Why is Cholesterol Rising Among The Young?

Dr Suranjit Chatterjee, Senior Consultant, Internal Medicine, Indraprastha Apollo Hospital, New Delhi, on the need for early screening.

Many of my patients in their early 20s do not believe that they have high cholesterol till they see their lipid profile reports. Cholesterol has long been associated with older age groups but a worrying trend has emerged in recent years – a significant rise in cholesterol levels among the younger population. This silent health issue is often overlooked as high cholesterol rarely presents noticeable symptoms until it’s too late.

Most importantly, the cholesterol buildup could have begun at a younger age, in the teens even, but the patients have not felt any anomaly until they crossed into their 20s. That’s why you have so many youngsters report heart attacks caused by plaques, a result of high cholesterol in their blood.

What does cholesterol do and what’s the ideal range?

Cholesterol is a waxy substance made by the liver that is necessary for producing hormones, vitamin D and bile salts, which play a role in digestion. It is carried as lipoproteins, high-density lipoprotein (HDL) and low-density lipoprotein (LDL). HDL is known as the “good cholesterol,” and ideally should be 50mg/dL or higher. The amount of LDL, or “bad cholesterol,” in your body should be kept low. Specifically, LDL cholesterol should be less than 100 mg/dL for Indians, who are more prone to heart disease than other populations. An LDL reading of 130 to 159 mg/dL is categorized as “borderline high,” 160 to 189 mg/dL is “high,” and a reading of 190 mg/dL or above is considered “very high.”

What causes cholesterol spike in the young?

This is linked to lifestyle and dietary choices, beginning with that packet of chips in your childhood. The prevalence of processed and fast foods, high in saturated fats and trans fats, has skyrocketed in recent decades. Unhealthy dietary habits, combined with a sedentary lifestyle and lack of physical activity, create the perfect storm for cholesterol build-up in the body. So your liver cannot handle the overload of fat or flush them out. Furthermore, the convenience of readily available sugary drinks and snacks has led to increased consumption of added sugars, which can contribute to high triglyceride levels and low levels of HDL (good) cholesterol. This imbalance in cholesterol levels can significantly increase the risk of heart disease and other related health issues.

Having a family history or diabetes might also affect your numbers. A condition known as diabetic dyslipidemia can raise both your LDL (bad) cholesterol and lower your HDL (good) cholesterol.

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The invisible threat

One of the most concerning aspects of high cholesterol in young people is its asymptomatic nature. This leads to a false sense of security, allowing the condition to progress unchecked until serious complications arise.

High cholesterol can lead to a gradual buildup of plaque in the arteries, a condition known as atherosclerosis. This narrowing of the arteries can restrict the blood flow and increase the risk of heart attacks, strokes and other cardiovascular issues. The damage LDL (bad cholesterol) does to the arteries is cumulative and irreversible.

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Early detection and prevention

While high cholesterol can lead to heart disease, the elevated level itself does not cause any symptoms. That’s why young adults 20 years and older should get their cholesterol checked every five years even if they look fit. And if they show a tendency, they should check it every year.

Also many people mistakenly link high cholesterol to obesity. Even thin people can have high cholesterol. By identifying elevated cholesterol levels early on, appropriate lifestyle modifications and, if necessary, medical interventions, you can reduce the risk of long-term complications. Focus on a balanced diet rich in fruits, vegetables, whole grains and lean proteins. Regular physical activity and maintaining a healthy weight are also crucial for managing cholesterol levels. Additionally, quitting smoking and limiting alcohol consumption can significantly improve cardiovascular health.

If your levels are so high as to warrant use of cholesterol-lowering medication like statins, lifestyle changes can boost their efficacy.

The views are orginially published on Indian Express!