We've all heard stories about cholesterol. Not only is it a subject tackled on the media platforms, but it also appears in many of our daily conversations. How many of the rumors are confirmed in the long run?

Cholesterol is a fatty substance found in the majority of body tissues. You might know its definition from chemistry or biology: a sterol, which is an organic molecule having the structure of a lipid. Produced by the liver and present in each cell of our bodies, cholesterol undoubtedly has many functions to sustain. Being a compound synthesized not only by humans but also by all animal cells, it helps to maintain the integrity and fluidity of the membranes. Just imagine what essential nutrient cholesterol truly is if he makes up for nearly 30 percent of animal cell membranes!

However, it doesn't act solely on its own. It is a component of the lipid bi-layer (what surrounds all animal cells), alongside membrane proteins and phospholipids(triglycerides). Only by being part of this can it interact with other fatty-acid chains and consequently facilitate intracellular transport and cell signaling.

Concerning steroid hormones, cholesterol precedes the synthesis of vitamin D, bile acids, and the much-known adrenaline-generators-cortisol and aldosterone. In addition, it influences the sexual hormones: progesterone, testosterone and estrogen.

Is cholesterol good or bad for our health?

To answer this question, we need to get accustomed to the types of cholesterol generally known as LDL-the bad cholesterol-, HDL-the good cholesterol, and VLDL- the one mostly containing triglycerides. All of these are lipoproteins and their objective is to carry the cholesterol in the blood.

But what makes the difference between these types? It is a problem that concerns cholesterol levels. The cholesterol normal levels can be measured by a blood test, the lipoprotein panel. Before the test, it is recommended that you should fast (abstain from eating or drinking anything apart from water) for minimum 9 hours.

You can even do the test at home, but you'll need to buy a cholesterol home test kit. Be careful of the instructions and pay attention to the meaning of the chemicals that change colors after you place the blood droplet on the strip!

The panel can show you the values of the:

• Total cholesterol
• LDL levels
• HDL levels
• VLDL levels
• Non-HDL cholesterol
• The ratio from cholesterol and HDL.

Cholesterol healthy levels depend significantly on age and gender and are calculated in milligrams per deciliter(mg/dL). Let's see what these levels are!

Under 19 years old:

• Total cholesterol: less than 170mg/dL
• Non-HDL: less than 120mg/dL
• LDL: less than 100mg/dL
• HDL: more than 45mg/dL

It is required that, at this age, the first test should occur between 9 and 11 years old and should be repeated every 5 years. Regarding special circumstances, however, were a child to be born in a family with a history of high blood cholesterol, strokes or heart attacks, the test can be done even at the age of 2.

Men aged 20 or older:

• Total cholesterol: 125-200mg/dL
• Non-HDL: less than 130mg/dL
• LDL: less than 100mg/dL
• HDL: 40mg/dL or more

Women aged 20 or older:

• Total cholesterol: 125-200mg/dL
• Non-HDL: less than 130mg/dL
• LDL: less than 100mg/dL
• HDL: 50mg/dL or more

The frequency of the cholesterol tests depends on a mixture of factors: family history, risk factors, age. As for adults, especially from 45 to 65 years old for men and 55 to 65 years old for women, the test must be done every year or every 2 years.

The Bad Cholesterol - LDL

LDL is the abbreviation for low-density lipoprotein. It is coined as being "bad" because of the fact that it can narrow the walls of the arteries by building up on their walls. Fatty deposits are made, and these can form so-called atherosclerosis, because of a buildup called plaque that is likely to cause many blockages, as well as chest pain (angina), heart attacks, carotid artery disease, coronary artery disease, and strokes. There are some signs that your levels of LDL are extremely elevated, such as little bumps on the skin called xanthomas, along with gray-white rings around the corneas(corneal arcus). In general, though, people don't notice them, as there are no obvious symptoms concerning high levels, but only critical signs.

What can you do to minimize the presence of LDL in your organism, you may wonder. A cholesterol-lowering diet might and incorporating cholesterol-lowering foods might be the only way in which to do so.

