Understanding Cholesterol

Co Written By: Alyssa Costantino

Ischemic heart disease is the number one cause of mortality worldwide, and elevated cholesterol exists as one of the largest risk factors (World Health Organization, 2020). Whether yourself or someone you know has been diagnosed with high cholesterol, it can be a scary, confusing, or overwhelming concept. While it is true that high levels of certain types of cholesterol can increase the risk of heart disease, not all cholesterol is created equally. Understanding your lab results is a crucial component towards lowering your risk and maintaining your health.

Understanding the Lipid Panel: 

A lipid panel is a blood test that measures fats and fatty substances used as a source of energy by your body. This gives yourself and your healthcare provider a variety of information about the exact composition of the fat content of your bloodstream as major indicators of your cardiovascular health. 

This includes: Total Cholesterol, HDL, LDL, and Triglycerides.

What do these mean?

Cholesterol is a type of fat that is produced by the body as well as consumed in a variety of food choices. Your body needs cholesterol to form cell membranes, produce hormones, produce bile salts which aid in digestion, and even make vitamin D! In addition to this, cholesterol is essential for brain and neurotransmitter function, and low cholesterol can cause major health issues such as hormonal imbalances and reduce immune system function. Although cholesterol is a necessary component of our bloodstream for a variety of reasons, more common in our population is the problems that begin to arise when there is too much cholesterol, or an imbalance of the types of cholesterol in the body. 

*Healthy Total Cholesterol: 250 mg/dL and below

Your total cholesterol value is made up of your LDL, HDL, and Triglycerides

Types of cholesterol: 

Cholesterol travels through the bloodstream in multiple forms, each with its own unique composition and function. What differentiates the types of cholesterol in the bloodstream is the size and proportion of protein to fat content within the molecule. You have likely heard of “good cholesterol” and “bad cholesterol”. The lower the density of the cholesterol molecule, the higher the proportion of fat and lower proportion of protein. This causes lower density cholesterol to be more likely to cause complications to your blood vessels and reduce blood flow.

HDL: high density lipoprotein- what you hear of when you consider “good” cholesterol. This molecule has a high amount of protein in comparison to fat. HDL works to carry excess cholesterol from the bloodstream back to the liver to be metabolized and removed from the body. HDL is considered cardioprotective as it acts as a preventative mechanism against the bad effects of LDL cholesterol, reducing the risk of cardiovascular disease. 

*Ideal value: above 60 mg/dL

LDL: low density lipoprotein- what you hear of when you consider “bad” cholesterol. A high amount of fat on this molecule causes buildup within the subendothelial space of the blood vessels, causing progressive oxidative stress, inflammation, weakening your artery walls and reducing blood flow. This molecule can be considered harmful in excess due to its contribution to atherosclerosis which can increase the risk of heart attack, stroke, and peripheral artery disease. 

*Normal ideal value: below 100 mg/dL

Triglycerides are a type of fat found in your bloodstream that comes from food. Triglycerides are made by the liver and digestive system in proportion to the amount of saturated fat, added sugars, and calories from food choices. Excess triglycerides are carried by VLDL molecules through the bloodstream to be stored in adipose tissue. This contributes to the development of atherosclerosis increasing the risk of heart disease. 

*Healthy Triglycerides: below 150 mg/dL

How to manage your cholesterol:

Getting a variety of nutrients through your diet, eating vegetables with every meal, cutting down on processed foods, boosting fiber, and keeping track of your saturated fat intake are all methods of promoting your health and managing your cholesterol.

What raises cholesterol:

Your cholesterol can be impacted by your age, genetics, health habits, and nutrition choices.

Top factors that raise cholesterol include consuming processed foods, fried or fatty foods, added sugars and excess carbohydrates, insufficient fiber, caffeine, alcohol, physical inactivity, and stress. 

Overall Tips:

  • Fiber: aim to consume at least 30-35 grams of fiber per day!
  • Fruit: aim to include 3-4 servings per day
  • Vegetables: aim to include 3-5 servings per day
  • Exercise: aim for at least 150 minutes of moderate intensity physical activity per week

To boost HDL: focus on healthy fats

  • Increase intake of mono and polyunsaturated fats

To lower LDL: focus on saturated fat

  • Aim for about 12-15 total grams per day 

To lower Triglycerides: focus on added sugars

  • Aim for <10% of total daily calories 

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