Cholesterol is a fat (or lipid) very important for life. It is, in fact, a structural component of the membrane of all cells.
But not only: it is an essential component of the myelin sheath that surrounds the nerve cells, where it acts as an insulator and allows the nerve impulse to transmit without dispersing. And yet: it serves the body to produce sex hormones and steroids, it becomes part of the bile acids necessary for the digestion of fats, and is the precursor of vitamin D, essential for regulating calcium metabolism and keeping bones in good condition and teeth.
Cholesterol, therefore, is essential to life, so much so that our body is able to synthesise it even when it is completely lacking in the diet.
The organ that most needs cholesterol is the brain.
Cholesterol is a discovery by the German pathologist Mailer in 1775. Mailer showed that in the hardened and restricted human arteries there was a greasy and yellow substance: cholesterol.
In 1932 the cholesterol structure was chemically defined. To understand the value of cholesterol a blood sample is taken, with which the presence of total cholesterol, HDL (called good cholesterol) and triglycerides will be obtained.
Most of the cholesterol present in the body is produced by the liver, while the rest is introduced with food. Both, however, are found in the intestine.
Once assimilated, food cholesterol is transported through the blood from the intestine to the liver. From here, together with most of the cholesterol produced by the liver itself, it returns to the intestine through the bile, whose function is to make the substances contained in foods better assimilable from the intestine.
This “journey” of cholesterol can be repeated several times, so that we talk about “recirculation” of cholesterol itself.
It is necessary to distinguish between LDL (bad): low-density lipoproteins that carry between 60% and 80% of the serum cholesterol. By presenting much affinity with the cells of the endothelium of the arteries, they release cholesterol on the wall of the vessels; vice versa HDL (good) lipoproteins perform the opposite function, removing cholesterol from the arteries and bringing it back to the liver.
The significance of the cholesterol present in the VLDL lipoproteins is uncertain.
In simple words, LDLs distribute cholesterol to cells. And this function is positive. Unfortunately during this function, part of the LDL cholesterol is deposited on the inner walls of the arteries forming the plaques. HDL lipoproteins remove excess cholesterol from the artery wall and bring it back to the liver.
It is evident that HDL does not “destroy” LDL, but HDL lipoproteins report cholesterol to the liver. Having high HDL cholesterol reduces the negative effect of LDL on plaque formation.
Today, for a better assessment of the situation, we consider the cardiovascular risk index, ie the ratio between total cholesterol and good HDL cholesterol; this index for a healthy person must be less than 5 for men and 4.5 for women. (total cholesterol / HDL)
A subject with total cholesterol at 250 and good cholesterol at 85 has a risk index at 2.94 and is in a much better condition than those who have total cholesterol at 200 and good at 40, where the risk index is 5 .
The important thing is to understand that: the value of total cholesterol has little relevance.
Regarding the treatment, at any age, 84% of women and 81% of men with hypercholesterolemia are not subjected to any pharmacological treatment; while, respectively, 6% and 5% are not adequately treated (the total cholesterolemia value remains above 240 mg / dl).
We talk of hypercholesterolemia when total cholesterol (LDL plus HDL) is too high. Desirable values are as follows:
- total cholesterol: up to 200 mg / dl
- LDL cholesterol: up to 100 mg / dl
- HDL cholesterol: not less than 50 mg / dl.
Cholesterol is introduced into the body through some foods, but endogenously the human body is able to produce it inside the liver and in the adrenal cortex, for at least 2 grams a day. In reality, our body produces enough cholesterol to cover the need, which is why those who take large quantities of foods rich in cholesterol, runs the risk of increasing the normal levels of this fat in the blood, producing damage to the arteries and cardiovascular diseases.
Inheritability plays a fundamental role in the production and metabolism of cholesterol. Many people are in fact predisposed from birth to suffer from dyslipidemia (increase in fat in blood), due to a hereditary factor.
In the daily diet, the cholesterol intake should therefore not exceed 180-150 mg / dl, and it is also recommended to check the consumption of cholesterol-rich foods: butter, cheese, fresh Edam, Emmenthal, Gruviera, Mascarpone, Pecorino Romano, Provolone, sweetbreads, brain, heart, liver, hen, bacon, veal kidney, tripe, molluscs, cannoli with cream, stuffed snacks, ladyfingers, egg yolk, egg, mayonnaise, ketchup, chicken skin, cold cuts.
Accumulation of cholesterol in the blood does not cause obvious disturbances, although some people with high levels of cholesterol in the blood may experience small ailments such as headaches, dizziness or nausea, but many others do not show symptoms and can discover the problem only through a blood test.
Cholesterol is therefore a hidden enemy, because it attacks and damages our body but we can not immediately notice it.
The main damage that cholesterol brings to our body is arteriosclerosis, a disease of the arteries and veins (blood vessels). In subjects with arteriosclerosis, the blood vessels harden and the space is reduced in the internal diameter due to the passage of blood, which is why we also suffer from hypertension, another cardiovascular disease.
In more chronic and serious cases, the subject may be affected by a myocardial infarction or cerebral thrombosis. This is why it is so important to always be careful and fight cholesterol, because we are all potentially at risk.
To prevent cardiovascular diseases, keep them under control and avoid the most serious consequences may be useful to follow some simple measures, first of all to keep an eye and control what is the most important risk factor for their onset, cholesterol. Essential for life, cholesterol can indeed show a completely different face and turn into a real threat to our lives. To avoid this, it is important to know it, know how and how much to invite it to our table, and what to do when its levels become excessive.
According to the World Health Organization, a sedentary lifestyle doubles the risk of heart disease, type II diabetes mellitus, obesity and cardiovascular mortality and stroke, and increases the risk of hypertension and cancer by 30 percent.
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