HIGH CHOLESTEROL

Cholesterol is a substance that is found in the blood that is needed for good health. It is an integral part of cellular function. Your body uses cholesterol to make the outer coverings of cells. Cholesterol is a part of certain hormones, including estrogen and testosterone. It also helps your body make vitamin D and produces the bile that helps you digest food.

The liver makes most of the cholesterol in your body. A small amount comes from foods, such as meat and dairy products. The fat in these foods is turned into triglycerides. Triglycerides travel through the bloodstream and are stored in fat cells as a source of energy. The body also converts sugars in fruits and sugary foods into triglycerides.

In the liver, cholesterol, triglycerides, and a protein are packaged into substances called lipoproteins. There are two main types of lipoproteins:

    LDL (low-density lipoprotein)—This type of lipoprotein carries cholesterol to where it is needed in the body. If there is too much of it, it tends to collect in the walls of blood vessels. LDL sometimes is called “bad cholesterol.”

    HDL (high-density lipoprotein)—This type of lipoprotein picks up cholesterol in the bloodstream and takes it back to the liver. The liver breaks down cholesterol so that it can pass out of the body. HDL sometimes is called “good cholesterol.”

An easy way to remember the two types of cholesterol is that you want a high level of “happy” HDL and a low level of “lousy” LDL.

The problem is, people sometimes have too much cholesterol. Compared with people with normal cholesterol, people with high cholesterol have a higher risk of heart attacks, strokes and other health problems. The higher your cholesterol, the higher your risk of these problems.

When the level of LDL is high, it can collect inside the walls of blood vessels. When the level of HDL is low, there may not be enough available to remove the “bad cholesterol” from the blood vessels.

LDL within the walls of blood vessels triggers a response by the body’s immune system. Eventually, this immune response can lead to a buildup of a substance called plaque in the blood vessels. Plaque can narrow and harden the arteries, a condition called atherosclerosis.

Atherosclerosis makes it harder for blood to move through the arteries. Coronary artery disease is a condition caused by the narrowing of the arteries in the heart.

Over time, plaque can develop into a blood clot that narrows or blocks the flow of blood in an artery. If this occurs in an artery in the heart, it can cause a heart attack. If this occurs in an artery in the brain, it can cause a stroke.

The usual lipid panel ordered by healthcare providers is broken down into several categories: total cholesterol which should be below 200, LDL cholesterol which should be below 130, HDL cholesterol which should be above 60, triglycerides which should be below 150, and non-HDL cholesterol which should be below 160, or lower, if the patient is at risk of heart attacks or strokes.

High cholesterol, by itself, is not always a reason to worry as there are no symptoms. Having high cholesterol is just one of many things that can increase your risk of heart attacks and strokes. Other factors that increase your risk include: cigarette smoking, high blood pressure, having a parent or sibling who got heart disease at a young age (younger than 55 for men and younger than 65 for women), a diet that is not heart healthy (diets low in fiber and high in saturated fats, etc.) and lastly, older age.

If you are at high risk of heart attacks and strokes, having high cholesterol is a problem. On the other hand, if you are at low risk, having high cholesterol might not lead to treatment.

According to the National Lipid Association, not everyone who has high cholesterol needs medicines. Your healthcare provider will decide if you need them based on your age, family history and other health concerns.

You should probably take a cholesterol-lowering medicine called a statin if you had a heart attack or stroke, have known heart disease, have diabetes, have a condition called peripheral artery disease (when the arteries in your legs get clogged with fatty deposits) or have an abdominal aortic aneurysm (widening of the main artery in the belly). Most people with any of the conditions listed above should take a statin no matter what their cholesterol level is. If your healthcare provider puts you on a statin, stay on it. The medicine might not make you feel any different, but it can help prevent heart attacks, strokes and death.

Yes, you can lower your cholesterol some by avoiding red meat, butter, fried foods, cheese and other foods that have a lot of saturated fat, losing weight (if you are overweight) and being more active. Even if these steps do little to change your cholesterol, they can improve your health in many ways.

A heart-healthy eating plan has lots of plant foods like legumes (cooked beans, peas and lentils), nuts, fruits and vegetables, and also lean protein foods, low-fat dairy foods and healthy fats. Eat more foods rich in soluble fiber like beans, peas, lentils, apples, oranges, pears, sweet potatoes, oats, oat bran and ground flax seeds. These changes can help lower your LDL levels and decrease your overall cardiovascular risk. Replace foods high in saturated fat with foods that contain healthy fats. Use canola, corn, olive, peanut, safflower, sesame and soybean oils in place of butter and coconut oil. Try incorporating avocados, nuts and seeds into meals and snacks. Avoid regular ground beef, bacon, sausage, fatty cuts of meat and fast food hamburgers. Avoid foods with trans fat by not buying foods with “partially hydrogenated oil” on the ingredient list. Trans fats are also found in deep fried foods.

Avoid drinks sweetened with sugar like soda, sweetened tea, fruit punch and sport drinks, and sugary foods like donuts, cookies, pies, pastries and candy. This can also help you achieve a healthy weight. Try to exercise 150 to 300 minutes each week. You can do this by walking for 30-45 minutes five to seven days per week. If you have not been exercising at all, start with just a few minutes of light activity at a time. Limit your cholesterol intake to less than 200 mg per day. Limit egg yolks to two or three a week. Instead, choose egg whites and egg substitutes—they don’t have cholesterol. Avoid organ meats like liver and gizzards and fatty cuts of red meat (beef, pork and lamb).

In all age groups, lifestyle modification is the primary intervention. By making healthier choices and getting regular medical care, you can increase your chances of living a long, healthy life.