Cholesterol is transported through the bloodstream by lipoproteins molecules (lipo- means "fat.") There are three main kinds: high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL). LDL carries fats from the liver to the body cells, while HDL carries fat back to the liver. The higher the level of LDL, the more fat you have in circulation, and the greater your risk of fat-related illnesses such as atherosclerosis ("hardening of the arteries"). In contrast, HDL protects against these illnesses because it removes fats from circulation and puts them back into storage in the liver. When doctors measure cholesterol levels, they are analyzing the ratio of HDL to LDL. The more HDL you have, and the less LDL, the better off you are. That's why you'll often hear HDL described as "good" cholesterol and LDL as "bad" cholesterol.
The more LDL you have, the more cholesterol is in circulation, and the greater your risk of heart disease. Currently, experts recommend that your total blood cholesterol level should be less than 200 mg/dl. The LDL level should be less than 130 mg/dl and the HDL level should be greater than 35 mg/dl. For every one percent drop in LDL levels, there's a two percent drop in the risk of heart attack. By the same token, for every one percent increase in HDL, the risk of heart attack drops three or four percent.
The ratio of your total cholesterol to HDL and the ratio of LDL to HDL are clues that indicate whether cholesterol is being deposited into tissues or is being broken down and excreted. The ratio of total cholesterol to HDL should be no higher than 4.2, and the LDL-to HDL ratio should be no higher than 2.5.
Reducing cholesterol levels
Reducing cholesterol levels in the blood is not enough to reduce the risk of coronary heart disease (CHD). People could further reduce their risk of heart disease by eating a diet high in "good" fats, vitamin E, beta-carotene, and flavonoids (Challem, 1996). Tocotrienols (Vitamin E family) also lower the level of LDL cholesterol (the bad cholesterol) and apolipoprotein B, both indicators of atherosclerosis and cardiovascular disease.
The Vitamin E group, mixed tocotrienols (220 mg total) and gamma-tocotrienol (200 mg.) can lower serum cholesterol in humans by 10% and 13% respectively. Importantly, the more harmful LDL and VLDL cholesterol fractions decreased, while HDL cholesterol, the good one, was left unchanged. Tocotrienols reduce the liver's production of VLDL and LDL cholesterol by inhibiting a key enzyme in the synthesis of cholesterol by the liver.
Cholesterol levels of 210 mg/dL led to a 4 to 5 percent increase in the death rates from heart disease in Japan and Mediterranean Europe (Greece and Italy). The same cholesterol level led to a 10 percent increase in the death rate in central Europe, 12 percent in the United States, and 15 percent in Northern Europe (Challem, 1996).
Most medical doctors advise that cholesterol levels should stay under 200 mg/dl (5.2 mmol/liter). Cholesterol levels lower than 200 are not without risk, as many people with levels below 200 have heart attacks. Research has shown that men with a cholesterol level of 190 mg/dL (generally considered safe), were twice as likely to die of heart disease in Northern Europe than in the Mediterranean. The difference is presume to be related to diet. Lower rates of heart disease were related to higher intakes of antioxidant vitamins beta-carotene and alpha-tocopherol [vitamin E] and flavonoids (Challem, 1996).
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