If you're like most people, you don't think about cholesterol until you or someone you know is told that his or her numbers are already too high. So just what is "high cholesterol," anyway? In fact, what is cholesterol in the first place, and what makes it high or low?
For starters, know that cholesterol isn't bad — in fact, it's essential to good health. Cholesterol is a natural fat-like substance found in the cell membranes of all animals, humans included. Cholesterol is also part of the myelin sheath that surrounds and protects nerves, and it is used to make vitamin D, bile, and several hormones. Our bodies make all the cholesterol we need for health, but we get extra from eating meat, poultry, and fish. (Incidentally, cholesterol is never found in plant-based foods, so “cholesterol-free!” labels on products like peanut butter are really just stating the obvious.)
To complicate matters, blood cholesterol comes in two varieties: low-density lipoprotein (LDL) cholesterol (commonly called bad cholesterol — remember L for LOUSY) and high-density lipoprotein (HDL) cholesterol (“good cholesterol” — remember H for HERO). As the mnemonics imply, the former kind is bad for you, and you want that number to be low; the latter is good for you, and you want that number high. The bad cholesterol is one of the components of plaque, which clogs your arteries and puts you at risk for blood clots, heart attacks, and stroke. The good cholesterol, on the other hand, is like nature’s vacuum cleaner for plaque — it picks up the vessel-clogging cholesterol and carries it away to the liver, where it is disposed of in the form of bile. The ratio between the two types counts, too.
Here's the bottom line:
How to Control Cholesterol
The higher your LDL cholesterol, the greater your risk of developing life-threatening plaque. So, you want your low-density low. According to the National Institutes of Health (NIH), the optimal level of LDL cholesterol is below 100 mg/dL. High LDL cholesterol is defined as 160 mg/dL and higher — but certainly anything above 130 is worth treating.
The higher your HDL levels, the cleaner your blood vessels will be. So, you want your high-density high. According to the American Heart Association, people with HDL of 60 mg/dL or higher have a lower risk of heart disease, whereas HDL below 40 mg/dL for men and 50 mg/dL for women is considered too low.
Because HDL is so important to the health of blood vessels, some physicians prefer to talk about the cholesterol ratio — your total cholesterol divided by your HDL cholesterol. For example, if your total cholesterol number is 250 and your HDL is 50, your ratio is 250/50 or 5. People are urged to aim for a ratio of 5 or less, but a ratio of 3.5 or lower is considered optimal.
High LDL cholesterol can be caused by several factors — some you can change, and some you can’t. Heredity can play a big part: Some people can have a perfect heart-healthy lifestyle, and still have skyrocketing LDL cholesterol because their bodies naturally make too much of it. For these folks, medication is often the only way to bring down their number. However, for the vast majority of people diagnosed with high cholesterol, you can improve your profile by taking these three steps:
- If you are overweight, focus on losing weight. Research has shown that losing just ten pounds can reduce LDL cholesterol by 5 to 8 percent.
- Become more physically active. Even moderate exercise can help improve your cholesterol, as well as triglycerides and blood pressure.
- Follow my cholesterol-busting nutrition program.
Now that you know the basics about cholesterol, it's time to start changing your eating habits!