1.1. Should I eat less fats, if cholesterol is made out of fat?

One common misconception is that eating less fat reduces cholesterol levels. While it's true that a diet high in certain fats can increase harmful LDL cholesterol, it's not as simple as just reducing fat intake. It’s about the quality of the fats you consume.

The type of fat consumed matters significantly. Saturated fats and trans fats, often found in processed foods and red meats, can raise your LDL cholesterol levels. However, monounsaturated fats and polyunsaturated fats, found in foods like avocados, nuts, and certain oils, can actually help lower your LDL cholesterol levels when used in place of saturated and trans fats.

Studies have shown that the fibre from avocados can improve HDL cholesterol levels and the quality of LDL cholesterol. Furthermore, walnuts, which are rich in omega-3 fats, have been found to protect the heart and lower the risk of heart attack for people with heart disease.

1.2. How can I lower my cholesterol without drugs?

To lower cholesterol without drugs, it's crucial to adjust your diet. Reducing your intake of trans fats and saturated fats, can significantly lower your LDL cholesterol levels.

Instead, add more fruits and vegetables into your meals, which are rich in fibre and can help lower bad cholesterol.

Embrace polyunsaturated and monounsaturated fats from sources like plant oils, fatty fish, and nuts.

Swap refined grains for whole grains like brown rice and whole-wheat bread. Be mindful of hidden sugars and opt for healthier fats instead.

According to a study published in the National Library of Medicine, increasing soluble fibre intake by 5 to 10 grams each day could result in a 5% drop in LDL cholesterol.

Finally, remember that managing weight can also help, so keep an eye on calorie intake as you make these changes. Small steps over time can lead to big improvements in your cholesterol levels and overall heart health.

1.3. Can I eat eggs if I have high cholesterol?

This is a common question, and the answer is not as straightforward as you might think.

While eggs are high in dietary cholesterol, with one large egg containing about 215-275 mg of cholesterol, research indicates that the cholesterol in food has a much smaller effect on blood cholesterol levels than previously thought.

A study published in the National Library of Medicine found no significant link between egg consumption and heart disease or stroke in healthy individuals. However, another study did find a potential link between egg consumption and heart disease in people with type 2 diabetes.

According to a study published in the American Journal of Clinical Nutrition, eating eggs did not have a significant impact on the lipid profile of prediabetic participants.

So, what does this all mean for the average egg-lover? While research leans towards moderate egg consumption being generally safe for healthy individuals, it's important to consider personal health factors and consult with a healthcare professional for personalised advice.

If you have concerns about cholesterol or pre-existing health conditions, discussing your specific situation with a doctor or registered dietitian can help you create a balanced and informed dietary approach.

2. Can cholesterol influence fertility?

Recent medical research has begun to investigate the potential impact of high cholesterol on fertility. Studies suggest that high LDL cholesterol levels may reduce semen quality and increase the time it takes for a couple to conceive.

Cholesterol aids in the creation of cell membranes, the production of many steroid hormones, and the synthesis of vitamin D. However, when cholesterol levels become imbalanced, particularly with an excess of low-density lipoprotein (LDL) (bad cholesterol), can negatively impact hormone levels, specifically the maturation of the sperm, which can lead to fertility issues.

The male reproductive function is heavily dependent on cholesterol homeostasis, which is the balance of cholesterol levels in the body. Furthermore, sperm are rich in PUFA (polyunsaturated fatty acids), which are necessary for healthy sperm production, increasing motility and improving the development of testes and spermatogenesis (the development of sperm within the testes). Therefore, maintaining cholesterol homeostasis is vital for optimal male reproductive function.

Scientists have recently discovered a potential link between chemerin, a protein produced by fat cells, and metabolic syndrome and heart function in people with obesity and diabetes.

While higher BMI levels often correlate with increased chemerin, studies surprisingly show an inverse association between chemerin and subfertility. This means individuals with lower levels of chemerin seem to experience higher rates of difficulty conceiving.

2.1. What are the types of infertility in males?

Male infertility can be categorised into a few main etiologies: endocrine or sperm transport dysfunction, testicular defects, or idiopathic (a disease with no identifiable cause) issues.

While multiple genetic, environmental, and behavioural factors are known to contribute to testicular dysfunction, a significant portion of cases (approximately 30%) remain idiopathic, lacking a definitive explanation.

Transport dysfunctions refer to physical or physiological issues that prevent the proper release of sperm. This could be due to obstructions in the sperm delivery routes, physical injury to the testicles, or surgeries in the testicular area.

For instance, a condition known as varicocele, which heats up the testicles and affects sperm quality, can be corrected through a minor surgical procedure.

On the other hand, unexplained disorders refer to cases where the cause of infertility is not immediately apparent. This could be due to factors such as oxidative stress, immunologic causes, or sperm dysfunction.

In some cases, even though the testes are producing sperm, it may not be released in the ejaculate due to blockages or the brain not stimulating the testes to make sperm. In such cases, advanced sperm technology can perform comprehensive sperm tests to detect the presence of sperm, potentially preventing the need for surgery to extract sperm.