You likely know cholesterol as a substance found in your blood that can put you at risk of a heart attack. But your knowledge may stop there. I mean, why waste your brain power on something that may or may not affect you, right? Well…
Heart disease is the leading killer of men in the United States, responsible for one in every four deaths, according to the CDC. Half of men who die suddenly from heart disease have no prior symptoms. In other words, they have no clue facts about cholesterol, blood pressure and the like could save them. Further, high cholesterol have twice the risk of heart disease compared to those with lower levels. So, yeah, you may want to reserve a little brain space for this.
No one wants to manage their cholesterol. This isn’t a hobby or even a really interesting task. But if you like living, and prefer living without a shelf full of medications and a mountain of doctors’ bills, it’s a necessary grown-up thing to do.
What You Need to Know About Cholesterol
- Cholesterol alone isn’t bad — your body needs it and creates it naturally.
- LDL is known as “bad” cholesterol and HDL is known as “good” cholesterol. HDL is good because it helps transport LDL from your body.
- Dietary changes such as reducing saturated fats and eliminating trans fats are the best ways to manage blood cholesterol levels.
- Failure to manage your cholesterol can lead to heart attacks and strokes.
- Dietary cholesterol, or cholesterol found in foods, shouldn’t be a top concern when choosing a heart healthy diet.
The Basics: What is Cholesterol?
There are two ways we normally talk about cholesterol — cholesterol in the blood and cholesterol in your food, known as blood cholesterol and dietary cholesterol, respectively.
Blood cholesterol is a “waxy-like substance” (in quotes because if you click nearly any Google result on the topic, this is how they define it). This sticky, fatty stuff is created in your liver and intestines and is used to make hormones and vitamin D, among other things.
Cholesterol and other fats circulate throughout your body in packages known as lipoproteins, allowing them to mix more easily with blood. You’ve likely heard of two of these lipoproteins: high-density lipoproteins (HDL) and low-density lipoprotein (LDL). HDL is known as “good” cholesterol because it helps remove excess cholesterol from your blood. LDL, on the other hand, is commonly referred to as “bad” cholesterol because it is richest in pure cholesterol and linked to the buildup of plaque on the artery walls.
Yes, plaque on the artery walls. Too much blood cholesterol can lead to fatty deposits forming on the walls of your arteries. This plaque makes your arteries a narrower passageway for blood, putting you at a greater risk of heart disease.
Cholesterol, in general, is good — necessary for cell health. But too much of a good thing can be deadly, in this case.
The Risks of High Cholesterol
It’s pretty simple: When blood can’t travel unimpeded through your body, bad shit happens. When high levels of blood cholesterol lead to plaque buildup on the arteries (known as atherosclerosis), you’re at a greater risk of chest pains, heart attacks, and strokes.
“Having high cholesterol puts you at risk of heart disease, the leading cause of death in the United States.” Succinctly put by the CDC.
Measuring Your Cholesterol
Getting your cholesterol checked should be part of an annual check-up by your physician. It’s called a lipid panel and is a simple blood test that you’ll likely fast for. The results consist of four numbers: your total cholesterol, LDL, HDL, and triglycerides, a common fat in the bloodstream.
Desirable ranges for these numbers are:
- Total cholesterol: <200 mg/dL
- LDL: 100-129 mg/dL (lower for people at risk of heart disease or those with existing heart disease or diabetes)
- HDL: >50 mg/dL (remember, this is “good” cholesterol, so you want this number to be high)
- Triglycerides: <150 mg/dL
The first line of defense if any of these numbers are not ideal is lifestyle changes. Unless your LDL and triglyceride levels are alarmingly high, your doctor won’t likely go straight to drug treatment. If, however, they are high or if lifestyle changes don’t move the needle, your doctor may prescribe statins or other cholesterol-reducing medications.
Managing Your Cholesterol
Blood cholesterol levels can be nearly entirely managed by lifestyle choices (“nearly” because there are some genetic factors at play in high cholesterol). Preventing alarming results on your lipid panel is really quite simple — it’s the same sage advice you see for living a heart healthy lifestyle:
- Eat a healthy diet. A “heart-healthy” diet consists of a few factors:
- Reducing saturated fats found in animal products, which can raise your cholesterol.
- Eliminating trans fats found in packaged snack foods, margarine, and baked goods. Check your nutrition levels for these, as they’re notorious for raising blood cholesterol levels.
- Eating a fiber-rich diet, as fiber helps move cholesterol out of your bloodstream.
- Exercise regularly. Getting consistent physical activity can raise HDL, the “good” cholesterol that helps transport the “bad” cholesterol out of your body.
- Quit smoking. Smoking has many deleterious effects on your heart health, but quitting now can raise your HDL.
A Note About Dietary Cholesterol
You’ll notice nothing was said about eating “low cholesterol” foods. That’s because scientists have come to the conclusion that dietary cholesterol has minimal impact on blood cholesterol. It’s the fats that you should be concerned about.
There is evidence that recommending lower intake of dietary cholesterol does not impact a population's rate of heart disease or high blood cholesterol. Further, there is little evidence that dietary cholesterol has a direct impact on heart disease risk. By limiting saturated and trans fats, you’ll naturally eat foods lower in dietary cholesterol, though it’s the fats and not the cholesterol in foods you should be tracking.