You probably know you should be concerned about your cholesterol but aren’t sure why or what to do about it. This article is for you. Let’s break it down and find out what cholesterol is and what you can do to make it an ally for better health. It’s not something to fear and certainly not to ignore.
What is cholesterol?
Cholesterol is a waxy, fat-like substance made by your liver. It’s needed for good health because it builds cells, and make hormones, Vitamin D, bile acids and other substances your body needs.
Found in the walls of cells all over your body, cholesterol travels through your blood in “packages” called lipoproteins. There are two kinds of lipoproteins:
LDL is low-density lipoprotein and often called “bad” cholesterol. The higher your LDL numbers, the higher your risk for heart disease, stroke and peripheral artery disease (PAD). Most of the cholesterol in your body is the LDL type.
HDL is high-density lipoprotein and called “good” cholesterol. You want to have a high level of HDL because it carries cholesterol back to your liver where it is flushed out of your body. High HDL can lower your risk for heart disease and stroke.
Certain foods, originating from animals, can also cause high cholesterol levels. These include meat, fish, chicken, eggs, cheese, cold cuts, pasta, pizza and dairy desserts. Foods with a lot of cholesterol usually also have a lot of saturated fat and trans fats, palm oil or palm kernel oil. They cause your body to make more cholesterol than it normally would, increasing your cholesterol levels.
Your body’s cholesterol levels are also affected by your weight, exercise habits, age, family history and if you smoke tobacco. Cholesterol increases if you have diabetes, high blood pressure, drink a lot of alcohol, are overweight or eat a lot of high-carbohydrate foods.
Men generally have higher cholesterol levels than women. The estrogen in women’s bodies helps protect women from heart disease and cholesterol. However, after menopause when estrogen declines, women’s cholesterol levels are more equal to men’s levels.
How does it become a health problem?
If there’s too much of the wrong kind of cholesterol (LDL) circulating in your blood, your doctor will warn you that your numbers are too high. Your doctor is concerned because cholesterol is an important indicator of your risk for heart disease, heart attacks and strokes.
Cholesterol can become a health problem when it gets trapped in artery walls where it builds up and turns into plaque. Thick, hard plaque deposits can narrow your arteries and make them less flexible – called hardening of the arteries (atherosclerosis). Plaque build-up also reduces the amount of oxygen and other nutrients that get to your heart and other internal organs. If you don’t improve your lifestyle, the result can be chest pain (angina), blood clots, heart attack, stroke or long-term heart disease. Cholesterol can be deadly.
How can I improve my cholesterol level?
Cholesterol is controllable. If your cholesterol is too high, it’s usually due to lifestyle choices that need your attention: diet, exercise, weight and tobacco use. And, while your gender, age and family history also affect cholesterol levels, you can’t change those things like you can your diet, exercise or smoking.
Even if you take a medication to lower your cholesterol, making lifestyle changes is the most effective way to reduce your risk for heart attacks and strokes.
Here are the top six ways to control your cholesterol.
- Get your cholesterol checked regularly
Work with your doctor to develop a cholesterol lowering plan, if needed. If your levels are slowly creeping up, consider starting your plan with lifestyle changes. Start with one or two of the following recommendations, add more as you start adopting healthier habits. For healthy younger people, lifestyle changes are often enough to improve your cholesterol.
Regular cholesterol screenings are important because there are rarely any symptoms to warn you that plaque is building up in your blood vessels. By the time that damage has been done you may feel some shortness of breath or chest pains.
A simple blood test is all that’s needed to check cholesterol levels. You will be asked to fast for nine to 12 hours before the blood test to provide the most accurate reading.
A complete cholesterol test, also called a lipoprotein or lipid profile, will give you results for your HDL, LDL, triglycerides, and your total blood (or serum) cholesterol. A total blood cholesterol score is a calculated by adding your HDL, LDL and 20 percent of your triglycerides level. Triglycerides are a measure of fats in your body.
More than 20 percent of American children have an unhealthy cholesterol reading. The process of hardening of the arteries begins in childhood and progresses slowly into adulthood, often leading to heart disease as an adult.
The Centers for Disease Control and Prevention (CDC) recommends that children be tested once before age 11 and once between ages 17 to 21.
About 100 million adults also have unhealthy cholesterol levels. Both the CDC and American Heart Association recommend that all adults over age 21 be tested every four to six years. The exception to this recommendation is if your family has a history of early heart attacks, stokes or heart disease, or if you’re overweight or have diabetes. In those cases, your doctor will recommend more frequent testing.
When women near menopause or are postmenopausal, they should have their cholesterol levels checked more frequently and talk with their doctor about their personal risk factors and treatment options.
- Choose healthier foods
What you eat – or don’t eat – is the main cause of a high LDL cholesterol. Dietary experts recommend eating only 100 to 300 milligrams (mg) of cholesterol a day, depending on the number of calories you need to maintain your weight. Here are some ways you can choose to naturally limit the amount of cholesterol you eat:
- Get in the habit of reading food labels (here's a guide including recent changes) to avoid foods that boost your cholesterol. Choose foods with low or no saturated fats or trans fats. Check the serving size, it may be smaller than you expect. Ingredients are listed in descending order by amount, so choose items where fats and oils appear near the end of the ingredients list.
- Beware of slick marketing. Many foods labeled as “low-cholesterol” have high levels of saturated or trans fats. Even foods billed as “low-fat” may have a surprisingly high fat content. Find out by reading the nutrition label.
