LECTURE 11

CHOLESTEROL
MANAGEMENT

What is cholesterol?
Cholesterol is a chemical that is naturally produced by
the body .
Cholesterol is a building block for cell membranes and
for hormones like estrogen and testosterone.
About 80% of the body's cholesterol is produced by the
liver, while the rest comes from our diet.
The main sources of dietary cholesterol are meat,
poultry, fish, and dairy products. Organ meats, such as
liver, are especially high in cholesterol content.
Foods of plant origin contain no cholesterol.
The liver is able to regulate cholesterol levels in the
blood stream and can secrete cholesterol if it is needed
by the body.

What are LDL and HDL

cholesterol?
LDL cholesterol is called "bad cholesterol "
because it is associated with an increased risk
of coronary heart disease, stroke, and
peripheral artery disease.
HDL cholesterol is called the "good
cholesterol" and prevents atherosclerosis
Low levels of LDL cholesterol and high
levels of HDL cholesterol (low LDL/HDL
ratios) are desirable and protect against heart
disease and stroke.

CHOLESTEROL TRANSPORT
HDL (High Density Lipoprotein)
It brings back cholesterol to the liver
LDL (Low Density Lipoprotein)
Its over-accumulation and deposition lead
to
serious ailments
VLDL (Very Low Density Lipoprotein)
Converted into LDL by endothelial cellassociated lipases

OPTIMAL CHOLESTEROL LEVELS

Total Cholesterol
Less than 200 mg/dL
Desirable level that puts you at lower risk for coronary heart
disease
200 to 239 mg/dL
Borderline high
240 mg/dL and above
High blood cholesterol. Twice the risk of CAD as below 200
mg/dl

HDL Cholesterol
Less than 40 mg/dL
Low level. A major risk factor for CAD
40 to 59 mg/dL
The higher the level the better
60 mg/dL and above
High level. Considered protective against CAD

LDL Cholesterol
Less than 100 mg/Dl Optimal

100 to 129 mg/dL Near or above optimal

130 to 159 mg/dL Borderline high
160 to 189 mg/dL High
190 mg/dL and above Very high

What determines the level of

LDL cholesterol in the blood?
Both heredity and diet have a
significant influence on a person's
LDL, HDL and total cholesterol levels.
Diets high in saturated fats and
cholesterol raise the levels of LDL
cholesterol in the blood.
Saturated fats are derived primarily
from meat and dairy products and
can raise blood cholesterol levels.

Does low cholesterol prevent

heart attacks and strokes?
The benefits of lowering LDL
cholesterol are:
Reducing of cholesterol plaques on the
artery walls
Decreasing the risk of heart attacks
Decreasing the risk of strokes

FACTORS INFLUENCING
CHOLESTEROL LEVELS
Age
Weight and its body location
Gender (men, menopause)
Genetics (enzyme deficiencies)
Diseases (diabetes)
Lifestyle (exercise, stress, smoking)

PHYSIOPATHOLOGICAL
CONSEQUENCES OF THE
PLAQUE

Coronary Artery Disease (CAD): angina.

Peripheral Artery Disease (PAD)
Ischemic Stroke (brain infarct)
Transient Ischemic Attacks (TIAs)
Secondary Erectile Disorder (ED)
Chronic Renal Ischemia (renal failure)

CHOLESTEROL AS CORONARY
ARTERY DISEASE RISK FACTOR
High LDL is responsible for 70% of heart diseases
(leading killer of men and women after 45)
Age 49-82: The most potent risk factor for CAD
is low HDL.
Every 2% raise in HDL = 2% in men
and 3% in women decrease in CAD risk
Same impact for LDL reduction, Combined
benefits

GENDER AND HEART DISEASE

(WOMEN)
Most important risk factors
Diabetes
Low HDL
High triglycerides
Inflammatory disorders
Symptoms/disease
Fatigue, malaise, shortness of breath, nausea,
depression
First heart attack at average age 70 with higher fatality
rate than men
More likely to have microvascular disease
Diagnostic procedures
ECG stress test less informative than nuclear test
Treatment
Less likely to have bypass surgery or angioplasty for
coronary lesions
Longer hospital stays, higher complication rate

GENDER AND HEART

DISEASE (MEN)
Most important risk factors
High LDL
High blood pressure in young men
Symptoms/disease
Unstable angina warrants immediate
attention
First heart attack at average age 65
Diagnostic procedures
Stress tests more reliable than in women
Angiography more likely to be informative
Treatment
More likely to receive bypass surgery,
angioplasty for coronary lesions
Shorter hospital stays

How can LDL cholesterol levels

be lowered?
Lifestyle changes:
losing excess weight
exercising regularly
following a diet that is low in saturated fat and
cholesterol.
Medication to lower cholesterol:
The most effective and widely used medications to
lower LDL cholesterol are called statins.
Most of the large controlled trials that demonstrated
the heart attack and stroke prevention benefits of
lowering LDL cholesterol used one of the statins.

How to Lower Your Cholesterol

Naturally
1. High-quality, animal-based omega3-fats.
2. New research suggests it may lower your
total cholesterol and triglycerides and
increase your HDL
3. Red Yeast Rice may lower cholesterol
4. Reduce grains and sugars in your daily diet.
5. Eat the right foods for your nutritional type.
6. Eat a good portion of your food raw.

7-Eat healthy, preferably raw, healthy fats, etc. This

includes:
1.Olive oil
2.Organic raw dairy products (including butter, cream, sour cream,
cheese, etc.)
3.Avocados
4.Raw nuts
5.Seeds
6.Eggs (lightly cooked with yolks intact or raw)
7.Organic, grass-fed meats

8-Get the right amount of exercise:

When you exercise you increase your circulation and the
blood flow throughout your body.
9-Avoid smoking and drinking excessive amounts of
alcohol.

What is CoQ 10?

CoQ10 is an enzyme found in every
single mitochondrial cell in the body.
About 95% of your bodys energy is
produced by these cells, which
convert sugars and fats into energy.
Your internal organs (like your heart)
need the most energy, which is why
you will find the highest
concentrations of CoQ10 here.

CHOLESTEROL PROFILE
IMPROVEMENT STRATEGY
1- DIET
2- EXERCISE
3- SMOKING CESSATION
4- STRESS REDUCTION
5- WEIGHT CONTROL
6- BEHAVIOR CHANGE
7- NUTRITIONAL GENOMICS