Cholesterol levels regulator

How do cells sense and control their cholesterol levels? Whereas most of the cell cholesterol is located in the plasma membrane, the effectors of its abundance are regulated by a small pool of cholesterol in the endoplasmic reticulum (ER). The size of the ER compartment responds rapidly and dramatically to small changes in plasma membrane cholesterol around the normal level. Consequently, increasing plasma membrane cholesterol in vivo from just below to just above the basal level evoked an acute (<2 h) and profound (%u224820-fold) decrease in ER 3-hydroxy-3-methylglutaryl-CoA reductase activity in vitro. We tested the hypothesis that the sharply inflected ER response to cholesterol is governed by the thermodynamic activity (fugacity) of plasma membrane cholesterol. The following two independent measures of plasma membrane cholesterol activity in human red cells and fibroblasts were used: susceptibility to cholesterol oxidase and cholesterol transfer to cyclodextrin. Both indicators revealed a threshold at the physiologic set point of plasma membrane cholesterol. Incrementing the phospholipid compartment in the plasma membrane with lysophosphatidylcholine, previously shown to decrease cholesterol oxidase susceptibility, reduced the transfer of plasma membrane cholesterol to cyclodextrin and to the ER. Conversely, the membrane intercalator, n-octanol, increased cholesterol oxidation, transfer, and ER pool size, perhaps by displacing cholesterol from plasma membrane phospholipids. We conclude that the activity of the fraction of cholesterol in excess of other plasma membrane lipids sets the cholesterol level in the ER. Cholesterol-sensitive elements therein respond by nulling the active plasma membrane pool, thereby keeping the cholesterol matched to the other plasma membrane lipids.

Your Total Blood (or Serum) Cholesterol Level

Less than 200 mg/dL: Desirable
If your LDL, HDL and triglyceride levels are also at desirable levels and you have no other risk factors for heart disease, total blood cholesterol below 200 mg/dL puts you at relatively low risk of coronary heart disease. Even with a low risk, however, it's still smart to eat a heart-healthy diet, get regular physical activity and avoid tobacco smoke. Have your cholesterol levels checked every five years or as your doctor recommends.

200-239 mg/dL: Borderline-High Risk
If your total cholesterol falls between 200 and 239 mg/dL, your doctor will evaluate your levels of LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. It's possible to have borderline-high total cholesterol numbers with normal levels of LDL (bad) cholesterol balanced by high HDL (good) cholesterol. Work with your doctor to create a prevention and treatment plan that's right for you. Make lifestyle changes, including eating a heart-healthy diet, getting regular physical activity and avoiding tobacco smoke. Depending on your LDL (bad) cholesterol levels and your other risk factors, you may also need medication. Ask your doctor how often you should have your cholesterol rechecked.

240 mg/dL and over: High Risk
People who have a total cholesterol level of 240 mg/dL or more typically have twice the risk of coronary heart disease as people whose cholesterol level is desirable (200 mg/dL). If your test didn't show your LDL cholesterol, HDL cholesterol and triglycerides, your doctor should order a fasting profile. Work with your doctor to create a prevention and treatment plan that's right for you. Whether or not you need cholesterol-regulating medication, make lifestyle changes, including eating a heart-healthy diet, getting regular physical activity and avoiding tobacco smoke.
-www.americanheart.org

Triglyceride is a form of fat. People with high triglycerides often have a high total cholesterol level, including high LDL (bad) cholesterol and low HDL (good) cholesterol levels.

Your triglyceride level will fall into one of these categories:

Normal: less than 150 mg/dL
Borderline-High: 150-199 mg/dL
High: 200-499 mg/dL
Very High: 500 mg/dL
Many people have high triglyceride levels due to being overweight/obese, physical inactivity, cigarette smoking, excess alcohol consumption and/or a diet very high in carbohydrates (60 percent of more of calories). High triglycerides are a lifestyle-related risk factor; however, underlying diseases or genetic disorders can be the cause.

The main therapy to reduce triglyceride levels is to change your lifestyle. This means control your weight, eat a heart-healthy diet, get regular physical activity, avoid tobacco smoke, limit alcohol to one drink per day for women or two drinks per day for men, and limit beverages and foods with added sugars. Visit your healthcare provider to create a plan of action that will incorporate all these lifestyle changes. Sometimes, medication is needed in addition to a healthy diet and lifestyle.

A triglyceride level of 150 mg/dL or higher is one of the risk factors of metabolic syndrome. Metabolic syndrome increases the risk for heart disease and other disorders, including diabetes.

americanheart.org

Some of your cholesterol is made by your body. The food you eat is responsible for the rest. Food products from animals contain cholesterol - including meats, poultry, shellfish, eggs, butter, cheese and whole or 2 percent milk. And any type of food can also contain saturated fats and trans fats, which cause your body to make more cholesterol.
The American Heart Association recommends that you keep your intake of total fat to between 25 percent and 35 percent, your saturated fat consumption to less than 7 percent and your intake of trans fat to less than 1 percent of your total daily calories.

