Questions about cholesterol:

• Why do I need to test my cholesterol levels?

  Low cholesterol levels are a known risk factor for cardiovascular disease. If there is too much "bad" LDL cholesterol in the blood, it can cause the blood vessels to calcify. This in turn increases the risk of cardiovascular disease, heart attack, and stroke.

  The World Health Organization estimates that 1 in 2 people in countries with high incomes has high cholesterol. Many of those affected are not aware of this, as cholesterol does not usually cause noticeable symptoms. Therefore, it may be worthwhile to check your cholesterol levels regularly.

  This is especially true for people who have an increased risk of higher levels of LDL cholesterol. These include:
  - Elderly people and men
  - Smokers
  - People with high blood pressure
  - People with type 2 diabetes
  - People with a family history of heart attacks and strokes

• How does the cholesterol test work?

  For the cholesterol test, take a small blood sample from your fingertip with a lancet. Collect the drops of blood in the blood collection device. The sample is sent to a specialized lab by return envelope. The lab will then examine the concentration of various blood fats (LDL and HDL cholesterol, triglycerides) in your capillary blood. You should perform the cholesterol test on an empty stomach, i.e. you should not have eaten anything in the 12 hours prior to the test.

• What do the results of the cholesterol test tell me?

  The cholesterol test helps you assess your risk of arteriosclerosis , along with other risk factors.

  The test determines the following values, which you will find in your individual results report:
  - Total cholesterol in micromoles per litre of blood (mmol/l)
  - HDL cholesterol in mmol/l
  - LDL cholesterol in mmol/l
  - LDL/HDL quotient, i.e. the ratio of LDL to HDL cholesterol
  - Triglycerides in mmol/l

  If your LDL cholesterol value and thus the LDL/HDL quotient is increased, this means an increased risk of calcification of the blood vessels (arteriosclerosis). This calcification is in turn a risk factor for cardiovascular diseases such as high blood pressure, stroke and heart attack.

  Elevated triglyceride levels can also damage the health of the heart and blood vessels, but can be reduced by a balanced diet.

• What recommendations will I receive?

  If your LDL cholesterol levels—the "bad" cholesterol—are above the normal range, you may need to consider changes to your diet.

  You will receive recommendations on how to lower LDL cholesterol levels. These consist of advice about diet and physical activity.

  If the result indicates an increased risk of arteriosclerosis, consult a doctor. With medical assistance, you can then check further risk factors and initiate treatment if necessary.

• What is cholesterol?

  The blood lipid cholesterol is a fat-like substance that is packaged in the body in certain proteins, either the HDL or the LDL protein. HDL cholesterol is referred to as the "good" cholesterol, and LDL cholesterol the "bad" cholesterol.

  Cholesterol is produced in the liver. The body requires choloesterol to produce hormones such as vitamin D, cortisol and estrogen. We can also ingest cholesterol through food; it is mainly found in animal fats such as butter, eggs, milk, cheese and meat. The more cholesterol we take in through food, the less the liver produces.

• What are bad cholesterol levels?

  LDL cholesterol levels that are too high do not directly manifest with symptoms — this makes it difficult to detect them without a test. However, "bad" cholesterol can cause fats to accumulate in the blood vessels over time. This is called calcification of the blood vessels (arteriosclerosis), and it increases the risk of cardiovascular diseases.

• How do cholesterol levels get too high?

  In fact, it is probably not primarily due to consumption of high cholesterol foods that leads to bad cholesterol levels. Other factors can include obesity, lack of exercise, diabetes, alcohol and cigarettes. Genetic predisposition also plays a role.

• How can I improve my cholesterol levels?

  In fact, cholesterol-containing foods do not contribute much to your cholesterol levels. The biggest influence is your weight and how much you exercise. Weight loss, regular exercise and a balanced diet are the most important measures to improve your cholesterol levels.

  In addition, you may consider reducing your consumption of foods that increase LDL cholesterol. These include chips and sweets, heavily processed meat, soya, rapeseed and sunflower oil and alcohol.