Cholesterol plays a key role in maintaining health. It’s important for cellular maintenance, digestion and hormone production. It only becomes problematic when cholesterol levels – and particularly LDL cholesterol – become too high. But the consequences of high cholesterol can be severe.
Cholesterol is a substance produced by the liver that has a waxy texture and moves through the bloodstream by attaching to a fatty substance called lipoprotein. Low-density lipoprotein (LDL) is sometimes called “bad cholesterol,” and high amounts are associated with adverse health effects. High-density lipoprotein (HDL) is known as “good cholesterol” and can help lower the risk of certain diseases.
The body produces all the cholesterol it needs to function, but additional cholesterol can also be consumed with food. Triglycerides are not technically cholesterol, but they are related. When the body has more energy than it needs, it can store it in the form of triglycerides — a type of fat – that can increase the risk of many health conditions, especially when someone also has high cholesterol levels.
Blood cholesterol levels are measured in mg/dL. Having 150 mg/dL of total cholesterol is a good healthy target, and levels above 200 mg/dL are considered high. LDL cholesterol should ideally be around 100 mg/dL, and triglycerides should remain below 150 mg/dL. HDL cholesterol should be 40 mg/dL or higher for men, and 50 mg/dL or higher for women. Blood cholesterol levels can be measured with a simple blood test, and it’s a good idea for healthy adults to have it checked during each annual physical.
As total cholesterol and triglyceride levels increase, plaque begins to build up in blood vessels and arteries. This increases blood pressure, strains the cardiovascular system and increases the risk of heart disease, heart attack and stroke.
The best way to avoid these effects is to prevent high blood cholesterol to begin with.
The first and perhaps most controllable way is to make healthy decisions about what to eat and what not to eat. Avoid foods that are high in saturated fat; trans-fatty acids (trans fats); sodium (salt); and added sugars. Instead, try to consume a diet high in fiber and unsaturated fat. The Mediterranean Diet is often a good choice as it shifts focus away from dairy and red meat and onto seafood, fruits, vegetables, nuts, seeds and whole grains.
In addition to good nutrition, you need a healthy amount of physical activity. For adults, that means at least 2 and 1/2 hours of moderate exercise per week. This can include moderately-paced walks, cycling, swimming or other types of exercise that maintain an elevated heart rate. Exercise can be habitual, and forming habits early can be helpful for preventing health issues later in life. Thus, children and adolescents need one hour of physical activity a day.
Maintaining a healthy weight through proper diet and exercise has numerous health benefits, one of which is improving the body’s ability to use and remove excess blood cholesterol. While not a perfect tool, a Body Mass Index (BMI) calculator can help indicate whether a person’s weight is healthy or not. If weight loss is an appropriate goal, dietary and activity choices may be helpful in achieving a healthy weight. A doctor can help determine if specific weight loss goals or plans are safe to pursue.
However, all the exercise and careful eating in the world will be for naught if you smoke. Not only is smoking generally hard on a person’s cardiovascular system on its own, but the effects can be exacerbated by high cholesterol. For people who have never smoked or who have already quit, maintaining that lifestyle can be beneficial for heart health. For those who do smoke, quitting can ease strain on the heart and allow some amount of healing.
Along with smoking, alcohol consumption can have adverse effects on the body, including increased cholesterol and triglyceride levels. While avoiding alcohol entirely isn’t always necessary, alcohol consumption should be limited to two drinks per day for men and one drink per day for women.
All of the above methods can help to prevent high cholesterol as well as help lower cholesterol levels after they’re already elevated. After these other methods have been examined, it might be appropriate to take medication to help control cholesterol levels. There are several types of cholesterol medications, such as statins, bile acid sequestrants, niacin, ibrates and PCSK9 inhibitors. Medications are an important, helpful tool in fighting high cholesterol, but all medications also include some risk of side effects. Getting ahead of high cholesterol with healthy choices earlier in life is always the preferred option.
Robert Pilchik, M.D. is a multiple board-certified cardiologist at Manhattan Cardiology with expertise in cardiovascular disease and nuclear cardiology. He’s also a contributor to LabFinder.com. For more, visit mahattancardiology.com and LabFinder.com.
