CHOLESTEROL

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What is cholesterol?

Cholesterol is used by tissues in various ways. The liver makes cholesterol from the saturated fat ingested in the diet, and some cholesterol comes directly from eggs, meats, dairy products, and other foods.

Why is high cholesterol unhealthy?

While some cholesterol is needed for good health, too much cholesterol in your blood can raise your risk of having a heart attack or stroke.

The extra cholesterol in your blood may be stored in your arteries (blood vessels) and cause them to narrow. (This is called atherosclerosis.) Large deposits of cholesterol can completely block an artery, so the blood can't flow through. If an artery that supplies blood to your heart becomes blocked, a heart attack can occur. If an artery that supplies blood to your brain becomes blocked, a stroke can occur.

When should I start having my cholesterol level checked?

Men aged 35 and older and women aged 45 and older should have their cholesterol checked periodically. Depending on what your cholesterol level is and what other risk factors for heart disease you have (see the box below), you may need to have it checked more often.

Risk factors for heart disease

• Having already had a heart attack
• Being a male age >45 years
• Father or brother with heart disease before age 55
• A woman going through or completed menopause
• Mother or sister who had heart disease before she was 65
• Smoking cigarettes
• Uncontrolled high blood pressure
• Uncontrolled diabetes
• Obesity
• Inactive lifestyle

Are there different types of cholesterol?

Cholesterol travels through the blood in different types of packages, called lipoproteins. Low-density lipoproteins (LDL) deliver cholesterol to the body. High-density lipoproteins (HDL) remove cholesterol from the bloodstream.

This is why too much LDL cholesterol is bad for the body, while the HDL form is good. It's the balance between the types of cholesterol that tells you what your cholesterol level means (see the box below).

For example, if your total cholesterol level is high because of a high LDL level, you may be at higher risk of heart disease or stroke. If your total level is high only because of a high HDL level, you're not at higher risk.

Total cholesterol levels:

• Less than 200: acceptable risk
• 200-239: borderline high
• > 240: increased risk

LDL cholesterol levels

• < 70: if heart disease already known
• < 130: for general population
• 130 to 159: borderline high
• > 160: increased risk

HDL cholesterol levels

• < 40: higher risk
• > 60: reduces

What can I do to improve my cholesterol level?

You can do a number of things to improve your cholesterol level. Eating healthy food can help lower your LDL cholesterol level. You can lower your risk by quitting smoking if you smoke, losing weight if you're overweight and exercising.

What sort of foods are healthy choices?

Lowering your cholesterol level by eating healthy foods is easier than you might think. You don't have to give up your favorite foods. Just eat them less often. Also try sometimes substituting healthier choices.

Tips for eating smart

• Limit saturated fats, like dairy fats (in ice cream and butter) and palm and coconut oil (in baked goods).
• Limit high-cholesterol foods, like egg yolks, organ meats (such as liver) and shellfish.
• Eat more fruits and vegetables.
• Eat more broiled or grilled fish and skinless chicken breasts.
• Choose lean cuts when you eat beef, pork and lamb. Also eat smaller portions.
• Eat a variety of fiber-rich foods, like oats, dark breads and apples.
• Choose low-fat or nonfat dairy products.
• Avoid fried foods.

Instead of these:	Try these:
Egg whites	Egg yolks
Sausage, bacon, organ meats (like liver)	Fish; poultry without skin; lean beef, pork and lamb
Buttered or fried vegetables	Raw or steamed vegetables
French fries	Baked potatoes
Creamed soups	Clear soups
Whole milk	Nonfat or low-fat milk
Ice cream	Sherbet, sorbet, fat-free ice cream
Saturated fats: butter, coconut oil, palm oil, lard, bacon fat	Unsaturated vegetable oils: olive, corn, canola
Cheesecake	Angel food cake, reduced-fat cheesecake
Potato chips, regular popcorn	Pretzels, air-popped popcorn, fat-free potato chips
Pastries, doughnuts	Pancakes or cereal with nonfat milk, bagels, English muffins

What about medicine to lower cholesterol?

Depending on your risk factors, if healthy eating and exercise don't work after about 6 months to 1 year, your doctor may suggest medicine to lower your cholesterol level.

Several types of medicines are used to lower high cholesterol levels: bile acid absorbers (such as Questran, etc.), lipoprotein synthesis inhibitors (such as Nicobid, etc.), coenzyme A reductase inhibitors (such as Mevacor, etc.) and fibric acid derivatives (such as Lopid, etc). Your doctor will decide which type of medicine is right for you.

Your values:

Total cholesterol _____________

LDL _____________

HDL _____________

Triglycerides _____________