What is cholesterol and why should you care

in Well-being

High cholesterol levels can lead to heart disease and stroke

Watch those fats!

For years we’ve been hearing about cholesterol and fat – “good” cholesterol, “bad” cholesterol, the dangers of high cholesterol. LDL, HDL, saturated fats, trans fats and monosaturated fats. And for most of us, it’s all enough to make our heads – and stomachs — spin. What exactly is cholesterol and why is high cholesterol dangerous? And how would I know if I had high cholesterol?

Let’s answer those questions one by one:

What is cholesterol?

Cholesterol is a form of fat your body uses to make cell membranes, vitamin D and hormones. The liver makes about 80 percent of the body’s cholesterol, the remainder comes from fats contained in the food we eat.

Cholesterol can’t dissolve in the blood. It has to be transported to and from the cells by carriers called lipoproteins. Low-density lipoprotein, or LDL, is known as “bad” cholesterol. High-density lipoprotein, or HDL, is known as “good” cholesterol. These two types of lipids, along with triglycerides and Lp(a) cholesterol, make up your total cholesterol count, which can be determined through a blood test.

What is LDL (bad) Cholesterol?

When too much LDL (bad) cholesterol circulates in the blood, it can slowly build up in the inner walls of the arteries that feed the heart and brain. Together with other substances, it can form a thick, hard deposit called plaque that can narrow the arteries and make them less flexible. This condition is known as atherosclerosis. If a clot forms and blocks a narrowed artery, heart attack or stroke can result.

What is HDL (good) Cholesterol?

About one-fourth to one-third of blood cholesterol is carried by high-density lipoprotein (HDL). HDL cholesterol is known as “good” cholesterol, because high levels of HDL seem to protect against heart attack. Low levels of HDL (less than 40 mg/dL) also increase the risk of heart disease. Medical experts think that HDL tends to carry cholesterol away from the arteries and back to the liver, where it is passed from the body. It’s also believed that HDL removes excess cholesterol from arterial plaque, thus slowing its buildup.

All about triglycerides

Triglyceride is a form of fat made in the body. Elevated triglycerides can be due to overweight/obesity, physical inactivity, smoking, excess alcohol consumption, and a diet very high in carbohydrates (60 percent of total calories or more). People with high triglycerides often have a high total cholesterol level, including a high LDL (bad) level and a low HDL (good) level. Many people with heart disease and/or diabetes also have high triglyceride levels.

And then there’s Lp(a) cholesterol

Lp(a) is a genetic variation of LDL (bad) cholesterol. A high level of Lp(a) is a significant risk factor for the premature development of fatty deposits in arteries. Lp(a) isn’t fully understood, but it may interact with substances found in artery walls and contribute to the buildup of fatty deposits.

How do I know if my cholesterol levels are normal?

The only way to know if your cholesterol levels are normal or abnormal is through a blood test. Many doctors routinely test for cholesterol during a patient’s annual physical, but if you’re unsure, ask to be tested.

Who should be tested?

The latest Canadian Cholesterol Guidelines recommend testing for:

  • men over 40 years of age
  • women over 50 years of age
  • postmenopausal women (of any age)
  • people with diabetes
  • people who are overweight – especially those who carry their weight around their
  • smokers
  • people who have high blood pressure
  • those with a family history of heart disease at an early age
  • people with physical signs of high cholesterol, such as yellow lesions under the
    skin or a grey ring around the cornea (the transparent layer that covers the eye)
  • people with atherosclerosis (narrowing and hardening of the arteries)

High cholesterol is very common. It‘s estimated that about 48 percent of Canadian men and 43 percent of Canadian women have high cholesterol.

What should my optimal levels be?

The results of your cholesterol blood test are in five parts:

  1. LDL cholesterol — this should be less than 3.5 mmol.L
  2. HDL cholesterol – this should b higher than 1.0 mmol/L for men and 1.3 mmol/L for women
  3. Triglycerides – should be less that 1.7 mmol/L
  4. Total cholesterol/HDL cholesterol ratio — should be less than 5.0 mmol/L
  5. Total cholesterol that should be less that 5.2 mmol/L. The higher your total cholesterol, the higher your risk of heart attack and stroke.

How do I prevent high cholesterol or bring my cholesterol down?

Lifestyle changes are the first line of defense against high cholesterol. To promote healthy cholesterol levels:

  • Lose excess pounds
    Losing even five to 10 pounds of excess weight can help lower total cholesterol levels.
  • Eat heart-healthy foods
    Use Canada’s Food Guide to Healthy Eating to plan a healthier diet. Eat more whole grains, cereals, vegetables and fruit. Fruits and vegetables are rich in dietary fibre, which can help lower cholesterol.
  • Cut the fat
    Reduce your fat intake to 20 to 35 percent of your daily calories. Limit your intake of saturated fats and avoid trans fats completely. Saturated fats, found mainly in red meat and high-fat dairy products, and trans fats, derived from a chemical process known as “partial hydrogenation” are found in vegetable shortenings, some margarines, crackers, cookies, snack foods, and other foods made with or fried in partially hydrogenated oils, raise your total cholesterol and LDL cholesterol. Monounsaturated fat – found in olive, peanut and canola oils – is a healthier option.
    Also try to avoid fried foods. Use lower-fat cooking methods such as baking,
    broiling or steaming.
    Snack wisely. Choose low-salt pretzels, plain popcorn or fruit, rather than higher-fat
    or “junk food” types of snacks.
  • Limit your cholesterol intake
    Aim for no more than 300 milligrams of cholesterol a day – or less than 200 mg if you have heart disease. The most concentrated sources of cholesterol include organ meats, egg yolks and whole milk products. Use lean cuts of meat, egg substitutes and skim milk instead.
  • Select whole grains
    Choose whole-grain breads, whole-wheat flour and brown rice. Oatmeal and oat bran are other good choices.
  • Eat fish
    Some types of fish – such as cod, tuna and halibut – have less total fat, saturated fat and cholesterol than do meat and poultry. Salmon, mackerel and herring are rich in omega-3 fatty acids, which help promote heart health.
  • Drink in moderation
    If you choose to drink, do so in moderation – no more than one drink a day for women, and one to two drinks a day for men.
  • Exercise regularly
    Regular exercise can help improve your cholesterol levels. With your doctor’s OK, work up to 30 to 60 minutes of exercise a day.
  • Don’t smoke
    If you smoke, stop. Smoking increases HDL cholesterol. And the benefits don’t end there. Just 20 minutes after quitting, your blood pressure decreases. Within 24 hours, your risk of a heart attack decreases. Within one year, your risk of heart disease is half that of a smoker’s. Within 15 years, your risk of heart disease is similar to that of someone who’s never smoked.

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