What actually are cholesterol and triglycerides?
Cholesterol and triglycerides are essential fats in the blood that the body uses to produce hormones, build cell membranes and store energy, but at the wrong levels they can lead to diseases such as cardiovascular disease.
Triglycerides come both from the food we eat and from the body's own production in the liver. They serve as the body's main energy reserve. Cholesterol is also found in certain foods, but a large proportion is produced by the body itself. Because fat cannot dissolve and be transported freely in the blood, these fats are transported by special transport proteins called lipoproteins.
In healthcare, two types in particular are discussed:
- LDL (Low Density Lipoprotein): LDL is often called the "bad" cholesterol because high levels are linked to an increased risk of atherosclerosis. LDL transports cholesterol around the body, but has a tendency to become trapped and release fat in the walls of blood vessels, which can lead to fatty deposits in the arteries and eventually heart attack and stroke.
- HDL (High Density Lipoprotein): HDL is often called the "good" cholesterol because it helps transport excess cholesterol back to the liver, where it can be broken down and processed.
- Good balance: The aim is to keep LDL cholesterol and triglycerides at favourable levels. High HDL levels are often linked to better metabolic health, but overall cardiovascular risk is influenced by several factors.
Why do you get high cholesterol?
High cholesterol can be caused by a combination of heredity, lifestyle habits and other diseases. Overweight and obesity are common risk factors because they can affect the body's metabolism of blood lipids and contribute to elevated levels of LDL cholesterol and triglycerides. Physical inactivity, smoking, high alcohol consumption, type 2 diabetes and certain hormonal or metabolic diseases can also affect cholesterol levels.
Overweight, particularly abdominal obesity, is closely linked to disturbances in the body's fat metabolism. Adipose tissue around the internal organs is metabolically active and can contribute to insulin resistance and altered levels of blood lipids, increasing the risk of cardiovascular disease.
In some cases, high cholesterol levels are caused by hereditary factors, such as familial hypercholesterolaemia. In this condition, the body has more difficulty removing LDL cholesterol from the blood, which can lead to very high cholesterol levels from a younger age.
Because high cholesterol rarely causes any symptoms, it is often only discovered during a health check or through a blood test.
Why do high blood lipids increase the risk of cardiovascular disease?
Elevated levels of certain blood lipids, particularly LDL cholesterol, can contribute to fat accumulating in the walls of blood vessels. Over time, this can cause the vessels to become narrower and stiffer in a process called atherosclerosis.
When LDL cholesterol is stored in the vessel wall, the body's immune system reacts, which can lead to local inflammation and the formation of what are known as plaques. These plaques can gradually grow and reduce blood flow through the vessels.
If a plaque ruptures, a blood clot can form. If the blood clot blocks a vessel supplying the heart, it can lead to a heart attack. If it instead occurs in a vessel supplying the brain, it can cause a stroke.
Elevated blood lipids are therefore an important risk factor for cardiovascular disease. The risk is also influenced by other factors, such as high blood pressure, diabetes, smoking, overweight and heredity.
Physical activity is important for blood lipids and heart health
Regular physical activity can improve blood lipids and reduce the risk of cardiovascular disease. Exercise can, among other things, contribute to lower levels of triglycerides and higher levels of HDL cholesterol, the blood lipid that helps transport excess cholesterol away from the blood vessels.
Physical activity also has positive effects on other risk factors that often occur together with elevated blood lipids, such as overweight, high blood pressure and type 2 diabetes. Both cardiovascular exercise and strength training can be valuable parts of a healthy lifestyle.
General recommendations for adults are at least 150 minutes of moderate-intensity physical activity per week, preferably combined with muscle-strengthening activity at least twice a week. However, how physical activity is best structured needs to be adapted to the individual's circumstances, health and everyday life.
The right diet can contribute to better blood lipids
Eating habits play an important role in blood lipids, but the effect is often greatest when dietary changes are combined with weight loss in overweight or obesity and regular physical activity.
It is not only about how much fat you eat, but also about what type of fat the diet contains. Foods high in saturated fat, such as high-fat dairy products, butter and certain processed meat products, can contribute to higher levels of LDL cholesterol. Choosing unsaturated fats instead, from foods such as fish, nuts, seeds, avocado and vegetable oils, can contribute to a more favourable blood lipid profile.
