LDL vs HDL: Which is the Bad Cholesterol and Why?

Cholesterol is a type of fat our bodies need. It is a building block for cell membranes and is used to produce hormones and vitamin D. About 80% of the cholesterol in your body is made in the liver, with the rest coming from your diet.

LDL Cholesterol: Why It’s Called “Bad” Cholesterol

LDL cholesterol is called “bad cholesterol.” It carries cholesterol made in the liver to cells throughout the body. However, when levels get too high, it tends to build up in the walls of arteries. This is why it’s called bad cholesterol.

HDL Cholesterol: The Function of “Good” Cholesterol

HDL cholesterol is called “good cholesterol.” It helps remove excess cholesterol from cells and artery walls, carrying it back to the liver. It can be thought of as a scavenger that cleans up the blood vessels. Higher levels of HDL help keep blood vessels healthy.

Why is LDL Called “Bad” and HDL “Good”?

LDL transports cholesterol, but too much can negatively affect blood vessels. In contrast, HDL helps remove cholesterol from blood vessels. This difference in function is why LDL is classified as “bad” and HDL as “good.”

Triglycerides: Understanding From Another Perspective

Triglycerides are another type of fat in the blood. They are mainly stored as energy reserves in the body. However, high levels can increase LDL cholesterol and decrease HDL cholesterol. Triglycerides and cholesterol are closely related.

Found in Health Checkups: Target Cholesterol Levels

Health checkups measure levels of LDL cholesterol, HDL cholesterol, triglycerides, and other values. These values assess your lipid status. Target levels vary depending on your individual health status and risks.

What Normal, High, and Low Levels Mean

General target levels are as follows (referencing the Japan Atherosclerosis Society Guidelines for Prevention and Treatment of Atherosclerotic Cardiovascular Diseases 2022):

High LDL, low HDL, or high triglycerides are collectively referred to as “dyslipidemia” or “lipid disorder.” Specifically, high LDL is “hyper LDL cholesterolemia,” low HDL is “hypo HDL cholesterolemia,” and high triglycerides is “hypertriglyceridemia.”

Total Cholesterol and Non-HDL Cholesterol Are Also Important

Total cholesterol is the sum of cholesterol contained in LDL, HDL, and VLDL (Very Low-Density Lipoprotein). Recently, Non-HDL cholesterol has also been emphasized. This value is calculated by subtracting HDL cholesterol from total cholesterol and is considered a better indicator for assessing the risk of atherosclerosis.

Why Are High LDL Levels Problematic?

Persistently high levels of LDL cholesterol can damage blood vessels. This can lead to various diseases.

Relation to Atherosclerosis and Cardiovascular Disease Risk

Excessively high LDL cholesterol builds up in artery walls, forming plaques. This plaque buildup hardens and narrows the arteries, a condition known as “atherosclerosis.” As atherosclerosis progresses, blood flow is impaired.

Related Diseases (Heart Attack, Stroke, etc.)

Advanced atherosclerosis increases the risk of serious conditions where blood flow to the heart or brain is blocked or ruptured. These include “heart attack” (myocardial infarction) where the heart’s arteries are blocked, and “stroke” where blood vessels in the brain are blocked or burst. These are life-threatening diseases.

How to Lower “Bad” (LDL) Cholesterol

Keeping LDL cholesterol within a healthy range is crucial for preventing atherosclerosis. Lifestyle changes are the cornerstone of management.

Dietary Adjustments: To Lower LDL

Modifying your diet is one of the most effective ways to lower LDL cholesterol. A balanced diet is essential.

Foods to Avoid and Recommended Foods

• Foods to Avoid: Foods high in saturated fats such as fatty cuts of meat, butter, lard, heavy cream, instant foods, and fast food. Also limit foods containing trans fats like margarine and processed foods.
• Recommended Foods: Fatty fish (like mackerel, sardines, rich in omega-3 fatty acids), soy products, vegetables, mushrooms, seaweed, whole grains, etc.

