Cholesterol is a soft, fat-like, waxy substance found in the bloodstream and in all your body's cells. It's normal to have cholesterol. Cholesterol is an important part of a healthy body because it's used for producing cell membranes and some hormones, and serves other needed bodily functions. But too much cholesterol in the blood is a major risk for coronary heart disease (which leads to heart attack) and for stroke. Hypercholesterolemia is the medical term for high levels of blood cholesterol.
Too much cholesterol in the blood can lead to heart disease and stroke - America's No. 1 and No. 3 killers. Even though there's much you can do to lower your cholesterol levels and protect yourself, half of American adults still have levels that are too high (over 200 mg/dL). You can reduce cholesterol in your blood by eating healthful foods, losing weight if you need to and being physically active. Some people also need to take medicine because changing their diet isn't enough. Your doctor and nurses will help you set up a plan for reducing your cholesterol - and keeping yourself healthy!
Most heart and blood vessel disease is caused by a buildup of cholesterol, plaque and other fatty deposits in artery walls. The arteries that feed the heart can become so clogged that the blood flow is reduced, causing chest pain. If a blood clot forms and blocks the artery, a heart attack can occur. Similarly, if a blood clot blocks an artery leading to or in the brain, a stroke results.
Cholesterol can't dissolve in the blood. It has to be transported to and from the cells by carriers called lipoproteins. Low-density lipoprotein, or LDL, is known as "bad" cholesterol. High-density lipoprotein, or HDL, is known as "good" cholesterol. These two types of lipids, along with triglycerides and Lp(a) cholesterol, make up your total cholesterol count, which can be determined through a blood test.
LDL (Bad) Cholesterol
When too much LDL (bad) cholesterol circulates in the blood, it can slowly build up in the inner walls of the arteries that feed the heart and brain. Together with other substances, it can form plaque, a thick, hard deposit that can narrow the arteries and make them less flexible. This condition is known as atherosclerosis. If a clot forms and blocks a narrowed artery, heart attack or stroke can result.
HDL (good) Cholesterol
About one-fourth to one-third of blood cholesterol is carried by high-density lipoprotein (HDL). HDL cholesterol is known as "good" cholesterol, because high levels of HDL seem to protect against heart attack. Low levels of HDL (less than 40 mg/dL) also increase the risk of heart disease. Medical experts think that HDL tends to carry cholesterol away from the arteries and back to the liver, where it's passed from the body. Some experts believe that HDL removes excess cholesterol from arterial plaque, slowing its buildup.
What should I eat?
Focus on low-saturated-fat, trans fat-free, low-cholesterol foods such as these:
- A variety of fruits and vegetables (choose 8 to 10 servings per day)
- A variety of grain products like bread, cereal, rice and pasta, including whole grains (choose 6 or more servings per day)
- Fat-free and low-fat milk products (2 to 3 servings per day)
- Lean meats and poultry without skin (choose up to 5 to 6 total ounces per day)
- Fatty fish (enjoy at least 2 servings baked or grilled each week)
- Beans and peas
- Nuts and seeds in limited amounts (4 to 5 servings per week)
- Unsaturated vegetable oils like canola, corn, olive, safflower and soybean oils (but a limited amount of margarines and spreads made from them)
What should I limit?
- Whole milk, cream and ice cream
- Butter, egg yolks and cheese - and foods made with them
- Organ meats like liver, sweetbreads, kidney and brain
- High-fat processed meats like sausage, bologna, salami and hot dogs
Cholesterol Questions To Ask Your Doctor
Many people have questions for their doctors about tests, drug treatments, risk factors and lifestyle changes. Below are examples of common questions. For a printable version to take to your doctor's office, click the link in the right column of this page.
About Blood Cholesterol
- What do my cholesterol numbers mean?
- What is my cholesterol goal?
- How long will it take to reach my cholesterol goals?
- How often should I have my levels checked?
- How does exercise affect my cholesterol levels?
- How does smoking affect my cholesterol levels?
- What type of foods should I eat?
- Do I need to lose weight, and if so, how much?
- Will I need cholesterol-lowering medicine?
About Drug Treatment - What kind of medicine should I take?
- Can I take the generic form of the medicine?
- What should I know about the medicine?
- What are the side effects?
- How do I know if it's working?
- How can I remember when to take the medicine?
- What if I forget to take a medicine?
- Should I avoid any foods or other medicines?
- Can I drink alcohol?
- How long will I need to take my medicine?