How to determine good and bad cholesterol. What is “bad” and “good cholesterol”? Nutrition plays a role

The most famous medical word is “cholesterol”. But the more we hear about him, the less we know about him. Information noise has completely confused us on this issue. What should we do?

Bad or good?

This word has become simply demonic, but on the other hand, advanced people have well learned that there are two cholesterols: bad and good. Where is the truth and how do these substances differ? In fact, cholesterol is one thing. And it’s his “retinue” that makes him good or bad. There is cholesterol in our blood just like that pure form doesn't float. It is always combined with fats, proteins and other substances - such complexes are called lipoproteins. And depending on the composition of these substances, cholesterol can be either bad or good. For example, it is bad in low-density lipoproteins (LDL or LDL). From such complexes, cholesterol settles on the walls of blood vessels, forming so-called cholesterol plaques. Triglycerides (fats), which are mostly part of lipoproteins, behave in a similar way. But good cholesterol is found in high-density lipoproteins (HDL). In this form, it is transferred from the plaques themselves and from other organs for processing in the liver. That is, HDL even have a preventive and slightly therapeutic effect.

Yours or someone else's?

Another the most important question Where does cholesterol come from, from food? In fact, most of the cholesterol is synthesized by our liver, and a much smaller part from the digestive tract - approximately 20-25%. And it is very important that even this cholesterol absorbed from the intestines is not all from food. Some of it comes from bile, which in turn is produced by the liver and released into the digestive tract. With the help of diet, you can reduce your cholesterol intake and reduce its level by 10-15%. This is not very much, therefore, first of all, drugs are used that suppress the synthesis of cholesterol in the liver, in the place where most of it is formed. This approach to lowering cholesterol is more effective.

When to reduce and for how long?

Generally speaking, it is good for adults to have total cholesterol no higher than 5.18 mmol/l, and for children no higher than 4.4 mmol/l. It is believed that this level does not contribute to the development of cardiovascular vascular diseases and their complications. But in reality there are many subtleties in this issue.

Explains Yuri Vasyuk, cardiologist, doctor of medical sciences, professor, head of the department of clinical functional diagnostics and Scientific Secretary of the Moscow State Medical and Dental University. A.I. Evdokimova:

— First of all, when prescribing medications that lower blood cholesterol, you need to focus on the level of so-called low-density lipoproteins (LDL). This is one of the most harmful fractions, which contributes more than others to the development of atherosclerosis. It is called “bad cholesterol”. At what level of cholesterol in the blood should treatment begin? The modern view on this is this: there is no single norm for its content in the blood for everyone. It depends on the risk of developing heart attacks, strokes and other diseases associated with atherosclerosis. The higher the risk of their occurrence, the lower the cholesterol level should be, the more it needs to be reduced (see table). There are special methods for calculating risk. For example, if a person has many risk factors for cardiovascular complications (hypertension, obesity, smoking, diabetes, etc.) or has already developed manifestations of this disease (damage to the heart, cerebral vessels, kidneys, eyes, etc.), then drugs to reduce it should be prescribed at lower concentrations of cholesterol in the blood, or even at normal levels. Many very large studies have shown that this actually reduces the number of cardiovascular complications and mortality from them. And we understand very well why this is happening. First of all, because drugs from the statin group are the main medicines, used to lower cholesterol, also have so-called pleiotropic effects: they not only inhibit the synthesis of cholesterol in the liver, but also suppress immune inflammation of the inner wall of blood vessels. Thus, they significantly reduce the risk of damage to the vessels themselves and the formation of cholesterol plaques and blood clots. The latter lead to heart attacks, strokes and other complications of atherosclerosis. In addition to statins, drugs from the group of fibrates are also used, acting mainly on triglycerides, as well as drugs that suppress the absorption of cholesterol in the intestine, which enters the body along with fatty foods. And in Lately so-called monoclonal antibodies appeared. They have the most powerful effect and are usually used in cases where statins, fibrates and other drugs do not sufficiently lower cholesterol. This happens especially often with hereditary hypercholesterolemia - metabolic disorders that lead to its significant increase.

Optimal cholesterol levels in people with different risks of developing atherosclerosis and its complications (mmol/l)

Type of cholesterol		In people at low risk	In people at moderate risk	In people at high risk	In people at very high risk
Total cholesterol
LDL (bad)
HDL (good)
Triglycerides

Note: Compiled according to Russian recommendations for “Diagnostics and correction of lipid metabolism disorders for the purpose of prevention and treatment of atherosclerosis.” Developed by a committee of experts of the Russian Society of Cardiology (RSC), the National Society for the Study of Atherosclerosis (NOA) and Russian society cardiosomatic rehabilitation and secondary prevention (RosOKR).

Cholesterol (CS) is a substance from which the human body forms atherosclerotic plaques. They are the cause of the manifestation, which is a very dangerous disease.

What cholesterol is can be judged by the meaning of this word, which is translated from Greek as “hard bile.”

