Firstly What Is Cholesterol
Cholesterol is an essential type of fat that’s carried in the blood.
All cells in the body need cholesterol it’s an essential part of cell walls in our bodies and has important roles, including to produce some hormones, maintain healthy nerve cells and in the synthesis of vitamin D.
Your body needs a small amount of cholesterol to function, but an imbalance between different types of cholesterol in the blood increases the risk of heart disease, one of the leading chronic diseases in Australia today.
About ¾ of the cholesterol in your body is made in the liver and a small amount may come from the food you eat. Various factors affect blood cholesterol levels including your diet and lifestyle, body weight and genes.
Dietary Tips To Avoid Cholesterol
The most important thing you can do to reduce your cholesterol level is to maintain a healthy lifestyle. You should try to:
- Increase the amount and variety of fresh fruit, vegetables and wholegrain foods you have each day.
- Choose low or reduced-fat milk, yoghurt and other dairy products or have added calcium soy drinks.
- Choose lean meat .
- Limit fatty meats, including sausages and salami, and choose leaner sandwich meats like turkey breast or cooked lean chicken.
- Have fish at least twice a week.
- Replace butter and dairy blends with polyunsaturated margarines.
- Include foods in your diet that are rich in soluble fibre and healthy fats, such as nuts, legumes and seeds.
- Limit cheese and ice cream to twice a week.
Other storage fats that are transported in blood lipoproteins include triglycerides. When present in high concentrations in the blood, this fat is also a risk for heart attack. Some foods will affect the cholesterol level or the triglyceride level and some will affect both.
Lipid Levels And Heart Health
Cholesterol and triglycerides are necessary for your body to function properly. However, if too many triglycerides or LDL particles are in the bloodstream, they can stick to the walls of arteries and clog them, causing a disease called atherosclerosis, a major risk factor for heart attack and stroke. HDL cholesterol helps “escort” LDL particles out of the bloodstream, so an increased level of HDL lowers your risk of coronary diseases.
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What’s Considered As Normal Cholesterol Levels
Many factors influence what your personal cholesterol or lipid targets should be, and so cholesterol tests should be interpreted in the context of your personal risk.
Your doctor can help you understand your results and guide you on strategies to not only lower your cholesterol but lower your risk of heart disease.
Normal Cholesterol With High Triglycerides What Is That
When measuring total cholesterol levels, low-density lipoprotein , high-density lipoprotein , and triglycerides are used in the measurement.
For adults, standard cholesterol levels are:
- Less than 200 mg/dL is desirable
- Between 200 – 239 mg/dL is considered borderline
- Over 240 mg/dL is considered high
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What Do Your Cholesterol Results Mean
When you have a cholesterol test, it is really important that your healthcare professional explains the results to you to prevent unnecessary worry and confusion.
Its not just your total cholesterol thats important and your results will include different types of cholesterol. If you are only given your total cholesterol, ask for a break-down of the other numbers. Its possible to have a healthy total cholesterol number but an unhealthy balance of the different types of cholesterol.
As a minimum, you should be given your total cholesterol and HDL numbers, then you can work out your ratio of total cholesterol to HDL cholesterol .
You might also have your triglycerides tested, these are another type of blood fat which are linked to heart disease.
Ask for a print out of your results if you are not able to speak to your GP, nurse or pharmacist.
Your results should include:
- Total cholesterol
This is sometimes written as serum cholesterol or TC and refers to your overall level of cholesterol.
- Non-HDL cholesterol
Your non-HDL cholesterol is your total cholesterol minus your HDL cholesterol. Its all the bad cholesterol added together, including your LDL cholesterol. Ideally it should be as low as possible.
- HDL cholesterol
- TC:HDL ratio
You might be given a TC:HDL ratio, which is the ratio of HDL compared to the total cholesterol. If not, you can work it out from your HDL and total cholesterol numbers. This should be as low as possible. Above 6 is considered high.
