Cholesterol. A word you’ve probably heard many times before. You know it’s an important factor in your overall health, but what exactly is it? And why should you care?
Just the facts
Cholesterol is not fat. It is a waxy, fat-like substance that occurs naturally in your body and in many foods. There are two types: LDL (“bad” cholesterol) and HDL (“good” cholesterol). Like fat, your body actually needs some cholesterol for good health. But like fat, too much of it can cause problems.
What kind of problems?
Heart disease and stroke, mainly. Heart disease is the leading cause of death in the United States. This risk increases when too much bad cholesterol builds up in your arteries, causing them to narrow (think of hair clogging your bathroom drain). The buildup is called plaque, and it blocks blood flow to and from your heart and other organs. High cholesterol is linked to increased risk of other diseases. There’s even some evidence that increased mortality in certain COVID-19 patients is due to high cholesterol levels.
High cholesterol is one of the most common health issues, with more than 102 million adults measuring cholesterol above healthy levels (kids and teens are at risk too—in the U.S. more than 20% of kids have at least one abnormal lipid level).
Yikes. How did that happen?
Unhealthy habits, mostly. Eating a diet high in saturated and trans fats increases LDL cholesterol (that’s the bad one—if you have trouble remembering which is which, remember LDL should be lower, and HDL should be higher). Trans fats are found in foods that are fried, processed, or prepared with shortening, and some margarines. Saturated fat occurs in meats and dairy products. Triglycerides, which go hand in hand with cholesterol, are fats carried in the blood. Not only are they found in food, but excess calories, alcohol, and sugar are converted to triglycerides as well as stored as fat throughout the body. This is all compounded by a sedentary lifestyle. Stress is a factor, as is age, genetics and certain medical conditions.
Wait, what about “Good” cholesterol?
HDL’s job is to return cholesterol to your liver where it is broken down and removed from your body. A high level of HDL lowers your risk of heart attack and stroke. HDL is found in unsaturated fats like nuts, oils, and avocados. Evidence links moderate use of alcohol (about 1 drink a day) with higher levels of HDL. But eating more of these foods isn’t the most effective way to optimized your overall cholesterol. And if you don’t drink, don’t start to increase your good cholesterol!
Then what should I do?
Eat more fiber, especially via fresh fruits and veggies (fiber supplements aren’t nearly as effective). Get exercise—enough to make you sweat—and get to or stay at a healthy weight. Finally, manage stress, get enough quality sleep, and don’t smoke.
How can I tell if my levels are unhealthy?
High cholesterol is easy to ignore because there are no symptoms. Most people don’t know they have it until they are tested during a routine doctor’s visit (or have a cardiac event—that’s definitely not how you want to find out your levels are too high!). Your doctor will order a lipid panel to screen cholesterol levels. If any are found to be too high, your doctor will recommend lifestyle changes and in some cases medication. Most kids over 9 and adults should be screened every five years, increasing to every 1-2 years after age 45 for men and 55 for women (high cholesterol is more prominent in men).
How high is too high?
Your medical professional can help you interpret your panel results, but you can refer to the chart below as a guide.
|Desirable Cholesterol Levels|
|Total cholesterol||Less than 170 mg/dL|
|Low LDL (“bad”) cholesterol||Less than 110 mg/dL|
|High HDL (“good”) cholesterol||35 mg/dL or higher|
|Triglycerides||Less than 150 mg/dL|