Substance belonging to the class lipids , comes with food. However, in this way, only a small part of the cholesterol enters the body - approximately 20% of the cholesterol a person receives mainly from products of animal origin. The remaining, more significant part of this substance (approximately 80%) is produced in the human liver.

In the human body, pure Chl is present only in small quantities, being part of lipoproteins. These compounds may have low density (so-called bad LPN cholesterol ) and high density (the so-called good cholesterol LPV ).

What should it be normal level cholesterol, as well as good and bad cholesterol - you can find out what it is from this article.

Cholesterol: good, bad, total

The fact that if cholesterol levels are higher than normal is harmful is said very often and actively. Therefore, many people are under the impression that the lower the cholesterol, the better. But in order for all systems in the body to function normally, this substance is very important. It is important that a person’s cholesterol remains normal throughout his life.

It is customary to distinguish between so-called bad and good cholesterol. Low cholesterol (bad) is the one that settles on the walls inside the blood vessels and forms plaques. It has low or very low density and binds to special types of protein - apoproteins . As a result, VLDL fat-protein complexes . It is when the LDL level increases that a dangerous health condition occurs.

VLDL - what it is, the norm of this indicator - all this information can be obtained from a specialist.

Now the LDL norm in men and the LDL norm in women after 50 years of age and at a younger age are determined by conducting cholesterol tests and are expressed by different laboratory methods, the units of determination are mg/dL or mmol/L. You need to understand when determining LDL that this is a value that should be analyzed by a specialist and appropriate treatment prescribed if LDL cholesterol is elevated. What this means depends on the metrics. Thus, in healthy people, this indicator is considered normal at a level below 4 mmol/l (160 mg/dl).

If a blood test shows that cholesterol is high, you should ask your doctor what to do. As a rule, if the value of such cholesterol is elevated, this means that the patient will be prescribed, or this condition should be treated with medications.

The question of whether you should take cholesterol pills is controversial. It is important to note that statins do not eliminate the causes of high cholesterol. We are talking about low mobility. only suppress the production of this substance in the body, but at the same time they provoke numerous side effects. Sometimes cardiologists say that the use of statins is more dangerous for the body than elevated levels.

• In people suffering from ischemic heart disease, who have had or, cholesterol levels must be below 2.5 mmol/l or 100 mg/dl.
• Those who do not suffer from heart disease, but have more than two risk factors, need to maintain cholesterol level at 3.3 mmol/l or below 130 mg/dl.

Bad cholesterol is counteracted by so-called good cholesterol, HDL cholesterol. What is high-density lipoprotein cholesterol? It is an essential substance for the body, as it collects bad cholesterol from the walls of blood vessels, after which it promotes its removal to the liver, where it is destroyed. Many people are interested: if HDL is lowered, what does this mean? It should be borne in mind that this condition is dangerous, since atherosclerosis develops not only against the background of increased low-density cholesterol, but also if LDL cholesterol is reduced. If HDL cholesterol is elevated, what does this mean, you need to ask a specialist.

That is why the most undesirable option in adults is when the level of bad cholesterol is increased and the level of useful cholesterol is decreased. According to statistics, approximately 60% of people mature age This combination of indicators is noted. And the earlier such indicators can be determined and treatment carried out correctly, the lower the risk of developing dangerous diseases.

Good cholesterol, unlike bad cholesterol, is produced only by the body, so it will not be possible to increase its level by consuming certain foods.

The normal level of good cholesterol in women is slightly higher than normal HDL cholesterol in men. Most important recommendation regarding how to increase its level in the blood, the following: you need to practice physical exercise, during which its production increases. Even if you do ordinary exercises at home every day, this will help not only increase HDL, but also reduce levels of bad cholesterol, which comes into the body from food.

If a person has eaten food that contains very high cholesterol, to activate its removal it is necessary to ensure the active work of muscles of all groups.

Thus, those who want the LDL and HDL levels to be restored need to:

• move more (especially for those who have suffered a heart attack or stroke);
• exercise moderately;
• practice intense physical activity (in the absence of contraindications).

You can also increase the level of good cholesterol by taking a small dose of alcohol. However, in no case should it be more than one glass of dry wine per day.

It is important to take into account that excessive load threatens to suppress the synthesis of cholesterol.

To correctly decipher a blood test, you should take into account the level of cholesterol in a person’s blood.

There is a table of cholesterol norms for women by age, from which, if necessary, you can find out what the cholesterol norm is for women after 50 years of age, and what the norm is considered to be for women at a young age. Accordingly, the patient can independently determine whether she has an increased or low cholesterol and consult a doctor who can help you find out the reasons for low or high levels. It is the doctor who determines what treatment and diet should be.

• The normal level of cholesterol in the blood for women and men based on HDL, if the condition of the heart and blood vessels is normal, is above 1 mmol/l or 39 mg/dl.
• In people with coronary artery disease who have had a stroke or heart attack, the indicator should be 1-1.5 mmol/l or 40-60 mg/dl.

The analysis process also determines the norm of total cholesterol in women and men, that is, how good and bad cholesterol correlate.

