THE TRUTH ABOUT CHOLESTEROL.

Cholesterol is an indispensable architect, a master builder.

Let’s understand the paradox that exists around cholesterol.

Cholesterol is not as some villainous substance, but as an absolutely essential building block for life.

It’s a waxy, fat-like substance that’s found in every single cell in your body.

But why is it blamed to everything then?

Because the problem is in the transport not the molecule.

Cholesterol is a fatty substance.

Blood is mostly water.

It can’t just float freely.

That’s where lipoproteins come in – these are little "trucks" made of fat and protein that will transport cholesterol (and other fats) throughout your bloodstream.

Then what does good and bad cholesterol mean?

When you say "good" and "bad" cholesterol - you really mean is the lipoproteins (truck) carrying cholesterol.

There are 2 types:

- Low-Density Lipoprotein (LDL)

- High-Density Lipoprotein (HDL)

LDL – The “Outgoing Delivery Truck”

LDL are the trucks that leave the main factory (your liver) to deliver cholesterol to all the different construction sites (your body’s cells).

But why do we need to deliver this?

• Cell repair
• Hormone production

But isn’t this a great thing then?

Why are they referred as bad cholesterol then?

Problem arises only when there are too many LDL trucks or if they’re carrying “sticky” types of cholesterol.

They get stuck or damaged along the way.

If too much of this cholesterol is delivered, it doesn’t get cleared efficiently and starts accumulating in walls of your blood vessels.

But what do you mean by “sticky” cholesterol?

Oxidation: When LDL particles gets exposed to free radicals, they become damaged.

Oxidised LDL doesn’t get de loaded efficiently.

Glycation: Sugar molecules in your bloodstream attach to LDL particles and form a sugar coating which makes it more sticky.

Glycated LDL particles are also more prone to oxidation and inflammation.

Now imagine HDL - C, this is the “cleanup crew”

They go around the city, pick up excess, unused cholesterol from the cells and artery walls, and bring it back to the main factory (the liver) for recycling.

HDL is the superhero that clears out the excess cholesterol buildup in your arteries.

Which is why it’s often called “good” cholesterol.

So having low LDL and high HDL is the way to go right?

Yes but it's not that simple.

Let's understand how the components of lipid profile.

Whenever you get your lipid profile checked there are 5 things:

- Total cholesterol
- LDl-C
- HDL-C
- TGs
- VLDL-C

1. Total cholesterol

Sum of all the cholesterol in all the lipoproteins.

Honestly it's least informative on its own.

2. LDL- C

This is the "delivery truck" that's carrying cholesterol.

A high LDL-C indicates higher risk of cholesterol deposition in arteries.

3. HDL-C

This is the clean-up crew cholesterol.

A higher HDL is considered protective because it pulls out excess cholesterol from arteries and sends back to liver.

This is called reverse cholesterol transport.

4. Triglycerides

High TGs are often a strong indicator of Metabolic disorder.

5. Non-HDL cholesterol

This is simply total cholesterol - HDL cholesterol.

Represents all the cholesterol carried by lipoproteins that are considered potentially atherogenic

Another advanced metric: ApoB

It measures the actual number of LDL particles circulating in your blood.

It’s like counting the actual number of trucks.

It’s a superior predictor of cardiovascular health than LDL-C

When you look at your lipid profile don’t just stop at cholesterol delve into LDL-C, HDL-C, TGs and Non-HDL cholesterol.

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