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Cholesterol: The good, the bad, and the...wine?

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Cholesterol. It’s something we need, but becomes a problem when there’s too much of it. It’s a buzzword often thrown around in advertisements for both food and medication, and something people watch out for in their diets. But what is cholesterol, and why can it be a problem?

This week on Take Care, Dr. Robert S. Rosenson answers these questions and more. Dr. Rosenson is a professor of medicine at the Icahn School of Medicine at Mount Sinai, and is also director of cardio-metabolic disorders at the Mount Sinai Hospital in New York City.

Click 'Read More' to hear our interview with Dr. Rosenson.

By definition, cholesterol is very important.

“Cholesterol is a fat, a lipid, that is critical for the importance of making membranes, which are the outer parts of the cell. Cholesterol is used to make certain vitamins, such as vitamin D. It’s also used to make certain hormones, estrogen for women and testosterone for men,” says Dr. Rosenson.

Then how does something so important become a problem for some people?

When calories are consumed by the body, they get turned into particles known as lipoproteins, which contain cholesterol. These get secreted into the bloodstream, but when cholesterol is in excess concentration, often because of an unhealthy diet, it can get deposited in the tissue of arteries and blood vessels. This causes a build-up of plaque and a progressive dysfunction of the lining of the vessel, which can lead to even more severe problems such as high blood pressure and heart disease.

There are two major forms of cholesterol:

  • Low-density lipoprotein (LDL): Often called “bad cholesterol,” as it can cause the build-up of cholesterol in the bloodstream.
  • High-density lipoprotein (HDL): Also known as “good cholesterol,” due to its ability to remove cholesterol buildup and provide protection from the hazards of the LDL particle.

Foods that are high in calories and saturated fat, such as fried foods and animal products, often increase LDL cholesterol. And while the age of patients dealing with this issue often skews older, Dr. Rosenson has noted that it can start as early as childhood if diet isn’t well monitored.
According to Dr. Rosenson, the most effective way to fight off cholesterol problems is to maintain a healthy lifestyle by eating well and exercising regularly.

“The healthy lifestyle does two things. It prevents the accumulation of LDL cholesterol in many individuals, and it also increases the HDL cholesterol, which counterbalances the potential hazards of the LDL particle on our vascular system,” he says.

While medications do exist to treat high cholesterol, Dr. Rosenson recommends beginning with lifestyle changes, which will have positive effects on other aspects of the body as well.

Interestingly enough, red wine contains HDL cholesterol, and many people drink it for that reason. Dr. Rosenson doesn’t recommend looking at it as a form of treatment though.

“As a clinician I don’t recommend that my patients drink alcohol to raise the HDL cholesterol, because there’s a lot of calories, it increases the blood pressure, and again, we don’t have the scientific evidence that it’s helping reduce your risk of heart disease through its effects on increasing HDL cholesterol content,” he says.