Health, Heart Health, Men's Health, Nutrition, Supplements & Vitamins, Women's Health
Cholesterol is often portrayed as being bad for you, but in fact it has many critical functions within the body. It serves as a crucial component of cell membranes, is a component of essential hormones and is involved in synthesising vitamin D and making bile acids that aid digestion and the absorption of fat-soluble nutrients such as vitamins A, E and K.
The story of cholesterol doesn’t stop there – it has several other functions in the body, some of which may be new to you. For example, research has shown a connection between cholesterol and osteoarthritis, indicating a sophisticated relationship between lipid levels and joint health. This finding is particularly significant for post-menopausal women, highlighting the nuanced effects of cholesterol at different life stages.
Cholesterol circulates in the bloodstream in two main forms: Low-Density Lipoprotein (LDL), often dubbed ‘bad’ cholesterol, and High-Density Lipoprotein (HDL), known as ‘good’ cholesterol. Although high levels of LDL can lead to plaque build-up in arteries, HDL works beneficially to remove cholesterol from the bloodstream, transporting it to the liver for excretion or reuse.
There’s far more to cholesterol than simply ‘good’ and ‘bad’. Learn more with these surprising facts.
Research has shown that LDL particles vary in size, and their impact on health can vary significantly. Smaller, denser LDL particles (VLDL) have a greater tendency to promote plaque formation (furring) within arteries than larger, buoyant LDL particles, as they are more prone to oxidation.
Plaque formation in the arteries can lead to atherosclerosis, putting you at greater risk of heart disease. This distinction is crucial for understanding individual cardiovascular risk beyond the traditional LDL cholesterol measurements.
Cholesterol plays a pivotal role in the immune system. It is involved in the formation of cell membranes and functions as a defensive barrier against harmful pathogens (foreign invaders such as bacteria and viruses that can cause harm).
Additionally, cholesterol is essential to produce bile acids, which not only aid digestion but have antimicrobial properties, providing another layer of protection against gastrointestinal infections.
The brain is rich in cholesterol, which makes up around 25% of its dry weight. Cholesterol is vital for the formation of myelin sheaths, which insulate nerve fibres and enhance the speed and efficiency of electrical signal transmission between nerve cells.
Unlike other tissues in the body that can obtain cholesterol from the bloodstream, the brain produces all the cholesterol it needs locally, indicating its critical role in cognitive function, memory, and overall neurological health.
Widespread misunderstandings about cholesterol have given rise to several myths that should be cleared up to help people take better control of their health.
Truth: The belief that you would feel it if you had high cholesterol is a common one, but high cholesterol usually does not present any symptoms. High cholesterol can lead to serious health issues such as heart disease and stroke. However, these conditions typically develop over time and do not produce noticeable symptoms in the early stages.
High cholesterol itself is often termed a ‘silent’ condition like blood pressure, because it doesn’t manifest through physical symptoms that one can easily identify or ‘feel’. The only reliable way to know if you have high cholesterol is through a blood test, often referred to as a lipid profile. This test measures the levels of various types of cholesterol and triglycerides in your blood. Based on these results, your GP can determine your risk for heart disease and stroke and recommend appropriate lifestyle changes or medications to manage cholesterol levels.
Truth: The idea that consuming large amounts of dietary cholesterol directly translates to elevated blood cholesterol levels is a widespread myth, resulting from a misunderstanding about how cholesterol is regulated within the body.
Most of the cholesterol in your body is produced by your liver, which is also responsible for regulating levels depending on what is required. For many people, eating foods high in cholesterol does not significantly increase their blood cholesterol levels. Instead, the body compensates by producing less cholesterol internally.
It’s the saturated fat in the diet that has a more pronounced effect on raising blood cholesterol levels, specifically LDL cholesterol. Liver cells take up LDL cholesterol via receptors in their surface. High levels of saturated fat reduce the activity of these receptors, meaning less cholesterol is removed from the blood, leading to high circulating levels of LDL cholesterol.
