Cholesterol values: table, cholesterol ratio and high values

High cholesterol levels can have several causes. Increased cholesterol levels can, for example, be caused by eating a lot of saturated fat, being overweight or obese, diabetes, an underactive thyroid and hereditary predisposition. High cholesterol levels are common in some families, sometimes at a young age. In the Benelux, the cholesterol level of an estimated two out of three people between the ages of 25 and 74 is slightly or occasionally even seriously elevated. In people who are overweight or who exercise little, there is a good chance that the levels of cholesterol and other blood fats are not in order. But what exactly is cholesterol and what can someone do about high cholesterol? And when is your cholesterol too high? We discuss cholesterol levels in detail, measuring cholesterol and lowering cholesterol with medicines and nutrition.

  • What is cholesterol?
  • Cholesterol is a type of fat
  • Cholesterol in itself is not bad
  • Types of cholesterol
  • LDL: low-density lipoproteins
  • LDL cholesterol values table
  • HDL: high-density lipoprotein
  • HDL cholesterol values table
  • Cholesterol-HDL ratio
  • Cholesterol levels in children
  • The triglycerides
  • Measuring cholesterol
  • Risk factors: elevated cholesterol levels
  • Type 2 diabetes
  • Lifestyle
  • Family history
  • Familial hypercholesterolemia
  • Age (60+) and gender
  • Reduce high cholesterol levels
  • Healthy lifestyle
  • Healthy food
  • Plant-based diet
  • Psyllium seed
  • Combination of dates and pomegranate juice
  • Cholesterol medications
  • Statin increases cancer survival rate

 

Cholesterol / Source: BruceBlaus, Wikimedia Commons (CC BY-3.0)

What is cholesterol?

Cholesterol is a type of fat

Cholesterol is a soft, pale yellow, fatty substance found in cell walls and membranes throughout the body. Some people believe that cholesterol is inherently bad, but that is not the case. Cholesterol is one of the fats (or lipids) that the body produces. The body needs cholesterol, without cholesterol a person cannot live. Cholesterol is necessary for the production of hormones (estrogen, progesterone and testosterone) and vitamin D and bile (bile plays an important role in digestion). Cholesterol is also necessary for building body cells. A person needs relatively little cholesterol for all these functions. The human body (liver, intestines and skin) produces more than enough of it. In addition, cholesterol is absorbed from the diet.

Cholesterol in itself is not bad

Cholesterol in itself is not bad for humans. However, an elevated cholesterol level is unfavorable for health. Someone does not notice a high cholesterol level, it is not a disease and it does not cause any complaints in itself. However, an elevated cholesterol level is a risk factor for developing cardiovascular diseases, such as angina pectoris (chest pain), a heart attack or a stroke.

Types of cholesterol

There are different types of cholesterol, some of which are bad and some of which are good. Actually, it is not cholesterol that is good or bad, but the means of transport by which cholesterol is transported through the blood. Cholesterol is waxy and therefore cannot mix with the watery blood. The blood transports cholesterol by attaching it to proteins (also called proteins) and these compounds are called lipoproteins. These are special means of transport that transport the cholesterol. Some of them are good for the body, but most of them are harmful.
Different types of lipoproteins are distinguished:

  • HDL (High Density Lipoprotein); this is a favorable strain.
  • LDL (Low Density Lipoprotein) is the body’s main enemy.

 

Blood pressure measurement / Source: Istock.com/KatarzynaBialasiewicz

LDL: low-density lipoproteins

LDL (Low Density Lipoprotein) in excessive amounts is unfavorable to health and harmful to the body. LDL particles transport most cholesterol through the blood and these compounds can become lodged in the inner walls of blood vessels, contributing to the calcification that narrows the arteries. Some types of LDL cause more damage to blood vessels because they stick more easily to the blood vessel walls and to places damaged by smoking, high blood pressure or old age. They dig in there and so-called plaque is formed. As a result, the blood vessels gradually become clogged and it becomes increasingly difficult for blood to flow through them. Later, calcium is often deposited in the affected vessel wall. That’s where the name arteriosclerosis comes from. The medical name is ‘atherosclerosis’.