Total cholesterol in the blood should be no more than 5.2 mmol/l or 200 mg/dl.

If the norm is for men young even slightly exceeded, then this must be considered a pathology.

There is also a table of cholesterol norms in men by age, which can easily be used to determine the norm of cholesterol in men, its indicators in at different ages. From the corresponding table you can find out what norm of hdl-cholesterol is considered optimal

However, in order to determine whether the level in men and women is actually normal for this indicator, first of all, you need to do a blood test, which makes it possible to find out the content of total cholesterol, as well as the content of other indicators - low or high sugar, etc.

After all, even if the norm of total cholesterol is noticeably exceeded, it is impossible to determine the symptoms or special signs of such a condition. That is, a person does not even realize that the norm has been exceeded, and his blood vessels are clogged or narrowed, until he begins to notice that he has pain in the heart, or until a stroke or heart attack occurs.

Therefore even healthy person of any age, it is important to get tested and monitor whether the permissible norm cholesterol. Also, each person should prevent an increase in these indicators in order to avoid the development of atherosclerosis and other serious ailments in the future.

Who needs to control cholesterol levels?

If a person is healthy, he does not develop negative symptoms, he does not need to think about the condition of the blood vessels or check whether the level is normal Cholesterol takes place in the body. That is why patients are often not even aware of the increased level of this substance at first.

This indicator should be measured especially carefully and regularly for those who suffer from hypertension or have problems with the heart and blood vessels. In addition, indications for regular tests have the following categories:

• people who smoke;
• those who are sick hypertension ;
• overweight people;
• patients suffering from diseases of the cardiovascular system;
• those who prefer a sedentary life;
• women after;
• men after reaching 40 years of age;
• aged people.

Those who need a blood test for cholesterol should ask appropriate professionals about how to take a cholesterol test. The blood formula, including cholesterol content, is determined. How to donate blood for cholesterol? This analysis is carried out in any clinic; for this, approximately 5 ml of blood is taken from the ulnar vein. Those who are interested in how to donate blood correctly should note that before these indicators are determined, the patient should not eat for half a day. Also, in the period before blood donation, you should not engage in intense physical activity.

There is also special test for use at home. These are disposable test strips that are easy to use. The portable analyzer is used by people with lipid metabolism disorders.

How to decipher a blood test

You can find out whether total cholesterol is elevated by conducting a blood test in the laboratory. If total cholesterol is elevated, what does this mean, how to act, and everything about treatment will be explained by your doctor. But you can try to decipher the test results yourself. To do this you need to know that biochemical analysis contains three indicators: LDL cholesterol, HDL cholesterol and total cholesterol.

Lipidogram is a comprehensive study that allows you to evaluate lipid metabolism in the body, which allows you to determine how lipid metabolism occurs and calculate the risk of atherosclerosis and coronary artery disease.

Correct interpretation of the blood lipid profile is also important from the point of view of assessing the need to take statins, daily dose such drugs. Statins are drugs that have many side effects, and their price is quite high. Therefore, based on what it is - a lipid profile, this analysis allows you to find out what a person’s blood consists of and prescribe the most effective therapy to the patient.

After all, total cholesterol is an indicator that in itself does not make it possible to clearly assess the likelihood of a patient developing atherosclerosis. If total cholesterol is elevated, what to do can be assessed by full spectrum diagnostic indicators. Therefore, the following indicators are determined:

• HDL (alpha cholesterol) – it is determined whether high-density lipoproteins are increased or decreased. It is taken into account when determining the parameters of β-lipoproteins that this substance performs protective function, preventing the development of atherosclerosis.
• LDL – low-density lipoproteins are increased or decreased. The higher the beta cholesterol level, the more activated the atherosclerotic process.
• VLDL – very low density lipoproteins, thanks to which exogenous lipids are transported in plasma. Synthesized by the liver, they are the main precursor of LDL. VLDL take an active part in products atherosclerotic plaques.
• Triglycerides are esters of higher fatty acids and glycerin. This is a transport form of fats, therefore, their increased content also increases the risk of atherosclerosis.

What normal cholesterol should be is determined depending on age; it can be different for women and men. In addition, it is important to understand that there is no exact number that indicates the norm of cholesterol. There are only recommendations on what the index should be. Therefore, if the indicator is different and deviates from the range, then this is evidence of some kind of disease.

However, those who are planning to take the test should take into account that certain errors may occur during the analysis. The data from the study showed that in 75% of laboratories in the country such errors are allowed. What to do if you strive to get an accurate result? It is best to do such analyzes in those laboratories that are certified by the VCS (Invitro, etc.)

Normal cholesterol levels in women

• Normally, in women, the total chol level is 3.6-5.2 mmol/l;
• Cholesterol, moderately elevated – 5.2 – 6.19 mmol/l;
• Hc, significantly increased - from more than 6.19 mmol/l.
• LDL cholesterol: normal indicator– 3.5 mmol/l, elevated – from 4.0 mmol/l.
• HDL cholesterol: normal level is 0.9-1.9 mmol/l, a level below 0.78 mmol/l is considered dangerous to health.

