I was recently visiting with a patient who said she was told her bad cholesterol was too high and her husband’s good cholesterol is too low. She was confused as she thought all cholesterol was bad and wanted to know what exactly is “good” and “bad” cholesterol and what they could do with their diet to prevent the need from taking cholesterol-lowering medications commonly known as statins.
Total cholesterol is the sum of all the cholesterol in your blood. When your total cholesterol is high, your risk for heart disease goes up as well. Having total cholesterol less than 200mg/dL is desirable. Cholesterol is then broken down into two groups, LDL and HDL.
LDL most often called bad cholesterol can be dangerous when levels are too high. LDL cholesterol is what builds up in your arteries and may block the flow of blood. Having a level less than 100mg/dL is optimal. If the level is above 130mg/dL, your doctor may recommend lifestyles changes or even starting a statin to help lower the level of LDL cholesterol in your blood, and reduce your risk of heart disease.
HDL cholesterol is the good form of cholesterol and it helps protect from heart disease. It carries cholesterol from parts of your body back to the liver, where it can be broken down and removed. For HDL cholesterol higher numbers are better. Having a level of 60mg/dL and above is protective and lowers your risk for heart disease.
There are numerous food items that can affect your levels of both LDL and HDL cholesterol. High levels of LDL cholesterol are correlated with a diet that is high in saturated fat and trans fats. Saturated fats are mainly found in high fat animal foods, such as red meat, chicken, butter, and whole-milk dairy products. Trans fats are found in stick margarine, solid shorting, and many prepared foods, such as crackers, cookies, doughnuts, snack foods, and commercially fried foods.
High levels of HDL cholesterol are correlated with a diet that is high in unsaturated fats. Unsaturated fats, like monounsaturated and polyunsaturated, can be found in some fish, nuts, peanut butter, avocadoes and plant-based oil such as peanut, canola and olive oil. Other factors, like exercise, and quitting smoking can help increase your level of HDL cholesterol.
A simple blood test called a fasting lipid profile measures these various types of cholesterol in your blood. While someone may have a total cholesterol level that is desirable, the breakdown of LDL and HDL cholesterol may not be desirable. That is why it is important to have a complete lipid profile. After age 20, everyone should have a fasting lipid profile at least every 5 years, sooner if you have elevated cholesterol or are taking a statin. If you have a strong family history for heart disease, talk to your primary care clinician about having the test performed more often.
For more information on cholesterol and testing options, please visit ministryhealth.org.
Author: Sally Andersen
Sally Andersen is an advanced practice nurse practitioner (APNP) at Affinity Medical Group’s Greenville Clinic.