LDL cholesterol values table

Two groups are distinguished for assessing LDL cholesterol levels. The first group can afford suboptimal LDL cholesterol better than group 2, which consists of people with an increased or high risk of cardiovascular disease. They should aim for an LDL cholesterol of less than 2.5 mmol/l. In the Netherlands, the amounts of cholesterol are expressed in millimoles per liter of blood (mmol/l). The notation ‘mmol/l’ therefore stands for millimoles per liter.
Group 1 consists of people with a low risk of cardiovascular disease. She:

  • have no coronary artery disease or family history of premature heart disease;
  • do not have diabetes mellitus;
  • do not have high blood pressure (hypertension);
  • no smoking.

People in this group can use the table below to assess their LDL cholesterol levels:

LDL level

Category

Lower than 2.6 mmol/l

Optimal

2.6-3.3 mmol/l

Almost optimal

3.4-4.0 mmol/l

Just acceptable

4.1-4.8 mmol/l

High

4.9 mmol/l

Very high

Many factors, such as a person’s diet, weight and family history, can affect LDL levels.

Overweight / Source: Istock.com/VladimirFLoyd

HDL: high-density lipoprotein

HDL (High Density Lipoprotein) are the ‘garbage trucks’ of the body and are therefore of a beneficial kind. These particles transport the bad type of cholesterol in the blood to the liver, where it is broken down and this cholesterol leaves the body with the feces via the bile and the intestines. HDL protects the body against cardiovascular disease and it is even so beneficial that a high level of these guys can counterbalance the risk of heart disease due to diabetes (diabetes) or obesity. The higher the HDL cholesterol values, the better.

HDL cholesterol values table

In the table below you can read the cholesterol values used in the Netherlands for HDL cholesterol, broken down by men and women:

HDL levels in men

Category

Lower than 0.8 mmol/l

Strong too low

Between 0.8 and 1.0 mmol/l

Slightly lowered

Between 1.0 and 1.5 mmol/l

Good

Higher than 1.5 mmol/l

Very good

 

HDL levels in women

Category

Lower than 1.0 mmol/l

Strong too low

Between 1.0 and 1.2 mmol/l

Slightly lowered

Between 1.2 and 1.7 mmol/l

Good

Higher than 1.7 mmol

Very good

Factors such as smoking, being overweight, little exercise and eating a lot of carbohydrates contribute to a low HDL level. But not always someone has influence on it. Roughly half of the cases of HDL deficiency are hereditary. Women generally have higher HDL levels than men. Women need more than men to stay healthy.

Cholesterol-HDL ratio

A safe maximum value for total cholesterol has been set at 5 mmol-l. The ratio between total cholesterol and HDL is important to determine the risk of cardiovascular disease. This ratio is called the cholesterol-HDL ratio and is calculated by dividing the total cholesterol level by the HDL. The ratio (i.e. the result of this sum) should be less than 5. A low level (four or lower) is beneficial for the blood vessels. The cholesterol level is often slightly higher, between 5 and 6.5. As one gets older, the average content increases.

Saturated fats are found in cakes and biscuits, among others. / Source: Syda Productions/Shutterstock.com

Saturated fats in the diet (animal and solid fats) have an unfavorable effect on the total cholesterol content and the cholesterol ratio. Polyunsaturated fats (vegetable and liquid fats, fish oil), on the other hand, have a beneficial effect.

Cholesterol levels in children

The cholesterol level in the blood increases with age and therefore different standards apply to children for what is normal or too high. For a 10-year-old, the average cholesterol level is about 4.0 mmol/l and for a 15-year-old about 4.2 mmol/l.

