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Cholesterol

What is Cholesterol?
Cholesterol is a waxy, fat-like substance found in every cell of the body.  It is used to help digest fats, strengthen cell membranes and make hormones.  Although cholesterol serves many important functions in the body, too much cholesterol in the blood can be dangerous.  When blood cholesterol reaches high levels, it can build up on artery walls, increasing the risk of blood clots, heart attack and stroke.

The bloodstream transports cholesterol throughout the body by special carriers called lipoproteins.  The two major lipoproteins are low density lipoproteins (LDL) and high density lipoproteins (HDL).  LDL is most often referred to as the “bad” cholesterol whereas HDL is knows the “good” cholesterol. 

LDL- The “BAD” Cholesterol
LDL is the most numerous cholesterol carrier found in the blood.  It is also the material that contributes most to the build up of plaque on artery walls.  Plaque forms when LDL combines with other substances and sticks to the walls of arteries.  Decreasing the amount of LDL cholesterol in the blood is an important part of decreasing risk of heart disease. 

HDL- The “GOOD” Cholesterol
HDL cholesterol makes up a smaller portion of the cholesterol carriers.  However, HDLs are probably just as, if not more important than LDLs in preventing heart disease.  HDL removes cholesterol from the blood by carrying it to the liver where it is metabolized.  Therefore, it is beneficial to have high levels of HDL in the blood. 

Your Cholesterol Reading- What Should It Be?
Cholesterol readings you receive from your medical provider generally include total cholesterol, LDL cholesterol, and HDL cholesterol levels.  It is important to look at all three readings, not just the total cholesterol.  The following are recommended goals for your cholesterol readings: 

LDL Cholesterol                                  
<100                 Optimal
100-129             Near or above optimal
130-159             Borderline high
160-189             High
≥190                  Very high
Total Cholesterol
<200                  Desirable
200-239              Borderline High
 ≥240                  High
HDL Cholesterol
<40                     Low
 ≥60                     High [high HDL is good & desirable

Triglycerides
Having elevated Triglycerides may also increase the risk of heart disease.  Exercise, a low-fat diet, and weight loss can all decrease Triglycerides.  A desirable triglyceride reading is below 150 mg/dl.

COMBATING HIGH CHOLESTEROL
Many factors, such as genetics, obesity, inactivity and poor diet contribute to high cholesterol.  Understanding how these factors affect your cholesterol is important in the prevention and treatment of high cholesterol. 

Genetics
Just as some people inherit physical characteristics from their parents, others inherit an increased likelihood of developing high cholesterol.  If you have a family history of heart disease or high cholesterol, it is important to focus on those aspects, which you can control, rather than feeling genetically doomed.  By maintaining a healthy weight, exercising regularly and eating a low-fat, well-balanced diet you will decrease your chances of developing heart disease. 

Weight
Accumulating excess weight is generally associated with increased total and LDL cholesterol.  Every individual responds differently to weight loss, however most people find that blood cholesterol drops as weight decreases.  The best way to lose weight and lower cholesterol is through increased activity coupled with low-fat eating. 

Exercise
Exercise is very important in controlling cholesterol levels.  Not only does total and LDL cholesterol tend to decrease with activity, but HDL cholesterol increases.  In order to get this effect “aerobic” activity is best.  Aerobic exercise is any exercise that is continuous, rhythmical and involves large muscle groups. Most types of aerobic exercise end with the  letters “ing” (walking, running, rowing, cycling, swimming, rope skipping, dancing, hiking, and skating).  The cholesterol lowering effect of exercise is greatest when individuals exercise at least 3 times per week for 30 minutes or more. 

Diet is also a major component of decreasing blood cholesterol.  A proper diet can help lower cholesterol for several reasons.  Diet modifications are essential for weight loss but can affect cholesterol levels even if weight remains unchanged.  Also, a proper diet is essential to provide energy for those engaging in daily aerobic exercise.  Fat is often targeted as the main dietary factor, which affects blood cholesterol.  However, some fat in the diet is necessary to serve many functions in the body.  A diet devoid of fat is not a healthy diet.  Remember that it is the amount and type of fat in the diet that is important in controlling cholesterol. 

Saturated fat is the main dietary component associated with raising cholesterol.  Saturated fats are found mainly in animal should be used sparingly in the diet:

*beef fat, lamb, pork fat (lard), butter, cream, whole milk dairy products, (whole milk and cheeses), coconut oil, palm oil, palm kernel oil, and cocoa butter.

Replacing saturated fats in the diet with monounsaturated and polyunsaturated fats can help decrease total cholesterol.  The two fats highest in monounsaturated fats are canola and olive oil.  Examples of fats high in polyunsaturated include:  corn, cottonseed, sunflower, safflower and soybean oil. 

Trans fats (hydrogenated fats) are formed by adding hydrogen to unsaturated fats.  This makes the fat more firm and makes the fat more durable.  Hydrogenation increases the saturation and therefore makes it more harmful to the body.  New recommendations call for eliminating or severely restricting trans fats. Trans fats (hydrogenated oils) are commonly found in fast foods, margarine, peanut butter, snack crackers, cookies and convenience packaged foods.  

It is evident that not all fats are created equal and do not affect your body the same way. However, all fats have about the same amount of calories regardless of their degree of saturation.  Fats have over twice as many calories as protein or carbohydrate of a given weight.  This is why a donut has many more calories than a bagel of the same size.  For those people who need to lose weight, consuming too much of any fat will be counterproductive. 

Other Dietary Suggestions
Eat a variety of foods from all food groups choosing low-fat products from each group.  A copy of the food guide pyramid is available from Health and Wellness Education, 855-7338. 

  • Fiber binds cholesterol and can help in cholesterol reduction.  Choosing whole grain products (bran cereal, whole wheat bread) as well as fresh fruits and vegetables will increase fiber intake.
  • Read food labels.  Food labels are required to list ingredients as well as the amount of fat, saturated fat and cholesterol in the food.  Reading food labels will allow you to choose heart healthy foods.
  • Select protein sources from: *fish which contains omega 3 fatty acids and can be helpful in reducing the risk of heart disease *lean cuts of meat (trim visible, fats and look for little marbling), *skinless poultry, *cooked dry beans and legumes, *eggs (limit 3-4 per week).


Other factors which compound risks due to high cholesterol:

  • Smoking constricts blood vessels, elevates blood pressure, and raises LDL cholesterol.  If you smoke- STOP!
  • High Blood Pressure damages blood vessels and increases risk of heart attack and stroke. 
Blood screening tests for cholesterol levels are available at low cost through Health and Wellness Education.  Call 855-7338 for this and additional information about blood cholesterol. 

For additional information contact:

The American Heart Association,
1-800-242-8721
www.americanheart.org

The American Dietetic Association,
1-800-877-1600
www.eatright.org

The National Cholesterol Education Program, (301) 251-1222
www.nih.gov

LDL Cholesterol                                  

<100                 Optimal

100-129             Near or above optimal

130-159             Borderline high

160-189             High

≥190                  Very high

Total Cholesterol

<200                  Desirable

200-239              Borderline High

 ≥240                  High

HDL Cholesterol

<40                     Low

 ≥60                     High [high HDL is good & desirable