Cholesterol

Good day,

I would like to inquire about your perspective on the following issue. A lady at acupuncture told me that a high cholesterol level, as currently defined by tables as being over 5 mmol/l, is actually relatively low. Lower values are continuously reported in tables primarily due to pharmaceutical companies and, consequently, money. Apparently, 20 years ago, the tables were entirely different and indicated high values, for example, up to over 16 mmol/l. What do you think about this?

Thank you very much for your response.

This area is somewhat more complex, or rather, it is no longer viewed in such a black-and-white and strictly as it was in past decades when the impact of cholesterol on health was significantly demonized. On one side of the debate is the pharmaceutical lobby, which has gradually been lowering the risk value of cholesterol (today in our country, it's above 5 mmol/l, but these values vary between countries, with some nearing 6 mmol/l), and on the other side are the increasing scientific evidence that efforts to lower total cholesterol levels do not fulfill expectations in terms of reducing the risk of cardiovascular diseases (except in younger men under the age of 50). Today, we know that a much more important indicator is the ratio of LDL and triglycerides, including the level of oxidative stress (the body's antioxidant capacity); therefore, an elevated total cholesterol level by itself should not be considered a definitive indicator of heart and vascular health and should not be treated with medication (statins) at any cost. Twenty years ago, a cholesterol level of 5.2 mmol/l was presented as the risk value (in the 1980s it was 6.2 mmol/l). The values above 16 mmol/l were just plucked out of thin air by the lady at acupuncture... :-)

Good day, Mr. Jelínek,

I have a question regarding cholesterol. The issue is that we have cholesterol in the family - both parents and a sibling. My father even has levels over 7.5 mmol/l despite our efforts to maintain a relatively healthy diet, and my sibling and I are quite active in sports. I therefore assume it may be partially hereditary, and since the body has been accustomed to higher levels for a long time, it might not be as dangerous as when someone has high cholesterol primarily due to poor diet?

Thank you in advance.

If you know that there are cases of higher cholesterol levels in your family, don't wait to have the diagnosis of familial hypercholesterolemia confirmed or ruled out by a doctor. If the diagnosis is positive, it is worth treating this condition, as it poses a high health risk in relation to cardiovascular diseases. In general, higher cholesterol levels are dangerous and should not be underestimated. Dietary adjustments have a significant impact on this condition; however, it is also necessary to avoid smoking, control body weight, and engage in regular physical activity—dietary changes alone do not outweigh the importance of these factors. If you adhere to all necessary measures and the cholesterol level does not significantly decrease, medication prescribed by a doctor is warranted.

Hello, which cholesterol helps in the conversion of vitamin D?

Vitamin D3 is synthesized in the body from a derivative of cholesterol, 7-dehydrocholesterol, which is present in the skin of a healthy individual in sufficient quantities. Under the influence of UV radiation, this substance is converted into provitamin D3 (7-dehydrocholecalciferol), which is rapidly transformed through thermal isomerization into the actual vitamin D3, known as cholecalciferol.

Hello,

Perhaps this is a somewhat simple question, but could you please explain the terms: triglycerides, triacylglycerols? Which of these terms is correct in terms of standard language usage? Which parameter is the most important in practice (also from a health perspective) during a routine cholesterol (HDL, LDL) and blood lipid examination? What do these data indicate about my health?

Thank you.

Triglycerides and triacylglycerols are synonyms, both terms are commonly used in the literature. They are the main components of fats, composed of glycerol and three molecules of fatty acids. The body separates fatty acids from them through the process of lipolysis, and these fatty acids are subsequently metabolized. In practice, in relation to nutrition, you should always be concerned with (in addition to triglycerides) the parameters of the total amount of cholesterol, including HDL and LDL fractions, from which the so-called atherogenic index is calculated. This is a value that indicates the risk of developing atherosclerotic processes, and it is thus related to cardiovascular diseases (this also applies to elevated levels of triglycerides in the blood).

