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

Abdominal obesity and your health

Excess body fat has serious consequences for health. It' associated with high levels of LDL ("bad") cholesterol and triglycerides and low levels of HDL ("good") cholesterol. It impairs the body's responsiveness to insulin, raising blood sugar and insulin levels. Excess body fat contributes to major causes of death and disability, including heart attacks, strokes, high blood pressure, cancer, diabetes, osteoarthritis, fatty liver, and depression. Faced with these risks, it's no wonder that you want to know how much you should weigh. But this common and important question is actually the wrong question. For health, the issue is not how much you weigh, but how much abdominal fat you have. Methods have changed over the years. But when scientists recognized that what matters is not body weight but body fat, standards began to change. The body mass index (BMI), remains enshrined as the standard way to diagnose overweight and obesity. More »

Making sense of cholesterol tests

Time to get your cholesterol checked. Okay, but which test should you get? It's not so simple anymore. Here is a rundown of some of the choices and their pros and cons: Total cholesterol. This is the simplest and least expensive test. The test doesn't require any sophisticated lab work, either. The simple, do-it-yourself home cholesterol tests measure total cholesterol. But total cholesterol includes both "good" high-density lipoprotein (HDL) cholesterol, and the "bad" varieties, chiefly low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL). So if your total cholesterol is in the desirable category, it's possible that you may have unhealthy levels of HDL (too low) and LDL and VLDL (too high). Think of total cholesterol as a first glimpse, a peek. Doctors are not supposed to make any treatment decisions based on this number alone. More »

LDL cholesterol: Low, lower, and lower still

The overall message on "bad" LDL cholesterol is much the same as it has been: Lower is better and how low your level should be depends on your cardiovascular risk factors. But the standard for what low LDL means keeps on getting lower. While  an LDL level under 70 is still the usual goal for people at the highest risk for cardiovascular disease perhaps that is still too high. The main impetus for the "lower is better" mantra got started more than 10 years ago based on studies of the statin drugs such as atorvastatin (Lipitor) and simvastatin (Zocor). The studies involved only people with heart disease, so the lessons learned don't directly apply to everyone, but there are certainly enough people with heart disease to make them important. More »