Good cholesterol, bad cholesterol and weight — we unpack the facts

2019-01-30 06:00

UNDERSTANDING the relationship between cholesterol and weight can seem complicated; especially when you add into the equation that there is good and bad cholesterol and that your body actually needs a small amount of cholesterol.

Many people have too much cholesterol, especially the “bad” kind, called LDL cholesterol. This can happen when people eat too much saturated fat, found mainly in foods from animals. If a person’s LDL levels are too high, plaque can build up in their arteries and can lead to heart disease. The “good” cholesterol, known as HDL, can help to clear LDL from their blood.

In general, to boost your HDL levels, people should exercise regularly, avoid smoking, and maintain a healthy weight. Besides improving your HDL levels, avoiding obesity can reduce the risk for heart disease and many other health conditions.

While overweight people don’t all automatically have higher cholesterol, carrying extra weight can make a person more likely to get high cholesterol as well as high blood pressure and type 2 diabetes. These conditions are all potentially dangerous to a person’s health as they all affect the lining of your arteries, making them more likely to collect plaque from cholesterol.

Dr Alkesh Magan, a specialist Physician /Endocrinologist in the Division of Endocrinology, Diabetology and Metabolism at the Centre For Integrative Health at Sandton Medi-Clinic in Johannesburg, says that there is a definite link between belly fat and cholesterol, but says that while losing weight can help lower bad cholesterol levels, these levels may not normalise completely in all people.

“There is no direct link between obesity and cholesterol as you get metabolically healthy obese and metabolically unhealthy obese patients. However, if there is a greater visceral fat content — there is a correlation with increased cholesterol and triglycerides,” says Dr Rosetta Guidozzi, a General Practitioner from Johannesburg. She explains that visceral fat is the fat that is stored within the organs, such as in the liver and heart.

Once again reiterating the dangers of belly fat, Dr Guidozzi, who has a special interest in weight management, says that the other vital factor to recognise is that the more fat that is carried around the abdomen, the more metabolically active that fat becomes.

Cholesterol is always linked to cardiovascular disease, which can affect many organs, including the heart and the brain.

Dr Magan also stresses that the biggest dangers of high cholesterol, especially when it is undetected, are heart attack and stroke.

“Therefore the take-home message is that the more fat that is carried around the abdomen, measured by the waist circumference, the increased chances of having higher cholesterol,” Dr Guidozzi says.

The good news for anyone struggling with obesity is that it is preventable and it only takes losing five percent of one’s bodyweight for significant health benefits to be seen.

Waist circumference is also an important and useful measuring tool to assess obesity, with the criteria for clinical obesity being a waist circumference of more than 90cm in men and 85cm in women.

Dr Magan’s advice for people with high cholesterol includes adopting healthy lifestyle measures. In those who have not been successful, medical therapy will be needed.

Healthy lifestyle measures to help get your cholesterol in check include adopting portion control, aiming for five-nine helpings of fruit and vegetables per day, eating more fish, choosing whole grain carbohydrates and opting for unsaturated fats. Nuts, which are high in monounsaturated fat, lowers LDL “bad” cholesterol but leaves HDL “good” cholesterol as they are.

Limiting stress and including regular exercise is also highly recommended. Just half an hour of physical activity five days a week can lower your bad and raise your good cholesterol levels. Losing weight, especially belly fat, raises your good and lowers your bad cholesterol.

High cholesterol usually has no symptoms. That is why it is so important to have your cholesterol levels checked by your pharmacist or doctor, which can be by way of a simple finger prick test. The American Heart Association recommends that all adults 20 or older have their cholesterol and other traditional risk factors checked every four to six years.

It is important to speak to your doctor to determine your risk for cardiovascular disease and stroke.

Prescription medication together with lifestyle adjustments, such as a healthy eating and an exercise plan, can help kick-start a weight loss journey, or can help someone get back on track. Speak to your doctor about options for weight loss management or go to for more information or for dietician formulated, kilojoule specific meal plans, which are initiated and guided by your GP for individualised kilojoule intake.

— Supplied.


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