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Have you ever wondered what is the main difference between cholesterol, triglycerides and saturated fats? Well, sure, you definitely have heard of cholesterol and might even be taking prescription medications to lower your blood cholesterol level; and in the back of your mind you recalled your doctor advised you to avoid foods with high saturated fats (although they can be too tempting to give up). You thought you saw ‘triglycerides level’ somewhere on your blood test report but never quite sure what it is. This article aims to give you a concise and scientifically accurate explanation of these three important molecules.
When we talk about cholesterol in your blood, what we really mean is lipoprotein. The reason is that cholesterol does not dissolve in the blood but instead be carried around by protein as a lipoprotein. The cholesterol stated in your blood test result is indeed the levels of lipoprotein in your blood sample.
If you look closer at your blood test report, you would have noticed that your cholesterol level is further broken down into two types of lipoproteins: low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
As a general rule, LDL is the ‘bad cholesterol’ while HDL is the ‘good cholesterol’. Yes, cholesterol receives a lot of bad rap, but the truth is it is not completely harmful. What you really should watch out for is the level of LDL in your blood. This is because LDL takes cholesterol directly to your arteries. This can result in atherosclerosis, a plaque buildup that can even cause heart attack and stroke. HDL, on the other hand, carries cholesterol to your liver, where it can be removed from your bloodstream before it builds up in your arteries.
High LDL level is linked to a wide range of cardiovascular diseases, such as heart attack, stroke and peripheral artery disease (PAD). Many randomized controlled trials (1,2,3) repeatedly showed that lowering your LDL level can lead to reduced risk of future cardiovascular diseases; and the greater the reduction of LDL level, the greater the risk reductions. That’s why you should always remember to take your cholesterol medications prescribed by your doctor on time.
Likewise, reduced HDL level is also linked to higher risk of cardiovascular disease. To be exact, for every 1% decrease in HDL, the risk of cardiovascular disease would rise in 2-3%.
While there are standard reference levels for cholesterol level, your target cholesterol level should be tailored based on your age, biological sex and health status. Consult your doctor to get your own target total cholesterol (TC), LDL and HDL levels.
Triglycerides are the most common type of fat in the body. They store excess energy from your diet. If you regularly eat more calories than you burn, particularly from high-carbohydrate foods, you may have high triglycerides.
A high triglyceride level combined with high LDL or low HDL is linked with plaque build ups that we discussed earlier, which contribute to heart attack, stroke and other cardiovascular diseases. A controversial issue about triglyceride in the scientific committee is that its roles in causing heart diseases are not as robust as is with cholesterol levels. Looking at triglycerides level alone probably would not tell the doctor very much about your risk of cardiovascular diseases; it is more meaningful if the level of triglycerides is interpreted together with your cholesterol level.
The level of triglycerides in your blood tells you more than your cardiovascular health. High triglycerides can also be a sign of obesity, Type 2 diabetes or pre-diabetes and hypothyroidism. Extremely high triglycerides can also cause acute inflammation of the pancreas (pancreatitis).
Taking some medications long-term may also increase your triglyceride levels, such as thiazide diuretics (for high blood pressure), beta blockers (for high blood pressure or heart failure), anabolic steroids, and glucocorticoids. If you have any concern related to the medications you take with respect to triglyceride levels, talk to your doctor first before stopping them without consulting your doctor.
If you remember your Form 4 chemistry, you know that saturated fats are simply fat molecules that have no double bonds between carbon molecules because they are saturated with hydrogen molecules. They exist as solid at room temperature. Saturated fat is known to raise your level of cholesterol in your blood, hence its intake should be limited to approximately 13g per day.
Saturated fats are present naturally in many foods, with the majority comes mainly from animal foods, including meat and dairy products. You should replace foods high in saturated fats with foods high in monounsaturated and/or polyunsaturated fats. This means eating foods made with liquid vegetable oil but not tropical oils. It also means eating fish and nuts. You also might try to replace some of the meat you eat with beans or legumes. The best way forward is to learn how to read nutrition labels and compare the saturated fats levels between different products.
Taking cholesterol-lowering medications certainly DOES NOT mean that you don’t have to make diet and lifestyle changes. Whether you are already diagnosed with high cholesterol or not, adopting the following healthy living habits can help to reduce your LDL and triglycerides level:
Eating a heart-healthy diet: Limit your saturated fats intake and avoid trans fat if possible. A heart-healthy diet emphasizes fruits, vegetables, whole grains, poultry, fish, nuts and nontropical vegetable oils, while limiting red and processed meats, sodium and sugar-sweetened foods and beverages.
Becoming more physically active: A sedentary lifestyle lowers your HDL level. At least 150 minutes of moderate-intensity aerobic exercise a week is enough to lower both cholesterol and high blood pressure. And you have lots of options: brisk walking, swimming, bicycling or even yard work can fit the bill.
Quit smoking and vaping: By quitting, smokers can lower their LDL cholesterol and increase their HDL cholesterol levels. It can also help protect their arteries. Non Smokers should avoid exposure to secondhand smoke. Talk to a doctor or pharmacist if you would like to quit smoking with the help of nicotine replacement therapy.
Lose weight: A weight loss of as little as 5% to 10% of the original weight can help improve cholesterol numbers. Beware of weight loss products scams and instead look for healthcare professionals to help you lose weight safely.
Ministry of Health Malaysia - CPG Management of Dyslipidemia 2017. https://www.moh.gov.my/moh/resources/Penerbitan/CPG/CARDIOVASCULAR/4.pdf
NHS Inform - High cholesterol. https://www.nhsinform.scot/illnesses-and-conditions/blood-and-lymph/high-cholesterol
Mayo Clinic - HDL cholesterol: How to boost your 'good' cholesterol. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/hdl-cholesterol/art-20046388
Mayo Clinic - Triglycerides: Why do they matter? https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186#:~:text=Triglycerides%20are%20a%20type%20of,triglycerides%20for%20energy%20between%20meals.
American Heart Association - Saturated Fat. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/saturated-fats
American Heart Association - Cholesterol: Myths and Facts. https://www.heart.org/-/media/files/health-topics/cholesterol/cholesterol-myths-vs-facts-english.pdf?la=en
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