Cholesterol: friend or foe?

Cholesterol is both a friend and a foe. At normal levels, it is an essential substance for the body’s normal functioning, but if levels in the blood get too high, it becomes a silent danger that puts people at risk of terrible consequences for life.

Cholesterol has four main functions without which we could not live.
▪ Contributes to the structure of cell walls.
▪ Makes up digestive bile acids in the intestine.
▪ Allows the body to produce vitamin D.
▪ Enables the body to make certain hormones.

What is cholesterol?

Cholesterol is waxy and fat-like in appearance. It exists in every cell of the body and has important natural functions. It is manufactured by the body, but can also be taken in from food.

The parcels of cholesterol are carried in the blood by two types of protein “transporters”, small packages called lipoproteins, made of fat (lipid) on the inside and proteins on the outside.
▪ Low-density lipoprotein (LDL – cholesterol carried by this type is known as ‘bad’ cholesterol)
▪ High-density lipoprotein (HDL – cholesterol carried by this type is known as ‘good’ cholesterol).

Why is LDL cholesterol “bad”?

Too much LDL in the blood can collect on the walls of the arteries, building the so called “plaques”, narrowing and stiffening the arteries with the risk of a heart attack or a stroke, besides other problems related with bad arterial circulation.

Why is HDL cholesterol “good”?

HDL does a clean-up job in the blood vessels. It carries excess of cholesterol to the liver to be removed so it will not clog the arteries.

What are triglycerides?

Triglycerides are used for energy and are the most common form of fat in food and in the body. When people eat more calories than needed the extra triglycerides are stored in the liver fat cells, for an eventual need.

Symptoms of high cholesterol

High cholesterol has no symptoms. A blood test is the only way to detect high cholesterol.


High cholesterol can cause atherosclerosis, a dangerous accumulation of cholesterol and other deposits on the walls of the arteries, making it difficult for enough blood to flow through the arteries.

When the heart does not get as much oxygen-rich blood as it needs, the risk of a heart attack is higher and decreased blood flow to the brain can cause a stroke.

A healthy cholesterol level is good for your brain as well as for your heart. High cholesterol, as a consequence of deficient general brain circulation, can lead not only to strokes but to mini-strokes as well that might not even be noticed. Over time, memory and thinking problems can arise affecting daily life.

Watching cholesterol levels helps to keep the mind sharp.

Risk factors

People are more likely to have high cholesterol when any of these risk factors are present:
▪ Smoking – Cigarette smoking damages the walls of the blood vessels, making them likely to accumulate fatty deposits. It may also lower the level of HDL, or “good” cholesterol.
▪ Diabetes – High blood sugar contributes to higher LDL cholesterol and lower HDL cholesterol and it also damages the lining of the arteries.
▪ Lack of exercise – Exercise helps boost the body’s HDL “good” cholesterol while lowering the LDL “bad” cholesterol.
▪ Poor diet
▪ Obesity/Large waist circumference

High cholesterol (hypercholesterolemia) can be inherited, but even if your parents did not give you the bad genes, it is often the result of unhealthy lifestyle choices. Thus it is preventable and treatable. A healthy diet, regular exercise and sometimes medication can do a lot to reduce high cholesterol.
It is important not to forget that lowering blood cholesterol levels is just one part of an overall strategy to reduce the total risk of circulatory diseases, like heart disease and stroke.
Lowering your cholesterol may slow, reduce or even stop the build-up of plaque in your arteries. It may also reduce the risk of plaque rupturing and causing dangerous blood clots.

Do not forget:
▪ Children can have high cholesterol.
▪ Thin and super thin people can have trouble with cholesterol … they should blame it on genes.
▪ Quitting smoking is one of the best lifestyle changes for taming cholesterol.

Best healthy wishes,
Dr. Maria Alice

By Dr Maria Alice
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Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service / Medilagos. Medical Director – Grupo Hospital Particular do Algarve