Cholesterol is a type of fat that circulates in your blood. All cholesterol is not “bad.” Cholesterol is essential and is involved in maintaining cell membranes, manufacturing Vitamin D on the surface of the skin, producing hormones and possibly helping cell connections in the brain. About 70% of cholesterol is made in the liver and 30% comes from the foods you eat, specifically animal products. Cholesterol is not found in plants. Cholesterol requires proteins to be carried in the blood. Lipoproteins transport fats in the body and consist of protein, cholesterol, triglycerides and phospholipids.
“Bad” cholesterol or Low Density Lipoproteins (LDL) are associated with coronary atherosclerosis and “Good” cholesterol or High Density Lipoproteins (HDL) appears to protect against cardiovascular disease. The clinical manifestations of excessive cholesterol build-up in coronary arteries is responsible for more deaths and disability that all types of cancer combined.* Levels of cholesterol and related lipids circulating in the blood have proven to be excellent predictive tools to gauge the risk of a cardiac event. For example, a rise in total cholesterol in men from 200-240 mg DL is associated with a three-fold increase in death from cardiac disease. However, is you have a high total cholesterol and high HDL cholesterol; you may not be at an increased risk.
The American Heart Association has the following recommendations:
Low density lipoprotein (LDL cholesterol) goal values:
- Less than 70 mg/dL for those with heart or blood vessel disease and for other patients at very high risk of heart disease (those with metabolic syndrome)
- Less than 100 mg/dL for high risk patients (for example: some patients who have diabetes or multiple heart disease risk factors)
- Less than 130 mg/dL otherwise
Total cholesterol (TC) goal values:- 75-169 mg/dL for those age 20 and younger
- 100-199 mg/dL for those over age 21
- High density lipoprotein (HDL) goal value:
- Greater than 45 mg/dl (the higher the better)
- Triglyceride (TG) goal value:
- Less than 150 mg/dl
Data from the Lipid Research Clinics and the Framingham Heart Study suggest that the total cholesterol to HDL cholesterol ratio may have a greater predictive value for CHD than serum total or LDL cholesterol.
Among men, a ratio of 6.4 or more identified a group at 2-14% greater risk than predicated from serum total or LDL total.
Among women, a ratio of 5.6 or more identified a group at 25-45% greater risk than predicted from serum total of LDL cholesterol.
In some people, high cholesterol is inherited and may require the use of medications to help control their cholesterol.
What can you do to improve your cholesterol values?
The American Heart Association has the following recommendations:
1. Use up at least as many calories as you take in.
Know what your calorie intake daily should be and don’t eat more calories than you know you can burn up every day.
2. Eat a variety of nutritious foods from all the food groups.
For example:
Choose lean meats and poultry without skin and prepare them without added saturated and trans fat.
Select fat free, 1% fat and low fat dairy products
Use poly unsaturated fats (vegetable oils like olive oil). Avoid tropical oils such as coconut and palm oils.
Eat less than 300 mg of cholesterol per day
Eat fresh fruits and vegetables- they are high in vitamins, minerals, and fiber and low in calories
Eat unrefined whole grain foods
Eat fish at least twice weekly, especially those high in omega-3 fatty acids (salmon, trout and herring)
Avoid processed foods
Eat more fiber such as fruits, beans, peas and oats.
3. Don’t smoke; and stay away from tobacco smoke
4. Exercise: walk vigorously for 30 minutes at least 3 times per week.
References:
Lloyd-Jones D, Adams R, Carnethon M. et al. Heart disease and stroke statistics-2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation.2009;119:480-486
