Cholesterol: The good, the bad - and how to keep it from getting ugly

• Screening is Critical                      
• Understanding Cholesterol Levels                      
• Lowering Your LDL Cholesterol                      
• Raising Your HDL Cholesterol

Cholesterol is a waxy, fat-like substance that your body needs to function normally. It aids in the production of many hormones, cell membranes, vitamin D, and the bile acids that help to digest fat. It takes only a small amount of cholesterol in the blood to meet these needs, and your liver produces an adequate quantity.

Your body absorbs extra cholesterol from the foods you eat – primarily meat and dairy products that are high in saturated fat and cholesterol. Too much cholesterol in your bloodstream can accumulate along the artery walls, forming plaques. These plaques cause narrowing and blockages in blood vessels (atherosclerosis), making it harder for blood to reach the heart and brain and increasing the risk of heart attack and stroke.

It’s very important to pay attention to your cholesterol levels. Heart and blood vessel (cardiovascular) disease is the No. 1 cause of death for Americans, responsible for more deaths than all cancers combined. And atherosclerosis – a largely preventable condition – is a major contributing factor. You can significantly reduce your risk for a major cardiovascular problem by becoming aware of, and modifying, your risk factors.

Screening is Critical

Cholesterol is coated and transported in your bloodstream by little packages of proteins called lipoproteins. The most commonly-known lipoproteins are low-density lipoproteins (LDL), or "bad cholesterol," and high-density lipoproteins (HDL) commonly referred to as "good cholesterol."

LDL is called "bad cholesterol" because it tends to contribute to plaques. HDL is called "good cholesterol" because it tends not to stick in your blood vessels and can even help reduce existing blockages.

Triglycerides are another class of fat carried through the bloodstream via lipoproteins. The bulk of your body’s fat tissue is in the form of triglycerides. Elevated levels of triglycerides may be caused by medical conditions such as diabetes, hypothyroidism, kidney disease, or liver disease. Dietary causes of elevated triglycerides may include obesity and high intakes of fat, alcohol and concentrated sweets.

Many people with high triglycerides also have other risk factors such as high LDL levels or low HDL levels, and are at increased risk of cardiovascular disease.

The National Cholesterol Education Program (NCEP) recommends that adults have their cholesterol levels evaluated every 5 years. "If other cardiac risk factors are present, you may need a cholesterol screening more often," says Dr. Garrison. "If you do not have elevated risk factors, you may not need to be screened quite so often."

A cholesterol screening should include a "full lipid profile" to show the actual levels of each type of fat in your blood: LDL, HDL, triglycerides, and others. The test is administered by taking a simple blood sample after an overnight fast.

Understanding Cholesterol Levels

You want your LDL level to be low:

You want your HDL to be as high as possible:

Total Cholesterol should be low:

A healthy triglyceride level is less than 150 mg/dl.

Lowering your LDL cholesterol

To lower your LDL cholesterol, follow these tips:

• Reduce your overall fat intake. Limit the fat in your diet to no more than 30 percent of your daily calories.                        
• Reduce the animal fats and saturated fats in your diet. Limit foods such as red meats, cheese and high-fat dairy products, fried foods and those foods containing tropical oils (coconut, palm, palm kernel) or "hydrogenated" vegetable oils.                        
• Increase your fiber intake. Emphasize fruits, vegetables, and whole grains in your diet.                        
• Exercise regularly, with your physician’s approval. "A minimum of three times a week for at least 20 minutes a session is recommended," says Dr. Garrison.                        
• If you smoke, quit.                        
• Know your risk factors! A family history of heart disease, smoking, high blood pressure, obesity, diabetes and lack of exercise can increase your risk.                        
• Talk to your doctor. Follow your doctor’s recommendations for medications, regular physical examinations, or nutritional supplements.

Raising your HDL cholesterol

Some people can raise their "good cholesterol" by:

• Exercising regularly                         
• Stopping smoking                         
• Avoiding saturated fat intake                         
• Decreasing body weight                         
• Taking certain medications. Ask your doctor for more information.

Talk with your physician about a cholesterol-testing schedule that’s right for you.