February 2022

When it comes to your health, cholesterol isn’t always a bad thing. In fact, it plays an important role in maintaining your health, especially your heart health. That’s why you need to understand what your cholesterol levels mean to you.

What is cholesterol?

Cholesterol is a lipid, a waxy fat-like substance that circulates in your blood. Your body needs it to function because cholesterol helps build cells, digest fats, and make vitamins and hormones.

Too much cholesterol, though, can be harmful to your heart. High cholesterol can lead to plaque buildup in your arteries and is a major risk factor for coronary heart disease, heart attack, and stroke. That risk increases even more if you smoke or have diabetes or high blood pressure.

Here’s how the American Heart Association (AHA) breaks down the two sources of cholesterol:

• What your body makes naturally. Your liver makes the cholesterol your body needs to function.
• What you eat. Dietary cholesterol comes from animal proteins, such as meat, poultry, and dairy products. Because animal protein is also high in saturated fat and trans fat, these foods can trigger your liver to produce more cholesterol than it normally would make. This extra cholesterol can lead to unhealthy cholesterol levels for some people.

Managing your cholesterol

The good news is that you can do something about high cholesterol, also known as hyperlipidemia. To take charge of your cholesterol, follow the three Cs recommended by the AHA: check, change, and control.

Check your cholesterol

To know your risk posed by cholesterol, you have to know your cholesterol numbers. A simple blood test, known as a lipid panel or lipid test, can check for the following cholesterol levels:

• High-density lipoprotein or HDL. Also known as the “good” cholesterol, HDL can help clear your arteries of cholesterol buildup. A good HDL is more than 40 mg/dL.
• Low-density lipoprotein or LDL. Known as the “bad” cholesterol, LDL is what can build up and clog your arteries. An LDL of less than 100 mg/dL is considered normal.
• Total blood cholesterol. Also known as blood serum levels, total blood cholesterol is calculated by adding your HDL and LDL levels plus 20% of your triglyceride level. For most people, a total cholesterol level of less than 200 mg/dL is considered normal.
• Triglycerides. Part of your total cholesterol, triglycerides are another type of lipid found in your body. High levels of triglycerides can cause your arteries to harden and thicken. This can lead to heart disease, heart attack, or stroke. Normal triglyceride levels are typically below 150 mg/dL.

Change your habits

Diet and lifestyle can impact your cholesterol levels.

• Follow a heart-healthy diet. Eat a variety of nutrient-dense foods, including fresh fruits and vegetables, whole grains, and lean proteins. To choose nutrient-dense packaged foods, look for the American Heart Association’s Heart Check
• Stick to healthy dietary fats. These include olive oil or canola oil. Avoid saturated fats and trans fats.
• Get regular exercise. The CDC recommends getting at least 2 hours and 30 minutes of moderate exercise every week to keep your cholesterol in check.
• Quit smoking. Because smoking damages your blood vessels, this increases your risk of heart disease and stroke.
• Limit or avoid alcohol. Alcohol can raise both cholesterol and triglyceride levels. If you want an alcoholic drink, consider red wine. In moderation, it can increase good HDL cholesterol, according to a study published in Clinical Nutrition.

Control your cholesterol with medication

While dietary and lifestyle changes can help many people reduce high cholesterol levels, some people may also need to take medications to get their cholesterol to healthy levels.

Cholesterol-lowering medicines include:

• Statins. The most commonly prescribed drug to control cholesterol, statins slow down the liver’s cholesterol production. They also help the liver remove cholesterol from your blood.
• Bile acid sequestrants. These medications help remove cholesterol from the blood.
• Niacin. Also known as nicotinic acid, niacin is a B vitamin. Prescription niacin can increase good cholesterol while lowering bad cholesterol and triglycerides. It works by blocking the enzyme that makes cholesterol in your liver.
• Fibrates. They help reduce triglycerides.
• PCSK 9 inhibitors. This injectable medicine is mainly used to lower cholesterol in people with familial hypercholesterolemia, a genetic condition that causes very high LDL cholesterol levels.

Check with your doctor to determine what options make sense for you.