What is cholesterol? Cholesterol is a waxy steroid of fat that is produced in the liver or intestines.

It is used to produce hormones and cell membranes and is transported in the blood plasma of all mammals.[2] It is an essential structural component of mammalian cell membranes and is required to establish proper membrane permeability and fluidity. In addition, cholesterol is an important component for the manufacture of bile acids, steroid hormones, and vitamin D. 3
.Pearson A, Budin M, Brocks JJ (December 2003). "Phylogenetic and biochemical evidence for sterol synthesis in the bacterium Gemmata obscuriglobus". Proc. Natl. Acad. Sci. U.S.A.100 (26): 15352 7. doi:10.1073/pnas.2536559100. PMC 307571. PMID 14660793.

Function:
-modulates membrane fluidity over the range of physiological temperatures.7
Haines TH (July 2001). "Do sterols reduce proton and sodium leaks through lipid bilayers?". Prog. Lipid Res. 40 (4): 299 324.doi:10.1016/S0163-7827(01)00009-1.PMID 11412894.

- functions in intracellular transport,8

Pawlina, Wojciech; Ross, Michael W. (2006). Histology: a text and atlas: with correlated cell and molecular biology. Philadelphia: Lippincott Wiliams & Wilkins. pp. 230.ISBN 0-7817-5056-3.

- cholesterol is the precursor molecule in several biochemical pathways: 1 -cholesterol is converted to bile, 2- Cholesterol is an important precursor molecule for the synthesis of vitamin D and the steroid hormones, 9
Smith LL (1991). "Another cholesterol hypothesis: cholesterol as antioxidant". Free Radic. Biol. Med. 11(1): 47 61.doi:10.1016/0891-5849(91)90187-8.PMID 1937129.

Significance:

Hypercholesterolemia
According to the lipid hypothesis, abnormal cholesterol levels (hypercholesterolemia)that is, higher concentrations of LDL and lower concentrations of functional HDLare strongly associated with cardiovascular disease because these promote atheroma development in arteries (atherosclerosis). This disease process leads to myocardial infarction (heart attack), stroke, and peripheral vascular disease.34
Brunzell JD, Davidson M, Furberg CD, Goldberg RB, Howard BV, Stein JH, Witztum JL (April 2008). "Lipoprotein management in patients with cardiometabolic risk: consensus statement from the American Diabetes Association and the American College of Cardiology Foundation".Diabetes Care 31 (4): 81122.doi:10.2337/dc08-9018.PMID 18375431.

level mg/dL Level mmol/L Interpretation

< 200

< 5.2

Desirable level corresponding to lower risk for heart disease

200240

5.26.2

Borderline high risk

> 240

> 6.2

High risk

Hypocholesterolemia
Abnormally low levels of cholesterol are termed hypocholesterolemia. Research into the causes of this state is relatively limited, but some studies suggest a link with depression, cancer, andcerebral hemorrhage. In general, the low cholesterol levels seem to be a consequence of an underlying illness, rather than a cause. [36]
Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, Halsey J, Qizilbash N, Peto R, Collins R (December 2007). "Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths".Lancet 370 (9602): 182939.doi:10.1016/S0140-6736(07)61778-4.PMID 18061058.

High-density lipoprotein (HDL) is one of the five major groups of lipoproteins which, in order of sizes, largest to smallest, are chylomicrons, VLDL, IDL, LDL and HDL, which enable lipids likecholesterol and triglycerides to be transported within the water-based bloodstream. In healthy individuals, about thirty percent of blood cholesterol is carried by HDL.[1] Blood tests typically report HDL-C level, i.e. the amount of cholesterol contained in HDL particles. It is often contrasted with low density or LDL cholesterol or LDL-C. HDL particles are able to remove cholesterol from within artery atheroma and transport it back to the liver for excretion or re-utilization, which is the main reason why the cholesterol carried within HDL particles (HDL-C) is sometimes called "good cholesterol" (despite the fact that it is exactly the same as the cholesterol in LDL particles). Those with higher levels of HDL-C seem to have fewer problems with cardiovascular diseases, while those with low HDL-C cholesterol levels (less than 40 mg/dL or about 1 mmol/L) have increased rates for heart disease.[2] While higher HDL levels are correlated with cardiovascular health, no incremental increase in HDL has been proven to improve health. In other words, while high HDL levels might correlate with better cardiovascular health, specifically increasing one's HDL might not increase cardiovascular health.[3] Additionally, those few individuals producing an abnormal, apparently more efficient, HDL ApoA1 protein variant called ApoA-1 Milano, have low measured HDL-C levels yet very low rates of cardiovascular events even with high blood cholesterol values

Ways to increase HDL levels[vague]

[edit]Diet

and lifestyle

Certain changes in lifestyle may have a positive impact on raising HDL levels: [17] Aerobic exercise[18] Weight loss[19] Nicotinic Acid supplementation[19] Smoking cessation[19] Removal of trans fatty acids from the diet[20] Mild to moderate alcohol intake[21][22][23][24][25][26] Addition of soluble fiber to diet[27] Consumption of omega-3 fatty acids such as fish oil[28] or flax oil[citation needed] Increased intake of cis-unsaturated fats[29] and cholesterol.[citation needed]

