Salt Lake Community College

HIGH CHOLESTEROL:
THE
Health 1020
INVISIBLE ENEMY
By Amanda King-Robinson

Amanda King-Robinson 1

Amanda King-Robinson
Instructor Angela Lancaster
Health 1020 summer 2015
18 July 2015
High Cholesterol: The Invisible Enemy
According to the Center for Disease Control and Prevention it is estimated that 73.5
million or 31.7% of adults in the United States have high levels of low-density lipoprotein, also
known as bad cholesterol. Out of adults with cholesterol problems only 1 in 3 have their
condition under control. Less than half are seeking treatment to lower their cholesterol levels
therefore are at twice the risk for heart disease as people with ideal levels of LDL cholesterol
(High Cholesterol Facts).
Although these statistics show that the general American public are not giving cholesterol
the consideration needed as practitioners of health we need to have a strong grasp of what
cholesterol is, be able to teach people why they should care about it, what causes it, and how to
avoid it.
Because cholesterol is an invisible enemywe cant see it, smell it, or feel itmost
people dont bother figuring out what cholesterol is until its too late. According to our textbook,
Contemporary Nutrition: A Functional Approach, Cholesterol is a waxy lipid found in all body
cells. It has a structure containing multiple chemical rings that is found only in foods that
contains animal products (160). There are two different forms of cholesterol, low-density
lipoprotein, noted above as bad cholesterol, and high-density lipoprotein also known as good
cholesterol. High amounts of LDL is strongly linked to cardiovascular disease risk while high
amounts of HDL slows down the development of cardiovascular disease (179). It is important to

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note that cholesterol plays a vital role in the body. It helps to form important hormones, is an
essential structural component of cells, and is the building block of bile acids which are needed
for fat digestion (181).
In a Know the Facts article produced by The Center for Disease Control and
Prevention it provides the following guidelines for desirable levels of cholesterol: total
cholesterol should be less than 200 mg/dL, LDL should be less than 100 mg/dL, and HDL should
be 40 mg/dL or higher (1).
Genetics play a crucial role in getting high cholesterol. One genetic disorder is called
familial hypercholestolemia. A report in the Harvard Heart Letter titled, When High Cholesterol
Runs in the Family, explains this disorder saying, all people have two genes (one from each
parent) responsible for making receptors on cell surfaces that clear low-density lipoprotein (LDL
or bad cholesterol) from the blood. People who inherit just one of the faulty gene have
heterozygous FH. Half of their LDL receptors work; the other half dont. Those who inherit two
malfunctioning genes (homozygous FH) have no working receptors with nothing to pull harmful
LDL from the bloodstream, the levels stay high (4).
In the case of familial hypercholesterolemia the treatment includes cutting back on foods
that are high in cholesterol and saturated fat. This includes red meat, butter, and full-fat dairy
products. Anyone with this disorder is encouraged to eat more vegetables, fruit, whole grains,
and fish. Foods that help cut cholesterol include: beans, oats, soy protein, nuts and supplements
containing plant sterols or stanols. Exercising and controlling blood pressure are also crucial.
Familial hypercholesterolemia may also require taking additional drugs to assist in lowering
LDL levels and in some cases use of a dialysis-like procedure to filter LDL out of the
bloodstream (4).

