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What Is Cholesterol and How
Does It Affect Me?
You've heard about cholesterol and know that you have to "watch
it" to stay healthy. But what is cholesterol, and what
exactly are you watching? Don't wonder any longer -- find out here!
Cholesterol is a fatty substance that your body needs to
function. In fact, it is essential for life. You need cholesterol to
form cell membranes, many hormones and bile acids (which digest
fat), to name just a few. Without cholesterol, you couldn't live.
But, as is so often the case, too much cholesterol can hurt you.
When you have high levels of cholesterol in your blood, you're at
higher risk of coronary heart disease (CHD). The higher these
levels, the greater your risk. Given that heart disease is currently
the number one killer of men and women in the United States, this
isn't a risk that you should ignore. However, eating in a
heart-healthy way, being physically active and losing weight are
things everyone can do to lower their cholesterol levels and their
risk.
When your cholesterol is checked, what's being measured? Why
should some cholesterol referred to as "good," putting people at
lower risk for heart disease, and another "bad"?
Types of cholesterol
Your doctor may order tests to check your blood levels of
cholesterol. Since cholesterol can't dissolve in the blood (it's not
water-soluble), it doesn't circulate by itself. Instead, cholesterol
travels through the bloodstream linked to "carriers" called
lipoproteins.
There are three different types of lipoproteins. The two that are
most important to remember in terms of your possible risk of heart
disease are high-density lipoproteins (HDL) and low-density
lipoproteins (LDL).
Cholesterol that is carried on low-density lipoproteins is called
LDL cholesterol (the "bad" cholesterol). Higher levels of LDL
cholesterol are associated with an increased risk for heart
disease.
Cholesterol molecules that are linked to high-density
lipoproteins are called HDL cholesterol (the "good" cholesterol). If
you have higher levels of HDL cholesterol, you're at lower
risk for heart disease.
Can't remember which cholesterol is "bad" and which is "good?"
Try this as a way to remind yourself: LDL cholesterol ("bad") is
"low-down". HDL cholesterol ("good") comes "highly recommended."
"Good" and "bad" cholesterol
Why should one type of cholesterol be labeled "good," putting
people at lower risk for heart disease, and another labeled "bad?"
Because LDL is the main carrier of cholesterol to body tissues, and
HDL carries cholesterol away from body tissues.
When you have a lot of LDL cholesterol in the bloodstream, there
is a greater danger that too much may be deposited in artery walls,
which may then become damaged. The arteries may develop a
cholesterol and fatty buildup (called a plaque) on the inside,
referred to as atherosclerosis, or "hardening of the arteries."
Cholesterol buildup can prevent adequate amounts of blood from
flowing to the heart and may lead to complete blockage of an artery.
It is the most common cause of CHD, and happens so slowly that you
are not even aware of it. The higher your LDL cholesterol, the
greater your chance of this buildup.
When you have higher levels of HDL in your blood, it means that
more high-density lipoproteins carry cholesterol away from arterial
walls and to the liver. The liver then eliminates the cholesterol
from the body by excreting it in the bile. Clearly, the more this
happens, the less likely is cholesterol to accumulate in arterial
walls and worsen the progression of atherosclerosis.
What to do About Your Cholesterol
Let's start with a quick summary of how much cholesterol (or
triglycerides) is too much. How do your own results compare with
these numbers? What has your doctor told you about your cholesterol
levels?
|
Desirable |
Borderline |
Associated with higher risk |
| Total cholesterol |
less than 200 |
200-239 |
240 or more |
| HDL cholesterol |
40 or more |
none |
less than 40 |
| LDL cholesterol |
less than 130 |
130-159 |
160 or more |
| Triglycerides |
less than 150 |
150-199 |
200 or more |
Note: All levels in units of mg/dL
Perhaps you've been told your cholesterol is too high. Or perhaps
you'd just like to keep it at a healthy level, to minimize your risk
of heart disease as much as possible. Of course, you should always
follow your doctor's specific recommendations as a first priority.
But overall, what kind of lifestyle habits will help you with these
goals?
Change your eating habits
You can do it! Part of the solution toward lowering your
cholesterol and reducing your risk of heart disease is to eat fewer
high-fat, high-cholesterol foods. If your doctor has recommended a
specific diet for you, or if you have special dietary needs, it's
best to find out what applies to your specific situation.
Otherwise, this is how you can follow a heart-healthy diet:
 | Choose foods that are low in saturated fat. Saturated
fat will boost your cholesterol level more than anything else in
your diet; so you should definitely look for ways to cut these
foods out of your diet (or cut down on them). Foods from animals
are highest in saturated fat. They include fatty cuts of meat,
chicken or other poultry with skin, whole milk and whole-milk
dairy products, lard and some vegetable oils like coconut oil,
palm kernel oil and palm oils. We know all these foods sound
delicious! But it isn't too hard to get them out of your life, or
at least reduce their presence, if you try. Don't use lard or oils
high in saturated fat when cooking. Plan other meals besides those
based on "meat and potatoes" when the meat is a large fatty cut.