The triglycerides

Triglyceride is not a form of cholesterol but a blood fat or lipid. It is located in the same globules that transport cholesterol. The body of someone who consumes more calories than he needs converts them into triglyceride, which is stored in the fat cells. Normally, only small particles of triglyceride are in the bloodstream. These are used as an energy source. If triglycerides are elevated, this can accelerate the process of arteriosclerosis and cause cardiovascular disease. The triglyceride level in the blood is too high at more than 2.1 mmol/l. During a standard cholesterol test, the triglyceride level is also determined.

Measuring cholesterol

It is only wise to have your cholesterol measured if someone:

  • have or have had cardiovascular disease;
  • have a combination of risk factors for cardiovascular disease, such as:
    • smoking;
    • diabetes mellitus; and
    • high bloodpressure.
  • have an older brother or sister who has or had cardiovascular disease or seriously elevated cholesterol levels before the age of 60.

Cholesterol levels can fluctuate.
Cholesterol levels in the blood can fluctuate considerably. It is therefore advisable to examine the cholesterol level several times. If one wants to speak of an increased cholesterol level, there must be a constant and not a one-off increase.

Risk factors: elevated cholesterol levels

Certain health conditions, your lifestyle and your family history can increase your risk for high cholesterol. These are called ‘risk factors’. Some of these risk factors, such as your age or family history, are static and therefore unchangeable. But there are also dynamic risk factors, or factors that can be changed.

Pancreas / Source: Decade3d/Shutterstock.com

Type 2 diabetes

Type 2 diabetes lowers HDL (“good”) cholesterol levels and increases LDL (“bad”) cholesterol levels. This combination increases your risk of heart disease and stroke. Your body needs glucose (sugar) for energy. Insulin is a hormone that is made in the pancreas, in the islets of Langerhans. Insulin helps convert glucose into glycogen, a substance that can be stored in the muscles and in the liver. If you have diabetes, your body doesn’t produce enough insulin, or it can’t use its own insulin as well as it should, or both.

Lifestyle

Your lifestyle choices can increase your risk of high cholesterol. Eating a diet high in saturated fat and trans fat can contribute to high cholesterol and associated conditions, such as heart disease. Not getting enough exercise can make you gain weight, which can lead to high cholesterol. Obesity is linked to higher triglyceride levels, higher LDL cholesterol levels and lower HDL cholesterol levels. Obesity can also lead to heart disease, high blood pressure and diabetes. However, a healthy lifestyle can reduce your risk of high cholesterol levels.

Family history

Family members share genes and often also share behaviors, lifestyles and environments that affect their health and their risk for high cholesterol, heart disease and other related conditions. If you have many family members with high cholesterol levels, you are more likely to have high cholesterol levels yourself. The risk of high cholesterol can even increase when a family history of elevated cholesterol levels combines with unhealthy lifestyle choices, such as having an unhealthy diet.

Familial hypercholesterolemia

Some people have an inherited genetic condition known as ‘familial hypercholesterolemia’ (FH). This condition causes very high LDL (“bad”) cholesterol levels, starting at a young age that, left untreated, worsens over the years.

Age (60+) and gender

The risk of high cholesterol increases with age. This is because, as you get older, your body cannot remove cholesterol from the blood as well as it did when you were young. This leads to higher cholesterol levels, which increase the risk of heart disease and stroke. Until around age 55, women tend to have lower LDL levels than men. At any age, men have lower HDL cholesterol than women. Women generally naturally have higher HDL cholesterol than men. In the age group of 60 to 70 years there is a large increase in people with elevated cholesterol levels. As many as 40% of men and 48% of women over the age of 60 (up to 70 years) have elevated cholesterol levels.

Healthy and varied eating / Source: Istock.com/kabVisio

Reduce high cholesterol levels

Healthy lifestyle

Cholesterol levels can be lowered by living a healthy lifestyle. A healthy lifestyle means a healthy and varied diet, limited alcohol consumption, sufficient exercise, striving for a normal body weight and not smoking. These measures also have a beneficial effect on other risk factors for cardiovascular disease, such as high blood pressure and diabetes.

