Let's learn exactly about LDL cholesterol, the "bad cholesterol"?

When you recently checked your cholesterol levels in your blood test, did the doctor say that your LDL level was a little high? You may have been a little scared when he said that. Today, we are going to talk about LDL, also known as "bad cholesterol." Don't be afraid, let's understand this simply and clearly.

First, let's see, what is LDL cholesterol?

Okay, let's start simply. The blood in our body is not just water. It has many things in it, such as cells, proteins, and fats (oils). Now think about it, fat and water never mix together, right? Similarly, the fats in our body, namely cholesterol, cannot mix with blood and travel.

So, to carry this cholesterol from one place to another in the body, we need a special "transport service." That transport service is what we call lipoproteins . These are like little vehicles. These vehicles are made up of lipids and proteins.

There are several types of lipoproteins. One of them is LDL (Low-Density Lipoprotein) . This LDL vehicle has a large amount of cholesterol and a small amount of protein inside it. That means it is like a vehicle loaded with cholesterol. In fact, cholesterol is something that is indispensable to our body. Cholesterol is needed for many important functions such as making hormones and building cell walls. Therefore, the service provided by the vehicle called LDL is also really good.

So why is this LDL called "bad cholesterol"?

Here's the thing. When anything is too much, problems arise. The same thing happens to LDL. Imagine that when only a certain number of vehicles are on a road, there is no problem, everyone is going to their destination. But what happens if a large number of vehicles suddenly come on the road? Traffic builds up, the road gets blocked, and accidents can occur.

The same thing happens to LDL. When the LDL level in our blood exceeds the recommended amount, these extra LDL particles start to get deposited inside the walls of our blood vessels. Over time, this layer of cholesterol that is deposited gradually thickens. It's like rust forming inside a water pipe. In medicine, we call this "atherosclerosis."

When fatty deposits build up inside the blood vessels, the blood flow gradually narrows. This is what causes many dangerous health problems.

• If it affects the blood vessels of the heart (Coronary Artery Disease): The arteries that supply blood to the heart can become blocked, causing a heart attack .
• If the blood vessels to the brain are affected (Cerebrovascular Disease): Blood flow to the brain can stop, causing a stroke .
• If it affects the blood vessels in the arms and legs (Peripheral Artery Disease): Blood flow to the arms and legs is reduced, and symptoms such as pain when walking may occur.
• If the main aorta is affected (Aortic Aneurysm): The body's largest blood vessel may weaken and become at risk of rupturing.

That's why we say it's so important to keep LDL levels at a healthy level.

What should LDL cholesterol levels be like?

Your blood test report (Lipid Profile Report) will show your LDL level in milligrams per deciliter (mg/dL). Generally, it is best to keep your LDL level below 100 mg/dL for a healthy adult. However, if you have had a previous heart attack or stroke, your doctor may recommend that you keep your LDL level below 70 mg/dL .

You can get a better understanding of these levels from the table below.

A word about HDL, the "good cholesterol"

You may have noticed that your report includes a value for HDL (High-Density Lipoprotein) as well as LDL. We call this "good cholesterol". The role of HDL is to pick up the extra bad cholesterol (LDL) that is deposited in the blood vessels and take it to the liver. It is from the liver that it is removed from the body. In other words, HDL is like a cleaner for our blood vessels. Therefore , the higher the HDL value, the better (generally, if it is more than 60 mg/dL, it is very good).

What are the causes of high LDL levels?

There is not one single cause of high LDL, but many factors can contribute to it. While some things we can control, some things are beyond our control.

• Diet: This is the main reason. Eating foods high in saturated fat and trans fat increases LDL levels. For example, cured meats like sausage, bacon, and ham, high-fat dairy foods like cheese and butter, baked goods like cakes and donuts, and deep-fried foods like French fries.
• Body weight: When body weight increases, that is, if there is obesity, there is a greater chance of increasing LDL levels.
• Tobacco use: Smoking, smokeless tobacco (mawa, betel nut), and vaping reduce the level of good cholesterol (HDL) in our body. When HDL decreases, the blood vessels are not cleaned properly. Then the LDL level automatically increases.
• Certain medications: Some medications you take for other conditions can also increase your LDL levels. For example, some medications for high blood pressure and medications for HIV infection.
• Other medical conditions: If you have medical conditions like diabetes , chronic kidney disease , or HIV infection , your LDL levels may be high.
• Age: As we age, there is a natural increase in cholesterol levels in the body.
• Gender: After menopause, that is, after the cessation of monthly menstruation, women tend to have higher LDL levels.
• Heredity (genes): If your immediate family members, such as your mother, father, or siblings, have high cholesterol, you may also inherit that risk genetically.

Okay, so how do you reduce this "bad cholesterol"?

This is the most important part. There are many things you can do. Many people can achieve big results with small lifestyle changes.

1. Adopt a heart-healthy diet: It's a good idea to follow something like the Mediterranean Diet. That is, add more vegetables, fruits, legumes, whole grains (brown rice, oats, barley), nuts, and fish to your diet. Reduce your intake of fatty, fried, sugary, and fast foods.

2. Avoid tobacco use completely: Not only cigarettes, beedis, and cigars, but you also need to stop vaping.

3. Exercise: Do at least 30 minutes of aerobic exercise a day. It's great if you can do something like brisk walking, running, cycling, or swimming.

4. Maintain a healthy weight: Ask your doctor what the ideal weight is for your height. Try to maintain that weight.

5. Reduce stress: Prolonged stress can also increase LDL and decrease HDL. Relax your mind by doing things like yoga, meditation, or engaging in a favorite hobby.

6. Talk to your doctor about the medications you are taking: Talk to your doctor to see if any of the medications you are taking affect your LDL levels.

If these lifestyle changes don't lower your LDL levels, your doctor may prescribe medication. Statins are the main class of drugs commonly prescribed to lower LDL.