Clinical Dietetics

Cholesterol’s path

Par Nicolas Aubineau - 4 minutes de lecture

The cholesterol is vital for the body, we have seen the definition of cholesterol, what it provides, where to find it, but concretely, how does it reach our cells, how can we end up with a majority of bad cholesterol? Here are my answers with some guidance in clinical dietetics.

How does the cholesterol go all the way to our cells?

Cholesterol is a lipid product, which is soluble into fat and not into water. Thus, it does not melt into blood. In order to reach the cells, it has to use carriers formed with proteins and lipids.

These carriers, called lipoproteins are coming from 2 categories : the HDL « High Density Lipoproteins » (high density) and the LDL « Low Density Lipoproteins » (low density).

  • The HDL have more proteins than cholesterol. Their purpose is to pick up the cholesterol surplus and to bring it back towards the liver which will transform and eliminate it with the bile. The HDL are known under the name of « good cholesterol ». The more HDL you have, the better the elimination is.
  • The LDL have for purpose to transport cholesterol in the blood. They carry it towards the cells that need it. They have more cholesterol than proteins. If the alimentation is too rich in cholesterol, they tend to stick to the wall of the blood vessels and consequently, they block them. The LDL are known under the name of « bad cholesterol ». There is a dangerous situation when the balance between the HDL and the LDL is modified.

When the LDL are in excess, the HDL cannot do their job anymore! The fat lies down which creates plates on the arteries’ walls. These plates narrow the blood flow and reduce the organ’s blood irrigation. They can even turn into clots which raise the cardio-vascular risk.
The cholesterol surplus is one cause of the arteries’ obstruction (atherosclerosis) for women and men. The heart arteries obstruction frequency (ischemic heart disease) raises with the amount of cholesterol in the blood (cholesterolemia).


  • High HDL lowers the coronary risk
  • The ratio between the total cholesterol and the HDL has to be under 5 for men and under 4,4 for women
  • Normal cholesterol level is between 1,5g/l and 2,0 g.L-1
  • High level of cholesterol requires a LDL dosage

Note ==> The « normal » values of the cholesterol level for the adult are : Total Cholesterol: <2g/l ; LDL-CHO : <1.6g/l ; HDL-CHO : > 0.40g/l

Except when there is an inherited disease, your cholesterol level is mostly influenced by your alimentation and your physical activity (quality and quantity). Unfortunately, in the Occidental countries, the habits (alimentation, sedentary lifestyle, tobacco…) enhance the raise of the cholesterol level carried by the LDL.

How do we end up with a high level of cholesterol?

Regarding the alimentation, a high level is most of the time the consequence of an excessive consumption of fat acids associated with an under consumption of polyunsaturated fat acids, and a lack of food containing fibres.

Tobacco raises the « bad cholesterol » and lowers the « good cholesterol ».

The physical activity like « stamina (walk, nordic walk, footing, biking, rowing…) enhance the « good » cholesterol.

Note: A lot of studies teach us that the coronary mortality for non-menopausal women do not depend on the level of cholesterol, except if it is excessively high. Indeed, until the menopause, women are protected by their hormone. The oestrogens lower the bad cholesterol and raise the good one. The supplementation of oestrogens for the menopausal women insure her immunity.


What’s important to remember : one more « point » of « good » cholesterol is better than one less « point » of « bad » cholesterol meaning a high level « bad » cholesterol associated with a high level « good » cholesterol is better than a low level « bad » cholesterol associated with a low level « good » cholesterol!!

So, do sports, eat healthy by using and abusing of « natural » products and especially the « good fat » like first cold pressed virgin vegetal oils!

Grease intelligently … because good fat is for life!

Sports Dietitian Nutritionist


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