Lowering Cholesterol

What is Cholesterol?

Cholesterol is a soft, fat-like, waxy substance found in the bloodstream and in all your body’s cells. It’s normal to have cholesterol. It’s an important part of a healthy body because it’s used for producing cell membranes and some hormones, and serves other needed bodily functions. But too high a level of cholesterol (called Hyperlipidemia) in the blood is a major risk for coronary heart disease, which leads to atherosclerosis (hardening and narrowing of the arteries) in which fatty deposits (plaque) build up in the arteries, restricting and disrupting bloodflow leading to heart attack and stroke.

Good and Bad Cholesterol

Cholesterol has many components but the three most important are:Â

  • LDL-L Low-Density Lipoprotein. LDL is referred to as “bad” cholesterol; high levels may form fatty deposits in the arteries
  • HDL-J High-Density Lipoprotein. HDL is referred to as “good” cholesterol; it helps to remove excess LDL from the bloodstream.
  • Trliglycerides – Triglycerides–another form of fat in your blood

How to Diagnose High Cholesterol?

A laboratory blood test is necessary to give an accurate check of cholesterol levels. Generally, a blood sample is taken from the arm after the patient has fasted (gone without food) for at least 8-12 hours.

What is considered High Cholesterol?

Total Cholesterol Level

  • Less than 200 is best.
  • Between 200 to 239 is borderline high.
  • 240 or more means you’re at increased risk for heart disease

LDL Cholesterol Level

  • Less than 130 is best.
  • Between 130 to 159 is borderline high.
  • 160 or more means you’re at increased risk for heart disease

HDL Cholesterol Level

  • Less than 40 means you’re at increased risk for heart disease
  • 60 or higher reduces your risk of heart disease

Lower LDL and higher HDL are recommended if patient also other risk factor of heart diseases, like, diabetes, hypertension, smoking history, excessive alcohol, family history of heart disease, increased age, obesity and lack of exercise

What Affects Cholesterol Level?
A variety of things can affect cholesterol levels. These are things you can do something about:
  • DIET
    Saturated fat
    and cholesterol in the food you eat make your blood cholesterol level go up. When you think of “bad” fats, think saturated. Most saturated fats can increase your blood cholesterol levels and risk of coronary artery disease. Usually solid or waxy at room temperature, saturated fat is most often found in animal products — such as red meat, poultry, butter, egg yolks and whole milk. Other foods high in saturated fat include coconut, palm and other tropical oils.
    Trans fat Along with saturated fat, trans fat may raise your blood cholesterol levels and increase your risk of heart disease. Trans fat — also referred to as trans-fatty acids — comes from adding hydrogen to vegetable oil through a process called hydrogenation. This makes the fat more solid and less likely to turn rancid. Hydrogenated fat is a common ingredient in commercial baked goods — such as crackers, cookies and cakes — and in fried foods such as doughnuts and french fries. Shortenings and some margarines are high in trans fat. Look for the words hydrogenated or partially hydrogenated in the list of ingredients to see if trans fat is included. Some margarine labels state if the product has no trans-fatty acids.
    Polyunsaturated fat.
    Usually liquid at room temperature and in the refrigerator, polyunsaturated fats — when used instead of saturated fats — help lower blood cholesterol levels. In addition, they may help reduce the amount of cholesterol deposits on your arteries. Foods high in polyunsaturated fats include vegetable oils such as safflower, corn, sunflower, soy and cottonseed oils.

    One type of polyunsaturated fat — omega-3 fatty acids — may be especially beneficial to your health. Omega-3 fat appears to decrease your risk of heart attack, protect against irregular heartbeats and lower blood pressure levels. It may even protect against some cancers. You’ll find omega-3s mainly in fish — particularly in fatty, cold-water fish, such as salmon, mackerel and herring. Lesser amounts are in flaxseeds, soybeans and canola oil.You can get sufficient omega-3 fatty acids by consuming two to three servings of fish per week. Pregnant women and women who plan to become pregnant during the next few years should limit their weekly intake of cold-water fish because of possible mercury contamination.

    Being overweight is a risk factor for heart disease. Excess body weight can contribute to high cholesterol and most importantly to high triglycerides and low HDL cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.

