CHOLESTEROL TESTING - WHAT DO THE NUMBER MEAN & WHAT CAN YOU DO TO IMPROVE YOURS?
There’s a great deal of confusion about cholesterol and what the numbers really mean. So today I’m going to address the standard cholesterol test, HDL and LDL cholesterol, triglycerides, and how often you should be tested.
𝗪𝗵𝗮𝘁 𝗶𝘀 𝗖𝗵𝗼𝗹𝗲𝘀𝘁𝗲𝗿𝗼𝗹?
According to the National Institutes of Health, “Cholesterol is a waxy, fat-like substance that’s found in all cells of the body.” Your body needs cholesterol in order to manufacture hormones (including estrogen and testosterone), bile acids for digesting fat, and vitamin D. It is also an essential part of the structure and protection of every cell in the body.
𝗛𝗼𝘄 𝗱𝗼𝗲𝘀 𝗖𝗵𝗼𝗹𝗲𝘀𝘁𝗲𝗿𝗼𝗹 𝗴𝗲𝘁 𝗶𝗻𝘁𝗼 𝗼𝘂𝗿 𝗯𝗹𝗼𝗼𝗱 𝗮𝗻𝗱 𝗰𝗲𝗹𝗹𝘀?
Less than 20 percent of the cholesterol in your body comes from the food you ingest. The remaining 80 percent is produced by your liver, from the basic building blocks of fats, sugars, and proteins. As anyone who has ever taken a basic chemistry class or cooked will know, fat and water do not mix: The water cells repel the fat cells.
Cholesterol is a fat, so in order for it to travel in the blood stream, it is encased into packages called lipoproteins. Lipoproteins have cholesterol and triglycerides on the inside, surrounded by a protein coating on the outside, which is not repelled by the water in blood.
𝗧𝘆𝗽𝗲𝘀 𝗼𝗳 𝗹𝗶𝗽𝗼𝗽𝗿𝗼𝘁𝗲𝗶𝗻𝘀?
There are 5 types of lipoproteins but we’ll focus on two: LDL (low density lipoprotein) and HDL (high density lipoprotein).
This is the bad cholesterol. Low-density lipoproteins (LDL) carry cholesterol around the bloodstream, delivering it to tissues that need it. They are formed in the blood when very-low-density and intermediate-density lipoproteins have given up their fatty acids. While they form an important function, research shows that high levels of LDL cause a buildup of cholesterol in the blood vessels—a process known as atherosclerosis, a precursor to coronary heart disease.
This is the good cholesterol. One of the main functions of HDL cholesterol is to remove excess cholesterol from cells and transport it to the liver where it is disposed of. It helps removes fats from the body and prevents clogging of the arteries with cholesterol. HDL cholesterol is also an antioxidant, anti-inflammatory, and more.
Triglycerides are a type of fat (lipid) found in your blood.
When you eat, your body converts any calories it doesn't need to use right away into triglycerides. The triglycerides are stored in your fat cells. Later, hormones release triglycerides for energy between meals.
If you regularly eat more calories than you burn, particularly from high-carbohydrate foods, you may have high triglycerides.
𝗪𝗵𝗮𝘁'𝘀 𝘁𝗵𝗲 𝗱𝗶𝗳𝗳𝗲𝗿𝗲𝗻𝗰𝗲 𝗯𝗲𝘁𝘄𝗲𝗲𝗻 𝘁𝗿𝗶𝗴𝗹𝘆𝗰𝗲𝗿𝗶𝗱𝗲𝘀 𝗮𝗻𝗱 𝗰𝗵𝗼𝗹𝗲𝘀𝘁𝗲𝗿𝗼𝗹?
Triglycerides and cholesterol are different types of fats that circulate in your blood:
• Triglycerides store unused calories and provide your body with energy.
• Cholesterol is used to build cells and certain hormones.
𝗪𝗵𝗮𝘁 𝗱𝗼𝗲𝘀 𝗶𝘁 𝗺𝗲𝗮𝗻 𝘁𝗼 𝗵𝗮𝘃𝗲 𝗛𝗶𝗴𝗵 𝗖𝗵𝗼𝗹𝗲𝘀𝘁𝗲𝗿𝗼𝗹?
