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What is cholesterol?

Dietary cholesterol is a waxy substance found only in foods of animal origin such as poultry, beef, fish, eggs and dairy products. Fruits and vegetables do not contain cholesterol. Cholesterol is necessary to keep the body functioning normally. The liver manufactures enough cholesterol for normal cell processes such as building cell walls and producing hormones. In children, cholesterol plays an important role in the development of the brain and nervous system.

When cholesterol is combined with fats and proteins for use by your body, it forms particles called lipoproteins. There are two types of lipoproteins.

Low-density lipoproteins (LDL or "bad" cholesterol) are associated with the buildup of excess cholesterol on the walls of the arteries. This buildup (plaque) forms on the inner walls of the arteries, reducing blood flow to the heart and brain.

High-density lipoproteins (HDL or "good" cholesterol) remove excess cholesterol from the bloodstream and carry it to the liver for excretion. HDL prevents the accumulation of cholesterol and other fats along the artery walls.

Why does cholesterol matter?

A number of medical studies have found that a high level of cholesterol is a major factor in developing atherosclerosis, the narrowing of arteries through a buildup of fatty plaque. The typical American diet tends to be high in cholesterol and dietary fat.

(from the CDC: Leading risk factors for heart disease and stroke are high blood pressure, high LDL cholesterol, diabetes, smoking, secondhand smoke exposure, obesity, unhealthy diet, and physical activity.)  

People who consume large amounts of cholesterol and saturated fats tend to have higher levels of blood cholesterol, as well as a higher incidence of atherosclerosis. Cholesterol buildup in the arteries is one of the most common causes of heart disease and stroke and happens so slowly that you may not even be aware of it.

Anyone can have high blood cholesterol; there are no warning signs. The only way to find out if you have high blood cholesterol is by visiting a health care professional. The doctor will ask about your eating habits, physical activity, family history, medicines you are taking, and risk factors for heart and blood vessel diseases. If the doctor believes you have risk factors for high blood cholesterol, they will perform a lipoprotein profile test (after a 9 to 12 hour fast), which measures total blood cholesterol, LDL, HDL, and triglycerides. The National Heart, Lung, and Blood Institute recommends that people 20 years of age or older get tested for cholesterol. For younger adults, every five years; men ages 45-65, every 1 to 2 years; women ages 55 to 65, every 1 to 2 years; and people over the age of 65, every year.  

Cholesterol Guidelines*

The National Heart, Lung, and Blood Institute recommends* the following desirable numbers:

Desirable Cholesterol Numbers for Adults
Total Cholesterol Less than 200 mg/dL
LDL “bad” cholesterol Less than 100 mg/dL
HDL “good” cholesterol Greater than or equal to 60 mg/dL
Triglycerides Less than 150 mg/dL

How can I lower my cholesterol?

According to the National Heart, Lung, and Blood Institute, the main goal in treating high cholesterol is to lower your LDL (bad) cholesterol level. Studies have shown that lowering you LDL can slow, stop, or even reverse the buildup of plaque in your arteries.

To lower your cholesterol levels, it is important to: 

Get Moving

Generally, 150 minutes of weekly physical activity is recommended to help lower your LDL (bad) cholesterol and triglycerides and raise your HDL (good) cholesterol.

Maintain a Healthy Weight

Individuals who have high cholesterol and are overweight or obese should aim to maintain a healthy weight. Being overweight or having obesity, increases triglycerides and LDL (bad) cholesterol and lowers HDL (good) cholesterol.

Eat Smart

Adopting a heart-healthy diet, such as the Mediterranean diet or the Dietary Approaches to Stop Hypertension (DASH) eating plan, can help lower high blood pressure and studies found they also improve cholesterol levels.

Both diets focus on consuming vegetables, fruits, whole grains, fat-free or low-fat dairy, fish, poultry (chicken), beans, nuts and seeds, and healthy oils, while reducing fatty meats, full-fat dairy, sugar sweetened beverages, sweets, and sodium.

Quit Smoking

Smoking can lower your HDL (good) and raise your LDL (bad) cholesterol levels.

Get Enough Sleep

Sleep helps heal and repair your heart and blood vessels. It is recommended that adults get 7 to 9 hours a sleep a night.

Limit Alcohol Consumption

More than two drinks a day for men and one drink a day for women, has the potential to raise your total cholesterol level.

Drug Treatment

For some people, high cholesterol levels may continue despite other lifestyle changes. For these persons, lipid-lowering drugs may be recommended. A health care provider can help to determine whether this option is best suited for your needs.

You can find out more about blood cholesterol by contacting the following organizations: