We make it easy for you to participate in a clinical trial for Cholesterol, and get access to the latest treatments not yet widely available - and be a part of finding a cure.
Cholesterol is a fatty substance in our bloodstream that increases when we consume excess fats in our diet. Cholesterol is important for regulating body processes and maintaining cell structure. It is a constituent of certain hormones, bile salts, and vitamin D.
There are two main types of cholesterol:¹
Low-density lipoprotein (LDL), known as bad cholesterol
High-density lipoprotein (HDL), known as good cholesterol
Oxidation² is a chemical reaction that occurs in the body due to a combination of products from normal body processes and external factors, including exposure to certain food types, environments, or substances like tobacco cigarettes. Oxidation occurs in many substances in our blood, including LDL cholesterol.
Although oxidation is a normal process, having excessive oxidized LDL can be harmful as it contributes to plaque formation, leading to severe health conditions. This is why LDL is called “bad cholesterol.”
On the other hand, HDL cholesterol is called “good cholesterol" as it alleviates the harmful effects of LDL by transporting it from body tissues to the liver, where it can be excreted.
As oxidized cholesterol levels increase in your body, so does the risk of plaque formation.
Plaque is abnormal cholesterol deposits within the walls of your blood vessels. It narrows them and causes atherosclerosis, which is the hardening of blood vessels.
This leads to reduced blood flow, which can negatively affect your health.
Sometimes, plaques can break off and cause blood clots. This can sometimes block blood vessels that supply the heart (leading to heart attacks) and the brain (leading to strokes).
Some risk factors result in high oxidized LDL levels, a few of which can be reduced or eliminated with adequate lifestyle changes.
Other risk factors, like genetic conditions, may be more difficult to manage and require closer monitoring by your doctor.
Unhealthy fats are mostly saturated fat and trans fat. They tend to decrease our good HDL cholesterol and increase our bad LDL cholesterol.
Saturated fat usually comes from animal products like:
Fatty meats
Full-fat milk
Cheese
Coconut and palm oil contain saturated fats as well.
Trans fats are found in processed foods like:
Margarine
Some breakfast spreads
Baked goods
The standard American diet³ is high in unhealthy fat, processed foods, and added sugar. Food in this diet is often high in oxidized LDL cholesterol.
Cigarette smoking promotes oxidation and has been strongly associated with:
Atherosclerosis
Heart disease
Stroke
Both active and passive smokers can be affected. Nicotine in tobacco can significantly increase levels of bad LDL cholesterol.
Cigarette smoking also reduces good HDL cholesterol and causes inflammation in the body which encourages oxidation.
You may already be aware of a personal history of high LDL cholesterol levels. This could be due to:
Lifestyle
Environmental factors
Genetic conditions like familial hypercholesterolemia (FH)⁴
With more LDL cholesterol available for oxidation, your risk of high oxidized LDL levels would also increase.
LDL oxidation is regulated by the balance of pro-oxidants, which encourage oxidation, and antioxidants, which prevent oxidation.
Preventing LDL oxidation involves reducing oxidation triggers and increasing antioxidant levels in your body. This can be achieved through the following recommendations.
Eliminate foods that cause or promote LDL oxidation. This includes reducing your intake of:
Processed foods
Unhealthy fats like saturated fat and trans fat
Refined sugar
A diet centered on fish and poultry with limited amounts of red meat is recommended. Consider making changes to how you cook as well. For instance, use low-fat milk and liquid vegetable oils instead of butter or lard in your meals.
However, we still need some fat in our diets to fuel our bodies. Fat helps us:
Absorb certain vitamins
Cushion our internal organs
Maintain structures in our body
Regulate body temperature
Having 20%–30% of total calories from fat is recommended for adults. Instead of having unhealthy saturated fats, consider eating good fat sources in moderation, such as:
Oily fish
Avocados
Nuts
These foods are high in healthy monounsaturated fat, which is heart-healthy.
Fruits and vegetables are high in antioxidants and have anti-inflammatory properties which prevent LDL oxidation, so they are associated with a lower risk of heart disease and stroke.
