Cholesterol

Cholesterol isn't entirely the health villain it's made out to be, its name darkly linked to heart attack, stroke, and other types of cardiovascular disease. Our bodies need cholesterol, which is a type of lipid (another name for fat) to make cell membranes, key hormones like testosterone and estrogen, the bile acids needed to digest and absorb fats, and vitamin D. Cholesterol is so important to the body that the liver and intestines make it from scratch.

What is "bad" about cholesterol isn't the substance itself — in fact, we can't live without it — but how much of it is in the bloodstream.

The body packages cholesterol in two main particles: low-density lipoprotein (LDL), the so-called bad cholesterol, and high-density lipoprotein (HDL), the so-called good cholesterol. Too much LDL in the bloodstream helps create the harmful cholesterol-filled plaques that grow inside arteries. Such plaques are responsible for angina (chest pain with exertion or stress), heart attacks, and most types of stroke.

What causes a person's LDL level to be high? Most of the time diet is the key culprit. Eating foods rich in saturated fats, trans fats, and easily digested carbohydrates boost LDL. Genes are sometimes at the root of high cholesterol, and some medications can boost LDL.

If you have high cholesterol, making changes in your diet can help bring it down into the healthy range. Exercise can help boost the level of protective HDL. Several types of medication, notably the family of drugs known as statins, can powerfully lower LDL. Depending on your cardiovascular health, your doctor may recommend taking a statin.

Cholesterol Articles

When very high cholesterol runs in the family

Familial hypercholesterolemia (FH) is an inherited condition that leads to very high levels of harmful LDL cholesterol. Although FH is as common as type 1 diabetes and cystic fibrosis, many people have never heard of it. Because it’s a leading cause of premature heart attacks, ongoing efforts seek better ways to identify FH. Genetic testing isn’t always necessary, because high LDL cholesterol is an excellent indicator of heart disease risk. In children, an LDL cholesterol level of 160 mg/dL or higher suggests FH; in adults, an LDL of 190 mg/dL or higher raises suspicion. (Locked) More »

Do you need a calcium scan?

Coronary artery calcium scans, which can reveal dangerous plaque in the heart’s arteries, are now recognized by guidelines and being are used more often than in the past. Results from the scan may help refine or reclassify a person’s risk of heart disease. But the tests don’t make sense for everyone. People who already have heart disease should not have a calcium scan, nor should people at low risk, which includes most people under age 40. Instead, the scans are an option for people who fall in between. This borderline and intermediate risk group includes people ages 40 to 75 whose 10-year risk of heart disease or stroke ranges from 5% to 20%. More »

Skip vitamins, focus on lifestyle to avoid dementia

New guidelines released May 19, 2019, by the World Health Organization recommend a healthy lifestyle—such as keeping weight under control and getting lots of exercise—in order to delay the onset of dementia or slow its progression. More »

Bust your belly for a healthier heart

Visceral fat lies deep within the abdominal cavity and pads the spaces between your abdominal organs. While it makes up only 10% of total body fat, it can have the biggest impact on health, as high amounts are linked with a greater risk of heart disease. Following a high-quality diet is necessary to lose visceral fat, but high-intensity aerobic exercise may help even more. An ideal visceral fat-burning workout is 20 to 30 minutes of some kind of high intensity exercise, at least three days a week. (Locked) More »

For most people, no need for niacin

Niacin, also known as vitamin B3, is unlikely to provide any heart-related benefit for most people. Its only possible role is for people who cannot tolerate statins, but other, newer medications would likely offer greater benefits. More »

Unscrambling the message on eggs

Advice about eating eggs has changed over the years, ranging from a limit of three to seven per week. Although eggs are high in cholesterol, dietary cholesterol does not affect blood cholesterol very much in most people. Saturated fat from meat and full-fat dairy products likely plays a bigger role. However, some people are more affected by dietary cholesterol than others. People with high blood cholesterol, diabetes, or heart disease should eat no more than two eggs a week. Focusing on overall diet quality, rather than one particular food, is also important. (Locked) More »