According to the World Health Organization, cardiovascular disease is the leading cause of death in modern times, as it is estimated that it accounts for 31% of deaths worldwide. This fact should make us wonder what leads to the development of cardiovascular disease and how to avoid it. One of the main indicators of cardiovascular health is cholesterol.

Cholesterol is a component that exists normally within our body, since in addition to food, it is also produced endogenously in the liver. It is found in the blood in various forms, the best-known being LDL or “bad” cholesterol and HDL or “good”, each of which performs a different function. The reason behind these characterizations is that LDL is associated with an increased risk of developing atherosclerotic plaque, the development of which very often leads to death, while HDL protects the cardiovascular system. To ensure good health, the levels of the former should be kept low, while those of the latter should be kept high.

Clearly, there is always the genetic background that may influence blood cholesterol levels, but lifestyle can reverse, at least to some extent, the effect of a “bad” gene.

Very frequently, the individual is forced to face the issue of high cholesterol (hypercholesterolaemia) when it is already established, as a result of which medication must be used. Cholesterol-lowering drugs, like any medication, are not enough to ensure a complete cure. By taking medication, the person often rests and maintains previous lifestyle habits that may have led to the problem. The reality, however, is that with or without medication, when we are dealing with cholesterol, we must completely reshape our lifestyle. Eating habits and the amount of time a person spends in sedentary or energetic activities are determinants of cholesterol levels. Current scientific data show that dietary cholesterol has only a small effect on blood cholesterol levels. The component of the diet that negatively affects seems to be some types of fatty acids, particularly saturated and trans. These are mainly found in animal fats (especially red meat, cheese, cold cuts), highly processed foods (all forms of junk food and packaged snacks), heat-treated oil (frying) and sweets. With a simple example, it is much safer for cholesterol levels to eat a boiled egg, the yolk of which is rich in cholesterol, rather than a fried zucchini, as the oil in which it is fried is rich in saturated and trans fatty acids.

Besides foods to avoid, however, there are foods that help lower LDL cholesterol levels, with fiber sources, such as fruits and vegetables, as main representatives, as well as omega-3 and omega-6 fatty acids sources, such as fish and nuts. Other ingredients that have been shown to contribute are plant sterols and stanols, which are normally found in vegetable oils (such as

sesame oil), nuts, but also in fruits and vegetables, while several commercial foods (such as spreads) are now fortified with them. As for HDL, it increases with physical activity, either as part of an organized exercise or as part of recreational activities, such as a walk with friends. The more frequent the physical activity, the easier it becomes to maintain cholesterol at normal levels and thus avoid the development of cardiovascular disease.

Scientific data from Ikaria show low rates of cardiovascular disease, which is related to the plant-based diet of the inhabitants, in addition to preferring white to red meat, combined with the daily exercise that their life includes, for example in the form of agricultural work or as long walks on the island. The instructions of a health professional could not be different in order to ensure the prevention of hypercholesterolaemia, even when the person has a genetic predisposition. Adopting such a lifestyle promotes the maintenance of normal blood cholesterol levels and is therefore an invaluable treasure for cardiovascular health.