High cholesterol? Good and bad cholesterol? To measure? And what exactly do you measure? In this article we will discuss cholesterol in more detail, and especially how to measure it. Because measuring is important. Cholesterol – and of course high cholesterol – is an indicator of cardiovascular disease. By measuring you can take preventive action.
WHAT IS CHOLESTEROL?
Cholesterol is a fatty substance that occurs in our body in small globules. Most of it is produced in your liver. This is often just enough for what your body needs. You also get cholesterol through food through saturated fat. The amount of cholesterol the liver produces is influenced by lifestyle. In addition to eating too much saturated fat, smoking and little exercise are also factors that can disrupt the balance. Hereditary factors also play a role. For example, 1 in 300 people is predisposed to elevated LDL cholesterol levels.
You will not feel high cholesterol, but it does increase the risk of cardiovascular disease. So it must be measured to demonstrate. And this is done using blood. In that blood, at least the total cholesterol is examined, but also the ratio of HDL cholesterol (high-density lipoprotein), LDL cholesterol (low-density lipoprotein) and triglycerides.
TYPES OF CHOLESTEROL
Initially, total cholesterol is often examined. But total cholesterol is made up of HDL and LDL. And then there are triglycerides.
- LDL: Also called bad cholesterol. With high LDL cholesterol you are more likely to have narrowing in your arteries. The LDL particles accumulate in the blood vessels.
- HDL: Good cholesterol. HDL cholesterol helps clear cholesterol in the blood.
- Triglycerides: High levels of triglycerides contribute to the development of arteriosclerosis. But the effect is less clear than with LDL cholesterol.
TO MEASURE
The most common method of measuring cholesterol is through a venous blood sample. A healthcare provider takes a blood sample from a vein in your arm. The sample is then sent to a laboratory, where cholesterol levels and other relevant values are analyzed. Everything is often tested for. So on total cholesterol, HDL, LDL and triglycerides.
Measurements are increasingly being taken at home. The measurement is then reminiscent of a glucose measurement that diabetics do. Venous blood cannot be collected at home. Blood collection is then done with a finger prick. The disadvantage is that relatively little blood is released and some meters only test for total cholesterol. So don’t worry about HDL, LDL and triglycerides. The advantage is of course that measuring at home is easier and in practice it is done earlier and more often. It is more practical to take measurements at home every three months than to always have to go to the doctor. Especially if there is no indication. Preventive measuring is (unfortunately) still something that often has to be done on one’s own initiative.
RESULT MEASUREMENT
Total cholesterol is all the cholesterol in the blood added together: HDL + LDL.
If total cholesterol is below 5 mmol/l, this is good. Between 5 and 6.5 means a slightly increased cholesterol level. Between 6.5 and 8 we speak of increased. And above 8 mmol/l means strongly increased.
If HDL and LDL are also detected, the values can be interpreted as follows:
- LDL cholesterol below 3 is generally good. But this does depend on age and risk factors. Lower target values may apply for people with hereditary risk factors.
- HDL cholesterol is ideally higher than 1. Below 1 we speak of increased risk.
- For triglycerides, a value lower than 2 indicates a lower risk.
Naturally, a GP will help with interpreting the results. When you measure yourself at home, it is important to look carefully at the total and any individual results. Also pay attention to the unit of measurement. In the Netherlands we measure in mmol/L. In many other countries measurements are taken in mg/dl, for example in Belgium. A measurement in mg/dl has much higher values!
FROM WHAT AGE TO MEASURE?
It is often advised to monitor your cholesterol levels from the age of 50. This applies to people who are not in a risk group. You can have this measured once every 5 years and from the age of 65 it is wise to do this annually.
Measuring also makes sense if you are younger than 50 and, for example, hereditary factors play a role. Or when cardiovascular disease runs in your family. Of course, measuring also makes sense if you smoke or are overweight. Regardless of age.
Measuring = knowing. It may sound a bit cliché, but it remains the truth. Only by measuring do you gain insight. And sometimes that insight turns out to be very valuable. Measuring will also be the first step towards lifestyle adjustments. For example, if the result is 6.5 (total cholesterol), it may be decided to eat slightly less saturated fats. After 6 months you can measure again and see what the effect is.
Authors: Sebas Eikholt and Marjolein Aarts
Sources:
https://www.voedingscentrum.nl/encyclopedie/cholesterol.aspx
https://diabetesmagazijn.nl/zelf-cholesterol-meten-hoe-werkt-het/
https://www.cm.be/ziekte-en-behandeling/klachten-en-ziekten/cholesterol/meting
https://www.hartstichting.nl/oorzaken/cholesterol/cholesterol-meten