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For those of us that dont have a genetic link, but instead a nutritional link, with high
cholesterol we need to know how to prevent it. In the Know the Facts article by the CDC they
recommend, Eating a healthy diet, a high amount of saturated fat and cholesterol in food that
you eat can increase blood cholesterol. Maintain a healthy weight, being overweight can
increase your cholesterol level. Losing weight can help lower your LDL cholesterol and total
cholesterol, and raise your HDL cholesterol level. Exercise regularly, regular physical activity
can help lower LDL cholesterol and raise HDL cholesterol. You should try being physically
active for 2 hours and 30 minutes, 150 minutes, each week (2).
If prevention of high cholesterol is not possible treatment is the only option. The
treatment for nutritional based high cholesterol is very similar to those that of familial
hypercholesterolemia. In a paper written for the British Journal of Community Nursing titled,
Natural Alternatives to Tackling High Cholesterol: Guidance for Community Nurses, Helen
Bond writes, A healthier diet and lifestyle modifications should always be recommended to
patients as a first step for tackling raised cholesterol. Many food and lifestyle choices can affect
blood cholesterol levels (377).
The modifications Bond discusses in her paper include: reducing saturated fat and
replacing it with polyunsaturated fat or monounsaturated fat, increasing fruit and vegetable
intake, eating oat-based foods, eating nuts for snacks, consuming wholegrain foods, and plant
stanols/sterols. Replacing saturated fat with monounsaturated fat or polyunsaturated fat has been
shown to decrease LDL (bad) cholesterol levels. These types of oils can be found in olive oil.
Fruits and vegetables contain cholesterol-lowering soluble fiber, vitamins, minerals, and
phytochemicals that have been found to be beneficial for heart health. Oat based foods are rich in
a soluble fiber called beta-glucan and has been scientifically shown to reduce LDL cholesterol by

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up to 5%. Nuts are high in monounsaturated fat, soluble fiber, and important vitamins and
minerals that have been associated with cholesterol reduction. Whole Grain foods are loaded
with soluble fiber, unsaturated fats, and important vitamins and minerals to help with reductions
of cholesterol. Plant stanols and sterols have been proven to lower LDL cholesterol levels by 710% within 2-3 weeks when enough are consumed daily (377-378).
In a study published in the European Journal of Clinical Nutrition titled, The Effects of a
Low-fat, High carbohydrate Diet on Serum High Density Lipoprotein Cholesterol and
Triglyceride, it states, low saturated fat diets can lower serum total and LDL cholesterol
concentrations in men with average cholesterol levels to an extent that could markedly reduce
their risk of coronary heart disease. Secondly our data shows that replacing two-thirds of dietary
saturated fat with carbohydrate has little effect on HDL cholesterol and improves the LDL to
HDL cholesterol ratio (730).
Exercise is another major component in treating high cholesterol. In her article Natural
Cholesterol Control Vera Tweed writes, The liver multitasks all the time, and making
cholesterol is only one of its duties. When you exercise enough, or when you eat few calories
than you burn (which results in weight loss), the liver has to work harder to generate energy, and
cholesterol production decreases (32).
Written earlier in this paper it was recommended that adults get at least 150 minutes of
exercise per week in help in cholesterol reduction. In a Harvard Heart Letter, Longer Workouts
Better for Boosting Good Cholesterol, it discusses the reason longer workouts are recommended
for assistance with high cholesterol it reads, On average, exercise increased HDL by 2.5 mg/dL.
Using various statistical techniques, the researchers determined that the weekly amount of
exercise was more important for raising HDL than its intensity or frequency. Getting at least 120

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minutes of exercise a week (or exercising away 900 calories), in segments of at least 30 minutes
apiece, appeared to be the best way to boost HDL. The researchers estimated that every
additional 10 minutes of weekly exercise time boosts HDL by an average of 1.4 mg/dL (7). Not
only does exercise help keep the body from producing cholesterol it also helps the body to
increase good cholesterol. Other important side effects of exercise include a stronger heart and
bones, better endurance, and improved circulation.
If a person is a smoker and has high cholesterol or is at risk for developing high
cholesterol it is highly recommended that they quit. Smoking, Bond says, lowers HDL
cholesterol and damages the lining or the arteries, leading to atheroma, and may also make blood
clot more easily (378). Smoking is not the only possible addiction associated with high
cholesterol. Bond notes that it has been observed that having 1-2 units of alcohol daily may
provide some benefits in increasing HDL levels. However, increased alcohol consumption is
associated with increased risk of cardiovascular disorders. It is not recommended that people
increase their alcohol intake for this purpose. Women should have no more than 2-3 drinks per
day, and men should not consume more than 3-4 drinks per day (378). While a glass of wine with
dinner is okay as far as cholesterol is concerned people should stay away from high alcohol
consumption.
We need to educate the public that they should go and get a blood test for high cholesterol
simply because of the high percentage of people who have problems and the problem is invisible.
They need to understand that if their HDL level is below 35 and their LDL level is above 130
they could be in potential danger and they need to take the next step by looking into all risk
factors. In an article by Richard Laliberte titled, Cholesterol Unplugged, he lists the following
risk factors: smoking, high blood pressure, diabetes, and/or a family history of heart attacks or

