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UAMS Women's Health Services
9 Things You Need to Know About Cholesterol

You’ve heard warnings about high cholesterol rates, but do you really know what cholesterol is? And why should you care about it?

High levels of “bad” cholesterol contribute to heart disease, which kills more Americans than all cancers combined. “Good” HDL cholesterol rates have been tied to lower risk of cancer.
Why is a high cholesterol level unhealthy?
Cholesterol causes a problem only when you have too much of it in your blood. Excess cholesterol is deposited in the lining of the arteries, including the arteries that feed your heart muscle. This narrows the area inside the artery, through which blood flows.
“High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high,” says Amy Phillips, one of our OB/GYN doctors at UAMS
What is cholesterol?
Cholesterol is a waxy, fatlike substance that your body -- mainly the liver -- produces. Cholesterol is used to make some hormones, vitamin D and bile acids, which help to digest fat.
Cholesterol also is used to build healthy cell membranes (walls) in the brain, nerves, muscles, skin, liver, intestines and heart. It only takes a small amount of cholesterol to meet all these needs. Your body makes enough; you don’t have to get cholesterol in your diet.

When should I have my cholesterol checked?
The National Cholesterol Education Program (NCEP), an expert group of doctors and scientists affiliated with the National Institutes of Health, recommends that all people older than age 20 have a cholesterol test every 5 years.

An adult who is being treated for high cholesterol may need more frequent tests, depending on his or her cholesterol level and the type of treatment being used.

An adult who has coronary artery disease should have a cholesterol test at least once a year.

Most adults who have diabetes should be tested at least once a year.
How is my cholesterol checked? 
The most accurate test is a lipid profile, a blood test given after fasting for nine to 12 hours. The test will give you these details:
  • Your total cholesterol.
  • Your LDL ("bad") cholesterol; this cholesterol is what's deposited in your arteries.
  • Your HDL ("good") cholesterol; this cholesterol helps keeps deposits from building up in your arteries.
  • Your triglycerides; these are another form of fat in your blood.
Even without a lipid profile, you can get a rough idea of your cholesterol health if you know your total cholesterol and HDL cholesterol. These levels can be determined through a non-fasting cholesterol test often given at shopping malls or health fairs.
If your total cholesterol is 200 mg/dL or more, or if your HDL cholesterol is less than 40 mg/dL, you should ask your doctor about getting a complete lipoprotein profile.

What do the numbers mean?
Total cholesterol
A total cholesterol level of 200 mg/dL to 239 mg/dL is considered borderline high; 240 mg/dL and above is high.

“Good” -- HDL (high-density lipoprotein) cholesterol
An HDL level of less than 40 mg/dL is low; 40 to 59 mg/dL is satisfactory but not optimal; 60 mg/dL and above is considered optimal. The higher your HDL cholesterol, the better, because it helps protect against heart disease.

“Bad” -- LDL (low-density lipoprotein) cholesterol
A high LDL is anything above 130 mg/dL. An LDL level of 130 to 150 mg/dL is considered borderline high; 160 mg/dL and above is high to very high.
For people with known heart disease, the cholesterol level targets are more stringent; ask your doctor what they are. Having a high level of LDL cholesterol can cause fatty plaque to form along the insides of your artery walls. This makes the arteries narrower and stiffer. Narrower arteries mean less room for blood to flow through -- like a partially clogged pipe. This process, called atherosclerosis, develops over a long time. It is especially dangerous if it narrows the vessels to the heart and brain, creating a major risk for heart attack and stroke. Build-up of cholesterol in the arteries of the legs can cause leg and foot pain and trouble walking.

What causes high cholesterol?
Heredity is the main factor determining your cholesterol. Then, depending on your genetic makeup, your diet is next in line as a risk factor for high cholesterol. Foods containing cholesterol, saturated fats or trans-fats all contribute to your total cholesterol pool.
People with the right genes to handle cholesterol usually have no problem handling a regular fatty diet. But for a large portion of the population, a bad diet drives the cholesterol up. 

Many foods that come from animals are high in both saturated fat and cholesterol. Some non-animal foods also are high in saturated fat; these include foods made with coconut and palm oils and trans-fats, or hydrogenated vegetable oils like shortening and margarine.

These are other factors that influence your cholesterol levels:
  • Weight. Being overweight usually raises your LDL cholesterol. Losing weight may lower your LDL level as well as your triglycerides, and losing weight may also boost your HDL cholesterol. 
  • Exercise. Getting regular exercise may lower your LDL cholesterol and raise your HDL cholesterol.
  • Age and gender. Until menopause, women usually have lower total cholesterol levels than those of men. After age 50, women often have higher total cholesterol levels than men of the same age. For both men and women, total cholesterol levels rise until about age 65.
  • Alcohol. Although alcohol boosts HDL cholesterol, it has no effect on LDL cholesterol, and excessive alcohol consumption raises triglycerides. 
  • Stress. Long-term stress can raise cholesterol levels, although this may be because some people try to ease their stress by eating fatty foods (fatty foods boost cholesterol levels).
  • Anger can raise cholesterol rates, so take steps to learn to have a healthy mental lifestyle too.
The main goal of cholesterol-lowering treatment is to lower your LDL level enough to reduce your risk for developing heart disease or having a heart attack. The higher your risk, the lower your LDL goal will be.

What should you eat?
To eat a heart-healthy diet, you need to cut down on foods high in saturated fats, like fried foods, red meat, processed meats (cold cuts and hot dogs), some kinds of cheese and most commercially prepared baked goods (muffins, cookies, doughnuts).

Fish is a good choice for a healthy diet. You should also eat more vegetables, fruit and whole grains like oatmeal and barley. They contain fiber, which fills you up, and also limit your fat intake while still giving you the nutrients you need.
Healthy Menus for Calorie Counting

If you eat red meat, decrease the fat without giving up flavor by decreasing the amount of meat, serving smaller portions, selecting a lean cut of meat and trimming the fat before cooking. 
Other tips for reducing cholesterol
Drink black or green tea, which has powerful antioxidants.

Exercise. Regular physical activity -- 30 to 60 minutes on most, if not all days -- is recommended for everyone. 

Maintain a healthy weight. Losing weight if you are overweight can lower your LDL cholesterol. 

Control your blood pressure.

Don't smoke.

Consider medications. If your cholesterol level remains high (over 240 mg/dL) six months after you change your lifestyle, ask your doctor about available medications that can lower your cholesterol by 25 to 60 percent. 

Should I check my child’s cholesterol levels?
The American Academy of Pediatrics (AAP) recommends that all children be screened for high cholesterol between ages 9 and 11, and again between ages 17 and 21.
Children should be screened regardless of family history, the AAP says. In addition, the AAP and the National Heart, Lung, and Blood Institute recommend that children at 10 years old (or when puberty begins) who have risk factors such as overweight, obesity, or a family history be tested for type 2 diabetes. This test looks at fasting glucose levels. Learn more. 

To learn more, please visit the UAMS Health Library.

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