Along with diabetes and obesity, heart disease is one of the leading health issues among adults in the United States, and high cholesterol is often a contributing factor. According to the CDC, almost 94 million adults who are 20 years or older have at least borderline high cholesterol. While this is a significant concern, cholesterol should not be avoided entirely, as it is essential for our survival.
So what is cholesterol, anyway?
Cholesterol is a type of lipid, or fat, that is made in the liver. It has one of the most important roles of the body, and without it our bodies would be unable to perform essential tasks for proper organ function. It helps the liver manufacture bile for digestion, is involved in the production of sex hormones and vitamin D, is a necessary building block of cell membranes, among other things. Despite common belief, cholesterol itself is not necessarily harmful and is vital for the function of each of our cells. However, too much cholesterol can be harmful, especially when combined with other risk factors for cardiovascular disease.
The brain, an organ that relies mainly on cell membranes, contains the highest level of cholesterol in the body. Cholesterol in the brain plays a key role in the communication between neurotransmitters, such as dopamine and serotonin. It forms myelin, which is a protective coating on neurons, and is involved in the formation of membranes important for brain cell signaling. In fact, it shouldn’t be surprising to know that 60% of the brain’s mass is made up of fat, much of which is cholesterol!
In the rest of the body, cholesterol is shuttled throughout on a transport system composed of lipoproteins, or compounds made up of lipids and proteins. The lipoproteins deliver cholesterol to organs in order to meet certain needs as well as carry excess amounts away for disposal.
What are the different types of lipoproteins?
HDL cholesterol, or high-density lipoproteins, are made mostly of protein. This is considered the “good” type because it carries the extra cholesterol out of your bloodstream and back to your liver, where it is processed and disposed of. We want to aim for higher blood levels of HDL ideally above 60 mg/dL, to help keep the risk of heart disease low.
LDL, or low-density lipoproteins, are made mostly of cholesterol, which is delivered to your body’s cells. They can become problematic when combined with other substances and adhere to the walls of your arteries. These deposits form plaques and develop what is called atherosclerosis, which is a risk factor for strokes, heart attacks, and other diseases. Due to this potential for plaque buildup, LDL is known as the “bad” cholesterol and we want to keep it under a certain amount. For most adults, we want to see LDL below 100 mg/dL, and below 70 mg/dL for those with a history of atherosclerosis or cardiac risk.
VLDL cholesterol, or very low-density lipoproteins, carries fat and cholesterol and can also contribute to plaque buildup in your arteries.
What levels of cholesterol are too high?
Normal cholesterol levels are 135-200 mg/dL, and ideally they should be 165-200 mg/dL to support the body’s needs. The maximum amount should be around 200 mg/dL; however, this number carries greater significance if it exists concurrently with other health issues, such as heart disease or diabetes. In addition, studies show that cholesterol levels below 160 mg/dL can increase the risk of depression and suicide. It’s important to understand that low levels can be just as dangerous as high levels of cholesterol.
How can we support healthy cholesterol levels?
· A whole foods diet rich in vegetables, fruits, whole grains, lean meats, grass-fed meats, and healthy fats with a moderate intake of eggs is recommended. Dietary fats are not always our enemy, and aggressively low-fat diets are not our friends. To support cardiovascular and brain health, we want to eat healthy fats rich in omega 3s that combat inflammation, such as olive oil, avocados, nuts, seeds, and fatty fish. Some research shows a Mediterranean diet can help keep cholesterol within healthy limits.
· We want to avoid foods that are pro-inflammatory and will contribute to greater cardiovascular risk, such as processed meats, refined vegetable oils, like canola and soybean oil, baked goods, and refined carbohydrates. These foods will favor an increase of LDL over HDL.
· Maintaining a healthy weight and reducing excess body fat may lower LDL cholesterol. This is especially important for those with metabolic syndrome. However, there is no direct correlation between being overweight and having overall high cholesterol, yet being overweight will shift the ratio of HDL to LDL unfavorably.
· Physical activity, 30 minutes each day, can support healthy cholesterol levels. This includes walking, jogging, swimming, playing sports, or anything that gets the body moving.
· Chronic high stress can raise LDL and lower HDL, so practicing stress management will also support adequate levels of cholesterol. Stress management can include spending time with friends and family, using an app, like Mindspace or Calm that promotes mindfulness, making time for hobbies and interests, meditation, or other relaxation techniques.
· Limiting nicotine and alcohol supports healthy cholesterol levels by lowering LDL and raising HDL. Any habits that raise inflammation will also raise LDL levels.
· Managing underlying chronic inflammatory conditions, such as diabetes, hypertension, liver disease, kidney disease, and autoimmune disease, will help lower the overall risk for heart disease.
So what’s the take-home message?
While cholesterol is necessary for each of us to function, high levels are a risk factor for atherosclerosis and coronary heart disease, among other metabolic diseases. As athletes, it is important to undergo routine screening and be aware of any genetic predispositions to high cholesterol. To optimize performance, weight management combined with the proper lifestyle and dietary considerations are essential to maintain cholesterol levels in an optimal range. Obtaining sufficient calories from a whole foods diet and limiting processed foods, alcohol, and smoking will also help to keep inflammatory markers and cholesterol levels within a healthy range. However, don’t let perfect be the enemy of the good; making even minor changes to your diet and lifestyle can make a significant impact on your overall health and performance.