№	Age (years)	Total Cholesterin (mmol/l)
1	under 5	within 2.90-5.18
2	5-10	within 2.26-5.30
3	10-15	within 3.21-5.20
4	15-20	within 3.08-5.18
5	20-25	within 3.16-5.59
6	25-30	within 3.32-5.75
7	30-35	within 3.37-5.96
8	35-40	within 3.63-6.27
9	40-45	within 3.81-6.53
10	45-50	within 3.94-6.86
11	50-55	within 4.20-7.38
12	55-60	within 4.45-7.77
13	60-65	within 4.45-7.69
14	65-70	within 4.43-7.85
15	from 70	within 4.48-7.25

Normal cholesterol levels in men

• Normally, the total Chol level in men is 3.6-5.2 mmol/l;
• Normal LDL cholesterol is 2.25-4.82 mmol/l;
• HDL cholesterol is normal – 0.7-1.7 mmol/l.

№	Age (years)	Total Cholesterin (mmol/l)
1	up to 5	within 2.95-5.25
2	5-10	within 3.13-5.25
3	10-15	within 3.08-5.23
4	15-20	within 2.93-5.10
5	20-25	within 3.16-5.59
6	25-30	within 3.44-6.32
7	30-35	within 3.57-6.58
8	35-40	within 3.78-6.99
9	40-45	within 3.91-6.94
10	45-50	within 4.09-7.15
11	50-55	within 4.09-7.17
12	55-60	within 4.04-7.15
13	60-65	within 4.12-7.15
14	65-70	within 4.09-7.10
15	from 70	within 3.73-6.86

Triglycerides

Triglycerides are a specific type of fat found in human blood. They are the main source of energy and the most abundant type of fat in the body. A complete blood test determines the amount of triglycerides. If it is normal, then these fats are beneficial for the body.

As a rule, triglycerides in the blood are elevated in those who consume more calories than they burn. When their levels are elevated, the so-called metabolic syndrome , at which it is noted high blood pressure, increased blood sugar, low levels of good cholesterin, and also a large amount of fat around the waist. This condition increases the likelihood of developing diabetes, stroke, and heart disease.

The normal triglyceride level is 150 mg/dl. The normal level of triglycerides in the blood of women, as well as men, is exceeded if the level is more than 200 mg/dl. However, the rate is up to 400 mg/dl. is designated as acceptable. A high level is considered to be 400-1000 mg/dl. very high – from 1000 mg/dl.

If triglycerides are low, what does this mean, you need to ask your doctor. This condition is observed in lung diseases, cerebral infarction, parenchymal damage, myasthenia gravis, when taken, etc.

What is the atherogenic coefficient

Many people are interested in what is the atherogenic coefficient in a biochemical blood test? Atherogenic coefficient It is customary to call the proportional ratio of good and total cholesterin. This indicator is the most accurate reflection of the state of lipid metabolism in the body, as well as an assessment of the likelihood of atherosclerosis and other ailments. To calculate the atherogenic index, you need to subtract the HDL cholesterol value from the total cholesterol value, and then divide this difference by the HDL cholesterol level.

The norm for women and the norm for men of this indicator is as follows:

• 2-2.8 – young people under 30 years old;
• 3-3.5 is the norm for people over 30 years old who do not have signs of atherosclerosis;
• from 4 – an indicator typical for people suffering from coronary artery disease.

If the atherogenic coefficient is below normal, then this is not a cause for concern. On the contrary, if the coefficient is reduced, then the person’s risk of atherosclerosis is low.

It is important to pay attention to the patient's condition if the atherogenicity coefficient is increased. A specialist will tell you what it is and how to act in this case. If a patient’s atherogenic coefficient is increased, the reasons for this are due to the fact that bad cholesterol is increased in the body. What to do in such a situation? First of all, you need to contact a qualified doctor who will adequately assess the atherogenic index. What this means can only be clearly assessed and explained by a specialist.

Atherogenicity – this is the main criterion for monitoring how effective hypercholesterolemia therapy is. One should strive to ensure that lipoprotein levels are restored. It is important to ensure not only a decrease in total cholesterol, but also an increase in high-density lipoproteins. Therefore, decoding lipid spectrum blood test stipulates that β-lipoproteins, the norms of which are different in women and men, as already noted, are necessarily taken into account when assessing the patient’s condition.

Other studies for high cholesterol

If there is a risk of atherosclerosis, they are determined not only by lipoproteins (normal in the blood), but also by others important indicators, in particular, also the norm of PTI in the blood of women and men. PTI – this is the prothrombin index, one of the most important factors of a coagulogram, a study of the state of the blood coagulation system.

However, currently in medicine there is a more stable indicator - INR , which stands for international normalization ratio. If the level is elevated, there is a risk of bleeding. If the INR is elevated, a specialist will explain in detail what this means.

