Nearly 76 million Americans live with elevated LDL, known as “bad” cholesterol, which is a major risk for heart disease — the No. 1 killer in the U.S. High cholesterol also is linked to hardening of the arteries and can lead to stroke. Here’s what you need to know. [SOURCE: NATIONAL HEART, LUNG AND BLOOD INSTITUTE]
What is cholesterol?
Cholesterol is a waxy, fat-like substance produced in the liver and used by the body to make cell membranes, hormones, bile acids, vitamin D and other substances. Cholesterol is carried throughout the body in packages called lipoproteins, which have lipids (fat) on the inside and protein on the outside.
Two kinds of lipoproteins carry cholesterol in the blood:
* Low-density lipoprotein (LDL) takes cholesterol to tissues throughout the body, including arteries, where it can build up and impair circulation.
* High-density lipoprotein (HDL) helps return cholesterol back to the liver where it can be eliminated.
What factors affect your cholesterol level?
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* Heredity.
* Age and sex: Blood cholesterol begins to rise around age 20.
* Diet: Three nutrients make LDL levels rise: saturated fat, found mostly in foods that come from animals, especially red meat and full-fat dairy products; trans fat, found mostly in foods made with hydrogenated oils and fats, such as french fries; and cholesterol, which comes from animal products, especially egg yolks, liver and other organ meats, shrimp and many dairy products.
* Weight: Excess weight tends to increase LDL.
* Physical activity: Regular exercise can increase HDL, or “good cholesterol.”
How do you check your cholesterol levels?
* Have your doctor order a blood test from a reputable lab.
* A $100 FDA-cleared analyzer, CardioChek, is available for at-home testing.
How do you reduce LDL cholesterol?
The National Heart, Lung and Blood Institute says the safest, cheapest and best way to reduce high LDL cholesterol is through diet, physical activity and weight management. These changes can lower cholesterol by 20 percent to 30 percent in many people. Dr. Stephen Devries, author of “What Your Doctor May Not Tell You About Cholesterol” and associate professor of cardiology at Northwestern University Medical School, recommends:
* Cutting back on unhealthful fats from fried foods, red meat and full-fat dairy products.
* Eating healthier fats, such as nuts, avocados, olive oil and cold-water fish.
* A 30-minute walk, most days.
* Plant stanols and sterols. He notes that “with 2 grams per day, you can expect a 10 to 20 percent reduction in LDL.” Plant stanols/sterols are found in plants including soybeans. Some foods, including some of the more healthful margarine spreads and a few fruit juices, such as Promise activ SuperShots, are fortified with plant sterols. Devries also recommends a pill form.
* For patients with more serious cholesterol problems, Devries says, red yeast rice is the most potent over-the-counter supplement to lower LDL cholesterol but should be taken only under a doctor’s supervision.
What are the medication options?
Prescription drugs that lower LDL cholesterol include statins (such as Lipitor, Crestor, Mevacor and Zocor); Zetia, which reduces the amount of cholesterol absorbed by the digestive tract; WelChol, which binds cholesterol-rich bile in the digestive tract and prescription niacin, which raises HDL (good) cholesterol.
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LDL cholesterol (‘bad’ cholesterol)
The higher your LDL cholesterol, the greater your risk for heart disease. (Figures in milligrams/deciliter)
Under 100: Optimal
100-129: Near optimal/above optimal
130-159: Borderline high
160-189: High
190 and up: Very high
HDL cholesterol (‘good’ cholesterol)
The higher your HDL, the lower your risk of LDL building up and the lower your risk of heart disease. (Figures in milligrams/deciliter)
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Under 40: Major heart disease risk factor
60 and up: Gives some protection against heart disease
Total cholesterol
(Figures in milligrams/deciliter)
Under 200 Desirable
200-239 Borderline high
240 and up High
For more information
National Heart, Lung and Blood Institute: www.nhlbi.nih.gov or ldlhdl.info