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Hypercholesterolemia: causes and treatment

Hypercholesterolemia can be caused by many factors, often present simultaneously.
What are they?

And dietary cholesterol?
There is not a direct correlation between blood cholesterol and cholesterol intake. Dietary cholesterol may increase plasma cholesterol only when it is consumed with trans fats and saturated fatty acids.
However, if you want to reduce your cholesterol intake, we advise to reduce the use of animal products and/or use semi-skimmed or skimmed milk, light cheese, light yogurt, and lean meat.

Contents

Saturated fatty acids

A risky factor for hypercholesterolemia is a high intake of saturated fatty acids, a group of lipids that can be easily used for the endogenous synthesis of cholesterol.
These fatty acids are present in meat, diary products, and in abundance in vegetal fats and oils, such as margarine, palm oil, palm seed oil, and coconut oil, which are much used in the confectionery industry.
What to do:

Trans fatty acids

Trans fatty acids or trans fats are an extremely risky factor, and not only for hypercholesterolemia.
Studies have observed a high atherogenic potential caused by changes in plasmatic lipoproteins, where a decrease of HDL levels, and an increase of LDL and triglyceride levels occur.
Where can they be found?

As regards to the content of saturated and trans fatty acids, there is often no difference between classic products and “natural” or “organic” ones.
What can we do?
To avoid to buy products that contain vegetal fats and/or hydrogenated fatty acids, and to avoid to buy fried products.

Overweight

A significant body fat gain contributes to hypercholesterolemia.
In a lot of people, the decrease in the intake of satured and trans fatty acids doesn’t reduce the cholesterolemia levels till weight starts to drop.
What to do:

Genetic causes

In this case, it needs a drug prescription by physician, which must be however combined with right nutritional advices.

References

  1. Ascherio A., Katan M.B., Zock P.L., Stampfer M.J., Willett W.C. Trans fatty acids and coronary heart disease. N Engl J Med 1999;340:1994-1998. doi:10.1056/NEJM199906243402511
  2. Benito-Vicente A., Uribe K.B., Jebari S., Galicia-Garcia U., Ostolaza H., Martin C. Familial hypercholesterolemia: the most frequent cholesterol metabolism disorder caused disease. Int J Mol Sci 2018;19(11):3426. doi:10.3390/ijms19113426
  3. Fernandez M.L., Murillo A.G. Is there a correlation between dietary and blood cholesterol? Evidence from epidemiological data and clinical interventions. Nutrients 2022;14(10):2168. doi:10.3390/nu14102168
  4. Hu F.B., Willett W.C. Optimal diet for prevention of coronary heart disease JAMA 2002;288:2569-2578. doi:10.1001/jama.288.20.2569
  5. Lichtenstein A.H. Dietary fat, carbohydrate, and protein: effects on plasma lipoprotein patterns J. Lipid Res. 2006;47:1661-1667. doi:10.1194/jlr.R600019-JLR200
  6. Lichtenstein A.H., Ausman L., Jalbert S.M., Schaefer E.J. Effect of different forms of dietary hydrogenated fats on serum lipoprotein cholesterol levels. N Engl J Med 1999;340:1933-1940. doi:10.1056/NEJM199906243402501
  7. Mahan L.K., Escott-Stump S.: “Krause’s foods, nutrition, and diet therapy” 10th ed. 2000
  8. Mensink R.P., Katan M.B. Effect of dietary trans fatty acids on high-density and low-density lipoprotein cholesterol levels in healthy subjects. N Engl J Med 1990;323:439-445. doi:10.1056/NEJM199008163230703
  9. Mozaffarian D., Katan M.B., Ascherio A., Stampfer M.J., Willett W.C. Trans fatty acids and cardiovascular disease. N Engl J Med 2006;354:1601-1613. doi:10.1056/NEJMra054035
  10. Shils M.E., Olson J.A., Shike M., Ross A.C.: “Modern nutrition in health and disease” 9th ed., by Lippincott, Williams & Wilkins, 1999
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