Why It Is Done
Cholesterol and triglyceride testing is done:
- As part of a routine physical examination to screen for a lipid disorder.
- To check your response to medicines used to treat lipid disorders.
- To help determine your chances of having of heart disease, especially if you have other risk factors for heart disease or symptoms that suggest heart disease is present.
- If you have unusual symptoms, such as yellow fatty deposits in the skin , which may be caused by a rare genetic disease that causes very high cholesterol levels.
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Why Is There Tg In The Blood
The most common reason for elevated triglycerides is prediabetes. Chronically high insulin stimulates adipokines and hormone-sensitive lipase. This results in the release of too many fatty acids from fat cells. These excess fatty acids take up space in HDL and LDL particles.
TG can also become elevated in several inherited diseases.
What Are The Normal Cholesterol Levels For Men And Women
A cholesterol test generally determines 4 distinct numbers: Total cholesterol, LDL, HDL, and triglycerides. Cholesterol being fat, it is not soluble in water. So it cannot circulate freely in the blood. But, the fact is that nature has devised a way to make water-soluble cholesterol, and transport it through the blood. This is by lipoproteins. The LDL or Low-density lipoprotein and the HDL or high-density lipoprotein are the 2 fundamental cholesterol carriers but to make things simpler, they are considered as cholesterol types. In addition, the lipid panel appraises the triglycerides . They have an impact on health in the same manners as cholesterol. At last, the total cholesterol is integrated as well in the results. Apart from these 4 general lipid levels, your doctor may want to access your very low-density lipoprotein or VLDL that is considered bad when high.
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Know Your Cholesterol Levels
The first defense against out-of-whack cholesterol levels is knowledge. Once youâre aware of your current cholesterol levels, you can take steps to lower your LDL cholesterol level, increase your HDL cholesterol level, or both.
To determine your cholesterol levels, youâll need a lipid profileâa test result that comes from a blood sample. There are a few ways to obtain this result, including:
- Making an appointment with your healthcare provider
- Learning before taking an at-home test, such as the from Everlywell
Once you know how to compare HDL and LDL in your test results, a lipid profile can tell you if youâre doing everything right or if it might be time to change your habits. If you are wanting to take an at-home test it is important to properly learn how to test lipids and cholesterol levels because there are many options to choose from. Once you have decided on a test, you should learn how to understand cholesterol test results to better decipher your levels.
I Just Learned I Have High Cholesterol Now What
You may feel upset to learn you have high cholesterol. But now that you know about it, you can take action to lower your numbers.
Follow your providers guidance on how to lower your cholesterol and reduce your risk of heart disease. Some general tips include:
- Add more exercise to your daily routine.
- Avoid smoking and all tobacco products.
- Keep a weight thats healthy for you.
- Learn how food impacts your cholesterol, and start with small changes to your diet.
- Learn new strategies for dealing with stress.
- Take your medications as prescribed.
Most of all, dont blame yourself. High cholesterol is a common condition that can be hard to control through lifestyle choices alone. And many factors beyond our control limit the choices we can make.
Be kind to yourself, and remember that your cholesterol numbers dont define you as a person. They simply give you a window into whats happening inside your body. Your provider will help you use that information to plan your treatment and keep your arteries healthy for a long time to come.
A note from Cleveland Clinic
Last reviewed by a Cleveland Clinic medical professional on 07/28/2022.
References
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You Dont Need To Avoid Eggs And Seafood
Some foods are high in cholesterol but are fine to eat in moderation, as long as your overall diet is low in saturated fats. For example:
- Egg yolks a single egg yolk contains 200250 mg of cholesterol, which is almost the uppermost recommended daily intake . However, reducing egg intake is probably not important for healthy people with normal blood cholesterol levels.
- Seafood prawns and seafood contain some cholesterol, but they are low in saturated fat and also contain healthy omega-3 fatty acids. Seafood is a healthy food and should not be avoided just because it contains cholesterol. However, avoid fried and battered seafood.
