Cholestrol

Most of the cholesterol in your body is made by your liver from saturated fat in your diet. Some cholesterol also comes from foods such as eggs, meats and dairy products.

While some cholesterol is needed for good health, too much cholesterol in your blood can raise your risk of having a heart attack or stroke.

The extra cholesterol in your blood may be stored in your arteries (blood vessels) and cause them to narrow. (This is called atherosclerosis.) Large deposits of cholesterol can completely block an artery, so the blood can't flow through.

If an artery that supplies blood to your heart becomes blocked, a heart attack can occur. If an artery that supplies blood to your brain becomes blocked, a stroke can occur.

Men aged 35 and older and women aged 45 and older should have their cholesterol checked periodically. Depending on what your cholesterol level is and what other risk factors for heart disease you have (see the box below), you may need to have it checked more often.

Risk factors for heart disease

Having already had a heart attack
Being a man 45 years of age or older
Having a father or brother who had heart disease before he was 55
Being a woman who is going through menopause or has completed menopause
Having a mother or sister who had heart disease before she was 65
Smoking cigarettes
Having high blood pressure or diabetes
Being very overweight
Being inactive

Cholesterol travels through the blood in different types of packages, called lipoproteins.

Low-density lipoproteins (LDL) deliver cholesterol to the body. High-density lipoproteins (HDL) remove cholesterol from the bloodstream.

This is why too much LDL cholesterol is bad for the body, while the HDL form is good. It's the balance between the types of cholesterol that tells you what your cholesterol level means (see the box below).

For example, if your total cholesterol level is high because of a high LDL level, you may be at higher risk of heart disease or stroke. If your total level is high only because of a high HDL level, you're probably not at higher risk.

Total cholesterol level

Less than 200 is best.
Between 200 to 239 is borderline high.
240 or more means you're at increased risk for heart disease.

LDL cholesterol levels

Less than 130 is best.
Between 130 to 159 is borderline high.
160 or more means you're at higher risk for heart disease.

HDL cholesterol levels

Less than 40 means you're at higher risk for heart disease.
60 or higher reduces your risk of heart disease.

You can do a number of things to improve your cholesterol level. Eating healthy food can help lower your LDL cholesterol level. You can lower your risk by quitting smoking if you smoke, losing weight if you're overweight and exercising.

Lowering your cholesterol level by eating healthy foods is easier than you might think. You don't have to give up your favorite foods. Just eat them less often. Also try sometimes substituting healthier choices.

Tips for eating smart

Limit saturated fats, like dairy fats (in ice cream and butter) and palm and coconut oil (in baked goods).
Limit high-cholesterol foods, like egg yolks, organ meats (such as liver) and shellfish.
Eat more fruits and vegetables.
Eat more broiled or grilled fish and skinless chicken breasts.
Choose lean cuts when you eat beef, pork and lamb. Also eat smaller portions.
Eat a variety of fiber-rich foods, like oats, dark breads and apples.
Choose low-fat or nonfat dairy products.
Avoid fried foods.

Try these:	Instead of these:
Fish; poultry without the skin; lean beef, pork and lamb	Sausage, bacon, organ meats (like liver)
Nonfat or low-fat milk	Whole milk
Sherbet, sorbet, fat-free ice cream	Ice cream
Egg whites	Egg yolks
Raw or steamed vegetables	Buttered or fried vegetables
Baked potatoes	French fries
Clear soups	Creamed soups
Unsaturated vegetable oils: olive, corn, canola	Saturated fats: butter, coconut oil, palm oil, lard, bacon fat
Angel food cake, reduced-fat cheesecake	Cheesecake
Pretzels, air-popped popcorn, fat-free potato chips	Potato chips, regular popcorn
Pancakes or cereal with nonfat milk, bagels, English muffins	Pastries, doughnuts

Depending on your risk factors, if healthy eating and exercise don't work after about 6 months to 1 year, your doctor may suggest medicine to lower your cholesterol level.

Several types of medicines are used to lower high cholesterol levels: bile acid absorbers (such as Questran, etc.), lipoprotein synthesis inhibitors (such as Nicobid, etc.), coenzyme A reductase inhibitors (such as Mevacor, etc.) and fibric acid derivatives (such as Lopid, etc). Your doctor will decide which type of medicine is right for you.

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