Men, women: Why cholesterol matters

Recommended by Dr. Michael White, Updated on October 25th, 2018
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By Dr. Daniel Cepin, M.D.6 a.m.Jan. 29, 2015

This column is written by experts in the medical field and provides advice on mens and womens health issues.

Cholesterol is not often at the top of peoples minds until they hear the bad news from their doctor that theirs is too high. But the waxy, gel-like substance that is made naturally in the body can be a good thing. Cholesterol has many important functions, including helping with digestion, maintaining cell membranes and producing hormones like testosterone and estrogen. Cholesterol comes from two sources: the liver and food.

The liver produces all the cholesterol the body needs and circulates it through the blood. When cholesterol is derived from food, it comes from animal sources like meat, poultry and dairy; the liver produces excess cholesterol when foods high in saturated and trans fats are eaten, which can cause plaque to form between artery walls and make it difficult for blood to circulate. This is why high cholesterol is a major risk factor for heart attack and stroke.

While both men and women are at risk for heart disease, gender makes a difference when it comes to cholesterol. Cholesterol levels are categorized by two types: low-density lipoproteins (LDL), known as bad cholesterol, and high-density lipoproteins (HDL), known as good cholesterol.

The estrogen that women produce has been found to raise HDL cholesterol, generally giving women higher HDL levels than men. Since women produce the most estrogen during their childbearing years, premenopausal women usually have some protection against heart disease, but as estrogen production drops with age, so do HDL levels, raising the risk for heart disease later in life.

Where men are concerned, cholesterol frequently presents a problem in middle age. A Norwegian study of more than 40,000 men and women under age 60 found that middle-aged men with high levels of cholesterol have a risk for a first heart attack that is three times higher than women.

Regardless of gender, its recommended that all patients have their cholesterol tested every five years beginning in their 20s. Individuals with an increased risk of heart disease due to diabetes, family history, smoking, hypertension, or other factors should pay especially close attention to their cholesterol as high levels do not usually come with warning signs.

In addition, both men and women should eat a healthy diet and exercise regularly to improve their cholesterol. Patients should choose healthy fats, such as low-fat dairy and lean cuts of meat; avoid trans fats like fried foods, cookies and crackers; limit intake of cholesterol, which can be found in foods like egg yolks and whole milk products; opt for whole grains; eat plenty of fruits and vegetables; and incorporate foods that are rich in omega-3 fatty acids, such as salmon, walnuts and almonds. Men and women should also aim for exercise most days of the week, which may include taking a daily walk, playing a sport, swimming laps, or even taking the stairs instead of the elevator.

Recommended resources: The American Heart Association at heart.org.

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Men, women: Why cholesterol matters

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