Cholesterol hysteria unjustified? Why nutrition has little influence on cholesterol levels


For a long time, a change in diet was considered the best antidote to high cholesterol levels. But apparently the nutrition plays in many cases hardly a role. explains, why that is in such a way and which has it with the hysteria around Cholesterin on itself.

One does not see it, one does not feel it – therefore the diagnosis often comes surprisingly: “Your cholesterol values are much too high. This means that the blood lipid levels are not okay. It doesn’t matter. Because if the cholesterol level is permanently elevated, there is a threat of arteriosclerosis, or in the worst case, a heart attack or stroke. For years, people with high cholesterol levels were advised to go on a diet or to avoid high cholesterol foods. According to experts, this view has changed – they even speak of a cholesterol hysteria.

However, cholesterol cannot be demonized in principle, says Johannes Wechsler, President of the Federal Association of German Nutritional Physicians (BDEM). The body needs the fat-like substance – for the cell structure, for the formation of vitamin D or for the production of the sex hormone oestrogen. It produces a large part of this fat itself. But cholesterol is also absorbed through high-fat food.

“Good” and “bad” cholesterol: what is the difference?
Cholesterol is not just cholesterol. There is the “good” (HDL = high density lipoprotein) and the “bad” (LDL = low density lipoprotein) cholesterol. The more of the good HDL is in the body, the better. It protects the blood vessels, as it carries excess cholesterol in the blood from the artery walls back to the liver. From there it is excreted through the bile. The bad LDL, on the other hand, transports the fat particles to the cells, where it settles and can lead to the dangerous vascular calcifications.

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This can also lead to dangerous arteriosclerosis – which in turn increases the risk of a heart attack. Decisive factors for arteriosclerosis are cholesterol, smoking, diabetes, high blood pressure and genetic predispositions.

Triglycerides are also important fats in the blood. These neutral fats are considered the main component of body and dietary fats.

Standard values: How much cholesterol should there be in the blood?
There are guidelines for how much cholesterol should be in the blood: total cholesterol should not exceed 200 milligrams per deciliter (mg/dl). However, it often does: one third of the population between 18 and 79 years of age has a value above 200 mg/dl according to the German Nutrition Society (DGE).

The target values for the individual types of cholesterol depend on whether someone has other diseases such as high blood pressure or diabetes or whether they smoke, for example. “LDL cholesterol should not exceed 150 mg/dl if there is a single additional risk factor for cardiovascular diseases,” said Wechsler. If there are several risk factors, the LDL cholesterol should be below 100 mg/dl.

Even if a patient has severe hypertension, the LDL cholesterol level should not exceed 100 mg/dl. If someone has already had a heart attack or is suffering from diabetes, the value should even be below 70 mg/dl. The HDL should preferably be above 45 mg/dl for women and above 40 mg/dl for men.

Have cholesterol levels checked once a year
In order to prevent serious illnesses, everyone should have their cholesterol levels measured once a year. “This can be done by means of a quick test in many, but not all, pharmacies,” says Ursula Sellerberg, pharmacist and deputy press spokesperson at the Federal Chamber of Pharmacists. If the values determined deviate from the guideline values, patients should see a doctor.

If it turns out that a patient’s cholesterol level – and in particular the “bad” cholesterol – is permanently elevated, the first step is for the patient to change his or her diet and lifestyle.

“This means that the patient eats less high-fat and animal products and instead more vegetable and low-fat foods such as vegetables, fruit and cereal products,” explains Wechsler. If someone is overweight, the doctor also puts them on a diet. Incidentally, ginger is a natural cholesterol-lowering agent – even small amounts a day can reduce the cholesterol level.

Diet has little influence on cholesterol levels
However, a change of diet is not necessarily helpful. Professor Ulrich Laufs, cardiologist at the University Hospital of Leipzig, is quoted by the picture as follows: “Many people have inherited hypercholesterolemia. Due to a genetic defect, they have difficulty absorbing cholesterol from the blood into the liver. Their cholesterol levels rise.”


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