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Cholesterol 101

Posted by Stacy Covitz on Mar 8, 2017 9:50:27 AM

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It’s one of those medical terms we know is important…but we’re not really sure why. What really is cholesterol? What’s the difference between LDLs and HDLs, and why do we add them together? It’s hard to turn on the TV without a seeing a commercial for cholesterol-lowering medication, but few of us really understand what it really is, and why we need to care.

What is cholesterol?

Cholesterol is a waxy, fat-like substance that’s in every cell in the human body. Our bodies make the cholesterol we need for certain functions, such as making hormones. But the problem occurs when additional cholesterol is added through diet, especially a high-fat diet.

When there’s too much in the body – high cholesterol – it begins to bind with fat, calcium and other substances to create a plaque along interior artery walls. Lined with plaque, the arteries begin to narrow. Oxygen-rich blood flow becomes limited, and the plaque, now thickly lining the arterial walls, can rupture and break apart, causing an almost complete arterial blockage, angina or even a heart attack.

Wait, there is good cholesterol?

To understand high cholesterol, it’s important to break out the components of cholesterol – the good, the bad and the fat. HDL (high-density lipoproteins) is the good cholesterol; it carries cholesterol to the liver where it is then removed. LDL (low-density lipoproteins) is bad cholesterol. It is directly linked with buildup in the arteries. Then there are triglycerides, another form of fat in the blood. The higher LDL and triglyceride levels, the greater the chance of developing heart disease. However, the higher the HDL, the lesser chance of developing heart disease.

Overall, a total cholesterol level under 200 mg/dL is considered optimal with an LDL level under 100 mg/dL, HDL of 60 mg/dL or higher, and triglycerides below 150 mg/dL.

How does a healthy diet lower cholesterol?

Srinivas Yallapragada, MD, interventional cardiologist on the Methodist Dallas medical staff, says a heart-healthy diet should start in childhood because it builds good habits and reduces the likelihood of developing elevated cholesterol, diabetes or other risk factors for heart disease.

Heart healthy foods have been in the news for quite some time, but what many people don’t realize is why these foods are considered heart healthy. Foods containing soluble fiber bind with cholesterol and remove it from the body; thereby lowering LDL levels. Luckily, there’s a long list of cholesterol-lowering foods that can be enjoyed day in and day out.

  • Oats and oat bran lead the list of cholesterol-lowering foods. Americans should eat at least 3 grams of soluble fiber daily to decrease LDL cholesterol levels. Whether it’s a bowl of oatmeal or oat cereal like Cheerios, a day started with heart-healthy oats helps create a heart-healthy lifestyle.
  • All beans are rich in soluble fiber.  In fact, it only takes ½ cup of cooked beans a day to reap the benefits of this cholesterol-lowering food.  So whether pintos, navy, lima or black beans, enjoy.
  • Almonds, walnuts and pistachios are great substitutes for saturated fat. Plus, they are high in protein and full of fiber. Two-ounces a day is enough to lower LDL levels without affecting HDL levels.
  • There is science behind the mantra, “an apple a day, keeps the doctor away.” Apples are an excellent source of pectin, a form of soluble fiber that can lower LDL levels. Eat at least one apple a day, or try other pectin-rich fruits like grapes, strawberries and citrus.
  • Dark Chocolate. It’s not only dark chocolate, it’s foods that contain plant sterols and stanols, a naturally occurring substance found in nuts, fruits, whole grains, some vegetable oils, and dark chocolate. These phytosterols block the absorption of cholesterol in the small intestine, and when consumed daily, can lower LDL levels by close to 10 percent.

What if a healthy diet isn’t enough?

Often times, when diet and lifestyle isn’t enough to lower cholesterol, a physician may prescribe a statin drug. Statin medications block an enzyme in the liver that controls cholesterol production, decreasing the amount of cholesterol produced.

Those who may benefit most from statin medications include individuals with a history of cardiovascular events, adults with an LDL level of 70 to 189 mg/dL and at high risk of heart disease, young adults with a LDL of 190 mg/dL or higher, and individuals over 40 and living with diabetes and an LDL of 70 to 189 mg/dL.

Understanding high cholesterol can lead to a heart healthier life, so having an annual physical exam or biometric screening will give you a better glimpse into what’s happening in your arteries.

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