterol"
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