The determination of hgb () is also important, since with high cholesterol levels, hemoglobin levels can be very high, and this increases the risk of heart attack, stroke, thrombosis, etc. How much hemoglobin should be normal can be found out from a specialist.

Other indicators and markers (he4), etc. are determined in people with high cholesterol if necessary.

What to do to normalize cholesterol?

Many people, having received test results and learned that they have cholesterol 7 or cholesterol 8, simply have no idea what to do. The basic rule in in this case following: clinical analysis blood must be deciphered by a specialist, whose recommendations should be followed. That is, if low-density lipoproteins are elevated, the doctor should explain what it is. In the same way, if there is low cholesterol in the blood, what does this mean, you should ask a specialist.

As a general rule, it is important to be strictly followed in men as well as in women. Its conditions are not difficult to understand. It is enough just not to consume foods with saturated fats and dangerous dietary cholesterol. There are some important tips to keep in mind:

• significantly reduce the amount of animal fats in the diet;
• reduce portions of fatty meat, remove skin from poultry before consumption;
• reduce portions of butter, mayonnaise, sour cream with high fat content;
• prefer boiled rather than fried foods;
• You can eat eggs without overdoing them;
• the diet should contain a maximum of healthy fiber (apples, beets, legumes, carrots, cabbage, kiwi, etc.);
• It is useful to consume vegetable oils and fish.

If cholesterol is elevated with, it is important to strictly adhere to the doctor’s recommendations - it is he who will tell you which diet plan is most relevant in this case.

Seeing cholesterol 6.6 or cholesterol 9 in test results, what to do, the patient should ask a specialist. It is likely that the doctor will prescribe treatment based on individual indicators patient.

You should clearly remember that normal Chl levels are the key to the health of your blood vessels and heart, and do everything to improve these indicators

Normal fat metabolism occurs if the indicators are close to the following values.

For a long time, cholesterol produced in the body was considered dangerous substance. Patients tried to lower it, ate a special cholesterol-free diet, and lowered “bad” cholesterol with medications. Over time, experts found that cholesterol can be divided into “good” and “bad”, depending on the type of action.

Types of lipid fats

A substance produced in the liver, cholesterol, is used to build cells. Cholesterol is actually both harmful and beneficial. The production of sex hormones, the work of the adrenal glands and the pituitary gland depend on the level of lipids.

Fatty alcohol is divided into several types.

The optimal ratio of indicators is when the composition of HDL and LDL does not exceed the norm.

Normal cholesterol levels change with age and may differ depending on a person's gender. Both “good” and “bad” fatty alcohols are necessary for the body to function properly.

"Good" cholesterol

High-density lipoprotein cholesterol is useful and necessary for the productive functioning of the cardiac system. HDL performs a transport function, carrying waste fats from the heart to liver cells, clearing blood vessels of excess fat deposits. HDL promotes cell division and renewal.

Average HDL level table:

High-density lipoproteins decrease in blood plasma with inflammatory processes, liver and kidney diseases.

A decrease in HDL below normal causes problems with the functioning of blood vessels and the risk of heart disease. If a patient has an HDL density above 1.56 mmol/l, cholesterol is already performing its protective function.

You can increase “good” cholesterol by diversifying your diet. Recommended products to use:

Eating these foods promotes blood thinning and helps avoid the formation of large numbers of atherosclerotic plaques and fatty blood clots. Activates the production of high density lipoproteins.

Elevated levels of HDL are considered a genetic abnormality and, due to impaired lipid metabolism, cannot protect the patient from the development of heart disease and vascular problems. Exceeding the norm of “good” cholesterol is observed in chronic alcoholism, excessive consumption of steroids medicines, insulin.

"Bad" cholesterol

Low-density lipoproteins transport total cholesterol from the liver to the tissues and cells of the body. Calling this type of fatty alcohol “bad” or “harmful” can only be conditional. In the absence of LDL, everything in the body stops completely. metabolic processes. Low-density lipoproteins help bind and neutralize bacterial toxins, significantly aiding performance immune system person.

Average LDL level table:

An excess of LDL in the blood plasma is diagnosed if the patient is obese, leads a sedentary lifestyle, smokes, or enjoys alcohol. “Bad” cholesterol is often detected above the norm in those who eat unhealthy foods, eat unhealthy fast food, trans fats, and dense fats.

The more the LDL norm is exceeded, the greater the risk of developing vascular atherosclerosis; patients may be diagnosed with ischemia, myocardial infarction, and cerebral stroke.

“Bad” cholesterol can accumulate on the walls of blood vessels, forming dense fatty plaques. Over time, lipid plaques grow more and more, contributing to low blood flow, clogging blood vessels.

Since blood flow is disrupted, problems arise with a certain area of ​​the organ that should be supplied with oxygen and other nutrients. Tissue necrosis and death occur. This process is especially dangerous in the heart muscle and brain cells.

The level of low-density lipoproteins in the blood increases with age. Except external reasons, the development of hypercholesterolemia may be influenced by genetic predisposition. If parents had heart disease before the age of 55, a heart attack, a stroke were diagnosed, or there were deaths, the child needs to check the level of low-density lipoproteins after two years.

