The Good and the Bad of Cholestrol
Cholesterol is a substance that is carried on a fat-plus-protein package (molecule) called a lipoprotein. The reason for the concern about cholesterol is statistics show that a great majority of the heart disease we have in the U.S. is caused by abnormalities in the levels of cholesterol substances in our bodies. Heart disease causes one death every 34 seconds, approximately 2,400 deaths per day!
How Do You Know if
You Have High Cholesterol?
With most diseases, symptoms happen to the body that you may detect as different from normal. For instance, strep throat presents with the symptom of throat pain, heart attacks present with symptoms of chest pain. High cholesterol, however, rarely causes symptoms. It is silent and usually detected only during a routine blood test that measures cholesterol and other fat levels. You may first discover you have a problem only when you are diagnosed with a condition that is caused, in part, by high cholesterol, such as coronary or other artery disease.
What is cholesterol?
To answer that let's take a closer look at this substance. It is a waxy, fat-like substance needed for new cell production. Your body obtains cholesterol from two sources. The main source is from the foods you eat; the second is what your own body manufactures from raw ingredients in your diet. If you eat too many high-cholesterol foods or too much saturated fat or you are unlucky enough to come from a from a family with genes that have problems in the way they process fats, your cholesterol levels may be too high. In a perfect scenario, you eat grains and greens and your body will make almost all the cholesterol you need.
A total cholesterol level of less than 200 mg/DL is acceptable but lower than 160 is better.
The lipoprotein package that carries the cholesterol and other fats is either called high density (HDL-C), low density (LDL-C), triglycerides (TG) or very low density (VLDL), depending on how much protein there is in relation to the amount of fat. High-density lipoprotein cholesterol (HDL-C) is called "good" cholesterol because it helps prevent cholesterol from building up in your arteries. It is mostly protein with a bit of fat. A high HDL-C (over 60 mg/dL) is desirable and reduces the risk of heart disease. A low HDL-C cholesterol increases the risk of heart disease. Low-density lipoprotein cholesterol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C) are "bad" cholesterol because they can cause a buildup and blockage of your arteries, so keep LDL-C less than 70 mg/dL and VLDL-C less than 30 mg/dl. Triglycerides (TG) are another type of "bad" fat. You want TG less than 150mg/dl.
Lowering Cholesterol
There are two ways of lowering your cholesterol: modifying your lifestyle and/or taking medications. Your doctor may first recommend lifestyle changes, such as modifying your diet, quitting smoking, losing weight, and exercising. If you cannot lower your cholesterol to desirable levels with lifestyle changes, your doctor may add medications. The goal is to lower your LDL-C ("bad") cholesterol, raise your HDL-C ("good") cholesterol, and lower triglycerides (TG).
Lifestyle Changes are Critical
Making heart-healthy lifestyle changes such as changing one's diet, losing weight, exercising, and quitting smoking are as important as any drug. Diet changes here mean more than just "going on a diet." Your doctor can give you specific advice. Not all fats are created equal and have different effects on your cholesterol levels. The most critical lifestyle change is to stop smoking cigarettes. Smoking decreases "good" HDL-C cholesterol and increases the risk of heart disease. Next comes exercising and losing weight. Exercising 30 minutes, five days a week increases your "good" HDL-C cholesterol and lowers your "bad" LDL-C cholesterol and triglycerides. Excess weight adds many risks.
Therapeutic Lifestyle Changes (TLC) Diet
The National Cholesterol Education Program of the National Institutes of Health recommends the TLC diet. The diet's focus is to reduce saturated fats and dietary cholesterol like: egg yolks, poultry (especially skin), red meat, full fat dairy products and shellfish. Replace animal fats in your diet with unsaturated fats, like mono unsaturated oils (olive, canola, or peanut oil) and add complex carbohydrates. The TLC diet calls for less than 7% of your daily calories to come from saturated fat and to eat no more than 200 mg of dietary cholesterol per day. It suggests you add dietary fiber like: oats, dried beans (legumes), peas, barley, citrus fruits, apples, and bran cereals; they will reduce total cholesterol and LDL-C. You can lower your cholesterol from 8 to 20% on diet alone.
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"The Good and the Bad of Cholestrol"
authored by:
Craig Karpilow MD FACOEM is a Board Certified Family Practitioner, Fellow of the American College of Occupational & Environmental Medicine and the Royal Society of Tropical Medicine & Hygiene. He has published numerous articles in professional journa...
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