What Are The Types Of Cholesterol
Cholesterol moves throughout the body carried by lipoproteins in the blood. These lipoproteins include:
- Low-density lipoprotein is one of the two main lipoproteins. LDL is often called the bad cholesterol.
- High-density lipoprotein is the other main lipoprotein. HDL is often called the good cholesterol.
- Very-low-density lipoproteins are particles in the blood that carry triglycerides.
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Do High Tg Levels Affect Hdl And Ldl Cholesterol Levels
The image below shows how LDLs and HDLs transport TG. It is from the National Lipid Associations website, used with permission from Tom Dayspring .
Here, an enzyme called CETP facilitates the exchange of cholesterol in large HDL and large LDL with TG. What CETP does is it takes cholesterol out of large HDL and LDL particles and then transfers TG into these particles. In turn, hepatic lipase metabolizes TG-rich HDLs and LDLs, leading to smaller HDLs and LDLs.
In a nutshell, high TG levels affect HDL and LDL levels. And prediabetes leads to high TG levels.
Look at the image below showing what a lipid profile would look like in a patient with prediabetes.
Aside from prediabetes, this patient actually has another problemfamilial hypercholesterolemia . Neither condition was noticed before the patient came to us.
To make matters worse, the patient also has an elevated TG/HDL216/34 or 6.4! I recommend a goal of 1.5 or less.
What Are Hdl And Ldl
HDL and LDL are two types of lipoproteins.They are a combination of fat and protein. The lipids need to be attached to the proteins so they can move through the blood. HDL and LDL have different purposes:
- HDL stands for high-density lipoproteins. It is sometimes called the “good” cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
- LDL stands for low-density lipoproteins. It is sometimes called the “bad” cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.
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How To Lower Your Cholesterol
If youve been told that you have high cholesterol or you just want to prevent it what can you do?
There are several ways to manage it, including:
Medication: Depending on your overall cardiovascular disease risk, you might be treated with a cholesterol-lowering medication, such as a statin. The decision to use a statin is based on a womans overall risk for heart attack and stroke including all these factors and the LDL cholesterol value.
If you already have vascular disease or evidence of atherosclerosis, or if you are at high risk for cardiovascular disease, a statin for prevention is strongly recommended because this treats the plaque in the arteries, and lowers LDL cholesterol, Michos says.
Diet and lifestyle:Diet and lifestyle are very important to help maintain healthy cholesterol levels. Even for women who are recommended to take cholesterol-lowering medications, a healthy lifestyle helps these drugs work better, says Michos.
Heres how to maintain a lifestyle that promotes healthy cholesterol levels:
Add these to your shopping list:
- Fatty fish such as salmon, trout, mackerel, sardines and albacore tuna
- Nuts, including walnuts, pecans, almonds and hazelnuts
- Olive oil to drizzle lightly over your salads and vegetables
While nobody wants to have high cholesterol, there are plenty of ways to keep it in check. With regular checkups and attention to what you eat, its possible to manage your cholesterol and blood fats to keep your heart healthy, says Michos.
Questions To Ask Your Doctor
If testing shows you have high cholesterol, you may want to ask your doctor these questions at your next visit.
1. What are the dangers of having high cholesterol? Can other problems develop?
2. What could have caused my cholesterol to be too high? Is it inherited?
3. Are there things I can do at home or in my life to reduce my cholesterol?
4. Is medicine necessary? Are there alternative treatments?
5. If medicine is needed, how does the medicine work?
6. How long can I take medicine? What are the side effects? Is long-term use harmful?
7. How can exercise help to lower my cholesterol?
8. Where can I learn more about how to live with high cholesterol?
9. What changes should I make to the way I eat?
10. How often do I need to get my cholesterol level checked?
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General Information And Causes
Cholesterol is a white, waxy substance that is circulated in the blood. It is essential for your good health as it helps to build cell walls and is used in the manufacture of some hormones.