Healthy food

What does healthy eating entail? Limit the use of saturated fats. These usually have a solid form at room temperature and are of animal origin and we find them in, for example, the following products: cream, butter, regular margarine, whole milk products, full-fat cheese, fatty meat, cookies, pastries and snacks. Unsaturated fats actually lower cholesterol levels and can be found in fish, nuts, diet margarine and vegetable oil, among others.

Plant-based diet

It has been shown that a ‘whole foods plant based’ (WFPB) diet (or a plant-based diet) has a very beneficial effect on your cholesterol levels. A plant-based diet means eating foods that come primarily from whole, minimally refined plants, such as fruits, vegetables, tubers (such as potatoes), whole grains, legumes, nuts, and seeds. It also means avoiding meat, dairy and eggs, as well as refined foods such as (bleached) flour, sugars and oils.

Psyllium seed or psyllium seed / Source: Bastique, Wikimedia Commons (CC BY-SA-3.0)

Psyllium seed

The ESCOP (European Scientific Cooperative on Phytotherapy) gives positive advice for the use of psyllium seed (or psyllium seed) to support a low-fat diet with elevated cholesterol levels.[1] The scientifically proven daily dose of Indian psyllium to lower cholesterol levels is approximately 10 grams. It should be taken with sufficient fluid, at least in a ratio of 1:10 and not with milk, as this will prevent it from expanding.[2]

Combination of dates and pomegranate juice

Research shows that when dates are consumed along with pomegranate juice, they are a winning team in the war against heart disease. The researchers conclude that people at high risk of cardiovascular disease, as well as healthy individuals, may benefit from consuming the combination of half a glass of pomegranate juice, along with 3 dates. Ideally, the kernels should be ground into a paste and eaten as well, but even without the kernels the combination is better than either fruit alone.[3]

Cholesterol medications

If these measures are insufficiently effective and it is important for a person’s health to lower cholesterol levels, medication can be chosen. Nowadays, stratines are often used. A statin or cholesterol synthesis inhibitor is a cholesterol-lowering medication; they inhibit the body’s production of cholesterol.
All types of medications can have side effects, including statins. Research among American soldiers shows that patients who use statins are not only at risk of muscle complaints, but also of sprains and sprains. The researchers based their data on 46,249 soldiers, from which they composed two groups that were very similar, except in statin use. One group had never used cholesterol-lowering drugs, the other group had used them for at least three months. The soldiers were closely monitored for four and a half years.[4]

Statin increases cancer survival rate

People who used statins – medicines that reduce the amount of cholesterol in the blood – before being diagnosed with ‘cancer’ are less likely to die from cancer than patients who did not use statins. Danish scientists concluded this based on data from 300,000 people. Statins do not prevent cancer.[5]

Note:

  1. The objective of the ESCOP is to increase the scientific status of plant medicines and to promote the registration of plant medicines.
  2. Dr. Jörg Grünwald and Christof Jänicke. Practical handbook of plant medicine from A to Z. Zuidnederlandse Uitgeverij NV, n.d., p. 361-362.
  3. Mira Rosenblat, Nina Volkova, Hamutal Borochov-Neori, Sylvie Judeinstein, Michael Aviram. Anti-atherogenic properties of date vs. pomegranate polyphenols: the benefits of the combination. Food Function., 2015; DOI: 10.1039/C4FO00998C
  4. Artsnet. More side effects of statins than expected, June 4, 2013, www.artsennet.nl/nieuws/nieuws-uit-de-media/artikelen/132954/meer-bijwerkingen-statines-dan-gedacht.htm
  5. Sune F. Nielsen, Ph.D., Børge G. Nordestgaard, MD, DMSc., and Stig E. Bojesen, MD, Ph.D., DMSc. N Engl J Med 2012; 367:1792-1802. November 8, 2012. DOI: 10.1056/NEJMoa1201735

 

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