Most saturated fats increase HDL cholesterol to varying degrees but also raise total and LDL cholesterol. [30] A highfat, adequate-protein, low-carbohydrate ketogenic diet may have similar response to taking niacin as described below (lowered LDL and increased HDL) through beta-hydroxybutyrate coupling the Niacin receptor 1.[31]

Footnotes
1. ^ "LDL and HDL Cholesterol: What's Bad and What's Good?". American Heart Association. July 2, 2009. Retrieved October 8, 2009. 2. ^ Toth, Peter (2005). "The "Good Cholesterol" High-Density Lipoprotein". Circulation 111 (5): e89-e91. Retrieved 2 June 2011. 3. ^ a b c "NIH stops clinical trial on combination cholesterol treatment". National Institute of Health. National Heart, Lung, and Blood Institute (NHLBI). Retrieved 2 June 2011. 17- Fogoros, Richard N. (September 15, 2009). "Raising Your HDL Levels". About.com. Retrieved October 8, 2009. 18- ^ Spate-douglas, T; Keyser, RE (1999). "Exercise intensity: its effect on the high-density lipoprotein profile". Archives of physical medicine and rehabilitation 80 (6): 691 5. doi:10.1016/S0003-9993(99)90174-0. PMID 10378497. 2. 19-^ a b c Hausenloy DJ, Yellon DM (June 2008). "Targeting residual cardiovascular risk: raising highdensity lipoprotein cholesterol levels". Heart 94 (6): 70614. doi:10.1136/hrt.2007.125401.PMID 18480348. 3. 20^ "Trans fat: Avoid this cholesterol double whammy". Mayo Foundation for Medical Education and Research (MFMER). Retrieved 2010-06-25. 4. 21^ Baer, D.; Judd, J.; Clevidence, B.; Muesing, R.; Campbell, W.; Brown, E.; Taylor, P. (2002). "Moderate alcohol consumption lowers risk factors for cardiovascular disease in postmenopausal women fed a controlled diet". The American journal of clinical nutrition 75 (3): 593599. PMID 11864868. edit 5. ^ 22Van Der Gaag, M.; Van Tol, A.; Vermunt, S.; Scheek, L.; Schaafsma, G.; Hendriks, H. (2001). "Alcohol consumption stimulates early steps in reverse cholesterol transport". Journal of lipid research 42 (12): 2077 2083. PMID 11734581. edit 6. ^23 Hendriks, H.; Veenstra, J.; Van Tol, A.; Groener, J.; Schaafsma, G. (1998). "Moderate doses of alcoholic beverages with dinner and postprandial high density lipoprotein composition". Alcohol and alcoholism (Oxford, Oxfordshire) 33 (4): 403410. PMID 9719399. edit 7. ^24 Clevidence, B.; Reichman, M.; Judd, J.; Muesing, R.; Schatzkin, A.; Schaefer, E.; Li, Z.; Jenner, J. et al. (1995). "Effects of alcohol consumption on lipoproteins of premenopausal women. A controlled diet study". Arteriosclerosis, thrombosis, and vascular biology 15 (2): 179184. PMID 7749823. edit 8. ^ 25Cuvelier, I.; Steinmetz, J.; Mikstacki, T.; Siest, G. (1985). "Variations in total phospholipids and highdensity lipoprotein phospholipids in plasma from a general population: Reference intervals and influence of xenobiotics". Clinical chemistry 31 (5): 763766. PMID 3987006. edit 9. ^ 26Brenn, T. (1986). "The Troms heart study: Alcoholic beverages and coronary risk factors". Journal of epidemiology and community health 40 (3): 249256. PMC 1052533. PMID 3772283. edit

10. ^ 27Hermansen K, et al. "Effects of soy and other natural products on LDL:HDL ratio and other lipid parameters: a literature review.", "National Institues of Health", 2003 Jan-Feb. Accessed 2011 May 31. 11. ^ 28"The Power of Fish". The Cleveland Clinic Heart and Vascular Institute. Retrieved October 8, 2009. 12. ^ 29Mensink, Ronald P.; Zock, Peter L.; Kester, Arnold D. M.; Katan, Martijn B. (2003). "Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials". American Journal of Clinical Nutrition 77 (5): 1146. PMID 12716665. 13. 30^ Thijssen, M.A. and R.P. Mensink. (2005). Fatty Acids and Atherosclerotic Risk. In Arnold von Eckardstein (Ed.) Atherosclerosis: Diet and Drugs. Springer. pp. 171172. ISBN 9783540225690. 14. ^ a31 b Soudijn, W; Van Wijngaarden, I; Ijzerman, AP (2007). "Nicotinic acid receptor subtypes and their ligands". Medicinal research reviews 27 (3): 41733. doi:10.1002/med.20102. PMID 17238156.