In order for LDL to be eliminated from the body faster, it is recommended to eat more fiber: bran bread, legumes, whole grains, vegetables, greens.

An ideal product that helps increase the level of high-density lipoproteins in the body and lower the level of low-density lipoproteins is green tea, brewed according to all the rules.

Balance of HDL and LDL

After 40 years, it is recommended to periodically take a lipid profile - a blood test that determines the level of total cholesterol in a person’s blood. If the level of total fatty alcohol is elevated, the doctor prescribes detailed blood biochemistry. The ratio of “bad” cholesterol to “good” cholesterol is present in the blood plasma.

A blood test is taken from a vein. Before the procedure, you must not eat for about 12 hours, so examinations are usually scheduled for the morning. A week before the test, it is recommended to stop taking medications that change the composition of the blood. You need to eat normally, without changing anything, so that the analysis results are reliable.

The research results must be reviewed by a specialist. It is the doctor who can determine whether LDL is increased or HDL is decreased. The therapist may prescribe a special diet for the patient to normalize fatty alcohol levels. If there are significant, threatening readings of LDL or HDL, the specialist will prescribe a treatment that will help establish the optimal balance of “bad” and “good” cholesterol in the body.

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The “total cholesterol” indicator means nothing

Cholesterol is a kind of “scarecrow” modern medicine, says our regular expert, nutritionist Lyudmila Denisenko. - This is on the one hand. On the other hand, it is a way to enrich pharmaceutical monsters, because drugs to lower blood cholesterol - statins - always cost a lot.

In fact, even babies need cholesterol, and they get it from their mother's milk. Cholesterol is the “building blocks” of our brain, hormones, nerve endings, cell membranes...

And when we are called to “lower cholesterol levels,” we need to understand why and what kind of cholesterol we need to “lower.”

It is important to understand that we get only about 20% of the cholesterol we need from food, the remaining 80 is synthesized in our body. On average, each adult normally contains about 2 grams of cholesterol per kilogram of body weight. That is, with a weight of 70 kg - about 140 g of cholesterol.

Remember that there is no “good” or “bad” cholesterol in your plate; it becomes such in our liver, kidneys, adrenal glands, gonads, intestines and skin - the places where cholesterol formation occurs.

When patients start telling me that their therapist or cardiologist recommended a diet because their cholesterol is “higher than normal,” I immediately warn that the “total cholesterol” indicator means nothing! You need to know which cholesterol – “good” or “bad” – is responsible for this increase.

Say no to statins

“Good” cholesterol - HDL (high-density lipoprotein) can be arbitrarily high, although laboratories also give the upper limit of its “norm”. But if “bad” cholesterol is increased - LDL and LDL (low and very low density lipoproteins) - then you need to take care of reducing it. Just one request - no statins! Even if your doctors insistently offer them to you.

(Cardiologists, of course, may have their own opinion about the prescription of drugs. But even they clarify: statins are not prescribed for high cholesterol, and when high risk vascular diseases, and the risk is assessed taking into account cholesterol - Red.)

Statins, like doctors who have not delved very deeply into the topic, sometimes do not understand which cholesterol is “good” and which is “bad”, and reduce everything. Google it and see how many have come up now. scientific research about the dangers of statins, that they can lead to senile dementia and even Alzheimer's disease.

1. It’s not about food, but about heredity or place of residence

Why is it so unfair - someone can eat sandwiches with butter and caviar, topped with scrambled eggs, and still remain healthy until old age, while someone literally on water and bread has that very “high” cholesterol level that is blamed for all mortals? sins - atherosclerosis, strokes, heart attacks and other diseases of civilization?

And most importantly - what to do? Should you urgently go on a diet, eliminating all foods containing cholesterol from your diet? Take your time, because our body, sensing a deficiency of cholesterol in the incoming food, will simply begin to synthesize it more! The facts speak about this, because even vegans - people who have completely abandoned animal foods (and as you remember, cholesterol is found only in animal products) - hypercholesterolemia - an increase in cholesterol levels in the blood - is quite common. All the reasons for this have not yet been clarified; heredity, stress, bad habits, and even place of residence play a role here. It is known, for example, that residents of the Far North, whose diet is dominated by animal products, have virtually no atherosclerosis.

The cause of increased cholesterol is quite often diseases of the liver and intestines, because this is where endogenous cholesterol is synthesized.

2. Hormone deficiency is to blame

Most doctors recognize that one of the main reasons for increased cholesterol is... deficiencies. First of all, there is a deficiency of sex hormones. I already said above that cholesterol is extremely important for the synthesis of sexual hormones, but with age their production decreases, which means that “extra” cholesterol appears. What to do? Compensate for deficiency of sex hormones. Hormone replacement therapy from a certain age will also help reduce cholesterol, because the body, realizing that the level of these hormones is normal, will stop synthesizing “extra” cholesterol.

Another deficiency is thyroid hormones, which, alas, is becoming more common. It can also be adjusted perfectly and our doctors are excellent at doing it.

