Learn about cholesterol and take control of your heart's health

Cholesterol is a soft, fat-like substance found in the blood and in all your body's cells. Your body makes all the cholesterol it needs. Having too much cholesterol in your blood may lead to increased risk for heart disease and stroke. The saturated fats, trans fats and cholesterol you eat may raise your blood cholesterol level. About half of American adults have cholesterol levels that are too high. The good news is that you can take steps to control your cholesterol.

Types of Cholesterol

There are two types of cholesterol: "good" and "bad." It's important to understand the difference, and to know the levels of "good" and "bad" cholesterol in your blood. Too much of one type - or not enough of another - can put you at risk for heart disease, heart attack or stroke.

Cholesterol comes from two sources: your body and food. Your liver and other cells in your body make about 75 percent of blood cholesterol. The other 25 percent comes from the foods you eat.

LDL (bad) Cholesterol

Low-density lipoprotein (LDL) cholesterol is often called "bad" cholesterol. When too much of it is in the blood, it can clog arteries, increasing the risk of heart attack and stroke.

LDL cholesterol is produced naturally by the body, but many people inherit genes that cause them to make too much. Eating saturated fat, trans fats and dietary cholesterol also increases how much you have. If high blood cholesterol runs in your family, lifestyle changes may not be enough to help lower your LDL blood cholesterol. Everyone is different, so talk with your doctor to find a treatment plan that's best for you. You may need medication.

HDL (good) Cholesterol

The "good" cholesterol is called high-density lipoprotein (HDL). It carries harmful cholesterol away from the arteries and helps protect you from heart attack and stroke. It's better to have a lot of HDL cholesterol in your blood. Low levels of HDL (less than 40 mg/dL) also increase the risk of heart disease. Exercise increases the levels of HDL cholesterol in your body.

Triglycerides

Triglyceride is a form of fat made in the body. Elevated triglycerides can be due to overweight/obesity, not enough physical activity, cigarette smoking, excess alcohol consumption, and a diet very high in carbohydrates (60 percent of total calories or more). People with high triglycerides often have a high total cholesterol level, including a high LDL (bad) level and a low HDL (good) level. Many people with heart disease and/or diabetes also have high triglyceride levels.

What Your Cholesterol Levels Mean

High blood cholesterol means a higher risk of heart attack and stroke. That's why it's important to have your cholesterol levels checked regularly and discuss the results with your doctor. A "lipoprotein profile" is a test to find out your blood cholesterol numbers. It gives information about total cholesterol, LDL (bad) cholesterol and HDL (good) cholesterol, as well as triglycerides (blood fats). The test must be done when you have not eaten ("fasted") for 12 hours or more to be reliable.

To find out how your cholesterol levels affect your risk of heart disease, your doctor will also take into account other risk factors such as age, family history, smoking and high blood pressure.

What should my total cholesterol levels be?

Total blood cholesterol levels (includes LDL, HDL and Triglyercides):

Less than 200 mg/dL = Desirable

200 to 239 mg/dL = Borderline high

240 mg/dL and above = High blood cholesterol

What should my HDL and LDL cholesterol levels be?

HDL is good cholesterol because it seems to lower your risk of heart attack and stroke. So the higher your HDL, the better. You can raise your HDL by quitting smoking, losing excess weight and being more active.

HDL Cholesterol Levels:

Less than 40 mg/dL = Low HDL (higher risk)

40 to 59 mg/dL = The higher, the better

60 mg/dL and above = High HDL (lower risk)

LDL stands for low-density lipoprotein. A high level of LDL cholesterol means there's a higher risk of heart disease and stroke.

LDL cholesterol levels:

Less than 100 mg/dL = A good result for people with heart disease or diabetes

100 to 129 mg/dL = Near or above a good result

130 to 159 mg/dL = Borderline high

160 to 189 mg/dL = High

190 mg/dL and above = Very High

What should my triglyceride level be?

Triglyceride is a form of fat. People with high triglycerides often have a high total cholesterol level, including high LDL (bad) cholesterol and low HDL (good) cholesterol levels.

Your triglyceride level will fall into one of these categories:

Normal: less than 150 mg/dL

Borderline-High: 150-199 mg/dL

High: 200-499 mg/dL

Very High: 500 mg/dL

How Can I Lower High Cholesterol?

Too much cholesterol in the blood can lead to heart disease and stroke. Even though there's much you can do to lower your cholesterol levels and protect yourself, half of American adults still have levels that are too high (over 200 mg/dL).

You can reduce cholesterol in your blood by eating healthful foods, losing weight if you need to and exercising. Exercise not only makes you healthy by helping control weight and improve muscle strength and endurance, but it also raises the "good" cholesterol in your body-it helps increase your HDL cholesterol. Some people also need to take medicine because changing their diet isn't enough. Whether your plan includes taking medicine or not you can do a number of things every day that can improve your cholesterol - and your overall health.

Your diet, weight, physical activity and exposure to tobacco smoke all affect your cholesterol level - and these factors may be controlled by eating a heart healthy diet and enjoying regular physical activity - Try to get at least 30-60 minutes of physical activity most days of the week. It does not have to be all at once - 10 minutes 3 times a day is just as good!

Smoking has been shown to lower HDL (good) cholesterol levels. Smoking also decreases your tolerance for physical activity, which makes it harder to get the activity you need to help you reach healthy cholesterol levels.

What are some tips for a heart healthy diet?

Focus on eating low-saturated fat, low cholesterol foods such as these:

A variety of fresh fruits and vegetables (choose 5 or more servings per day)

A variety of grain products like bread, cereal, rice and pasta, including whole grains

Fat-free and low-fat milk products

Lean meats and poultry without skin (choose up to 6 total ounces per day)

Fish - especially salmon, mackerel, trout, herring and sardines (enjoy at least 2 servings baked or grilled each week)

Beans and peas

Nuts and seed in limited amounts

Unsaturated vegetable oils like canola, corn, olive, safflower and soybean oils (but a limited amount of margarines and spreads made from them)

Foods with high cholesterol content- eat these only as treats, NOT regularly, and avoid if you have a high cholesterol level:

Whole milk, cream and ice cream

Butter, egg yolks and cheese - and foods made with them

Organ meats like liver, sweetbreads, kidney and brain

High-fat processed meats like sausage, bologna, salami and hot dogs

Fatty meats that aren't trimmed

Bakery goods made with egg yolks and saturated fats

Saturated oils like coconut oil, palm oil and palm kernel oil

Solid fats like shortening, partially hydrogenated margarine and lard

Fried foods

What are some cooking tips?

Broil or grill instead of pan-frying

Use a rack to drain off fat when you broil, roast or bake

Cut off all visible fat from meat before cooking, and take all the skin off poultry pieces. (If you're roasting a whole chicken or turkey, remove the skin after cooking.)

Use a vegetable oil spray to brown or sauté foods.

Make recipes or egg dishes with egg whites or egg substitutes, not yolks.

Instead of regular cheese, use low-fat cottage cheese, part-skim mozzarella and other fat-free or low-fat cheeses.

Remember: high cholesterol is one of the major controllable risk factors for coronary heart disease, heart attack and stroke. Talk to your health care provider for more information about how to improve your cholesterol. By staying active, having healthy eating habits and not smoking you can make healthy choices to protect your heart today!

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