LDL

July 21, 2020

What is Low-density lipoprotein (LDL)?

Low-density lipoprotein (LDL) is one of five major types of lipoprotein responsible for transporting cholesterol in the blood. The different types of lipoprotein are all named according to how dense they are. LDL is often referred to as ‘bad’ cholesterol because it deposits excess cholesterol on the walls of the arteries which can lead to cardiovascular disease.[1]

Why take an LDL blood test?

Usually, an LDL reading is taken as part of your lipid profile which includes your total cholesterol as well as the amount of cholesterol carried by both LDL and HDL (high-density lipoprotein).

Generally having high cholesterol levels don’t cause any symptoms. So, checking your LDL level is essential to check your cholesterol, particularly because high levels can increase the risk of certain medical conditions.

You can test your LDL levels by purchasing a simple at-home finger prick test kit which is then analysed at an accredited lab. Forth offers a number of blood tests which include LDL such as a Cholesterol Check which can be purchased for just £39.00 or our best-selling Baseline Plus test which includes cholesterol and more than 15 other biomarkers essential to good health.

What function does LDL have in the body?

LDL is part of cholesterol’s special transport system. Low-density lipoproteins carry cholesterol from the liver to the different cells of the body. [2] LDL cholesterol circulates in the blood where it is transported to cells which need it for repair. However, excess cholesterol means it accumulates in arterial walls.[3]

The lipoprotein is required to transport cholesterol because cholesterol is insoluble in water and so needs the proteins to flow through the watery part of the blood.[4]

Cholesterol itself has three main functions in the body:

  • The structural component of cell membranes
  • Contributes to the synthesis of steroid hormones and vitamin D
  • Produces bile acids which aid digestion and the absorption of fats

The liver is responsible for making cholesterol but we ingest it through our diet, too, in foods such as eggs, meat and dairy products. Once made in the liver or ingested, cholesterol travels around the body via the blood attached to lipoproteins. The lower the density of the lipoprotein, the more fat it contains.

How do changes in LDL affect health and wellbeing?

Increased levels of LDL cholesterol increase the risk of heart disease or diabetes. When there is excess cholesterol in the body, it gets deposited on the artery walls which restricts the blood flow to vital organs such as the heart and brain.

High cholesterol also increases the risk of developing type II diabetes, where the body doesn’t produce enough insulin. Alternatively, it may be that the cells in the body are no longer able to react to the insulin it does produce and causes high blood glucose levels.[5]

If you are worried about your cholesterol levels or just want to check where you fall on the range, you can test your LDL level with a simple at-home blood test.

What can cause LDL to change?

There are a variety of reasons why LDL cholesterol levels rise, including:

  • Eating a diet high in saturated fat
  • Smoking
  • Leading a sedentary life
  • Drinking too much alcohol
  • Being overweight
  • Age
  • Ethnicity
  • Gender – males are more likely to have high cholesterol
  • Family history of high cholesterol
  • Genes[6]

What are the most common symptoms of High LDL?

It is unlikely that having high cholesterol will display any symptoms which is why it’s sometimes referred to as the silent killer. Instead, it is good to monitor your cholesterol levels with cholesterol tests.

How to keep LDL in the healthy range

The best way to ensure your cholesterol levels are under control is to adopt a healthy lifestyle.

Diet can help to reduce LDL cholesterol levels. The Mediterranean Diet has been shown to have healthy effects like lowering blood pressure and improved lipid profiles.[7]

You can make your diet more Mediterranean-like by:

  • incorporating lots of starchy foods like bread and pasta
  • eating lots of fruits and vegetables
  • include lots of fish in your diet
  • eating less meat
  • using products made from vegetable, plant oils like olive oil[8]

Other ways to reduce your LDL levels include:

  • give up smoking
  • increase unsaturated fat intake
  • reducing alcohol consumption

Exercise is also important for controlling cholesterol levels. Research has shown regular exercise increases LDL cholesterol which offsets increases in LDL cholesterol. However, intense exercise helps to reduce LDL cholesterol.[9] In individuals with elevated cholesterol levels, it is recommended that they take part in at least 30 minutes of exercise every day, five times per week. This should consist of moderate-intensity aerobic exercise at approximately 70-80% of your heart rate reserve, progressing to 85% of your maximal heart rate. You should also incorporate some moderate to high-intensity resistance training.

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References

[1] Lab Tests Online UK. (2015). LDL Cholesterol Test. Available at: https://labtestsonline.org.uk/tests/ldl-cholesterol-test

[2] British Heart Foundation. (2019). Reducing Your Blood Cholesterol.

[3] Heart UK. (2018). Cholesterol and Lipoproteins. Available at: https://heartuk.org.uk/images/uploads/healthylivingpdfs/HUKcfs_A_Cholesterol_and_Lipoproteins.pdf

[4] Pirahanchi, Y and Huecker, M, R. (2019). Biochemistry, LDL Cholesterol. In: StatPearls [Internet].

[5] Diabetes UK. (2019). What is Type 2 Diabetes? Available at: https://www.diabetes.org.uk/diabetes-the-basics/what-is-type-2-diabetes

[6] Heart UK. (2019). What is High Cholesterol? Available at: https://www.heartuk.org.uk/cholesterol/what-is-high-cholesterol

[7] Estruch, R et al. (2006). Effects of a Mediterranean-Style Diet on Cardiovascular Risk Factors. Annals of Internal Medicine: 145, pp 1-11.

[8] NHS. (2017). What is a Mediterranean Diet? Available at: https://www.nhs.uk/live-well/eat-well/what-is-a-mediterranean-diet/

[9] Mann, S., Beedie, C and Jimenez, A. (2014). Differential Effects of Aerobic Exercise, Resistance Training and Combined Exercise Modalities on Cholesterol and the Lipid Profile: Review, Synthesis and Recommendations. Sports Med: 44, pp 211-221.

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This information has been medically reviewed by Dr Nicky Keay

Nicola has extensive clinical and research experience in the fields of endocrinology and sport and exercise medicine. Nicky is a member of the Royal College of Physicians, Honorary Fellow in the Department of Sport and Exercise Sciences at Durham University and former Research Fellow at St. Thomas' Hospital.

Dr Nicky Keay

Dr Nicky Keay

BA, MA (Cantab), MB, BChir, MRCP.