The inflammation and rise in LDL cholesterol caused by cigarette smoking can increase your risk of forming excess oxidized LDL.
The negative effects of cigarette smoking on heart health are evident even with minimal exposure to smoking and other forms of tobacco. These effects can be reduced or even reversed if you stop smoking.
Those who successfully stop smoking in the long term can greatly reduce their risk of heart disease. These benefits of smoking cessation extend to people with established heart disease, as not smoking helps prevent the recurrence of heart attacks or strokes.
Smoking cigarettes harms overall health and can be an expensive lifestyle choice. However, it can be difficult to stop smoking. If you are interested in stopping smoking and would like support, talk to your doctor or smoking cessation service provider.
Regular exercise is essential for good health and can increase HDL levels, reducing oxidized LDL's ill effects.
Aim for at least 150 minutes of moderate-intensity aerobic activity each week. However, there is no hard and fast rule regarding exercise.
Even light-intensity activity can counter some health risks of being sedentary, so start with spending less time sitting. Slowly increase the intensity and frequency of your workouts over time.
If you have already started cholesterol-lowering medication, remember to take your medicines as advised to reduce your overall lipid levels. This ultimately reduces your risk of having excess oxidized LDL and can protect your heart health.
If you are concerned about your heart health or have any risk factors for high oxidized LDL, seek medical advice. Your doctor may recommend the following strategies and investigations based on your health status.
Currently, it is not routine for isolated oxidized LDL levels to be measured.
Instead, your doctor may recommend regular blood tests called “lipid profile tests” to measure your overall LDL levels. Although this does not test specifically for oxidized LDL, overall LDL levels can reflect your risk of high oxidized LDL.
Although oxidized LDL is not routinely measured, it is possible to determine the presence of its complications.
As discussed, a significant complication of excess oxidized LDL is plaque accumulation leading to atherosclerosis and heart disease.
Depending on your risk factors and health status, your doctor can arrange for a test to check for established disease. This test is called a “cardiac computed tomography (CT) for calcium scoring.”⁵ It uses x-rays to show if your arteries are blocked or damaged by atherosclerosis.
Lifestyle changes like healthy eating and increased physical activity can be sufficient to control the fat levels and oxidized LDL levels in your blood.
However, if you need more support to make these important changes, your doctor may connect you with dieticians.
Smoking cessation can be challenging, but it can improve your overall health significantly. Your doctor can provide tools like nicotine replacement therapy (NRT)⁶ to help you stop smoking.
If you have established high cholesterol levels and have already made healthier lifestyle changes to reduce cholesterol, see your doctor to review your cholesterol levels.
If required, your doctor can prescribe cholesterol-lowering medications to further optimize your LDL levels.
Excess oxidized cholesterol can cause narrowing and hardening of our arteries, leading to serious health conditions like heart disease and stroke.
You can prevent or reduce LDL oxidation in your body by adopting healthier dietary habits, increasing exercise levels, and stopping smoking. Fat is important in our diet so choose foods containing healthy fats and eat them in moderation.
Keep in touch with your doctor to monitor and manage your LDL cholesterol levels if needed.
Sources
HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events list of authors. (2007)
Lipid oxidation (2006)
Effects of a standard American diet and an anti-inflammatory diet in male and female mice (2018)
Guidelines for the diagnosis and management of heterozygous familial hypercholesterolemia (2004)
Other sources:
Physiology, cholesterol | NIH: National Library Medicine
A comprehensive review on lipid oxidation in meat and meat products (2019)
Dietary antioxidants and paraoxonases against LDL oxidation and atherosclerosis development (2005)
Bile acid physiology (2017)
Cardiovascular risk of smoking and benefits of smoking cessation (2020)
American heart association recommendations for physical activity in adults and kids | Heat Attack and Stroke Symptoms
Biomimetic sensors targeting oxidized-low-density lipoprotein with molecularly imprinted polymers (2020)
Cooking to lower cholesterol | Heart Attack and Stroke Symptoms
We make it easy for you to participate in a clinical trial for Cholesterol, and get access to the latest treatments not yet widely available - and be a part of finding a cure.