3. Not enough vitamin D

What other deficiencies cause high cholesterol? Vitamin D deficiency (and it is observed in at least 80% of the inhabitants of Russia, and even in sunny southern Sochi. The reason is banal - sunscreens, rare exposure to the open sun in the most favorable morning and pre-sunset hours, a shortage of products containing this vitamin (in first of all - fresh sea fish and seafood). How to compensate? It is clear that in Sochi you can sunbathe in the sun and eat black sea mullet, but it is not a fact that your intestinal microflora is in order and synthesizes inactive vitamin D from inactive vitamin D (from the sun and food) its active form. What should Muscovites or Murmansk residents do? Take vitamin D in the form of medications. Everyone, starting with infants and ending with very old people. The maintenance dose is 100 thousand IU per month; only a doctor will prescribe a therapeutic dose (if there is a deficiency of the vitamin detected in the blood).

4. Ate little fish

Another deficiency is omega-3 fatty acids. Again, where is fresh food in our diet? sea ​​fish northern seas, rich in this essential nutrient? Not the suspiciously red-orange salmon from our supermarkets, raised on farms on artificial feeds and additives, and having virtually no omega-3 fatty acids, but small fresh fish - mackerel, anchovies, herring - “grazed” in the open sea and not frozen on our tables? If you are unlucky enough to be born and live in the northern seas, there is a way out - omega-3 supplements, and only those in which the content of EPA + DHA (don’t worry about their full name, remember these abbreviations) is above 50% per capsule and obtained exactly from this small fish. How to check if you have enough omega? Donate blood for omega-3 index. And it should ideally be 12-13, and for most of us it is about 3... High cholesterol is also affected by a deficiency of iron, iodine, vitamin B12...

5. And went too far with sugar

But the same high cholesterol is also affected by... excess! But not fat in foods, which we are constantly afraid of (remember the Eskimos and their seal fat in their diet), but sugar! It is sugar, starting from refined white sugar, which you like to add to tea, and ending with “hidden” sugar, which is found in almost all industrially processed products - bread, cheese, sausage, canned food, baked goods, sweets, juices, drinks...

The food basket of today's Russian contains only refined sugar - 24 kg per year. “Hidden” sugar is almost impossible to count. And it is sugar that causes plaques in blood vessels. Attaching to hemoglobin, sugar molecules turn it into “hedgehogs” - glycated Hb - which “scratch” the walls of blood vessels, and in order to patch up these wounds, our body begins to synthesize more cholesterol, which is a kind of putty for these mucosal defects. This is how atherosclerotic plaques appear.

ON A NOTE!

Eggs and lard - yes

But it’s time to justify eggs, butter, lard, which are accused of all mortal sins! The same eggs contain choline, which removes “bad” cholesterol, and lard contains arachidonic acid, which is extremely necessary for us, which has the same effect. I am silent about butter, which contains vitamins A, D, E, C, B, calcium, phospholipids (building material for cells, especially nerve cells) and essential amino acids.

But don’t rush to run to the market tomorrow for fatty cottage cheese and sour cream; excess fat in your diet will increase not cholesterol, but the amount of fat – subcutaneous and internal. And here excess weight– this is almost 100% high cholesterol.

Is it worth using vodka to “clean vessels”?

Do not listen to “folk” advice that a glass of vodka “cleanses” blood vessels. She doesn't clean anything. In addition, alcohol abuse leads to fatty liver degeneration, one of the causes of increased cholesterol in the blood. But resveratrol in red wine helps remove “bad” cholesterol and is a strong antioxidant that protects our organs and tissues from free radicals - the cause of inflammation and even cancer. But remember the dose - 150 - 200 ml per day, no more.

IMPORTANT!

What diet will really lower cholesterol?

It is already clear from the above that these are fish and seafood containing vitamin D and omega-3, as well as complete protein - rich in choline, essential amino acids and, in particular, methionine. Choline and methionine are used by the body to synthesize phospholipids, in particular lecithin, which forms hydrophilic lipoprotein complexes with cholesterol. Lipotropic substances also prevent fatty infiltration of the liver, thereby ensuring its normal functioning. Lean meats, lean fish, cottage cheese, skim milk, egg whites, legumes (soybeans, peas), spinach, oatmeal, and herring are rich in choline. There is a lot of methionine in lamb, pike perch, cod, legumes (soybeans, peas, beans), and buckwheat. For more details, see below.

Vegetables, fruits, berries (fresh, frozen and dry), mushrooms.

Milk and some dairy products in their natural form (low-fat, but not low-fat cottage cheese, curdled milk, kefir, fermented baked milk).

Buckwheat, oatmeal, wheat cereals, legumes, pasta made from durum wheat.

Meat (veal, beef), skinless poultry (turkey, chicken).

Low-fat varieties of fish (cod, perch, pike, pike perch), and 2-3 times a week - fatty varieties of fish containing omega-3 (wild salmon, herring, mackerel, mackerel, sardines, etc.)

