‘People are being encouraged to know their cholesterol levels and blood pressure numbers as well as they know their bank Pin code – because it could save their life’ – BBC News
‘Bad cholesterol’ levels should be checked from the age of 25 – study’ – Guardian Newspaper
‘A group of scientists has been challenging everything we know about cholesterol, saying we should eat fat and stop taking statins. This is not just bad science – it will cost lives, say experts’ – Guardian Newspaper
‘Cholesterol and calorie hypotheses are both dead — it is time to focus on the real culprit: insulin resistance’ – The Pharmaceutical Journal
Cholesterol is a controversial area of medicine and has had so much media coverage in the last few years, both positive and negative, that it is hard to get to the bottom of what is fact or fiction. Should you be tested? Should you purchase home test kits from the internet? If your levels are high should you take statins? What age should you be tested? Are lifestyle factors important?
Cholesterol is a waxy substance found in your blood and in your cells. Your liver makes most of the cholesterol in your body and the rest comes from foods you eat. Cholesterol travels in your blood bundled up in packets called lipoproteins. There are two types of cholesterol. Low-density lipoprotein (LDL) is classed as the unhealthy kind because it can build up in your arteries and form fatty, waxy deposits called plaques. The second type is high-density lipoprotein (HDL) which is classed as good cholesterol. HDL transports excess cholesterol out of your arteries to your liver, which then removes it from your body. Too much LDL can have adverse effects throughout the body including strokes, heart attacks, angina, reduced blood flow through the arteries causing pain, and numbness in the arms and legs.
Cholesterol levels have become one of the main indicators of men’s health over the last few years and statins, medication to lower cholesterol, is one of the most widely prescribed drugs in the world. However, recent research using large groups of patients that have been prescribed statins has shown that around half of the patients who were prescribed statins did not see their cholesterol drop to desired levels within two years. The research also revealed that the patients who did not reach the targeted levels were 22% more likely to develop cardiovascular disease than those who did respond well. Although research like this contributes to the debate on the effectiveness of statin therapy, what it really does is highlight the need for more personalised medicine in cholesterol management for patients. Dr. Jeff states that cholesterol numbers should not be taken in isolation as an indicator of overall health and that this is one area of health where a holistic approach is vital. Dr. Jeff goes on to say that high cholesterol should be treated on an individual case by case basis not an arbitrary set of figures. Therefore, it is vital that GP’s build up a picture of their patients lives before reaching for the prescription pad.
Causes of cholesterol
Whilst it may be tempting to avoid a visit to the doctor if you think your levels are high, you have googled the symptoms and feel the next step is to get a home testing kit from the internet, is that a good idea? If the result comes back and it is high, what will you do with that result? The chances are you will visit a doctor and he will take the tests again so you may as well save your money and buy a quinoa salad and a super green smoothie – it will be more beneficial in the long run. By taking a more holistic look at patients rather than fixating on one set of figures, medical experts are getting better results than just addressing one issue alone, in this case cholesterol.
There are three big contributors to health and disease and the first one your GP should look at with you is diet. The old saying “You are what you eat” is quite literally true. Every one of your cells is replaced about every seven years, and your food is what those new cells are made from. So if you eat loads of processed meat, dairy, saturated fats, sugar, and refined foods, or just too much food in general, then that is the building blocks you are providing your body with and your health will inevitably suffer. Obesity is a huge indicator (no pun intended) of overall health and obese patients tend to develop high cholesterol. Obesity is also associated with an increased risk of developing insulin resistance and type 2 diabetes. Being overweight will have a hormonal impact, decreasing estrogen and testosterone levels, and as the cholestrol creeps up obese patients often develop metabolic syndrome which is a cluster of conditions that occur together, increasing your risk of heart disease, stroke, and type 2 diabetes. These conditions include high blood pressure, increased blood sugar, excess body fat around the waist, and abnormal cholesterol. For those of you that boast that you can eat what you like but don’t put weight on, beware because you maybe a TOFI, thin on the outside and fat on the inside. This is when visceral fat builds up around the internal organs, so while a patient may not be overweight, they have unhealthy stubborn fatty deposits inside. Being a TOFI may increase the risk of developing heart disease and diabetes in the long term as the excessive internal fat deposits disrupt the body’s internal communication system. So, watching what you eat and how much you eat is really important for your health.
The next element to consider which often overplays diet is genetics, if your parents have high cholesterol, then you are probably going to have it to some degree. In some cases the patient may have inherited familial hypercholesterolemia (FH). FH occurs because of a genetic chromosomal defect and makes it harder for your body to remove LDL or “bad” cholesterol from your blood. Unfortunately this means that even during childhood, cholesterol builds up along the walls of your arteries and veins, narrowing the passageways and drastically increases your risk of heart attack or stroke at a very early age. Fortunately, with a combination of lifestyle, diet, and medications the prognosis for FH sufferers is not as bleak as it sounds and they can lead a relatively normal life. Although, in extreme cases, some sufferers of FH require having their blood cleansed of LDL regularly and then put back into their bodies.
The final aspect that your GP should review with you is lifestyle elements, such as exercise, smoking and alcohol consumption. Exercise can significantly improve cholesterol levels, if you take moderate physical activity it can help raise HDL cholesterol. Under your doctor’s supervision, you should try to work up to at least 30 minutes of exercise five times a week or more vigorous aerobic activity for 20 minutes three times a week. The effects of smoking and drinking alcohol are harder to measure as it is a very individual thing. We all have that relative who smoked 80 B&H everyday, drank three fingers of whisky every night and died peacefully in their sleep aged 99, but is that a lottery you want to play? Smoking raises the LDL cholesterol in the blood and is responsible for at least 80,000 deaths per year in the UK. It also makes exercise harder and affects your sleep quality. Research shows that moderate alcohol consumption can raise your good HDL cholesterol levels by increasing the speeds at which proteins are transported through the body, but drinking more than a moderate amount can have the opposite effect.
Visit your doctor for your men’s health check
Your health is more than just a set of figures, so it is important that when you have health concerns you see a doctor that has an interest in and understands YOU, so you can have an informed discussion about lifestyle choices, diet, family history, medications, and exercise. It is not a one size fits all process – you need to build a bigger picture of a person as a whole not as a set of symptoms that need medicating.
If you have any health concerns at any age, or you want to get a baseline and a better understanding of your current state of health then book a men’s MOT with Dr. Jeff Foster by calling 01926 801111 or emailing firstname.lastname@example.org.