The consumption of pills to reduce cholesterol has increased by 50% in the last decade, according to data from the Spanish Agency for Medicines and Health Products (AEMPS). Cholesterol continues to be one of the main cardiovascular risk factors in Spain, according to the Spanish Society of Clinical, Family and Community Pharmacy (SEFAC), which ensures that "the Spaniards continue to neglect cholesterol control, even though they identify it as dangerous". . This body ensures, in fact, that up to 40% of the people who had their cholesterol measured in the last campaign of the SEFAC Foundation were referred to a specialist for the control of this pathology. For its part, the Spanish Heart Foundation warns that up to 50% of the Spanish population has high cholesterol and recalls that this is one of the main causes of 60% of cardiovascular diseases.
Despite the fact that cholesterol is usually on everyone's lips, and terms such as "bad" or "good" cholesterol are heard daily in medical consultations around the world, few know exactly what cholesterol is and what these terms mean. “We understand by cholesterol all those fat particles that circulate through our body. Although it is often negatively associated with health problems, such as heart disease, cholesterol plays several important roles in the body: it is involved in the formation of bile acids that are vital for the digestion of fats; it has a fundamental role in the production of vitamin D that protects the skin from chemical agents and prevents dehydration. In addition, it is involved in the production of certain hormones, such as sexual and thyroid hormones”, explains María Sánchez, eHealth Manager of Cigna Healthcare Spain. However, the expert recalls that "despite the fact that the body needs cholesterol to function properly, it is important to maintain an adequate balance, since having high levels of cholesterol in the blood can be detrimental to cardiovascular health."
For his part, the head of the Department of Cardiology at Quirónsalud Madrid, Roberto Martín Reyes, explains that "we are talking about LDL cholesterol when we refer to those low-density lipoproteins that deposit cholesterol particles in the arteries and promote the appearance of arteriosclerosis, that is, that is, they have an atherogenic effect. For its part, HDL, also known as "good" cholesterol, are those high-density lipoproteins that collect bad cholesterol particles and take them to the liver to be broken down, thus having an antiatherogenic effect and reducing the chances of having arteriosclerosis. ”. Therefore, despite the fact that we tend to look at the global cholesterol figure (which according to health recommendations should not exceed 200 mg/dl in healthy adults), the most sensible thing to do is to take into account the cholesterol called LDL, whose figure should be less than 130 mg/dl in those people who have not suffered a heart attack or stroke.
If you have any doubts regarding cholesterol, it is advisable to put yourself in the hands of a specialist, since in many cases these levels can be significantly reduced simply by introducing changes in diet and lifestyle. There are exceptions, such as all those cases in which the so-called hypercholesterolemia is due to genetic causes. Sánchez explains it, who assures that this phenomenon affects a large part of the population: "Genetic causes mean that, despite having healthy habits such as avoiding foods saturated in fat or exercising, we find ourselves with very high cholesterol figures from ages early, even from 8-10 years. In some cases it is necessary to prescribe medication from children”.
The drugs used to reduce cholesterol are statins, which act as inhibitors of an enzyme and, therefore, block a fundamental step in the production of cholesterol by the body. According to the Spanish Heart Foundation, it is advisable to resort to them in the case of "patients with cardiovascular risk who do not reach the targets set for LDL cholesterol figures with changes in lifestyle and heart-healthy diet, in those who have already had some type of cardiovascular pathology and in those considered healthy but with elevated LDL levels”. In all other cases, hypercholesterolemia can be prevented by “following a balanced diet with foods rich in omega-3 (nuts, seeds, salmon, trout or sardines, among others) and other sources of healthy fat, such as virgin olive oil. extra or avocado”, explains Sánchez.
The specialist adds that maintaining an active lifestyle through regular exercise helps control overweight and obesity and, at the same time, LDL cholesterol and triglyceride levels. Finally, "it is essential to avoid smoking, since smoking damages the walls of blood vessels and increases the risk of cardiovascular disease," concludes Sánchez.
As for food, it is advisable to eliminate from the diet a series of foods that contribute to raising HDL cholesterol. Here are some of them:
“Excessive alcohol consumption causes hypertriglyceridemia. This is because alcohol causes the liver to produce more triglycerides, which in turn causes less fat to be removed from the bloodstream. In addition, excessive alcohol consumption can also increase blood pressure, which increases the risk of cardiovascular disease. Therefore, that old belief that a couple of glasses of wine or beer a day could even be healthy has been completely refuted by numerous scientific studies, which affirm that the only safe alcohol consumption that can be prescribed is zero. To cite just one example, a study published in the Journal of Clinical Oncology warned that a single alcoholic drink a day could increase the risk of breast cancer by 5%, reaching 17% in the case of oropharyngeal cancer. and 30% in the esophagus.
The consumption of industrial ready meals is booming. According to the latest report from the Spanish Association of Manufacturers of Prepared Meals (Asefapre), its consumption increased by close to 11% in 2022. Despite the fact that there are healthy industrial pre-cooked meals on the market, we must not lose sight of the fact that in many cases These contain large amounts of additives such as salts, fats or even sugars, which not only considerably raises your caloric level but can also harm your health, causing, among other things, an increase in cholesterol. In fact, Sánchez includes industrial pre-cooked foods in the group of those foods that should not be consumed in any case, along with "fried, processed or fast food".
A study published in the Journal of the American Heart Association states that the intake of sugary drinks carries an increased risk of developing high levels of bad cholesterol (LDL) and triglycerides. This group includes industrial juices and smoothies, which, being made up of fruits, can often lead to deception, since many people consider them healthy and consume them at will.
Although Sánchez included pre-cooked foods, ultra-processed foods and sugary drinks among the prohibited foods, the Cigna expert points out that sausages and processed meats can be consumed occasionally. This is corroborated by the World Health Organization (WHO), which, although it does not recommend that the population stop eating processed meats, does insist on the need to reduce its consumption to prevent certain pathologies and reduce the risk of cardiovascular and certain types of cancer.
As for red meat, although different international organizations such as the WHO insist that it is necessary to moderate its consumption (both for health and environmental reasons), various studies have confirmed that its consumption does not have an appreciable effect on the increase in cholesterol. This is indicated by research published in the American Journal of Clinical Nutrition, which indicates that consuming red meat on a regular basis is not related to a significant increase in cholesterol levels or blood pressure, nor does it increase the risk of cardiovascular disease.
As for other foods that have traditionally been associated with high cholesterol levels, such as eggs and shellfish, science has denied this link over the years. With regard to eggs, numerous studies have not only dismantled the old belief that the consumption of eggs triggers cholesterol, but also recommend their regular consumption given their high-quality protein content and other beneficial nutrients. A study published in The American Journal of Medicine points out, in this sense, that eating more than one egg a day can be beneficial for the heart, since it helps the proper functioning of the blood supply and the main arteries.
Regarding shellfish, a study by Rockefeller University Hospital, carried out jointly with the Harvard School of Public Health, indicated that the consumption of shellfish such as prawns does not influence the increase in cholesterol. This is because what must be taken into account when evaluating a food is not its cholesterol content exclusively, but its total fat profile.