When you do eat meat, eat smaller portions. Remove the skin from
chicken and other poultry before preparing or eating it. Stay away
from popcorn made with coconut oil, and eat air-popped popcorn
instead. Switch to skim milk and milk products, not whole milk.
Foods that are low in fat, and therefore much better choices if
you'd like to decrease your cholesterol, include fruit, vegetables
and whole-grain foods. But remember, vegetables doused in a cream-
or oil-based sauce or if the fruit is part of a fatty dessert
don't help. Look for other ways to enhance taste. |
| Choose foods low in total fat. This will help you avoid
foods high in saturated fat and also will help you lose weight, if
needed. If you are overweight, losing weight can be an important
part of lowering your cholesterol levels. You can't (and
shouldn't) always avoid eating fat, but when you do, try to
substitute unsaturated fats for saturated fats. Unsaturated fats
are usually liquid at room temperature, and come in two types:
monounsaturated and polyunsaturated. Examples of foods high in
monosaturated fats are olive and canola oils. Foods high in
polyunsaturated fats include safflower, sunflower, corn and
soybean oils. When you must use fat to cook with, try olive oil or
another one of these oils, not lard. Better yet, use substitutes
for fat wherever you can; many recipes now have helpful tips
enabling you to do this. |
| Choose foods high in starch and fiber. It may take some
adjustment, but eventually these foods will help you forget you
ever planned your diet around so much saturated fat, especially if
they're prepared well. Fruits, vegetables and grain products like
oats, barley, peas (without sauce) and beans are the foods on
which you should be casting a culinary eye. |
| Choose foods low in cholesterol. Foods high in
cholesterol can increase your blood levels of cholesterol, though
saturated fats will raise these levels even more. Cholesterol is
only present in foods from animals. Plants and foods from plant
sources don't contain cholesterol, though they sometimes have
saturated fat. What does that mean to you? Try to cut down on the
animal foods you eat, while replacing them with healthy,
appropriate plant-based foods, but don't assume that all
plant-based foods are best, since those with saturated fats can
raise your cholesterol level. Be selective. |
Be more physically active
Yes, we've heard it before. Exercise to lose weight, right? Well,
yes, but did you know that physical activity can have direct effects
on your cholesterol levels? It can increase HDL cholesterol (the
good kind) and lower triglycerides LDL cholesterol (the bad kind).
This is good for reducing your risk of heart disease. Besides this
direct benefit, physical activity can help you by lowering your
blood pressure (if it's too high), reducing your stress and
improving your overall fitness, including that of your heart and
blood vessels.
Lose weight if you're overweight
Being overweight means that you probably have higher blood levels
of cholesterol and triglycerides than you otherwise would, placing
you at higher risk for heart disease. And if you have an "apple"
shape (you carry more weight in your belly than in your hips and
thighs), you're at higher risk than overweight people with a "pear"
shape (more weight in your hips and thighs).
If you are overweight, losing even a little weight can help
reduce LDL cholesterol and triglycerides and increase HDL
cholesterol. You don't have to lose all the weight you've always
wanted to take off to see these change, or to benefit from a reduced
heart risk. Don't give up.
Cholesterol-lowering drugs
A study published in the New England Journal of Medicine says
heart disease deaths have declined steadily over the last 30 years.
In fact, the report states that between 1990 and 1994, heart disease
deaths decreased by 10.3 percent. From this study and others, it
appears that this downward trend can be attributed to improvements
in medical care after heart attack, a reduction in the number of
repeat heart attacks, better prevention of heart disease, and the
discovery/development of a relatively new class of drugs known as
statins. These powerful medications have provided doctors with an
arsenal of therapies to lower elevated blood cholesterol levels,
often dramatically, when diet and exercise have failed. To date, FDA
has approved six statin drugs: Mevacor® (lovastatin), Lescol®
(fluvastatin), Pravachol® (pravastatin), Zocor® (simvastatin),
Lipitor® (atorvastatin) and Crestor® (rosuvastatin).
However, Baycol® (cerivastatin) was voluntarily withdrawn from
the market by its manufacturer, Bayer Pharmaceutical, because of
reports of patient deaths. The deaths were attributed to an unusual
condition called rhabdomyolysis (rhab-doe-my-olysis), in which
muscle tissue breaks down and releases proteins that damage the
kidneys. The condition, which can occur taking any statin, is rare.
It can, however, lead to kidney failure and other problems.
Source: Health A to Z
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