Understanding Your Cholesterol and How to Lower It

 Dr. James Stein explains what cholesterol is and how it affects your health


A quick blood test reveals the trio of numbers indicating your cholesterol status. But even if the doctor declares your cholesterol levels to be OK, you could still be at risk for heart disease, which is the No. 1 cause of death in the United States.


“The most important thing to know about cholesterol is it’s one of the main components of the buildup in blood vessel walls that eventually leads to heart attacks and strokes,” explains James H. Stein, MD, director of UW Health’s Preventive Cardiology Program. “What most people don’t understand is that most heart attacks are caused by mild blockages, less than 50 percent blocked, and that’s because when cholesterol gets into the blood vessel wall, it sets up an inflammatory reaction, and cholesterol-rich plaques get inflamed and break open. The majority of people who have heart attacks and strokes didn’t have symptoms beforehand, and a lot of people don’t consider that ‘normal’ cholesterol levels in the United States are still levels that put people at risk.”


Forty percent of American adults have total cholesterol above 200 milligrams/deciliter, which is considered a borderline high-risk level, according to the American Heart Association. Of those, 12 percent are above 240 mg/dL, which is considered high.


The Western diet doesn’t help. Just consider: A newborn baby’s bad cholesterol level is just 40 mg/dL, and modern hunter-gather societies who eat a mostly vegetarian diet similar to our prehistoric ancestors have bad cholesterol levels around 60 mg/dL, Stein notes. In contrast, the average American adult’s bad cholesterol level is 110.


“In general, the lower the better, because without cholesterol, you can’t have the buildup of plaque in your arteries,” he says. “What we recommend now is much lower than we ever would’ve recommended before.”


A recent national survey found that many people, including those with high cholesterol, don’t know how to keep their cholesterol levels under control.


Simple Lifestyle Changes Can Make a Difference for Your Heart Health


Fortunately, simple lifestyle changes can make a big difference. Stein recommends the following tips to curb your cholesterol and lower your risk for heart disease:


Get it Checked


Most people get their cholesterol tested every 2-5 years after the age of 20, though people with elevated cholesterol or a history of heart disease will need to have their cholesterol checked more frequently. It can be easy to put off the test if your doctor recommends an overnight fast first, but more recent research shows that non-fasting tests can be just as effective. Either way, get it done.


Understand Your Cholesterol Report


You’ll get three numbers from your test:

  • HDL (high-density lipoproteins), more commonly known as “good” cholesterol because it carries cholesterol to the liver for processing
  • LDL (low-density lipoproteins), otherwise known as the “bad” cholesterol that clogs arteries
  • Triglycerides, another type of lipids that can lead to hardening or clogging of the arteries

“Look at the bad cholesterol and triglycerides, which are fat. The good cholesterol number is less important than getting the bad cholesterol number down,” Stein says. He urges his patients to get their cholesterol down to numbers lower than the current national guidelines: Ideally, your numbers for bad cholesterol and triglycerides should both be below 100, he says.


Watch Your Weight


While genetics can affect your cholesterol level, what you eat can have a drastic effect on your numbers. “There’s no medicine that humans can’t overeat the effects of,” Stein says. “If people lose weight, we can see very rapid results in their cholesterol in a month or two.”


Calculate your weight


Portion control can go a long way — no second helpings, Stein says. And don’t forget to exercise. Not only can it help you trim down, but when you build muscle mass and lose fat, your body uses triglycerides and fat more efficiently, he says.


Improve Your Diet


Even if you’re at a healthy weight, be mindful of your food choices — trans fat, saturated fat, starches and alcohol can drive up your bad cholesterol and triglyceride levels. Increasing soluble fiber can help lower triglycerides, so choose whole grains over simple carbs and eat more fruits and vegetables. Also, substitute good fats, such as olive or canola oils, over bad fats, such as coconut, vegetable and palm oils.


Stein’s rule of thumb for a well-rounded meal: fill half your plate with fruits and vegetables, one quarter with lean protein, and the remaining quarter with another food, such as a starch or more vegetables.


Keeping your cholesterol low requires an ongoing commitment to better food choices, but it’s worth the effort. “Lifestyle changes can be very effective,” Stein says. “It can be as effective as going on a low-dose statin medication.” And more importantly, it could save your life.


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Date Published: 06/16/2017

News tag(s):  wellnesshealthy bodiesheartjames h stein

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