Today, more than 95 million American adults are living with total cholesterol levels above the healthy range. 29 million of those are at high risk for heart disease, according to the Centers for Disease Control and Prevention.
We often hear about high cholesterol, but what is it? How does it happen and what makes it so hazardous to our health? Let’s break it down.
What is cholesterol?
Cholesterol is a soft, faintly yellow, naturally occurring waxy substance found in cell walls and membranes throughout your body. It is one of several fats, or lipids, that your body produces.
Without enough cholesterol, you simply could not live. It is used to produce sex hormones, vitamin D and bile acids that help you digest fat. Cholesterol is also a major building block for the brain.
High cholesterol: Too much of a good thing
So, if cholesterol is good for us, what’s the problem? The problem is that we only need just a bit of it and our bodies do a great job making it all on its own. We don’t need to consume it. Yet, many of us eat diets high in saturated and trans fats, which contribute to a buildup of cholesterol.
Unfortunately, when there is too much cholesterol hanging around — much like friends who won’t leave after a party is over — they end up causing trouble.
Cholesterol will start to accumulate in arterial walls, which literally causes the pipes to clog up. It also causes an intense inflammatory reaction in the arterial walls. This inflammation, along with the deposits of cholesterol, are what create plaques and cause the acute blockages that eventually lead to heart attacks and strokes.
Our bodies try to get rid of excess cholesterol by shuttling it around and storing it in our livers. But eventually, the liver runs out of space and starts to develop something called fatty liver disease, which, if left unchecked for decades, will progress to cirrhosis.
Is your cholesterol at a healthy level?
The problem is that there really are no symptoms of high cholesterol like there are for diabetes or high blood pressure. That is why it is often considered a “silent disease.”
So, the only way to know is to get yourself screened for high cholesterol and get your cholesterol report card. It’s best to start young, first between the ages of 9-11 and then again between the age of 17-19.
After that, you should have your cholesterol checked at least once every five years, unless you or your family have history of other metabolic disease, such as diabetes, obesity or early onset heart disease. Then it may be as often as once a year, but your primary care physician can advise you on how often to come in to get checked.
Let’s dive into what is considered a “healthy” amount of cholesterol. There are two main types of cholesterol — HDL and LDL — and it’s important to pay attention to both of these numbers.
HDL: The “good” cholesterol
HDL’s are the “good guys.” Ideally, for women, your HDL should be 50 or higher, while for men it should be 45 or higher. Below that means that you are at risk for cardiovascular disease. Below 30 is considered high risk and is called “low HDL.”
HDL’s are considered by some experts to be the “garbage trucks” of the blood stream, carrying away the cholesterol from the tissues back to your liver to be processed. You want as many of them as you can get!
LDL: The “bad” cholesterol
LDL’s carry most of the cholesterol in the blood, depositing it into cells and arterial walls. This promotes the formation of plaque and begins a pathway of arterial wall inflammation that can all lead to the narrowing of arteries until there is a complete blockage — which in the heart can then cause a heart attack.
Depending on your other health concerns or history, your doctor may tell you that your LDL needs to be less than 130 or less than 100. Generally, those individuals who also have high blood pressure or diabetes will need to be at less than 100. For all others, less than 130 is usually appropriate but please check with your doctor.
Though these are the main two types of cholesterol we talk about, there are other cholesterols: triglycerides, VLDL, non-HDL’s, chylomicrons, lipoproteins and apolipoproteins. Your doctor can tell you if you need to have these evaluated or not. If you have strong, unusual cholesterol patterns in your family or other metabolic disease like diabetes, this information can be helpful.
How to lower your cholesterol
First, get your cholesterol report card, find out where your numbers are. Knowing where you are will establish a baseline risk profile from which you can start your positive changes. You’ve got to know where you are to know where you are going.
For most of us, cholesterol comes from a combination of the following: the food we take in, how much our body produces (aka genetics), how much we use it up through exercise and unhealthy habits like smoking.
For some, most of your cholesterol might be coming from your diet. A diet high in saturated fat, which is found in animal products and full-fat dairy, and trans fats, like in many processed foods, alcohol and high carb diets, can contribute to high LDL’s and low HDL’s. Lack of exercise and low lean body muscle mass can also contribute to low HDL’s. Smoking also causes HDL’s to be lower and contributes to the inflammation that is occurring in arterial walls.
But for other people, cholesterol is very strongly predicted by genetics and how much your body is producing. Unfortunately, that part we do not have control over.
Start putting in motion the things that you do have control over: your lifestyle habits and choices:
- Eat a low salt diet that emphasizes fruits, vegetables and whole grains. Limit processed foods. Consume lean proteins or protein alternatives.
- Limit the amount of saturated fat in your diet and use healthy fats in moderation.
- Lose extra pounds and aim to maintain a healthy weight.
- Establish healthy eating patterns to manage portions and encourage family participation and support of your journey.
- Quit smoking.
- Exercise on most days of the week for at least 30 minutes.
- Drink alcohol in moderation, if at all.
- Manage your stress levels, as stress can lead to inflammation in the body.
And finally, work with you doctor to see if there is a role for medication in your overall health plan goals.
Know your numbers. Put healthy habits in motion. Take charge!