- Choose cholesterol-free foods like fruits, vegetables, whole grains and beans. These foods provide other benefits including lower blood pressure, boost immunity, and protect against heart attack, stroke and some cancers. Look at the Mediterranean Diet here for a heart-healthy food plan.
- Use more vegetable fats (extra virgin olive oil or canola, soy, safflower and sunflower oils) and reduce use of fats from animals (butter, hard margarine, lard, shortening).
- Avoid processed foods like bakery items, crackers, cookies, biscuits, breakfast sandwiches, doughnuts, fried fast foods, microwave popcorn, cream-filled candy and other foods high in saturated fat. Look at the food label before you put any item in your grocery cart. If it includes trans fats, put it back.
- Start reducing the amount of salt in your diet by avoiding salty foods (canned soups, snack foods, processed or fast foods, cold cuts, cured meats, pizza). You won’t miss the excess salt if you make this change slowly over many months. You may be surprised to find out how much salt is in foods when you read food labels.
- Start reducing the amount of added sugar you eat by limiting soft drinks, fruit juices, desserts, ice cream and candy only to special occasions. Check the label for these commonly added sugars: corn sweetener, corn syrup, dextrose, fructose, fruit-juice concentrates, glucose, high fructose corn syrup, lactose, maltose and sucrose.
- Choose protein-rich plant foods over animal meats. Try eating more plain nuts (unsalted and dry-roasted without fat) and seeds as snacks or sprinkled in salads. Studies show that eating 2 ounces of nuts daily can lower LDL cholesterol by about 5 percent. But watch out for salt and calories; moderation is important with nuts and seeds. You may find they satisfy your hunger for a longer time than high-carbohydrate foods or soft drinks.
- Increase foods that reduce cholesterol, such as oats (oatmeal, oat bread), barley and other whole grains, beans, peas, fruits (apples, grapes, strawberries, oranges, lemons, limes, grapefruit all contain pectin, a type of soluble fiber that lowers LDL), and foods fortified with plant sterols and stanols. Soluble fiber binds with cholesterol so it can be eliminated from your body before it starts circulating in your blood.
- Limit high-saturated-fat foods such as red meats, fatty meats, cheese and foods with trans fats (stick margarine, crackers, cookies, doughnuts, French fries, potato chips and foods fried in shortening or lard).
- Choose lean meats, chicken without the skin and fish, especially salmon, albacore tuna and mackerel.
- Limit alcohol, if you drink, to no more than one drink a day for women; two drinks a day for men. Always drink plenty of water.
- Get regular physical activity
At least 30 minutes of any physical activity most every day can increase good HDL cholesterol, help you lose weight and, in turn, lower your LDL cholesterol and blood pressure. Moderately intense activities include dancing, bowling, gardening, house cleaning or golfing without a cart. Three, 10-minute sessions are as helpful as 30 minutes at one time.
- Maintain a healthy weight
Excess pounds increase your cholesterol by increasing your LDL (bad cholesterol) and lowering your HDL (good cholesterol). Too much weight also dramatically increases your risk of having diabetes, high blood pressure, heart disease, strokes, gout and many types of cancer. To control your weight:
- Slow down your meals and chew slowly. Set your fork down between bites. It takes your brain 15 minutes to know you’ve eaten something and to feel full.
- Slowly decrease your portion sizes; try using smaller plates and bowls so make portions look larger.
- Eat more fruits and veggies. They provide a sense of fullness without the calories and fat.
- Don’t skip meals because it causes you to overeat. Skipping meals slows your metabolism so you’re burning fewer calories, making it harder to lose weight. Eating four to six small meals helps control weight better than two or three regular meals.
- Identify your overeating triggers, such as eating when stressed, watching TV or eating out with friends. Avoid your triggers by focusing on another activity or monitor what you eat when triggers occur.
- Quit tobacco
Smoking damages your blood vessels, speeds up hardening of the arteries and increases your heart disease risk.
Check with your doctor about medications and other resources that can help you quit for good. If you’re ready to quit smoking, visit Be Well Arkansas website or call 833-283-9355. You’ll learn about free options to help you quit smoking and maintain a tobacco-free life. At this site, you can chat with a wellness counselor, get a doctor referral for medications, sign up for motivational text messaging, get smoke free apps and more. This is a healthy alternative that uses proven, evidence-based ways to help you quit. Another source is here.
- Ask about statin therapy
Statin drugs are highly effective in lowering LDL and preventing heart disease. See your doctor regularly so he or she can monitor your cholesterol levels. Your doctor will counsel you about ways to improve your cholesterol numbers. But if lifestyle changes (eat healthy, exercise more and stop smoking) don’t lower your numbers, the doctor may put you on a statin to lower cholesterol. Statin drugs are especially important for people who already have heart disease due to hardening of the arteries, type 2 diabetes, a family history of high cholesterol and/or heart disease or stroke, have a very high LDL cholesterol level and are over age 40. Take medicine exactly at your doctor prescribes.
- Get to know your numbers
Finally, we get to the numbers. Your doctor may have different targets for you, but the following general goals from the National Institutes of Health provide goals to work towards:
- Total cholesterol level: Less than 200 mg/dL is a desirable and normal level; 240 mg/dL and above is too high
- LDL level: less than 100 mg/dL is best; over 160 mg/dL is too high
- HDL level: greater than 40 mg/dL is best; less than 40 mg/dL is too low
- Triglycerides: less than 150 mg/dL is best
Cholesterol can be dangerous. But it can also be controlled with better lifestyle choices or statin drugs. The choice is yours!
Photo by Ralwel iStock / Getty Images Plus
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