Understanding Your Cholesterol Profile

Cholesterol is a wax-like substance produced in the liver. However, the amount of naturally occurring cholesterol is miniscule by comparison to the dietary cholesterol we get from eating animal food products. Only animal foods contain cholesterol.

What Heart Disease Patients Must Know About Cholesterol
And How It Affects Their Health

A certain amount of cholesterol is necessary for a number of important body functions. For example, small quantities of cholesterol are required to build and maintain cell membranes. Cholesterol is also instrumental in the synthesis of a number of hormones and in the production of bile acids for the digestion of dietary fats.

However, the amount of cholesterol needed to perform these complex tasks is limited to minute quantities. When too much cholesterol accumulates, it can become quite harmful. The reason is that the fatty substance has a tendency to stick to the interior of blood vessel walls, building up layers upon layers of plaque over time. Eventually, the vessels can narrow to the point where blood no longer flows through easily. This is called atherosclerosis, a.k.a. hardening of the arteries. When this happens, the risks for heart disease, hypertension, heart attack and stroke increase substantially.

Not all types of cholesterol are bad (but some really are)
In order to “travel” through the body, cholesterol has to be transported by so-called lipoproteins, which are a molecular combination of fat and protein. Lipoproteins are classified by their size and density.

Types of cholesterol
The best-known types of cholesterol are high density lipoproteins (HDL) and low density lipoproteins (LDL).

High-density lipoproteins (HDL) are called “good” cholesterol, because they help eliminate LDL (“bad” cholesterol). High levels of HDL cholesterol in the blood are desirable.

Low-density lipoproteins (LDL) are considered to be “bad” cholesterol, because they cause the build-up of plaque in the arteries. The more LDL is present in the blood, the greater is the risk of damage to the arteries. By contrast to HDL (“good” cholesterol), elevated levels of LDL are not welcome.

Triglycerides are a type of fat that is transported to the liver by lipoproteins. Triglycerides are found in most of the foods we eat. When we consume more fat, sugar or alcohol than we use up for energy, the surplus is converted into triglycerides and stored in fat cells. Overindulging in fatty and sugary foods or alcoholic beverages can elevate triglycerides to unhealthy levels.

Who should be tested for cholesterol?
Everyone over the age of 20 should be tested for cholesterol as part of their annual physical. There are two kinds of testing: the “non-fasting” test and the “fasting” test. A “non-fasting” cholesterol test will indicate the levels of total cholesterol and HDL, LDL and triglycerides in the bloodstream at the time the blood is drawn. However, the results may be skewed if foods or beverages are still being digested. For a more accurate “fasting” test, the patient is required not to consume anything for at least 12 hours prior to the test.

How much cholesterol is too high?
The recommended level for total cholesterol is below 200 milligrams per deciliter (mg/dL). 200 to 239 mg/dL is considered borderline high, and 240 mg/dL and above is seen as high.

HDL (“good” cholesterol) should be higher than 40 mg/dL. The higher the numbers, the better are the results.

LDL (“bad” cholesterol) should be below 130 mg/dL. The lower the numbers, the better are the results.

Triglycerides levels have a normal range of 40 to 150 mg/dL. 150 to 199 mg/dL is considered borderline high and 200 to 499 mg/dL is high. Everything above 500 mg/dL is dangerously high and should be treated aggressively.

Cholesterol and heart disease
When high levels of LDL (“bad” cholesterol) are present in the blood, plaque deposits can form inside the arteries to the point where these become too narrow for the blood to flow freely to the heart. When blood is kept from getting through, the heart muscle becomes starved for oxygen. If the blood supply is completely cut off to parts of the heart, the result can be a heart attack. This usually happens when a coronary artery is blocked by a blood clot on top of previous narrowing.

What affects my cholesterol?
There are number of factors that can contribute to cholesterol elevation:

Diet
A diet high in saturated fat and dietary cholesterol increases LDL (“bad” cholesterol). Reducing or eliminating consumption of meat, eggs and certain seafood, like lobster, shrimp and scallops, can help lower cholesterol.

Body weight
Weight problems are closely connected to elevated cholesterol. Obesity is one of the greatest risk factors for heart disease. Even moderate weight loss can help lower LDL levels. Both dietary improvements and aerobic exercise can help increase HDL levels.

Physical activity
Regular exercise can lower LDL and raise HDL significantly. Besides healthy nutrition, there is no better natural remedy for lowering cholesterol than staying physically active. If working out at a gym or playing sports is not an option, you still can get some form of exercise by taking short walks or by climbing the stairs instead of using the elevator.

Genetic predisposition
Hereditary conditions can indeed play a role in the way the body produces cholesterol. But most of these inherent tendencies can be counterbalanced through healthful nutrition and lifestyle choices.

Age and gender
Cholesterol levels rise naturally as we get older. Before menopause, most women show lower total cholesterol and higher HDL levels than men, because of the protective properties of estrogen. Post-menopausal women, however, tend to develop increase LDL (“bad” cholesterol), especially in cases of substantial weight gain around the waist.

Other causes
Diabetics suffer frequently from elevated LDL (“bad” cholesterol). Monitoring cholesterol is an important part of controlling diabetes. Certain medications and medical conditions can cause cholesterol to rise as well.

How can high cholesterol be treated?
Often a few simple dietary or lifestyle changes can significantly lower cholesterol levels.

Non-medical treatments
Healthy eating habits, weight management and regular exercise are among the best non-medical measures one can take to control cholesterol. The American Heart Association (AHA) recommends a daily cholesterol intake of 300 milligrams or lower. Those diagnosed with heart disease, hypertension or diabetes, should stay below 200 milligrams.

Reducing or avoiding foods high in saturated fat and dietary cholesterol is a good start if you are concerned about your cholesterol profile.

Smoking is a proven cause for lowering HDL (“good” cholesterol). Quitting can reverse these effects relatively fast.

Even moderately intense exercising can help increase HDL.

Medical treatments
There are a number of medical options to treat cholesterol. These should be considered as a last resort if dietary- and lifestyle improvements fail to produce the desired results. Some cholesterol-lowering drugs can have serious side effects. Patients should be tested and monitored by their physicians for liver problems before and while taking these medications.

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