Can the liver produce cholesterol even from purely plant-based fats?

The production of cholesterol is not dependent on the proportion of animal-derived foods in the diet. This substance is formed (in simplified terms) from fatty acids (contained in fats), from which the body creates acetyl coenzyme A. From this, mevalonate and squalene are formed, with the end product of this reaction being cholesterol. In this way, over 1000 mg of cholesterol is created every day in the body of an adult human.

I wonder why it is not recommended to eat eggs in combination with legumes, such as lentils. I also read that baking eggs is not healthy due to cholesterol oxidation, is that true?

The recommendation to avoid frying eggs is based on the fact that high temperatures lead to oxidation, which is assumed to have undesirable health effects. Eggs are a rich source of cholesterol (containing, on average, the full recommended daily intake), and consuming them in higher amounts could theoretically have a negative impact on blood lipid metabolism. However, this is also relative, as the individual's health status, including ensuring sufficient antioxidant capacity and the intake of substances that have the greatest influence on cholesterol metabolism (e.g., phospholipid complexes that are part of lecithin, etc.), plays a role in the entire process.

The combination of legumes with eggs is essentially unnecessary and burdensome at the same time, as both foods are an enormously rich source of proteins, making such a dish a very difficult-to-digest experience. Note that this is particularly characteristic of Czech cuisine, whereas nations where legumes are an integral part of their culture (India, Mexico...) process this group of foods in a completely different manner.

Good day,
does cholesterol oxidize in butter/lard when frying/baking, even if we pay attention to the correct temperature, i.e., when we pay attention to the smoke point? And in this regard, is it better to use ghee for similar preparations, or does it not matter?
Thank you in advance for your response.

During heat processing, cholesterol oxidation occurs, but the extent of oxidation is determined by the specific temperature (higher values lead to an increased share of oxidized cholesterol) and the duration of thermal manipulation. This applies to butter in general, including ghee. It is always more advantageous to use clarified butter for heat processing due to its higher smoke point (this point is determined by the content of impurities in the fat, not the lipid profile). However, in relation to cholesterol oxidation, the cooking process should be as short as possible.

Hello,
what does oxidized cholesterol in eggs mean, and what are the effects of its consumption on our body? Does it also form when preparing other ingredients? Additionally, I would like to ask whether omelet or scrambled eggs are suitable ways of preparing eggs.
Thank you.

Oxidized cholesterol is formed in foods during more intensive heating processes (frying, grilling, baking). If consumed in this form over a long period of time (eggs, meat, offal, etc.), such cholesterol has the ability to promote pro-inflammatory reactions in the body and contribute to the formation of chronic inflammation. When preparing eggs, the best method is "soft-boiled."

I would like to inquire about the preparation of "sunny-side up" eggs - is oxidized cholesterol also formed during this process, and how is it with digestibility?
Thank you in advance for your response.

If the yolk is in a soft state after cooking, the structure of cholesterol remains largely unchanged. Therefore, it depends on the method of preparation in terms of the temperature used and the duration of exposure.

Good day.
Perhaps a somewhat layman's question, but could you please explain the terms: triglycerides, triacylglycerols? Which of these terms is more correct in terms of formal usage? Which of the parameters is most important in the practice of a nutritionist (also from a health perspective) during a standard examination of cholesterol (HDL, LDL) and fats in the blood? What do these data indicate for me?
Thank you.

Triglycerides and triacylglycerols are synonyms, both terms are commonly used in the literature. They are the main component of fats, composed of glycerol and three fatty acid molecules. The body separates fatty acids from them through the process of lipolysis, which are then metabolized.

In practice, concerning nutrition, you should always be interested (in addition to triglycerides) in parameters of the total amount of cholesterol, including HDL and LDL fractions, from which the so-called atherogenic index is calculated. This is a value that indicates the risk of developing atherosclerotic processes and is thus related to cardiovascular diseases (this also applies to elevated triglyceride levels in the blood).