Cholesterol

Overview

Cholesterol is a substance found in your body and in many foods. It is described as “fat-like” and “waxy.” Cholesterol is essential to your body’s ability to function, but you don’t need cholesterol from food—your body produces the necessary amount.

Cholesterol and Heart Health

Excess, or high, blood cholesterol can be a hazard to your health. High cholesterol can result from diet and lifestyle and can also be hereditary. It can build up in your arteries, inhibiting the passage of blood and raising your risk for heart disease. This extra cholesterol in your arteries is called plaque.

Plaque buildup can block the arteries that carry blood to the heart, which causes a heart attack. As well, a heart attack can occur when a deposit of plaque ruptures, creating a clot in the artery. Plaque can also partially block a coronary artery, which reduces blood flow to the heart; in such cases a person may experience chest pain, or angina.

LDL and HDL: “Bad” Versus “Good” Cholesterol

You may have heard the two types of cholesterol described as “bad” and “good.” The distinction refers to the two kinds of lipoproteins that carry cholesterol in the blood: low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

  • Bad cholesterol, or LDL: When present in high levels, LDL can result in heart disease. LDL makes up the majority of the cholesterol in your blood.
  • Good cholesterol, or HDL: At high levels, HDL can reduce your risk of heart disease because it absorbs cholesterol and carries it back to the liver.

What are the symptoms of high cholesterol?

Only a blood test can detect high cholesterol. It usually has no signs or symptoms.

Risks

Anyone — regardless of age, background, or family history—can be at risk for high cholesterol, though it can also be a hereditary condition (see “Genetics and Cholesterol” below to learn more about hereditary risk).

According to the Centers for Disease Control and Prevention (CDC), approximately one in every six U.S. adults, or about 16 percent, has high cholesterol, a condition which doubles the risk of heart disease compared with healthy cholesterol levels. More women than men in the United States have high cholesterol.

Diabetes: People with diabetes—a condition involving the body’s use of the hormone insulin and its ability to regulate blood sugar—may be more likely to develop high cholesterol.

What Your Numbers Mean

To determine your cholesterol levels, you must get a blood test from your doctor. One test, called a lipoprotein profile, measures several types of cholesterol as well as triglycerides (a type of fat found in blood; high levels raise risk for heart disease). Another, simpler test measures total and HDL cholesterol.

The following, according to the CDC, are healthy, or desirable, cholesterol numbers:
Total cholesterol Less than 200 mg/dL
LDL (“bad” cholesterol) Less than 100 mg/dL
HDL (“good” cholesterol) 40 mg/dL or higher
Triglycerides Less than 150 mg/dL

Diet and Cholesterol

Avoiding or minimizing intake of certain foods that may raise cholesterol levels can be beneficial. Foods with saturated fats (such as animal fats and some vegetable oils), trans fatty acids (vegetable oil hardened by a process call hydrogenation; used in many snack foods and fast food), and triglycerides and foods high in dietary cholesterol (like beef, lamb, and eggs) may raise blood cholesterol levels.

Other dietary factors that can adversely affect your cholesterol levels include eating too many carbohydrates, which can lower HDL cholesterol and raise triglycerides, and drinking alcohol, which can raise triglycerides and also cause high blood pressure—another risk for heart disease.

A dietician can help you learn which foods are most beneficial. Fresh fruits and vegetables, for example, are an excellent addition to any healthy diet; they’re also good sources of fiber, which can help lower cholesterol. You may also be able to lower your cholesterol levels by eating certain fats, including monounsaturated and polyunsaturated; examples of food sources of these include salmon, trout, olives, olive oil, and avocadoes.

Controlling Cholesterol

Controlling cholesterol is achieved through diet, exercise, and weight maintenance (see “Diet and Cholesterol” above and “Lifestyle Changes” below) and sometimes with medications prescribed by your doctor.

The basic steps toward maintaining healthy cholesterol levels are:
1. Get a blood test to learn your cholesterol levels.
2. Maintain a healthy diet.
3. Get regular exercise.
4. Don’t smoke.
5. If you have high cholesterol, as indicated by a blood test, talk with your doctor about treating it—possibly with prescription medication (learn more about cholesterol-lowering drugs later in “Medical Treatments”).

Genetics and Cholesterol

High cholesterol can be hereditary, meaning it runs in families. This is called familial hypercholesterolemia, and those affected may develop high LDL levels at a young age. According to the CDC, familial hypercholesterolemia affects one out of every 500 people in the United States. High cholesterol also has a tendency to run in families without familial hypercholesterolemia, which is likely the result of shared genetic and environmental factors; this means family history is always an important consideration when determining risk.

People with family members with high cholesterol may want to be especially mindful of their cholesterol numbers and of following lifestyle recommendations. Detecting and treating high cholesterol early can help reduce risk of heart disease among those with a genetic risk, as well as among the general population.

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