Truth: This is a common misconception, as in reality, while body weight can influence cholesterol levels, it is not the only factor. High cholesterol can affect anyone, regardless of their weight, because it is influenced by a combination of dietary habits, physical activity levels, and genetics.
Some people are genetically predisposed to high cholesterol, a condition known as familial hypercholesterolemia. This means that despite maintaining a healthy weight and living a healthy lifestyle, they can still have high levels of cholesterol.
In the UK this condition can affect 1 in 137 people, according to recent research published in The British Journal of Common Practice,1 showing that cholesterol balance is a matter of genetic factors as well as weight management. Also, consuming foods high in saturated fats can raise cholesterol levels, even if you maintain a healthy weight.
Other factors such as smoking, alcohol consumption, and age can affect cholesterol levels and are not determined by someone’s bodyweight. Even if you’re a healthy weight, smoking or excessive alcohol consumption can negatively impact your cholesterol levels and overall heart health.
Truth: Although statins are an effective way to lower cholesterol levels and, in some cases, are the only option, you can increase their effectiveness by taking a supplement, alongside making dietary and lifestyle changes such as eating more fibre and less saturated fat and exercising regularly.
Plant sterols can lower cholesterol by up to 12% without side effects,2 and taking 2 to 3 tablets daily is scientifically shown to lower cholesterol levels. If you are looking to maintain cholesterol levels, just taking one Healthspan Plant Sterol of 800mg a day can help maintain these healthy cholesterol blood levels. Although diet is crucial, achieving the optimal amount of sterols from food is difficult. The average diet provides only 200mg-400mg of sterols daily, with vegetarian diets offering up to 800mg. However, to impact cholesterol levels significantly, daily doses of 2g to 3g are needed, try Healthspan Plant Sterols* 2400mg (daily dose) – £19.49 for 90 tablets.
Statins and plant sterols work in different ways to reduce blood cholesterol, so combing the two can have added benefits, and Healthspan Plant Sterols can be taken alongside statins but do tell your doctor if you take a plant sterol supplement or have added a fortified product containing plant or stanols to your diet, as this could affect the dose of statins prescribed.
Osteoarthritis (OA) is a degenerative joint disease associated with mechanical wear and tear. However, research has suggested that cholesterol levels may have a role to play, which is why high cholesterol is often associated with the condition.
Cholesterol crystals, particularly those derived from LDL, can induce inflammation, a central feature of osteoarthritis. These crystals can accumulate in the joint space, triggering the body’s immune response and leading to the release of inflammatory cytokines. This inflammation can exacerbate the degradation of cartilage, the cushioning tissue at the ends of bones, leading to the pain, stiffness, and reduced mobility characteristic of OA.
High levels of serum cholesterol can impact the health of cartilage cells, or chondrocytes, negatively affecting their ability to maintain and repair the cartilage matrix. Furthermore, dyslipidaemia, the term for abnormal lipid levels including cholesterol, has been linked to oxidative stress and the production of reactive oxygen species (ROS), contributing to the development of osteoarthritis.
Dyslipidaemia can contribute to atherosclerosis, which can impair blood flow, so impairing the delivery of nutrients and removal of waste products and potentially contributing to cartilage degradation and OA progression.
Cholesterol has many vital health functions in the body, and health risks can increase when levels become imbalanced. It’s clear that cholesterol is more than a simple villain in the story of human health, and understanding the beneficial role it can play and dispelling some common myths may help you to address this potential health concern before it becomes a serious issue.
References:
1. Durand, A., Morgan, C. L., Tinsley, S., Hughes, E., McCormack, T., Bitchell, C. L., & Lahoz, R. (2024). Familial hypercholesterolaemia in UK primary care: a Clinical Practice Research Datalink study of an under-recognised condition. The British journal of general practice: the journal of the Royal College of General Practitioners, BJGP.2023.0010. Advance online publication. https://doi.org/10.3399/BJGP.2023.0010
2. Ras, R. T., Geleijnse, J. M., & Trautwein, E. A. (2014). LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies. The British journal of nutrition, 112(2), 214–219. https://doi.org/10.1017/S0007114514000750
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