You should know that the fats that are responsible for increasing the levels of "dangerous" cholesterol in you are the saturated fats, or trans fats. While unsaturated fats are liquid, the saturated ones are solid and wax-like, at room temperature. Trans fats come from the hydrogenation process of the unsaturated fats, from a liquid state to a solid one.

Heart-healthy eating should be accompanied with:

• Weight management: the process of losing weight might help with lowering the LDL cholesterol.
• Engaging in daily physical activities: at least 30 minutes are required for leading a healthy lifestyle.
• Keeping the stress levels under control: it has been proved from research that chronic stress plays a mischievous role in raising LDL levels and lowering HDL levels of cholesterol.
• Giving up smoking: letting smoking go is likely to raise your HDL and, therefore, lower the bad cholesterol.

Lipid-lowering drugs also play a vital role in managing high levels of cholesterol. Cholesterol medications that your doctor could prescribe include:

• Statins. The most prescribed medication for lowering high cholesterol, they prevent strokes or heart attacks from occurring in individuals who have elevated LDL levels.
• Bile acid sequestrants. These are the meds that are taken provided a patient is sensitive to statins or needs to lower their cholesterol levels more than statins can do.
• Cholesterol vitamins. One of the best vitamins that can lower cholesterol is Niacin B, or nicotinic acid, which can be found in some types of food naturally (berberine or fish oil). Dietary supplements can limit the fats in the liver, subsequently lowering the triglycerides and the LDL cholesterol.
• Lomitapide or Mipomersen. These drugs are prescribed whenever there is a family history beyond the health problem.
• Cholesterol injections. Reducing the circulation of LDL in your body is possible with injections and cholesterol shots. Heart attack can be prevented with the prescribed doses of these administrations.

The good cholesterol - HDL

HDL is the equivalent of high-density lipoprotein. It is mainly referred as the "good" cholesterol because it contributes to removing bad forms of cholesterol away from the bloodstream. HDL also transports LDL cholesterol to the liver in order for it to be reprocessed, so he can reuse and recycle LDL. In this scenario, HDL can be pictured as the delivery truck and LDL as the dump truck.

Blood vessels can thank HDL for protecting and maintaining their inner walls (endothelium). In this way, atherosclerosis can be prevented, since it appears because of consistent damage to the intrinsic walls.

VLDL – The very low-density lipoprotein

VLDL stands for very low-density lipoprotein. It is made by the liver and is released into the bloodstream, like the other types that have been discussed.

What does it carry? It helps transport triglycerides, another type of fat, to the tissues.

VLDL and LDL are often thought about as being the "bad" cholesterol since both of them contribute to forming plaque, the sticky substance made up of cholesterol, fat or calcium, which then deposits on the artery walls.

How can you measure the VLDL levels? In contrast to LDL and HDL, this value doesn't usually appear on a cholesterol screening. However, it can be approximated as the percentage of triglycerides found in the blood. A high level of VLDL means more than 30mg/dL.

Too many triglycerides can lead to a person developing non-alcohol-related fatty liver disease.

Either having too much cholesterol or too little can pose a serious threat to our body. If the levels are too elevated, the problem is called hyperlipidemia. If cholesterol is too low, the condition is called hypolipidemia.

Cholesterol and Diet

We understood that cholesterol is vital for our bodies. But how much should we consume on a daily basis?

Dietary guidelines used to help doctors recommend approximately 300 miligrams of dietary cholesterol per day for a healthy person and 200 for a person with an elevated risk of heart disease. With more studies to come since 2015, it is now known that there are no exact specifications in regards to the amount of cholesterol consumed from food. Being mindful of your diet in order to maintain the cholesterol levels is still an important task to do.

What are the foods that are high in cholesterol? Saturated fats,trans fats and added sugars are the ones that you should try to stay away from as much as possible.

Have you ever wondered why oil is seen as the "villain" in many diets? That's because solid fats, such as coconut oil, shortening or butter are really high in saturated fats and the consumption of them can lead to increased risk of heart disease and stroke.

