Columnist Dr. Cheryl Christy

Author's note: This column is intended for educational purposes only. It aims to highlight gaps in health knowledge, provide support and empower organizations to guide their members in creating effective health and wellness programs.

Cholesterol is not the enemy. It is essential for life. Cholesterol is a key ingredient the body needs to build cell membranes and produce hormones like estrogen and testosterone. It helps produce vitamin D from sunlight, makes bile acids that aid digestion and supports neurological development. Only about 20% of cholesterol comes from your diet. The remainder is made by the liver and intestines.

Cholesterol is a waxy, fatty substance that travels throughout the body via the bloodstream by binding to a protein called a lipoprotein. There are two types of lipoproteins: LDL and HDL. LDL (low-density lipoprotein) is sometimes referred to as “bad” cholesterol because it can combine with other substances to form plaque in your arteries, causing them to narrow and leading to a heart attack or stroke. HDL (high-density lipoprotein) carries excess cholesterol away from your arteries back to the liver, where it can be broken down and removed from the body.

Cholesterol levels are assessed via a lipid panel that measures LDL, HDL, triglycerides and total cholesterol. But what the standard lipid panels miss are two markers of inflammation and free radical damage: hs-CRP and oxLDL. CRP (C-reactive protein) is produced by the liver and increases in the blood in response to inflammation, infection, a heart attack or trauma. CRP levels are strong predictors of cardiovascular disease. Ask your health care provider to order a CRP and oxidized LDL test to get a better idea of your risk. Once you know your risk, you can modify it with lifestyle changes. Along with a heart-healthy diet, consider adding more alkaline foods versus acidic foods.

THE REAL CHOLESTEROL PROBLEM: INFLAMMATION

New research points to inflammation as a key driver of cardiovascular disease. The prevention of chronic diseases, including heart disease, rests on controlling systemic inflammation. Cholesterol becomes problematic in the presence of inflammation, creating free radicals that damage cholesterol and other fats. This activates the immune system and triggers a cascade of events that lead to plaque formation in the arteries, causing atherosclerosis. Uncontrolled inflammation causes plaque to build up and break away, leading to a heart attack, stroke or pulmonary embolism, depending on which arteries are affected.

CHOLESTEROL PROFILE

Risk factors include genetics, poor sleep patterns, obesity, stress, inactivity, smoking, diabetes and highly processed food, which affect cholesterol levels. The cholesterol process is naturally accelerated by diet, regular physical activity and lifestyle adjustments, especially avoiding smoking. Diet can be improved by increasing soluble fiber intake, which binds to cholesterol in the digestive tract and excretes it in the stool before it enters the bloodstream. Foods high in fiber include oats, beans, lentils and apples. Add plant sterols and stanols, which are found in nuts, seeds and orange juice. Eat foods rich in omega-3 fatty acids to lower LDL and triglyceride levels. Foods in this category include salmon, tuna and mackerel at least twice a week. In addition, moderate-intensity aerobic exercise, such as brisk walking, swimming or cycling, helps the body clear harmful fats while raising HDL levels.

As with so many health concerns, the real story about cholesterol is that we may have allowed one piece of the puzzle to overshadow the rest. If we truly want a healthier community, we must return to the foundations of human health as individuals, not a one-size-fits-all approach.

Dr. Cheryl Christy is a Baldwin County resident and registered nurse with nearly 30 years of experience. She holds master's degrees in nursing education and nursing practice and a doctorate in nursing practice. She is a member of Sigma Theta Tau, Phi Pi Chapter, a certified lay counselor and the author of "Voices for Healthcare," a health care blog.

Read her previous column titled "A new look at chronic disease treatment" on www.GulfCoastMedia.com.