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sudden death (striking a father or brother before age 55 or mother or sister before age 65), and
are they over age 45? After they have taken a look at their risk factors it is time to make a plan
with their healthcare provider to start treatment (1-2).
High cholesterol does not have to be a death sentence or even an annoyance in everyday
life if people follow the guidelines given. Laliberte suggests that a good diet is the most
important line of defense against the effects of cholesterol. A simple change can give you
dramatic results fast. Your priorities for changing your eating habits are first, to cut back on
foods high in saturated fat; second, boost your fiber intake; third, take your vitamins; and finally,
eat seafood. Exercise is your second most important line of defense. Physical activity affects
cholesterol by lowering LDLs and raising HDLs. Try to get at least 150 minutes of exercise per
week. If you are a smoker, quit. If you drink limit it to 1-2 drinks per day (3).
If you have tried everything you can to lower your cholesterol in natural ways the final
step would be to consider medication. Laliberte says that doctors are slow to prescribe
cholesterol-lowering drugs, for a number of reasons. First, exercise and diet need to be consistent
for about six months before the benefits will kick in and second, medications can have unwanted
side effects including but not limited to insomnia, tiredness, stomach upset, loose stools,
flatulence, headache, muscle pain, and weakness (3).
As I concluded my research I realized just how much of an invisible enemy high
cholesterol really is. I know it runs in my family but it is never discussed. Both my parents have
issues with high cholesterol and also at least one of my siblings. My research has helped me
understand that it is important to start a dialog with my family about high cholesterol and how
important it is to avoid it. I hope that my research will help us as a family combat it before its
too late.

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Work Cited

Bhatnagar Deepak, Soran Handrean, Durrington Paul N. Hypercholesterolemia and its

Management BMJ 2008; 337: a993
"Bond, Helen.Natural Alternatives to Tackling High Cholesterol: Guidance for Community
Nurses." British Journal Of Community Nursing 19.8 (2014): 375. MEDLINE. Web. 2
July 2015.
Center for Disease Control and Prevention. Centers for Disease Control and Prevention. Centers
For Disease Control and Prevention, 17 Mar. 2015. Web. 02 July 2015.
<http://www.cdc.gov/cholesterol/facts.htm>.
High Cholesterol Facts." Centers for Disease Control and Prevention. Centers for
Disease Control and Prevention, 17 Mar. 2015. Web. 02 July 2015.
<http://www.cdc.gov/cholesterol/facts.htm>.
Laliberte, Richard. "Cholesterol Unplugged." Men's Health 10.2 (1995): 48. Health Source Consumer Edition. Web. 2 July 2015
"Longer Workouts Better For Boosting Good Cholesterol." Harvard Heart Letter 17.12
(2007):7. Health Source - Consumer Edition. Web. 2 July 2015.
Turley, M L, et al. "The Effect of a Low-Fat, High-Carbohydrate Diet On Serum High Density
Lipoprotein Cholesterol and Triglyceride." European Journal of Clinical Nutrition 52.10
(1998): 728-732. MEDLINE. Web. 2 July 2015.
Tweed, Vera. "Natural Cholesterol Control. (Cover Story)." Better Nutrition 71.2 (2009): 32-34.
Health Source - Consumer Edition. Web. 2 July 2015.
Wardlaw, Gordon M., Angela Collene, and Anne M. Smith. "Chapter 5." Contemporary
Nutrition: A Functional Approach. New York: McGraw-Hill Education, 2015. 160. Print.
"When Very High Cholesterol Runs In The Family. More Than 600,000 Americans Have An
Inherited Condition That Can Cause Heart Attacks At An Early Age." Harvard Heart
Letter: From Harvard Medical School 24.9 (2014): 4. MEDLINE. Web. 2 July 2015.