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Cholesterol, a white, waxy, fat-like substance, is required by your body in small amounts for such functions as building cells. To do its work, it is transported throughout the body through the blood vessels. However, when there is too much of the wrong kind of cholesterol, deposits (called plaque) can build up on blood vessel walls, causing them to become thicker, harder and less flexible so they are unable to do their job, transporting blood, efficiently. The result is an increased risk for heart attack and other forms of heart disease, such as hardening of the arteries (atherosclerosis). Excess cholesterol in the blood can join the ranks of high blood pressure as a "silent killer." That’s because a high serum (blood) cholesterol level creates no symptoms to alert its victim to its life-threatening activity. So your best defense against cholesterol’s threat is a good offense—in this case, a regular blood test to check your cholesterol level. The amount of cholesterol in the blood ("serum cholesterol") can be measured by a simple, nearly painless blood test. This test measures your total cholesterol level as well as the levels of cholesterol’s two main components: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL is also referred to as "bad" cholesterol because it is the form of this fat that is linked to heart disease. HDL is referred to as "good cholesterol" because it helps remove LDL cholesterol from the blood. It is wise to know what the desirable levels of cholesterol are, to keep a record of your cholesterol test results and know what to do to keep your levels in the "healthy" range, or, if necessary, lower them.
The desirable range for cholesterol levels depends on both your current health status and your other risk factors for heart disease. These risk factors include:
If you have no heart disease and fewer than two risk factors, your ideal total cholesterol is under 240 mg/dl and your ideal LDL is under 160 mg/dl. For those with no heart disease but two or more risk factors, the ideal total cholesterol is under 200 and ideal LDL is under 130. For people who already have heart disease, the ideal total cholesterol is 160 or less and ideal LDL is 100 or less.
Keeping your cholesterol at healthy levels requires a low-fat diet, exercise and, in some cases, medication.
Low-Fat Diet. Choose fish or white meat chicken and turkey (no skin), roasted or baked, and limit fatty cuts of red meat, fried foods, organ meats and processed meats, such as sausage and luncheon meat. Eat lots of fresh fruits and vegetables (except high-fat avocado and coconut), and whole grains, beans, pasta, potatoes and cereals. Use only small amounts of olive, corn or canola oils and avoid butter, mayonnaise, shortening and coconut, palm or palm kernel oils. Use skim/nonfat milk and low-fat/nonfat yogurt and cheeses, and avoid whole milk, cream, ice cream, egg yolks and cheeses. Healthy desserts include angel food cake, gingersnaps, fig cookies, animal crackers, hard candy or jelly beans, popsicles, low-fat/nonfat frozen yogurt and sorbet; avoid pastries, cakes, pies and cookies. (Note: cholesterol in foods is found only in items of animal origin. Other foods high in fat, such as peanut butter, coconut and avocado, can also raise blood levels of cholesterol, but they do not contain cholesterol.)
A regular exercise program not only helps decrease LDL cholesterol, it also helps raise HDL cholesterol and control your weight, another benefit for people with heart disease or other risk factors such as high blood pressure and diabetes. In addition to following an exercise program, you can increase your activity level by doing such things as using the stairs instead of an elevator, vacuuming, gardening, and parking your car at the farthest corner of a parking lot. Medication. If diet and exercise don’t lower your cholesterol to ideal levels, your doctor may prescribe a cholesterol-lowering medication. Taking this medication exactly as prescribed improves your chances of effectively lowering your cholesterol and decreasing your risk for heart disease. Keep in mind, however, that medication is an addition to a healthy diet and exercise program, not a substitute for them.
Diabetes and Hormone Center of the Pacific Ala Moana Pacific Center 1585 Kapiolani Boulevard, Suite 1500 Honolulu, Hawaii 96814 Tel: (808) 531-6886 Fax: (808) 523-5115
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| © 1996 All Rights Reserved. David Fitz-Patrick, M.D. |