 Cholesterol is a soft, fat-like substance found in the bloodstream. Everybody has cholesterol and it is an important part of a being healthy. Cholesterol is used for producing cell membranes and it is needed for other bodily functions. Of course, as with all things, there is a healthy level and an unhealthy level. Too much cholesterol in the blood is a major risk for coronary heart disease and stroke.
The body makes cholesterol and some foods contain additional cholesterol. The foods are animal products, including meat, poultry, fish, eggs, butter, cheese and whole milk. Plant derived foods do not contain cholesterol, but foods containing saturated fats and trans-fats can cause the body to make more cholesterol.
Cholesterol and fats cannot dissolve in the blood. Carriers called lipoproteins transport them to and from the cells. Two types of lipoproteins are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). You may have heard of these. LDL is sometimes referred to as the "bad" cholesterol and HDL is sometimes referred to as the "good" cholesterol. HDL carries cholesterol away from the arteries. Studies suggest that high levels of HDL cholesterol reduce the risk of heart attack.
If too much LDL cholesterol circulates in the blood, it can build up in the inner walls of the arteries, forming plaque. Plaque is a hard substance that can clog arteries. This condition is known as atherosclerosis. This may lead to clot formation. If a clot is formed and blocks an artery, which may already be narrowed with plaque, it can cause a heart attack or stroke.
About a quarter of the cholesterol in the blood is carried by HDL. The higher the HDL level in the blood, the lower the risk of having a heart attack. It is thought that HDL carries cholesterol away from the arteries and back to the liver, where it is passed from the body.
 Cholesterol is measured in milligrams per deciliter (mg/dL). It is recommended to keep total cholesterol below 200 mg/dL, the LDL below 130 mg/dL and the HDL above 40 mg/dL. These are general guidelines applying to otherwise healthy people. If you have risk factors for heart attack, such as smoking, a family history of heart disease, being overweight, etc., even these levels may be too high.
Total cholesterol levels above 240 mg/dL and LDL cholesterol above 160 mg/dL are considered high and the risk of heart attack and stroke is greater. In general, people who have a total cholesterol level of 240 mg/dL have twice the risk of heart attack as people whose cholesterol level is 200 mg/dL. About 20 percent of Americans have high blood cholesterol levels. So high total cholesterol and high LDL cholesterol is dad. High HDL cholesterol is good. The HDL cholesterol level can be raised by not smoking, maintaining a healthy weight and getting at least 30-60 minutes of exercise or physical activity a day.
Sometimes cholesterol is reported as a ratio of total cholesterol divided by HDL cholesterol. The optimum ratio is three and a half to one. The American Heart Association recommends using the individual numbers for total and HDL cholesterol rather than the ratio.
Women generally have higher HDL cholesterol levels than men since the female sex hormone, estrogen, tends to raise HDL cholesterol.
While cholesterol is more of a problem as we age, there is evidence that the atherosclerotic process begins in childhood and progresses slowly into adulthood. The recommended cholesterol level in children and adolescents is lower than for adults; below 170 mg/dL of total cholesterol and below 100 mg/dL of LDL cholesterol. Children should be encouraged to exercise regularly, eat a proper diet and avoid smoking.
The major cause of death in the United States is coronary heart disease, resulting in more than 500,000 deaths a year. Some risk factors for heart disease cannot be changed. The older we get the greater the risk of heart attacks. Men have a greater risk than women but women who have heart attacks are more likely to die within a few weeks. Having a family history of heart disease in parents, siblings or offspring also increases the risk of heart disease. Here are some suggestions to reduce the risk of heart attack and stroke:
- Check blood cholesterol regularly, especially above the age of 50, and take steps to reduce high cholesterol levels.
- Avoid smoking.
- Check blood pressure regularly and take steps to reduce it if it is high.
- Get at least 30 minutes of physical activity daily.
- Recognize and treat diabetes.
- Maintain a healthy diet and avoid foods with high cholesterol or high saturated fats or high sodium.
- Maintain a healthy weight.
- Reduce stress.
Saturated fat, trans-fatty acids and dietary cholesterol raise blood cholesterol. The American Heart Association recommends limiting saturated fat intake to less than 7-10 percent of total daily calories. Saturated fat is found mostly in foods from animals (meat, fat, poultry, butter, cream, milk and cheese) and some plants (tropical oils such as coconut oil, palm oil and palm kernel oils and cocoa butter). Hydrogenated fats and partially hydrogenated vegetable oils also raise blood cholesterol.
Monounsaturated fats and polyunsaturated fats do not raise blood cholesterol. Polyunsaturated fats include safflower, sesame and sunflower seeds, corn and soybeans, many nuts and seeds and their oils. Monounsaturated fats include canola, olive and peanut oils and avocados.
Some false comfort factors people often have are that margarine is cholesterol safe and that thin people don’t have to worry about cholesterol. While margarine is lower in cholesterol than butter, it does contain saturated fats, which contribute to cholesterol. Soft or liquid margarine is better than hard margarine. Margarines or other foods with trans fatty acids should be consumed in moderation or avoided because the trans fatty acids are converted to saturated fats.
While overweight people are more likely to have high cholesterol, thin people can also be at risk. People who don’t gain weight easily may be less aware of how much saturated fat they eat. It is best to get your cholesterol checked regularly and start early, especially if you have a history of heart disease in the family.
 Nutrition labels can be useful in food selection but be conscious of the amount of saturated fat or trans fatty acids in addition to the total cholesterol in a food product. Look for the amount of saturated fat, total fat, cholesterol and total calories in a serving of the product and check how much a serving is. It may be smaller than you think! Starting in 2006, the Food and Drug Association will require foods to be labeled for trans fats. Trans fats are found in most foods with partially hydrogenated oils including, baked goods, fried foods and some margarines and dairy products.
As always, staying healthy involves a balanced diet, avoiding alcohol and smoking, getting regular exercise and periodic medical checkups. If you have a risk factor for coronary heart disease, be sure to let your doctor know and follow the advice given.
(Extracted from the the American Heart Association website.)  |
Atherosclerosis is the process of plaque building up in the inner lining of the artery. It is referred to as hardening of the arteries and is caused by fatty substances, cholesterol, cellular waste products, calcium and fibrin. Some hardening occurs normally as we age. However, plaque may partially or totally block the flow of blood in the artery. This can cause bleeding (hemorrhage) into the plaque or the formation of a blood clot on the surface of the plaque. If the entire artery is blocked, it can cause a heart attack or stroke.