Here are some foods with saturated fats:

1. Red meat. This is the beef,lamb and pork meat. Even lean cuts of meat are associated with around 4.5 grams of saturated meat per 100g.
2. Full-fat dairy products. The amount of saturated fats depends on what you decide to buy. For example, 1% fat milk contains 1.5g fat in a one-cup serving, whereas a serving of whole milk has 4.5grams. On top of the list are creams with 28g of saturated fat. In spite of this, dieticians recommend eating fermented dairy products, such as kefir,yogurt or cheese,as it has been proven that they can have a positive effect on the heart.
   
3. For example, 1% fat milk contains 1.5g fat in a one-cup serving, whereas a serving of whole milk has 4.5grams. On top of the list are creams with 28g of saturated fat. In spite of this, dieticians recommend eating fermented dairy products, such as kefir,yogurt or cheese,as it has been proven that they can have a positive effect on the heart.
4. Ice Cream. Ice cream is a full-fat treat that we all love. It can certainly raise your cholesterol levels,provided it is eaten on a regular basis. A USDA study has shown that ½ cup of vanilla ice cream is the equivalent of 4.5 grams of saturated fat, more than an average adult should consume. However, no foods should be considered as the ultimate prohibition, since they can be part of a healthy lifestyle. Moderation is the key and even trying out healthier alternatives for that delicious sundae, such as frozen yogurt, sherbet, sorbet, popsicles or smoothies.
5. Baked goods. Nowadays, it is said that you can't really feel immersed into the holiday atmosphere unless you try the local cuisine and pastry. Biscuits, cakes, brownies, they are everywhere. A brownie serving contains nearly 11grams of saturated fat and we have to admit to the fact that rarely do we stop at eating only one.

On the other hand, trans fats are unsaturated fatty acids. They can either be natural or artificial. Natural trans fats, such as conjugated linoleic acid (CLA) are beneficial to our health in a moderated amount. The issue comes with the ever-expanding artificial fats or industrial fats. When do these fats occur? It has everything to do with the availability of a products and their prolonged shelf life. Vegetable oils, naturally in a liquid state, are chemically altered on the process of partial hydrogenation in order to become solid at room temperature. This marketing strategy helps the sellers, but potentially harms the customer's health. Trans fats are much used in the fast-food industry, because they are really cheap to manufacture. Processed foods, such as frozen pizza, microwave popcorn, French fries and hamburgers and even refrigerated dough products should be avoided. The Food and Drug administration banned these fats in 2018 in the United States but even after 4 years there are still a lot of foods on the market which contain small amounts of trans fats. Moreover, processed foods which were produced before this decision are likely to be full of trans fats.

Cholesterol and Eggs

For many times, chicken eggs have been seen as an enemy because they are naturally high in cholesterol. But they definitely don't raise the cholesterol levels as trans and saturated fats do. Rather than putting all the blame on the eggs, we have to consider what we eat along with eggs. Are sausages, bacon or ham among the list? Or do you enjoy frying the eggs in a deep bath of oil or butter? Then this can be the solution to the problem!

In regards to how many eggs we should eat during a week, studies have shown that an individual can easily eat up to 7 eggs a week without risking their health. This can prevent strokes and even the eyes, by preventing a condition called macular degeneration from occurring and leading to blindness.

Diabetes is, nevertheless, a condition that can require eating less than 7 eggs a week, because it can contribute to risking heart disease. There is still need to research more on the connection between diabetes and cholesterol.

One large egg contains approximately 186mg of cholesterol and all of it is found in the yolk, not in the egg white. If you happen to eat more than the recommended daily amount, which is 300 milligrams, you can opt for eating only the egg whites, since they contain lots of protein.

Cholesterol and Chicken

The amount of cholesterol that you get from eating chicken depends on your personal preferences: maybe you like it with the skin on, or maybe you particularly like the chicken thigh, breast or wing. You might ask yourselves twice how you would like your chicken  if you knew that poultry without the skin contains less saturated fats than with the skin on.

