Cholesterol: You can't live with (too much of) it, but you can't live without it. High levels are a risk factor for heart disease, yet we need this fat-like substance--manufactured by the liver and also found in the animal products we eat--to make hormones, vitamin E and bile acids in the body. Knowing what your cholesterol levels are, working with your doctor and making wise diet and lifestyle choices to get or keep levels within a healthy range can help keep your ticker ticking for the long haul.
The Big Picture
"Although cholesterol has a functional role in the body, a high blood level may lead to atherosclerosis [a buildup of plaque in the arteries] and coronary heart disease," says Sari Greaves, RD, CDN, spokeswoman for the American Dietetic Association and contributing author of "The Cardiac Recovery Cookbook". But, Greaves adds, "high cholesterol alone is not the only culprit in heart disease. A cluster of additional risk factors can increase your risk of heart disease. [These] include smoking, high blood pressure, diabetes, being overweight or obese, and physical inactivity."
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It's true that genetics can be the culprit in high cholesterol and heart disease, but the above risk factors can be altered through healthy lifestyle changes. In terms of cholesterol, a good place to start is by determining your blood levels with a fasting lipoprotein profile. This test is recommended by the American Heart Association for all adults 20 or older; it should be done every five years (more often if you have levels that put you at higher risk of heart disease, or if you're a man over 45 or a woman over 50).
Are You at Risk?
A fasting lipoprotein profile measures your levels of total blood cholesterol, as well as HDL (also known as "good" cholesterol), LDL ("bad" cholesterol) and triglycerides (fat in the blood from diet and from the body's fat stores). Generally speaking, total cholesterol levels of less than 200 mg/dL (deciliter of blood) are desirable, while levels of 200 to 239 are considered borderline high-risk and levels of 240 mg/dL and higher are equated with high risk. In fact, people in the high range typically have twice the risk of coronary heart disease as people with desirable total levels.
Your LDL cholesterol level is considered an even better gauge of heart disease risk than total blood cholesterol, Greaves notes. "The lower your LDL cholesterol, the lower your risk of heart attack and stroke." She recommends using the following LDL cholesterol levels to understand your level of risk.
| LDL Cholesterol Levels | Risk |
| Less than 100 mg/dL | Optimal |
| 100 to 129 mg/dL | Near Optimal/Above Optimal |
| 130 to 159 mg/dL | Borderline High |
| 160 to 189 mg/dL | High |
| 190 mg/dL and above | Very High |
When it comes to HDL levels, higher numbers are desirable. Levels of 40mg/dL for men and less than 50 mg/dL for women actually increases heart disease risk, while HDL levels of 60 mg/dL can help stave it off.
"Smoking, being overweight and being sedentary can all result in lower HDL cholesterol," Greaves says. "To raise your HDL level, avoid tobacco smoke, maintain a healthy weight and get at least 30 to 60 minutes of physical activity more days than not."
She also points out that people with high blood triglycerides usually also have lower HDL cholesterol and a higher risk of heart attack and stroke. "Progesterone, anabolic steroids and male sex hormones [testosterone] also lower HDL cholesterol levels, while female sex hormones raise them." A dietitian can help those with high triglycerides devise a healthy plan to lower them.
If your cholesterol screening indicates high levels of LDL and low levels of HDL, learn about your cholesterol treatment options in order to get those numbers into shape.
About the Author
Liz Brown is a health, nutrition and travel writer based in Portland, Oregon. She holds a B.S. degree in Nutrition and is co-author (with Chris Meletis, N.D.) of the book "Enhancing Fertility: A Couple's Guide to Natural Approaches " (Basic Health Publications, Inc., 2004). Brown is also a Spa magazine contributing editor.
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