Cholesterol: Just the facts

Heart disease remains the leading cause of death in the US and worldwide. Over 600,000 Americans die from heart disease every year. However, there are many things that we can do to prevent developing heart disease. One of the major risk factors for heart disease is high cholesterol, which leads to buildup of plaque in the arteries of the heart, brain, and other organs. This plaque can obstruct flow to our vital organs, and when it suddenly clots and completely closes the heart or brain arteries, heart attacks and strokes occur.

Cholesterol is a type of fat that is made by the liver and is absorbed by the body from the foods we eat. There are 3 important parts of cholesterol:

1) LDL or low-density lipoprotein (L is for “lousy” and the “lower” the better): This cholesterol is directly related to development of plaque in the arteries. LDL level less than 100 mg /dL is ideal for preventing heart disease.

2) HDL or high-density lipoprotein (H is for “healthy” and the “higher” the better): This part of cholesterol helps remove LDL from the plaques in the arteries. Low HDL is a major risk factor for developing heart attacks. Cigarette smoking, being overweight, and being sedentary are 3 modifiable risk factors that lower the HDL and increase risk. Goal for HDL is at least 50 mg/dL, and ideally greater than 60.

3) Triglycerides are fatty compounds that are elevated in people with poor diets that are high in saturated fats, overweight, or have diabetes. Ideally, triglycerides should be less than 150 mg/dL.

Total cholesterol has the 3 components above along with some others, and the typical goal for total cholesterol should be less than 200 or 160, depending on the levels of the above components.

Food that is high in saturated and trans fat, including meat, poultry, full-fat dairy products, and certain oils like coconut and palm oil, all increase the cholesterol in the body. In addition, there are other risk factors that affect cholesterol, including being overweight, being sedentary with no exercise, getting older, and smoking.

It is important for all adults > 20 years old to have their cholesterol measured. It is also important to understand that quite often, people who look and feel healthy, eat healthily, and are even athletic, can have high cholesterol because of their genetics. High cholesterol can run in the family, because of genetic variants of proteins in the liver—and it is important to control the cholesterol with a combination of a heart-healthy diet and sometimes medications, in order to prevent the development of atherosclerosis (plaque buildup in arteries), heart attacks, and strokes.

So please make sure you know your cholesterol numbers and talk to your doctors and health care providers about how you can reduce your risk for developing heart disease.

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