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June 18, 2014

Cholesterol: The Good, The Bad & The Ugly


Many of us get our cholesterol checked every year or so, but what do those numbers really mean? Here you will find a simple breakdown of each part of the cholesterol panel, and tips to make your numbers perfect.

First, it is important to realize that cholesterol is not inherently a bad thing. Your body needs cholesterol to support your cell’s membranes. However, when you have too much cholesterol in your blood it can build up as plaques in your arteries that lead to heart attacks and strokes. Cholesterol cannot move around your body on its own, so it uses lipoproteins. Think of lipoproteins as transport vehicles for your cholesterol. There are several different vehicles: HDL, LDL, and VLDL. Triglycerides are also a part of your cholesterol panel because they are a measure of the fat in your blood.

Your triglycerides:  This is a measure of the fat in your blood. Your body uses triglycerides as energy. Triglycerides are found in natural fats and oils, and high concentrations in the blood indicate an elevated risk of stroke. To help lower your triglycerides without medicine you should: limit fats and sugars in your diet, lose weight if you are overweight, exercise more, stop smoking, and limit alcohol intake.

Your HDL: HDL, or “good,” cholesterol picks up excess cholesterol and takes it back to your liver. You want this number as high as possible because HDL cholesterol protects against heart disease: a level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease; HDL levels of 60 mg/dL or more help to lower your risk for heart disease. The only way to increase your HDL is with exercise. If exercise alone does not work, medication can be used.

Your LDL: This is the “bad” cholesterol. Too much LDL builds up in your arteries and can cause heart attacks and strokes. Eating lots of saturated fats and being inactive can raise your LDL.  An LDL cholesterol-lowering diet is low in saturated fat (less than 7% of total calories a day) and dietary cholesterol (less than 200 mg a day). Adding fiber and plant sterols (like cholesterol-lowering margarine) can further lower LDL levels. Sticking closely with a cholesterol-lowering diet can lower LDL levels by up to 30%. Regular aerobic exercise lowers LDL cholesterol even further, and increases HDL — or “good” — cholesterol too.  Foods low in saturated fat includes fat-free or 1% dairy products, lean meats, fish, skinless poultry, whole grain foods, and fruits and vegetables. Look for soft margarines (liquid or tub varieties) that are low in saturated fat and contain little or no trans fat (another type of dietary fat that can raise your cholesterol level). Limit foods high in cholesterol such as liver and other organ meats, egg yolks, and full-fat dairy products.

Your VLDL: This type of lipoprotein contains the most triglycerides, a type of fat, attached to the proteins in your blood. VLDL cholesterol makes LDL cholesterol larger in size, causing your blood vessels to narrow with thick plaques. Lowering your LDL will in turn lower your VLDL.

In summary, if you have high cholesterol or if some component of your cholesterol panel is suboptimal, lifestyle changes are usually the first step in lowering your cholesterol. These changes include exercising for 30-60 minutes on most days of the week, and limiting foods that are high in saturated fat since saturated fats are the main culprit of high LDLs, triglycerides and low HDLs. (tip: saturated fats are solid at room temperature!)

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