However, when there is more cholesterol circulating in the blood than the body needs, it can build up on your artery walls, eventually leading to narrowing and hardening of the arteries. This process is known as atherosclerosis and increases the risk of heart attack, stroke and other cardiovascular diseases. More than half of New Zealanders admitted to hospital with a heart attack have high cholesterol levels.
This risk of a cardiovascular health event increases when high blood cholesterol is accompanied by other risk factors such as high blood pressure and a family history of heart disease.
Your liver produces most of the cholesterol circulating in your blood. A diet high in saturated fat stimulates the liver to produce more cholesterol so the saturated fat content of the food you eat is likely to have a strong influence on your blood cholesterol levels.
A small proportion of your blood cholesterol is derived from dietary cholesterol – i.e. cholesterol that is already present in animal foods you might consume .
Other factors that may influence your blood cholesterol levels include:
- Genetic susceptibility to high cholesterol
Low Levels May Be Associated With Worse Outcomes In Some Conditions
In one study, people with heart failure and lower levels were more likely to die from heart complications. The levels associated with risk were around 120 mg/dL on average, while levels of 130-149 mg/dL were considered protective .
Upon further analysis, the researchers concluded that only women with heart failure and low triglycerides may be at an increased risk of dying. According to them, low triglyceride levels may point to more advanced stages of heart failure .
In another study, people with lung scarring had triglycerides under 57 mg/dL, which was about 60% lower than the values of healthy controls .
Similarly, people with autoimmune disease had 50-70% reduced triglyceride levels compared to healthy people in a different study. Researchers suggested that low triglyceride levels might actually be a marker of autoimmunity and an overactive immune response .
Its important to note here that low triglycerides in all of these cases are not causing any of these conditions. They are the effect of these conditions. For example, in heart failure, low triglycerides may be due to liver damage due to diminished oxygen supply or increased levels of inflammation.
There is no proof that low triglyceride levels are harmful in and of themselves.
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Keep High Cholesterol Levels Under Control
If youâre already one of the nearly 94 million U.S. adults with excess cholesterol levels, you have various options for managing and lowering your cholesterol numbers. In addition to following the healthy living advice above, you can talk to your healthcare provider about LDL cholesterol-lowering medication.
Healthcare professionals can recommend several kinds of medications for high levels of cholesterol, including:
- Bile acid sequestrants
- Niacin or nicotinic acid
- Statins
As always, be sure to speak with your healthcare provider before taking any medication. The right treatment for you may depend on other medications youâre taking, as well as other factors of your health and lifestyle.
How Can I Lower Cholesterol With Diet
Heart-healthy lifestyle changes include a diet to lower your cholesterol. The DASH eating plan is one example. Another is the Therapeutic Lifestyle Changes diet, which recommends that you
Choose healthier fats.You should limit both total fat and saturated fat. No more than 25 to 35% of your daily calories should come from dietary fats, and less than 7% of your daily calories should come from saturated fat. Depending upon how many calories you eat per day, here are the maximum amounts of fats that you should eat:
| Calories per Day | |
|---|---|
| 69-97 grams | 17 grams |
Saturated fat is a bad fat because it raises your LDL level more than anything else in your diet. It is found in some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.
Trans fat is another bad fat it can raise your LDL and lower you HDL . Trans fat is mostly in foods made with hydrogenated oils and fats, such as stick margarine, crackers, and french fries.
Instead of these bad fats, try healthier fats, such as lean meat, nuts, and unsaturated oils like canola, olive, and safflower oils.
Limit foods with cholesterol. If you are trying to lower your cholesterol, you should have less than 200 mg a day of cholesterol. Cholesterol is in foods of animal origin, such as liver and other organ meats, egg yolks, shrimp, and whole milk dairy products.
Eat plenty of soluble fiber. Foods high in soluble fiber help prevent your digestive tract from absorbing cholesterol. These foods include:
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