Importance of Dietary Fiber and Omega-3 Fatty Acids

Dietary fiber helps inhibit cholesterol absorption and promotes its excretion from the body. Eat plenty of vegetables, fruits, seaweed, mushrooms, and beans. Omega-3 fatty acids (EPA, DHA) found in fatty fish are also expected to lower triglycerides and raise HDL levels.

Regular Exercise: For Heart and Blood Vessels

Regular exercise helps increase HDL cholesterol and lower triglycerides. It can also help reduce LDL cholesterol.

What Kind of Exercise is Good?

Aerobic exercises such as walking, jogging, swimming, and cycling are recommended. Aim for at least 30 minutes daily or a total of 150 minutes per week. Consistency is key, within a manageable intensity.

Lifestyle Improvement: A Comprehensive Approach

Beyond diet and exercise, reviewing your overall daily habits is important.

• Smoking Cessation: Smoking reduces HDL cholesterol and accelerates atherosclerosis. Quitting smoking is vital not only for cholesterol management but for overall health.
• Moderate Alcohol Consumption: While moderate amounts may be acceptable, excessive drinking increases triglycerides.
• Stress Management: Stress can affect hormone balance and lipid metabolism. Make time to relax.
• Maintaining a Healthy Weight: Obesity, especially accumulation of visceral fat, is strongly linked to dyslipidemia. Maintaining an appropriate weight is important.

Medication: Under Doctor’s Guidance When Necessary

If lifestyle changes alone are insufficient to reach target levels, or if the risk of atherosclerotic cardiovascular disease is high, medication may be considered. Drugs like statins are commonly used. Medication must always be taken under the guidance of a doctor. Do not stop or change medication on your own.

Other Cholesterol Types: VLDL and Non-HDL

LDL and HDL are not the only types of cholesterol in the blood. There are also VLDL (Very Low-Density Lipoprotein) and the recently noted non-HDL cholesterol. VLDL also transports cholesterol and triglycerides, and high levels are a risk factor for atherosclerosis. Non-HDL cholesterol is the total amount of cholesterol in lipoproteins other than HDL, including LDL and VLDL, and is a useful indicator for capturing risks not fully evaluated by LDL alone.

When Should You Consult a Doctor?

If a health checkup indicates abnormal cholesterol levels, be sure to visit a medical institution. Consulting early is especially important if you have high LDL cholesterol or other risk factors such as diabetes, high blood pressure, or smoking. A doctor will assess your condition, set target levels, and provide appropriate advice and treatment.

Frequently Asked Questions

Do Cholesterol Levels Fluctuate Daily?

Cholesterol levels can fluctuate slightly depending on diet, physical condition, time of day, etc. However, they do not dramatically change day-to-day. If an abnormality is noted during a checkup, it is important to consult a doctor rather than dismissing it as a temporary fluctuation.

Can Children Have High Cholesterol?

Yes, children can have high cholesterol. This can be related to genetic factors, diet, lack of exercise, etc. Caution is advised if there is a family history of dyslipidemia or if the child is obese. If you are concerned, consult a pediatrician.

What Types of Medication Are There to Lower Cholesterol?

Mainly used is a type of drug called statins. This effectively lowers LDL cholesterol by inhibiting cholesterol synthesis in the liver. There are also other types of medications, such as those that inhibit cholesterol absorption in the small intestine or lower triglycerides. Which medication to use is determined by the doctor based on the patient’s condition and the presence of other diseases.

Conclusion: Understanding Cholesterol for a Healthy Life

which is the bad cholesterol? It is LDL cholesterol. However, LDL cholesterol is also necessary for the body. The problem arises when its levels become too high. Leaving high “bad” cholesterol untreated can lead to advanced atherosclerosis and increased risk of heart attack and stroke.

To lower bad cholesterol, fundamental steps include lifestyle changes such as a balanced diet, regular exercise, quitting smoking, and moderate alcohol consumption. If your cholesterol levels are abnormal in a health checkup, be sure to consult a doctor and manage it appropriately. It is important to understand cholesterol correctly and apply this knowledge to your daily health management.

Disclaimer: This article is for general informational purposes only and does not constitute medical advice or diagnosis. Please consult with a healthcare professional for any individual health concerns.