    Being overweight can create a more serious risk factor for health problems depending on how you carry the extra weight. If you carry most of your fat around your waist or upper body, you may be referred to as apple-shaped. If you carry most of your fat around your hips and thighs or lower body, you may be referred to as pear-shaped. Generally, when it comes to your health, it’s better to have the shape of a pear than the shape of an apple. If you have an apple shape — a potbelly or spare tire — you carry more fat in and around your abdominal organs. Fat in your abdomen increases your risk of many of the serious conditions associated with obesity. A woman’s waist should measure less than 35 inches. A man’s waist should be less than 40 inches.
    Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.
    As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL levels tend to rise.
    Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families. If a close family member (parent or sibling) has developed atherosclerosis before age 45, high cholesterol levels place you at a greater-than-average risk of developing atherosclerosis.
    Cigarette smoking damages the walls of your blood vessels, making them likely to have cholesterol rich plaques rupture and have heart attacks. Smoking may also lower your level of HDL cholesterol by as much as 15 percent.
Tips on Lowering Your Cholesterol

Lifestyle changes – Diet

  • Reduce the intake of saturated fat (e.g., hamburgers, hot dogs, and other animal fats) and the total amount of fat in your diet to 25%-35% of total calories – with no more than 7% of fat calories coming from saturated fats.
  • Eat at least five servings of fruits and vegetables every day.
  • Eat fish, poultry without skin and leaner cuts of meat instead of fatty ones.
  • Eat fat-free or 1% milk dairy products rather than whole-milk dairy products.
  • Eat food with soluble fiber which include oat bran, oatmeal, beans, peas, rice bran, barley, citrus fruits, strawberries and apple pulp
  • Bake, steam, roast, broil, stew, or boil instead of frying. This helps remove fat.
  • Use a nonstick pan with vegetable cooking oil spray or a small amount of liquid vegetable oil instead of lard, butter, shortening, or other fats that are solid at room temperature

Lifestyle changes – Exercise

  • Get involved in activities such as brisk walking, jogging, bicycling or cross-country skiing.
  • Gradually work up to exercising for 30 minutes to 45 minutes at least 3-4 times a week
  • Stick with your exercise program.

Medical Therapy

Depending on your risk factors, if healthy eating and exercise don’t work after about 6 months to 1 year, your doctor may suggest medicine to lower your cholesterol level.

Several types of medications are used to lower your cholesterol: Bile Acid Sequestrants, Fibrates, HMG-CoA Reductase inhibitors (Statins), Nicotinic Acid derivatives and Cholesterol absorption inhibitors. Your doctor will decide which type of medicine is right for you.

Common Misconceptions
  • Vegetables have cholesterol in them. False. Cholesterol is produced in liver and is only found in animal. Plants do not have cholesterol because they do not have liver.
  • People should eat as much unsaturated fat as possible. False. There should not be no more than 30% of calories in an adult diet from fats.
  • Using margarine instead of butter will help lower my cholesterol. Most soft or liquid margarines have less saturated fat and so are preferable to the stick forms for a heart-healthy diet. However, both margarine and butter are high in fat, so use both in moderation.
  • Since I started taking medication for my high cholesterol, I don’t have to worry about what I eat. Unless your cholesterol is dangerously high, it’s best to try to reduce it by changing your diet. Modern medications have come a long way in helping to control blood cholesterol levels, but making lifestyle changes along with taking medication is the best way to help prevent heart disease. Reducing the amount of saturated fat and cholesterol in your diet and getting 30–60 minutes of exercise on most or all days of the week is recommended, even if you’re taking cholesterol-lowering medication.
  • You don’t need to have your cholesterol checked until you reach middle age. It’s a good idea to start having your cholesterol checked at an early age. Even children, especially those in families with a history of heart disease, can have high cholesterol levels. And evidence exists that these children are at greater risk for developing heart disease as adults. Lack of exercise, poor dietary habits and genetics can all affect a child’s cholesterol levels. You’re never too young to develop a heart-healthy lifestyle by eating foods low in fats, getting 30–60 minutes of physical activity on most or all days, and avoiding tobacco products
  1. Cholesterol Counts for Everyone (National Heart, Lung, and Blood Institute)
  2. Cholesterol (American Heart Association)
  3. Managing Cholesterol (Patient Education Institute) An interactive cholesterol learning tutorial – requires Flash plug-in
    Also available in: Spanish – *** excellent source
  4. What Are Healthy Levels of Cholesterol? (American Heart Association)
  5. Nutrition.gov. An excellent resource, provides easy access to all online federal government information on nutrition, healthy eating, physical activity, and food safety, easily accessible in one place. *** excellent source
  6. 10 Year Risk Calculatoronline calculator
  7. Interactive Menu Planner – NIHonline calculator
  8. Body Mass Index Calculatoronline calculator
  9. Create a Diet – Interactive tool to create online diet for health.

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About the Author: Adarsh Gupta