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September 2007

Most people think of cholesterol as a health hazard, but the chemical that everyone loves to hate is much more complex.

Your Goals

When it comes to cholesterol the lower your LDL ("bad") cholesterol, the better; the higher your HDL ("good") cholesterol, the better. Your doctor will set specific goals depending on your other heart disease risk factors. People with more risk factors need tougher goals. Some risk factors include:

• High blood pressure
• Diabetes
• Cigarette smoking
• HDL cholesterol below 40 mg/dL
• A family history of heart disease
• Age (over 45 in men, 55 in women)

For more information on recommended LDL and HDL cholesterol levels and risk factors see the PEC booklet 'Understanding Cholesterol.'

Improving Cholesterol: Lifestyle

• Avoid tobacco. Including secondhand smoke.
• Eat right. Cut down on saturated fat and cholesterol (from red meat and whole dairy products) and trans fat (from stick margarine, hydrogenated vegetable oils, fried foods, and many snack foods and baked goods). Eat lots of whole grains, fruits, vegetables, and fish. See the PEC booklet, 'Good Eating for Good Health.'
• Exercise regularly. Walking for 30 minutes a day is a good place to start.
• Control your weight. Cut down on the calories in your diet and boost the calories you burn off in exercise. Stick with a balanced plan for slow but steady progress instead of crash programs and fad diets.
• If you choose to drink, drink responsibly. Moderate doses of alcohol (1 to 2 drinks a day) can boost HDL ("good") cholesterol levels.

Improving Cholesterol: Medication

Many people will need prescription medication to reach their cholesterol goals. Your doctors will decide what’s best for you. In most cases, a statin drug will be the first choice, but other drugs can also help.
Cholesterol-lowering medications can cut your risk of heart attack or stroke by up to 40%. Use your medications carefully under your doctor's supervision. And remember to keep plugging away at your lifestyle treatment as well.

Here are 5 common misunderstandings about cholesterol:

1. Cholesterol is a fat. It's actually a sterol, a waxy fat-like substance. So a food that's "fat-free" can actually contain cholesterol.
2. Cholesterol is a killer. In fact, we all need some cholesterol. It’s the building block of steroid hormones and it's a vital part of cell membranes. But too much is a health hazard.
3. The cholesterol in your blood comes from your diet. Only one-third of cholesterol comes from your diet. The other two-thirds is produced by your liver.
4. Dietary cholesterol boosts blood cholesterol levels. There is some truth in this—but the saturated fat and trans fats in your diet are much bigger problems because they prod your liver into making more cholesterol.
5. There are different types of cholesterol. The truth is, all cholesterol molecules are the same, but there is "good" and "bad" cholesterol within the body. In your blood, cholesterol is attached to carrier proteins called lipoproteins. Different types of lipoproteins determine whether cholesterol is "good" or "bad." Low-density lipoproteins (LDL) carry cholesterol to your arteries, where it builds up into blockages; LDL cholesterol is the “bad” cholesterol. But high-density lipoproteins (HDL) carry cholesterol away from blockages; HDL cholesterol is the "good" cholesterol.