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Cholesterol

Many people hear the word 'cholesterol' and immediately think negatively about it. However, the story isn't as clear cut as that. What many people still don't know is that there are different types of cholesterol, some of which are good and beneficial for health, while some are indeed bad and have negative effects on one's health. Cholesterol is a wax like substance belonging to the steroid family and is essential for proper body function. About half of the cholesterol in the body is produced in the body while the other half in our body comes from the food we eat.1 Cholesterol is transported around the body by lipoproteins. When the doctor collects our cholesterol levels, they also examine the number of lipoproteins circulating around our body. They do this by measuring the amount of cholesterol attached to the lipoproteins.  There are 5 forms of lipoproteins of which the two most common ones are High Density Lipoprotein (HDL) and Low Density Lipoprotein (LDL). High density lipoproteins are the 'good' kind and are involved in drawing cholesterol from your cells and returning them back to the liver to be excreted. Low density lipoproteins are the 'bad' kind and are termed so because they have the potential to attach itself onto artery walls and eventually become plaque which clog arteries and predispose us to stroke and coronary heart diseases. A good way to remember the difference is:

  • H for healthy
  • L for lethal

Cholesterol Figures For Health

The American Heart Foundation has numerical levels of total cholesterol, HDL and LDL which are seen to be desirable and beneficial for overall health. These figures are usually also adopted by the laboratory when analysing your blood cholesterol results. Following are tables2 of these numerical figures:

Total Cholesterol

Level mg/dL

Level mmol/L

Interpretation

< 200

< 5.0

Desirable level corresponding to lower risk for heart disease

200–240

> 240

Borderline high risk

5.2–6.2

> 6.2

High risk

 

High Density Lipoproteins

Level mg/dL

Level mmol/L

Interpretation

<40 for men, <50 for women

<1.03

Low HDL cholesterol, heightened risk for heart disease

40–59

1.03–1.55

Medium HDL level

>60

>1.55

High HDL level, optimal condition considered protective against heart disease

 

Low Density Lipoproteins

Level mg/dL

Level mmol/L

Interpretation

<100

<2.6

Optimal LDL cholesterol, corresponding to lower, but not zero, rates for symptomatic cardiovascular disease events

130 to 159

3.3 to 4.1

Borderline high LDL level, corresponding to even higher rates for developing symptomatic cardiovascular disease events

>200

>4.9

Very high LDL level, corresponding to highest increased rates of symptomatic cardiovascular disease events

 

Testosterone - A Hormone of Cholesterol

Testosterone is a steroid male sex hormone synthesised from cholesterol. It is produced in the testes by the Leydig cells, and is responsible for secondary male sex characteristics. In some parts of the body, testosterone is converted to dihydrotestosterone (DHT), which is 10 times more potent.

Effects of Testosterone

Testosterone was found to have a major effect in increasing the level of HDL3. It has been postulated that low testosterone levels are associated with coronary artery disease and Type 2 Diabetes. In another study4, testosterone replacement therapy has been shown to have a positive outcome on blood sugar levels, cholesterol levels and the harmful fat surrounding internal organs (visceral fat), thus reducing total risks in cardiovascular diseases. Another study5 showed that lower testosterone levels resulted in increased insulin resistance - resulting in increased risk of Type 2 diabetes. More importantly, it has been shown that increasing testosterone levels which is an anabolic hormone can enhance muscle strength, promote lean body mass helps to promote muscle growth and hypetrophy.

Bodybuilding, Diet & Cholesterol

Regardless of whether you are a bodybuilder or the occasional exerciser, the amount of cholsterol in your diet is important for good health. To ensure optimum functioning of your heart, you would want your total cholsterol and LDL cholesterol to be down while your HDL cholsterol is increased. Moderate intensity exercise such as resistance training 30 minutes per day on five or more days per week can help to increase HDL levels in the body6. It is usually a misnomer that people should avoid foods high in cholesterol (e.g. eggs, seafood) as a large proportion of cholsterol is made by the body. Hence, reducing dietary cholesterol would be useless as our body compensates by manufacturing more cholesterol. A wiser alternative is to avoid dietary intake of trans fats such as hydrogenated oils and replacing saturated fats with mono- and poly- unsaturated. Increased consumption of omega-3 fatty acids, unrefined carbohydrates, legumes including soy, soluble fibre, oats and nuts have all been shown to help reduce LDL levels6.

1 Essentials of Human Nutrition 3rd Ed. Jim Mann & A Stewart Truswell. Oxford University press 2008. p. 50
2 American Heart Foundation. Cholsterol Guidelines 2009
3 Page ST et al. 'Higher testosterone levels are associated with increased high-density lipoprotein cholesterol in men with cardiovascular disease: results from the Massachusetts Male Aging Study'. Asian J Androl. 2008 March; 10(2): 193–200.
4 Kapoor, D et al, 'Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes' European Journal of Endocrinology (2006) 154(6)
5 Pitteloud N et al. 'Relationship Between Testosterone Levels, Insulin Sensitivity, and Mitochondrial Function in Men'. Diabetes Care July 2005 vol. 28 no. 7 1636-1642
6 Manual of Dietetic Practice 4th Ed. Briony Thomas and Jacki Bishop. Blackwell Publishing 2007. p. 620-622
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