Noyes News and Events

September 8, 2017

Understanding Cholesterol

 

High cholesterol is a sneaky thing.  It does not happen overnight, there are no symptoms, and unless you get a blood test, there is no way to know if you have it.  However, it can lead to heart disease the number one killer in the U.S.  People with high total cholesterol have approximately twice the risk for heart disease as people with optimal levels. Overtime, too much cholesterol in your system clogs the arteries, narrows the channel for blood flow, and puts you at risk for heart disease and stroke.  More than 102 million American adults (20 years or older) have total cholesterol levels above 200 mg/dL, which is above healthy levels and an additional 35 million have levels of 240 mg/dL, which puts them at risk for heart disease.  Moreover, many factors potentially affect cholesterol such as genetics, diet, activity level, and other chronic diseases.  

Cholesterol is a waxy, fat-like substance found naturally in our bodies and in many foods, like meat and dairy products. Your body, mainly your liver, produces 75 percent of your cholesterol and your small intestine aids in both the creation and absorption of cholesterol.   In addition, your diet can add 300 to 500 mg or more of cholesterol.  A simple blood test called a lipoprotein profile can measure your total cholesterol levels, including LDL (low-density lipoprotein, or "bad" cholesterol), HDL (high-density lipoprotein, or "good" cholesterol), and triglycerides. LDL cholesterol makes up the majority of the body’s cholesterol. LDL is “bad” cholesterol because high levels lead to plaque buildup in your arteries and result in heart disease. HDL cholesterol, on the other hand, absorbs cholesterol and carries it back to the liver, which flushes it from the body. HDL is “good” cholesterol because high levels reduce the risk for heart disease and stroke.  Triglycerides are a type of fat found in your blood that your body uses for energy. The combination of high levels of triglycerides with low HDL cholesterol or high LDL cholesterol can increase your risk for heart attack and stroke.

Because high cholesterol has no symptoms, it is important to go to the doctor and get blood drawn for the lipoprotein profile.  If you are 20 years or older and have not been diagnosed with heart disease, the CDC recommends your cholesterol be checked every 5 years.  All children and adolescents should have their cholesterol checked at least once between the ages of 9 and 11 years, and again between ages 17 and 21 years.  People of any age (including children) who are overweight/obese, have a family history of high cholesterol, a family history of heart disease, diabetes, high blood pressure, or certain chronic conditions (chronic kidney disease, chronic inflammatory diseases, congenital heart disease, and childhood cancer survivorship) should be checked more often.  When the bloodwork results are in, your numbers will fall somewhere in this chart:

Total Cholesterol Level

Category

Less than 200mg/dL

Desirable

200-239 mg/dL

Borderline high

240mg/dL and above

High

 

 

LDL (Bad) Cholesterol Level

LDL Cholesterol Category

Less than 100mg/dL

Optimal

100-129mg/dL

Near optimal/above optimal

130-159 mg/dL

Borderline high

160-189 mg/dL

High

190 mg/dL and above

Very High

 

 

HDL (Good) Cholesterol Level

HDL Cholesterol Category

Less than 40 mg/dL

A major risk factor for heart disease

40—59 mg/dL

The higher, the better

60 mg/dL and higher

Considered protective against heart disease

Source:  National Heart, Lung, and Blood Institute

 
 

 

Doctors, however, look at more than just the cholesterol numbers.  Your physician will look at other risk factors for heart disease such as cigarette smoking, hypertension (high blood pressure), low HDL (good) cholesterol, family history of premature heart disease, fasting blood glucose level,  gender, and age.  Combining all these factors, your doctor will determine if you need a therapeutic lifestyle change (TLC) including diet, weight management, and increased physical activity or if you need TLC with medication to control your cholesterol.   

To maintain healthy cholesterol levels and help prevent heart disease, the CDC and the American Heart Association recommend the following:

  • Don’t smoke.  If you do smoke, quit.  For help quitting, call the NYS Smoker’s quit line at 1-866-697-8487 or visit www.nysmokefree.com.  Locally, call UR Medicine Noyes Health at 585-335-4327 or email lwichtowski@noyeshealth.org.

  • Know what NOT to eat.  What you eat can affect your LDL cholesterol.  Avoid or limit foods high in saturated or trans fats.  The majority of saturated fat comes from animal products such as beef, lamb, pork, poultry with skin, butter, cream, cheese and other dairy products made from whole or 2 percent milk. Trans fats (or trans fatty acids) are created in an industrial process that adds hydrogen to liquid vegetable oils to make them more solid. Another name for trans fats is “partially hydrogenated oils." Trans fats are in many fried foods and baked goods such as pastries, pizza dough, piecrust, cookies and crackers.  Avoid fast food.   One should also eliminate or severely limit all sugary drinks including soda, fancy coffee drinks with added sugar and dairy, and fruit juice.  

  • Know what to eat.  The vast majority of your diet should include fruits, vegetables, whole grains (oats, barley, brown rice, quinoa, buckwheat, popcorn, whole-wheat crackers, pasta, or tortillas), low-fat dairy products, poultry, fish, beans, and nuts.  

  • Exercise regularly.  Regular physical activity can lower LDL (bad) cholesterol and raise HDL (good) cholesterol.  Adults should be physically active for at least 2 ½ hours each week – that breaks down to about 20 minutes a day of walking, biking, dancing, running, yoga…you choose!   

Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville, NY.  For article suggestions or questions, contact Lorraine at lwichtowski@noyeshealth.org or 585-335-4327.