Unrefined vegetable oil(linseed, olive) and butter.

2-3 times a week - eggs and dishes made from them.

Seafood (shrimp, mussels, squid, scallop, seaweed).

Coarsely ground rye and wheat bread.

And don't forget about physical activity! Not exhausting training, but feasible, but regular, let it be what you like - walking, walking at a fast pace, dancing, swimming, rollerblading or cycling, skating or skiing - but be sure to do it regularly! And better - in the fresh air.

High and low density lipoproteins

Being an essential vital substance in the body, cholesterol exists in two forms, conventionally called “good” and “bad”. Both forms are found in the blood plasma as part of lipoproteins (another name: lipoproteins) - complex compounds consisting of fats and proteins. Good cholesterol is the conventional name for high-density lipoproteins, referred to in medicine as HDL. This substance contains more than two times more proteins than low-density lipoproteins (bad cholesterol).

In addition to proteins, which make up more than half of the structure, HDL contains 25% phospholipids (the basis of cells), 15% cholesterol (a fat-like substance produced by the liver and supplied with food), and some triglycerides (the basis of the body's fatty tissue).

The main role of “good” cholesterol is the continuous transfer of excess cholesterol from the blood to the liver for processing and further elimination from the body. Therefore, HDL is an anti-atherosclerosis fraction that actively protects the body from serious illnesses, cleansing the inner walls of blood vessels from accumulations of bad cholesterol in the form of plaques.

Harmful cholesterol (another name: lipids, that is, fats) in combination with special proteins forms complex complexes - low-density lipoproteins. Their designation: LDL.

Functions in the body

Good cholesterol is created in the body in much smaller quantities than bad cholesterol. In addition, HDL is not found in foods and therefore does not enter the body through food.

As a conscientious caretaker of the body, good cholesterol protects human health with its presence. Medical experts rightly call increased HDL levels longevity syndrome.

Good cholesterol has another name: alpha cholesterol, and is responsible for the smooth functioning of a molecular structure in the body called cell membrane, necessary tissue renewal, bone growth, insulation of nerve fibers, protection of red blood cells from toxins, synthesis of sex hormones.

Being a building material in the formation of cells for the above components of the body system, beneficial lipoproteins take part in maintaining water balance and remove unnecessary substances from the body that can cause serious diseases.

According to doctors, increased level Bad cholesterol is not as worrisome as a lack of good cholesterol. In this case, the vessels lack protection from blood clots, the risk of heart attacks and strokes increases, a tendency to depression may develop, and female body- hormonal imbalances.

Normal in blood

In people in normal health, HDL levels should be greater than 1 mmol/L. Upper limit the average favorable indicator reaches a value of 1.88 mmol/l. Increasing the level of good cholesterol only benefits the body. With a low HDL value (less than 0.78 mmol/l), the risk of atherosclerosis increases three times.

Good cholesterol results are divided into best level (1.55 mmol/L), ranging from 1.3 to 1.54 mmol/L - good, low for women (less than 1.4 mmol/L) and men (1.03 mmol/l).

If a patient has suffered a heart attack or stroke, then his HDL level is 1-1.6 mmol/l. There is also an updated norm of good cholesterol in the blood for male body from 0.7 to 1.72 mmol/l, the correct HDL level in females is from 0.85 to 2.29 mmol/l.

The balance of bad and good cholesterol is very important for health. It is determined by dividing your total cholesterol by your blood HDL level. Normally, the resulting value should be less than six.

If total cholesterol is increased rate, which is usually considered a signal for cardiovascular disease, then increased value HDL is a decisive indicator and indicates the normal state of health of the body.

To determine the level of good cholesterol, you need to take a biochemical blood test at the clinic, but a more accurate result is guaranteed in special certified laboratories.

Products affecting its level

Good cholesterol is not found in foods, but some of them help increase HDL in the blood. Oat flour, oat bran, fatty fish, food additives with fish oil, legumes (lentils, green peas, beans), as well as soy products are recommended as the main diet. You can successfully increase the “necessary” cholesterol if you consume the listed products.

In addition to the above, green vegetables, herbs, apples, nuts, flaxseeds and flaxseed oil, spices, green tea should be mentioned.

Medicines

The most effective and the least safe medicine To increase HDL levels is nicotinic acid (niacin). Please note that food additives containing nicotinic acid located in free sale, can damage the liver.

Fibrates help normalize good cholesterol. have an effect on regulating the liver in relation to cholesterol and clearing it from the blood.

Policosanol, a natural plant wax extract that is used as a dietary supplement, may also be prescribed to raise HDL.

Correctly prescribed medicine is the key successful treatment patient. To avoid undesirable consequences, before using medications, you should consult your doctor and read the instructions.

The medicine prescribed by the doctor should be taken as directed, but still the basis for recovery should be proper nutrition, consumption of foods that increase healthy cholesterol.

By controlling the level of good cholesterol, maintaining proper nutrition, and maintaining your weight at normal levels, you can strengthen your blood vessels and heart and take a fresh look at life.