Cholesterol is a lipid, or fat-like substance, used to create cells and produce vitamin D and hormones. The liver naturally makes about 80 percent of our cholesterol, all we really need, but consuming animal products high in saturated and trans fats (like meat, poultry and dairy) increases lipid levels. And high cholesterol raises the risk of coronary heart disease.
“Cholesterol is necessary for us to function, but high levels can be problematic,” says Roper St. Francis Healthcare primary care physician Dr. Robin Malik. When too much cholesterol builds in the bloodstream, fatty deposits, known as plaques, accumulate in the arteries and reduce blood flow. Think of cholesterol particles as vehicles on a highway and high cholesterol as rush hour traffic. In the same way a fender bender can lead to a car jam, if plaques rupture and form a clot, blood flow may be blocked, potentially leading to a heart attack or stroke.
The Good versus the Bad
Lipids divide into two lanes depending on the protein to which they’re hitched. (You’re likely familiar with “good” and “bad” cholesterol.) High-density lipoprotein (HDL) may protect against heart attack and stroke, while low-density lipoprotein (LDL) can contribute to plaque buildup and raise the risk for major medical events. That’s because LDL carries cholesterol around the body, collecting on artery walls, while HDL moves excess cholesterol back to the liver to be broken down. “Good” cholesterol doesn’t entirely eliminate “bad,” though—smart lifestyle choices are also necessary.
Active Maintenance
When it comes to managing cholesterol, plenty of mileage can be gained through healthy living, says Dr. Malik:
- Diet: “I encourage a Mediterranean diet, mostly large amounts of vegetables, whole grains, beans, nuts, healthy fats and lean proteins such as fish.” The goal? Gain fiber and avoid saturated fat and refined grains and sugars.
- Exercise: “Boosting exercise increases HDL cholesterol and helps control weight.” Being overweight or obese elevates the risk of high cholesterol, since it affects how the body makes and manages lipids.
- Lifestyle: Abstain from smoking and drinking excessive alcohol. “Cigarette use may lower HDL levels, while imbibing too much can elevate overall cholesterol levels.”
Family Ties
While you can control many cholesterol factors, some people are simply predisposed to cholesterol problems. When genetics win out, doctors often prescribe medications called statins, which work by blocking an enzyme needed to make cholesterol and protect against heart attack and stroke.
Even with medication in the mix, a healthy lifestyle is still the first defense against high cholesterol. Consistent exercise and a diet low in saturated fats may lead to lower dosages of medication and an overall reduction in the risk for heart-related issues.
Checking Up
The National Heart, Lung, and Blood Institute encourages cholesterol screening (done with a quick and painless blood draw) as early as age nine and every five years until middle age. Men ages 45 to 65 and women 55 to 65 should get screenings every year or two and then annually after 65.
“Unless you have an event such as a heart attack or stroke, there are really no symptoms of high cholesterol, ” explains Dr. Malik. In fact, of the 102 million American adults with high cholesterol, 40 percent don’t even realize they have it. “That’s why it’s vital to see your doctor regularly.”
