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Cholesterol and your Health


What is cholesterol?

Cholesterol is a waxy, fat-like substance. Cholesterol is made by your body, but also comes from certain foods you eat. Your body uses cholesterol to make hormones and new cells. Your body also uses cholesterol to protect nerves. Cholesterol comes from foods such as meat and dairy products. Your total cholesterol level is made up by LDL cholesterol, HDL cholesterol, and triglycerides:

  • LDL cholesterol is called bad cholesterol because it forms plaque in your arteries. As plaque builds up, your arteries become narrow, and less blood flows through. When plaque decreases blood flow to your heart, you may have chest pain. If plaque completely blocks an artery that bring blood to your heart, you may have a heart attack. Plaque can break off and form blood clots. Blood clots may block arteries in your brain and cause a stroke.
    Blocked Coronary Artery
  • HDL cholesterol is called good cholesterol because it helps remove LDL cholesterol from your arteries. It does this by attaching to LDL cholesterol and carrying it to your liver. Your liver breaks down LDL cholesterol so your body can get rid of it. High levels of HDL cholesterol can help prevent a heart attack and stroke. Low levels of HDL cholesterol can increase your risk for heart disease, heart attack, and stroke.
  • Triglycerides are a type of fat that store energy from foods you eat. High levels of triglycerides also cause plaque buildup. This can increase your risk for a heart attack or stroke. If your triglyceride level is high, your LDL cholesterol level may also be high.

How does food affect my cholesterol levels?

  • Unhealthy fats increase LDL cholesterol and triglyceride levels in your blood. They are found in foods high in cholesterol, saturated fat, and trans fat:
    • Cholesterol is found in eggs, dairy, and meat.
    • Saturated fat is found in butter, cheese, ice cream, whole milk, and coconut oil. Saturated fat is also found in meat, such as sausage, hot dogs, and bologna.
    • Trans fat is found in liquid oils and is used in fried and baked foods. Foods that contain trans fats include chips, crackers, muffins, sweet rolls, microwave popcorn, and cookies.
  • Healthy fats, also called unsaturated fats, help lower LDL cholesterol and triglyceride levels. Healthy fats include the following:
    • Monounsaturated fats are found in foods such as olive oil, canola oil, avocado, nuts, and olives.
    • Polyunsaturated fats, such as omega 3 fats, are found in fish, such as salmon, trout, and tuna. They can also be found in plant foods such as flaxseed, walnuts, and soybeans.

What other things affect my cholesterol levels?

  • Smoking cigarettes
  • Being overweight or obese
  • Drinking large amounts of alcohol
  • Not enough exercise or no exercise
  • Certain genes passed from your parents to you

What do I need to know about having my cholesterol checked?

Adults 20 to 45 years of age should have their cholesterol levels checked every 4 to 6 years. Adults 45 years and older should have their cholesterol checked every 1 to 2 years. You may need your cholesterol checked more often, or at a younger age, if you have risk factors for heart disease. You may also need to have your cholesterol checked more often if you have other health conditions, such as diabetes. Blood tests are used to check cholesterol levels. Blood tests measure your levels of triglycerides, LDL cholesterol, and HDL cholesterol.

What should my cholesterol level be?

Your cholesterol level goal may depend on your risk for heart disease. It may also depend on your age and other health conditions. Ask your healthcare provider if the following goals are right for you:

  • Your total cholesterol level should be less than 200 mg/dL. This number may also depend on your HDL and LDL cholesterol goals.
  • Your LDL cholesterol level should be less than 130 mg/dL.
  • Your HDL cholesterol level should be 60 mg/dL or higher.
  • Your triglyceride level should be less than 150 mg/dL.

How is high cholesterol treated?

Treatment for high cholesterol will also decrease your risk of heart disease, heart attack, and stroke. Treatment may include any of the following:

  • Medicines may be given to lower your LDL cholesterol, triglyceride levels, or total cholesterol level. You may need medicines to lower your cholesterol if any of the following is true:
    • You have a history of stroke, TIA, unstable angina, or a heart attack
    • Your LDL cholesterol level is 190 mg/dL or higher
    • You are age 40 to 75 years of age, have diabetes, and your LDL cholesterol is 70 mg/dL or higher
    • You are age 40 to 75 years of age, have risk factors for heart disease, and your LDL cholesterol is 70 mg/dL or higher
  • Lifestyle changes include changes to your diet, exercise, weight loss, and quitting smoking. It also includes decreasing the amount of alcohol you drink.
  • Supplements include fish oil, red yeast rice, and garlic. Fish oil may help lower your triglyceride and LDL cholesterol levels. It may also increase your HDL cholesterol level. Red yeast rice may help decrease your total cholesterol level and LDL cholesterol level. Garlic may help lower your total cholesterol level. Do not take these supplements without talking to your healthcare provider.

What changes can I make to the foods I eat to lower my cholesterol levels?

A registered dietitian can help you create a healthy eating plan. Read food labels and choose foods low in saturated fat, trans fats, and cholesterol.

  • Decrease the total amount of fat you eat. Choose lean meats, fat-free or 1% fat milk, and low-fat dairy products, such as yogurt and cheese. Try to limit or avoid red meats. Limit or do not eat fried foods or baked goods such as cookies.
  • Replace unhealthy fats with healthy fats. Cook foods in olive oil or canola oil. Choose soft margarines that are low in saturated fat and trans fat. Seeds, nuts, and avocados are other examples of healthy fats.
  • Eat foods with omega-3 fats. Examples include salmon, tuna, mackerel, walnuts, and flaxseed. Eat fish 2 times per week. Children and pregnant women should not eat fish that have high levels of mercury, such as shark, swordfish, and king mackerel.
  • Increase the amount of plant-based foods you eat. Plant-based foods are low in cholesterol and fat. Eating more of these foods may help lower your cholesterol and help you lose weight. Examples of plant-based foods includes fruits, vegetables, legumes, and whole grains. Replace milk that contains dairy with almond, soy, or coconut milk. Eat beans and foods with soy for protein instead of meat. Ask your healthcare provider or dietitian for more information on plant-based foods.
  • Increase the amount of fiber you eat. High-fiber foods can help lower your LDL cholesterol. You should eat between 20 and 30 grams of fiber each day. Eat at least 5 servings of fruits and vegetables each day. Other examples of high-fiber foods include whole-grain or whole-wheat breads, pastas, or cereals, and brown rice. Eat 3 ounces of whole-grain foods each day. Increase fiber slowly. You may have abdominal discomfort, bloating, and gas if you add fiber to your diet too quickly.

What lifestyle changes can I make to lower my cholesterol levels?

  • Maintain a healthy weight. Ask your healthcare provider how much you should weigh. Ask him or her to help you create a weight loss plan if you are overweight. Weight loss can decrease your total cholesterol and triglyceride levels.
  • Exercise regularly. Exercise can help lower your total cholesterol level and maintain a healthy weight. Exercise can also help increase your HDL cholesterol level. Work with your healthcare provider to create an exercise program that is right for you. Get at least 30 minutes of moderate exercise most days of the week. Examples of exercise include brisk walking, swimming, or biking.
  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can damage your lungs, heart, and blood vessels. They can also raise your triglyceride levels. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Limit or do not drink alcohol. Alcohol can increase your triglyceride levels. Ask your healthcare provider if it is safe for you to drink alcohol. Also ask how much is safe for you to drink each day.

Care Agreement

You have the right to help plan your care. Discuss treatment options with your healthcare provider to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

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