Cholesterol management: dietary patterns and genetic factors

Managing cholesterol levels involves both dietary choices and understanding genetic factors. Scientific research indicates that overall dietary patterns are more significant than individual ingredients. While many believe foods high in cholesterol, such as eggs, are the primary cause of high blood levels, the liver produces most circulating cholesterol. Instead, saturated and trans fats are the main drivers of excessive production. To protect arteries, it is recommended to limit processed meats, fatty red meats, high-fat dairy, and industrial baked goods, opting instead for fish, legumes, lean meats, and extra virgin olive oil.

In some instances, high cholesterol persists despite a healthy diet and regular exercise due to genetic conditions like familial hypercholesterolemia. This hereditary disease is characterized by high LDL (bad cholesterol) levels starting from childhood, often caused by the liver's inability to properly remove LDL from the blood. The heterozygous form affects approximately 1 in 250-300 people, while the much rarer homozygous form affects about 1 in 250,000-360,000. Genetic variants involving LDLR, APOB, and PCSK9 are frequently associated with these conditions, which can lead to the formation of atherosclerotic plaques in the arteries.