In addition to this, while chicken breast contains the least cholesterol (only 86mg), the leg or drumstick has nearly double (155mg).

Now, about the preparation of the chicken. Frying it with flour and with batter gives nearly the same amount of cholesterol (89 and 85mg). Another option would be roasting (84mg), but the best remains stewing, with 77mg. The spices or sauces that you like, such as gravy or mustard can increase the cholesterol intake. How much chicken does a portion contain? The AHA suggests that you should not eat more than 3 ounces of chicken, which is approximately half of a large chicken breast.

Cholesterol and Alcohol

When you drink alcohol, it is decomposed and then rebuilt in the liver as 2 component, triglycerides and cholesterol. Were the levels of triglycerides to rise too high, they can lead to fatty liver disease, a serious condition caused by too much buildup in the liver. Your blood becomes embedded in cholesterol and from that, high blood pressure, heart disease may occur. Alcohol could also lead to another health problems, such as weight gain, obesity, cancer, pancreatitis and some mental health conditions, such as depression and dependency.

In order to avoid illnesses, it is recommended that people should drink no more than 14 units of alcohol per week (14 units equals 6 175 ml glasses of wine or 6 pints of average strength beer). The units ought to be spread out across the week evenly and there should be alcohol-free days.

Cholesterol on a Keto Diet

Does the diet that you follow influence your cholesterol levels? Undoubtedly! The ketogenic diet is a high-fat, moderate protein and low carbohydrate diet that allows you only to eat 20-50 grams of net carbs, while the rest of your calories (80%) should come from fat. Consequently, you might have no other choice than to eat unhealthy amounts of butter, coconut oil or animal fat, which increases the risk of poor heart health. The keto diet can also produce a spike in the cholesterol levels, which can lead to many complications.

Four things you might not know about Cholesterol: 

• Cholesterol for hair loss

Looking for new ways to combat hair loss? Then a cholesterol hair treatment might be a good solution for you. Specialists confirmed that such a treatment can repair and moisturize damaged hair and can even go as far as to strengthen the hair structure. Who should try this? People who complain of having dry, thick or coarse hair are likely to see positive outcomes, as well as the ones with oily hair. Beware of the fact that a cholesterol conditioner involves mayonnaise, egg yolks, honey or oils, such as jojoba oil or coconut oil.

• Can cholesterol affect your eyes?

Yes, it can. Fatty, yellowish deposits can be formed around the eyes, most specifically in the eyelids. The condition is called xanthelasma and some treatments for this would be surgical excision, chemical cauterization and cryotherapy.

• Cholesterol crystal embolism

Cholesterol crystals found in neutral or acid urine are a potential threat to your body caused by a disease called renal tubular affection. Untreated, it can lead to renal failure. Accumulated crystals in peripheral vessels is another pathological condition which is linked to cholesterol embolism (CCE). Up to this moment, there are no curative treatments for this, but they can prevent or keep the affection under control.

• Cholesterol granuloma

Another condition in which cholesterol crystals are included is a cholesterol granuloma. These are noncancerous cysts which can be found at the part of the skull adjacent to the middle ear and contain, in addition to the crystals, many fluids and lipids. The consequences of cholesterol granuloma can be permanent hearing loss, bone destruction and nerve damage.

Conclusion

There are still many ongoing studies about the importance of cholesterol in our lives. We know that normal levels of cholesterol can help us live healthier and longer but this means that it is high time we thought more about our diet, our physical activity and day-to-day habits and preferences!

The effects that cholesterol has are major and can be found everywhere we look: from eyes, liver and kidneys to heart, brain and membrane fluidity. Is he a loyal friend or a challenging enemy? The same way a lot of things are in life, cholesterol can be both. It's up to us to decide how we want to see it. By being mindful of little steps that can lead to a lifestyle change, such as replacing those

French fries and doughnuts that you have for lunch with whole grains, fruits and vegetables, we can wake up after a while to realize that cholesterol was never the problem, but our perspective from which we regarded it. No matter what anyone says, cholesterol plays a vital role in maintaining our health and we should be informed about the real meaning of it!