Fibre is also important for heart health. Soluble fibre in particular, found in foods including oats, barley, pulses, fruit and vegetables, can help lower cholesterol levels.
It can also be valuable to reduce the consumption of alcohol and foods high in added sugar. Small changes in eating habits can, over time, contribute to improved blood lipids and a reduced risk of cardiovascular disease.
Medical weight loss as part of treatment
For people with overweight or obesity, weight loss can contribute to improved blood lipids and a reduced risk of cardiovascular disease. A weight loss of around 5 to 10 per cent of body weight can, for many people, improve triglycerides, blood pressure and blood sugar control. At Yazen, medical treatment is combined with support around diet, physical activity, sleep and other lifestyle habits.
Obesity is a chronic disease in which biological mechanisms affect hunger, fullness and body weight. For some people, modern weight-loss medicines can be a valuable complement to lifestyle changes. GLP-1-based treatments affect the body's signals for hunger and fullness, which can make it easier to reduce energy intake and maintain new habits over time.
For many people, weight loss can contribute to improvements in several cardiometabolic risk factors. Blood lipids can improve, insulin sensitivity can increase and the risk of diseases such as type 2 diabetes and cardiovascular disease can decrease. The extent of these changes varies between individuals and is influenced by factors including the amount of weight lost and other health conditions.
Frequently asked questions about blood lipids and health
How do I know if I have high blood lipids?
High blood lipids usually cause no clear symptoms. Many people feel completely healthy despite elevated cholesterol or triglyceride levels, so the condition is often only discovered during a health check or through a blood test.
Because elevated blood lipids can increase the risk of cardiovascular disease, it is important to check your levels if you have risk factors such as overweight, obesity, type 2 diabetes, high blood pressure, smoking or a family history of cardiovascular disease.
Does cholesterol go down when I lose weight?
For many people, blood lipids improve with weight loss. Triglycerides often decrease and several other cardiometabolic risk factors can improve.
At the same time, LDL cholesterol can temporarily increase in some people during the active weight-loss phase. One possible explanation is that the body mobilises stored fat from areas including the liver and abdominal fat, which can affect blood lipid levels before they stabilise. It is therefore usually more valuable to monitor changes over time than to draw conclusions from a single test result during ongoing weight loss.
How blood lipids change varies between individuals and is influenced by factors including genetics, eating habits and the amount of weight lost. It is therefore important to monitor blood lipids over time and assess the results based on the overall health picture.
Do I need to take statins (cholesterol-lowering medicine)?
It depends on your cholesterol levels, your overall health and your total risk of cardiovascular disease. For some people, changes in lifestyle habits and weight loss may be enough to improve blood lipids, while others may need medication.
Statins are the most common medicines used to lower LDL cholesterol and are often used for high cholesterol levels, established cardiovascular disease or an increased risk of cardiovascular disease. Treatment can reduce the risk of heart attack and stroke.
Whether medication is appropriate is determined through an individual assessment by a doctor.
How does alcohol affect my triglycerides?
Alcohol can contribute to elevated triglycerides, particularly with high or regular consumption. When alcohol is broken down in the liver, it can affect the body's fat metabolism and increase the production of triglycerides.
High alcohol consumption is also linked to an increased risk of fatty liver, high blood pressure and other cardiometabolic risk factors. For people with elevated triglycerides, reducing alcohol consumption can therefore be an important part of treatment.
The extent of the effect of alcohol varies between individuals and depends on factors including the amount of alcohol, other lifestyle habits and overall metabolic health.
Do I have to stop eating all fat?
No. Fat is an important nutrient that the body needs for functions including hormone production, cell function and the absorption of certain vitamins. When it comes to blood lipids, it is therefore not only about the amount of fat in the diet, but also about the type of fat you eat.
Foods containing a lot of saturated fat can contribute to higher levels of LDL cholesterol. Choosing unsaturated fats instead, from foods such as fish, nuts, seeds, avocado and vegetable oils, can contribute to a more favourable blood lipid profile and better cardiovascular health.
The aim is therefore usually not to avoid fat completely, but to choose healthy sources of fat as part of a balanced diet.
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