At the same time, limit your intake of cholesterol from food to less than 300 mg per day. People with high LDL (bad) blood cholesterol levels or who are taking cholesterol medication should consume less than 200 mg of cholesterol per day.

Eat at least 25 to 30 grams of dietary fiber each day - preferably from whole grains, fruits, vegetables and legumes.

To combat high blood pressure and for overall cardiovascular health, also limit sodium to 2,300 mg or less per day. Some people - African Americans, middle-aged and older adults, and people with high blood pressure - need less than 1,500 mg per day. And if you drink alcohol, do so in moderation (no more than one drink a day for women, no more than two for men).

But a heart-healthy diet isn't just about what you shouldn't eat. It also means eating a diet rich in vegetables and fruits, with whole grains, high-fiber foods, lean meats and poultry, fish at least twice a week, and fat-free or 1 percent fat dairy products. Also, the diet should be low in saturated fat, trans fat and cholesterol.

By learning to make smart choices - whether you're cooking at home or eating out - you can enjoy flavorful foods while you manage your cholesterol.

Golden mustard sauce, white fish, and dark green spinach make a picture perfect plate that is incredibly easy to prepare.
serves 4

4 mild fish fillets, such as sole or flounder (about 4 ounces each)
1/4 cup fat-free or light ranch salad dressing
3 tablespoons fat-free or low-fat plain yogurt
1 1/2 tablespoons prepared mustard
8 ounces fresh spinach

Preheat the oven to 400°F.

Rinse the fish and pat dry with paper towels. Place in a 12 x 8 x 2-inch glass baking dish.

In a small bowl, stir together the salad dressing, yogurt, and mustard. Spoon evenly over the fish.

Bake for 8 to 10 minutes, or until the fish flakes easily with a fork.

Meanwhile, remove the stems from the spinach. Rinse the spinach thoroughly. Drain well.

Heat a nonstick skillet over medium%u2011high heat. Cook the spinach for 30 seconds, or just until wilted, stirring constantly.

Arrange the spinach in a single layer on serving plates. Top with the baked fish. Serve immediately.

Nutrition Analysis (per serving)

Calories
138

Total Fat
2.0 g

Saturated
0.5 g

Polyunsaturated
0.5 g

Monounsaturated
0.5 g

Cholesterol
54 mg

Sodium
376 mg

Carbohydrates
9 g

Fiber
2 g

Protein
22 g

Breakfast menus can be loaded with high-saturated fat items (like bacon and sausage) and baked goods that are high in trans fats. Instead, look for choices that include fresh fruit and whole grains.

Tips:

Start your meal with a glass of fruit juice.
Order whole-grain instead of white toast. Instead of butter, spread your toast with low-fat cottage cheese and a little jam.
Ask for low-fat cream cheese with your bagel.
Look for whole-grain cereals with fat-free milk (but watch out for high-fat granolas).
Enjoy fat-free or low-fat yogurt with fruit - either in a bowl or as a smoothie!
Hot cereals such as oatmeal, grits, cream of wheat or cream of rice with a little honey can warm you up on a cool morning.
source-americanheart.org

Fast food used to mean fried food, but today food franchises are offering people more healthy alternatives. Chef salads, grilled chicken sandwiches and frozen yogurt are just three examples.

Tips

Beware of topping burgers with cheese, special (mayonnaise-based) sauce and bacon - they add saturated fat and calories.

Pickles, onions, lettuce, tomato, mustard and catsup add flavor without the fat.
Steer clear of fried fish sandwiches.
A baked potato can be a healthy option, but have it with low-fat sour cream instead of butter, full-fat sour cream or cheese.

Danish
Small bagel

Jumbo cheeseburgers
Grilled chicken, sliced meats or even a regular 2 oz. hamburger on a bun with lettuce, tomato and onion

Fried chicken or tacos
Grilled chicken or salad bar (but watch out for high-calorie dressings and ingredients)

Fried chicken pieces
Chicken fajita pitas

French fries
Baked potato with vegetables or low-fat or fat-free sour cream topping

Potato chips
Pretzels, baked potato chips

Milkshake
Juice or low-fat or fat-free milk or a diet soft drink. (Limit beverages that are high in calories but low in nutrients, such as soft drinks)

Smoking is the single most preventable cause of death in the United States. Tobacco smoke is one of the six major controllable risk factors for heart disease (along with high cholesterol, high blood pressure, diabetes, being overweight and physical inactivity). If you smoke and have high cholesterol, you have two major controllable risk factors you need to work on. Exposure to other people's smoke increases the risk of heart disease even for nonsmokers.

