TriVita Asks, “Is Cholesterol Bad?”
Summary: Cholesterol and Your Heart: Where Do We Stand?
by Dr Brazos Minshew
Cholesterol. This article will explain the relationship between high cholesterol and heart disease, describe the different types of cholesterol, and review several ways to lower a high cholesterol level, including exercise, a low-fat diet, and medication.
What is Cholesterol?
Cholesterol, judging from the thousands of food labels and TV commercials boasting “zero cholesterol” has quite a bad reputation. Cholesterol is a vital component of all cell membranes. Unfortunately, too high a concentration of cholesterol in the blood is associated with an increased risk of heart disease. A high cholesterol level is one of many risk factors for developing heart disease.
Where Does Cholesterol Come From?
Most of the cholesterol circulating in your blood is made in the liver from fat metabolism. Dietary cholesterol comes from animal products such as meat, milk, cheese and butter.
Cholesterol and fat are transported through the bloodstream in particles called lipoproteins, which are so named because they contain different proportions of lipid (fat) and protein molecules. Chylomicrons carry triglycerides (fat from the foods you eat) from the intestine to body tissues, where they are used for energy or stored as fat.
LDLs (Low Density Lipoproteins) are stuffed full of cholesterol. They hold about two-thirds of all the cholesterol in the blood. These particles, nicknamed “bad” cholesterol, are partially responsible for forming plaque (debris) along blood vessel walls. The more LDLs you have, the greater your risk of getting coronary artery disease or a heart attack.
HDLs (High Density Lipoproteins) are known as “good” cholesterol. Cholesterol and Heart Disease
Increased levels of cholesterol in the blood can contribute to atherosclerosis, which is the gradual build-up of cholesterol, fat, and fibrous debris along the walls of your arteries. In the heart arteries called coronary arteries this can lead to chest pain or angina when someone exerts themselves.
What’s Your Risk?
A high level of blood cholesterol is associated with an increased risk of heart disease. But unlike other risk factors for heart disease that you can’t change or modify, such as age, sex, or a family history of heart disease, you can lower a high cholesterol level. The more risk factors you have, the greater your chances of developing heart disease.
Know Your Numbers
Cholesterol levels can be measured with a simple blood test. The higher the ratio (high total cholesterol, low HDL cholesterol), the greater your risk for coronary heart disease. Your doctor can help assess the degree of risk associated with your particular cholesterol values:
| Lab Test | Desirable | Borderline | High Risk |
| Total Cholesterol | less than 200 mg/dL
(5.2 mmol/L) |
200-239 mg/dL
(5.2-6.1 mmol/L) |
more than 240 mg/dL
(6.2 mmol/L) |
| LDL Cholesterol | less than 130 mg/dL
(3.4 mmol/L) |
130-159 mg/dL
(3.4-4.0 mmol/L) |
more than 160 mg/dL
(4.1 mmol/L) |
| HDL Cholesterol | More than 39 mg/dL
(1.0 mmol/L) |
n/a | less than 40 mg/dL
(1.0 mmol/L) |
| Triglycerides | less than 250 mg/dL
(2.8 mmol/L) |
n/a | more than 250 mg/dL
(2.8 mmol/L) |
| Ratio of total Cholesterol:HDL | less than 3.5 | 3.6-4.9 | more than 5 |
Ways to Lower Cholesterol
Is your cholesterol or ratio of cholesterol to HDL too high? The most effective ways to lower cholesterol and reduce your risk of heart disease include exercise, a low-fat diet and medication.
Exercise keeps your heart and blood vessels healthy. Exercise raises HDL, the “good” cholesterol.
The National Cholesterol Education Program’s (NCEP) dietary guidelines for lowering cholesterol have focused on lowering total fat, which often ends up increasing carbohydrate in the diet. Some nutrition experts have demonstrated that certain people on this diet may actually lower their HDL cholesterol, the “good” cholesterol. This often leaves the ratio of cholesterol to HDL unchanged. Other dietary guidelines include lowering cholesterol intake, changing the type of fat you eat, and increasing fiber.
General Tips for a Cholesterol-Conscious Diet
Reduce Total Fat
Depending on your cholesterol profile, a reduction in total fat may be beneficial. Less fat in the diet means that there is less “raw material” for the liver to use in making cholesterol. Reduce Saturated Fat
The type of fat you eat is just as important as how much you eat. Since the liver makes cholesterol more efficiently from saturated than unsaturated fat, changing the type of fat you eat can help to lower your cholesterol. Reduce Partially Hydrogenated Fats or Trans Fats.
To prolong the shelf life of foods, particularly margarine, snack foods and baked products, manufacturers use liquid vegetable oils, which have been partially hardened to form trans fats. Eating a diet containing these products has been associated with an increased risk of cardiovascular disease. Many foods now specify their content of trans fats; reading food labels can help you avoid these substances
Increase Polyunsaturated Fats
The type of fat found in fatty fish like salmon, mackerel and tuna is particularly healthful. Since bile, a substance that helps digest fat, is made primarily of cholesterol, excreting it will help lower total cholesterol levels. Intriguing research has shown that the vegetable protein in soy may be able to lower blood cholesterol.
A registered dietitian (RD) can help you plan a cholesterol-modifying diet that’s appropriate for your weight, height, activity level, and blood cholesterol profile.
Source: TriVita Article Cholesterol and Your Heart: Where Do We Stand?