Higher levels of HDL (good) cholesterol may reduce your risk of heart disease, but smoking has been shown to lower HDL (good) cholesterol levels. Smoking also decreases your tolerance for physical activity, making it harder to get the activity you need to help you reach healthy cholesterol levels.

The good news is that when you stop smoking - no matter how long or how much you've smoked - your risk of heart disease and stroke starts to drop. It's cut in half after one year without smoking, then continues to decline until it's as low as a nonsmoker's risk. And if you don't smoke, avoid exposure to secondhand smoke.
-American Heart Association

Many people have questions for their doctors about tests, drug treatments, risk factors and lifestyle changes. Below are examples of common questions. For a printable version to take to your doctor's office, click the link in the right column of this page.

About Blood Cholesterol

What do my cholesterol numbers mean?
What is my cholesterol goal?
How long will it take to reach my cholesterol goals?
How often should I have my levels checked?
How does exercise affect my cholesterol levels?
How does smoking affect my cholesterol levels?
What type of foods should I eat?
Do I need to lose weight, and if so, how much?
Will I need cholesterol-lowering medicine?
About Drug Treatment

What kind of medicine should I take?
Can I take the generic form of the medicine?
What should I know about the medicine?
What are the side effects?
How do I know if it's working?
How can I remember when to take the medicine?
What if I forget to take a medicine?
Should I avoid any foods or other medicines?
Can I drink alcohol?
How long will I need to take my medicine?

My choices about diet and physical activity are responsible for my cholesterol level.
Diet and physical activity contribute to overall blood cholesterol levels as well as the cholesterol that is made naturally by the body. The amount of LDL (bad) cholesterol in the blood is controlled in two important places - the liver and the intestines. The liver produces cholesterol (using it to make digestive - or bile - acids) and also removes cholesterol from the blood. The intestines absorb cholesterol, which comes from food and from bile. For some people, the liver produces more cholesterol than the intestines absorb. If this is the case for you, your physician may prescribe medicine to manage your cholesterol. However, a heart-healthy diet and regular physical activity are important to everyone for maintaining cardiovascular health. Have your cholesterol tested and work with your healthcare professionals on the plan that's best for you.

Cholesterol comes from two sources: your body and food. Your liver and other cells in your body make about 75 percent of blood cholesterol. The other 25 percent comes from the foods you eat.
LDL cholesterol is the "bad" cholesterol. When too much of it circulates in the blood, it can clog arteries, increasing your risk of heart attack and stroke.

LDL cholesterol is produced naturally by the body, but many people inherit genes from their mother, father or even grandparents that cause them to make too much. Eating saturated fat, trans fats and dietary cholesterol also increases how much you have. If high blood cholesterol runs in your family, lifestyle modifications may not be enough to help lower your LDL blood cholesterol. Everyone is different, so work with your doctor to find a treatment plan that's best for you.

http://www.americanheart.org/presenter.jhtml?identifier=3032767

The female sex hormone estrogen tends to raise HDL cholesterol, and as a rule, women have higher HDL (good) cholesterol levels than men do. Estrogen production is highest during the childbearing years. This may help explain why premenopausal women are usually protected from developing heart disease.

Women also tend to have higher triglyceride levels. Triglyceride levels range from about 50 to 250 mg/dL, depending on age and sex. As people get older, more overweight or both, their triglyceride and cholesterol levels tend to rise.

Postmenopausal hormone therapy (PHT) may benefit some women with osteoporosis or other medical conditions associated with menopause. However, the American Heart Association recommends that PHT not be used for cardiovascular prevention. The HERS trial of women who had previously had a heart attack showed that these women did not benefit from PHT. Recent clinical trials appear to confirm that PHT does not appear to reduce risk of cardiovascular disease and stroke in postmenopausal women. Women with a personal or family history of breast cancer or other endocrine-related cancers should not receive PHT either.

The American Heart Association recommends LDL (bad) cholesterol-lowering drug therapy for most women with heart disease. Drug therapy should be combined with a diet low in saturated fat, trans fat, cholesterol and sodium, and rich in fruits, vegetables, whole-grain and high-fiber foods, and fat-free and low-fat dairy. Fish (such as salmon, trout or haddock) should be eaten twice a week. In addition, women should manage their weight, get regular physical activity and not smoke.

To keep your cholesterol under control:

schedule a screening
eat foods low in cholesterol and saturated fat and free of trans fat
maintain a healthy weight
be physically active
follow your healthcare professional's advice