High cholesterol is a condition where you have too much LDL and not enough HDL (to mop up the excess cholesterol).
In the early stages there are no symptoms or signs, but it may be detected on a routine blood test. Research has shown that those with high cholesterol are at higher risk of developing atherosclerosis and coronary artery disease (CAD).
𝗪𝗵𝗮𝘁 𝗜𝘀 𝗔𝘁𝗵𝗲𝗿𝗼𝘀𝗰𝗹𝗲𝗿𝗼𝘀𝗶𝘀?
When your cholesterol level is high for a long period, excess cholesterol attaches to the walls of the arteries, forming “plaques” that harden and narrow your arteries. Blood flow is reduced and less oxygen can get to the heart and other tissue. The results can be:
Coronary Artery Disease (CAD)-
Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the United States in both men and women. CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls.
Stroke and Peripheral Artery Disease (PAD)-
Peripheral artery disease is a narrowing of the peripheral arteries serving the legs, stomach, arms and head. (“Peripheral” in this case means away from the heart, in the outer regions of the body.) PAD most commonly affects arteries in the legs.
• Your risk for peripheral artery disease increases with age.
• High blood pressure or high cholesterol puts you at risk for PAD.
• If you smoke, you have an especially high risk for PAD.
• If you have diabetes, you have an especially high risk for PAD.
• People with PAD are at a higher risk of stroke. A stroke is a “brain attack”. It can happen to anyone at any time. It occurs when blood flow to an area of brain is cut off. When this happens, brain cells are deprived of oxygen and begin to die.
𝗪𝗛𝗔𝗧 𝗔𝗥𝗘 𝗚𝗢𝗢𝗗 𝗖𝗛𝗢𝗟𝗘𝗦𝗧𝗘𝗥𝗢𝗟 𝗡𝗨𝗠𝗕𝗘𝗥𝗦?
Again, without getting into too much detail, you should aim for the following numbers:
LDL cholesterol- Ideally, below 100 (below 70 for those with heart or blood vessel disease and for other patients at very high risk of heart disease, ie diabetics)
HDL cholesterol- Levels above 60 are optimal. Levels below 50 in women or 40 in men puts you at higher risk of heart disease.
Triglycerides- Optimal levels are 150 or lower
To calculate your cholesterol ratio, divide your total cholesterol number by your HDL cholesterol number. So if your total cholesterol is 200 and your HDL is 50 your ratio would be 4-to-1. Higher ratios mean a higher risk of heart disease. An optimal ratio is around 3.5 or lower.
𝗟𝗗𝗟 𝗣𝗔𝗥𝗧𝗜𝗖𝗟𝗘 𝗦𝗜𝗭𝗘- 𝗪𝗛𝗬 𝗗𝗢𝗘𝗦 𝗜𝗧 𝗠𝗔𝗧𝗧𝗘𝗥?
Researchers now believe that a key factor is the size and density of LDL particles, which range from very small, densely concentrated particles to large “fluffy” ones. Studies have linked smaller, dense LDL particles to a higher risk of heart disease compared to larger particles, which may be relatively benign. This is true even if your LDL level is in the desirable range. I won’t get into detail about particle size but your doctor will, particularly if he or she sees a problem.
𝗚𝗘𝗧𝗧𝗜𝗡𝗚 𝗧𝗘𝗦𝗧𝗘𝗗- 𝗪𝗛𝗢 𝗔𝗡𝗗 𝗛𝗢𝗪 𝗢𝗙𝗧𝗘𝗡?
Who should be tested?-
According to the CDC, testing should be done as follows:
• Once between ages 9 and 11 (before puberty)
• Once between ages 17 and 21 (after puberty)
• Every 4 to 6 years in adulthood
Adults aged 20 and older should have their cholesterol and triglyceride levels checked once every five years. However, your doctor may suggest doing this annually if you have certain risk factors such as diabetes, high blood pressure, obesity, or a family history of heart disease.
𝗛𝗢𝗪 𝗖𝗔𝗡 𝗬𝗢𝗨 𝗟𝗢𝗪𝗘𝗥 𝗕𝗔𝗗 (𝗟𝗗𝗟) 𝗖𝗛𝗢𝗟𝗘𝗦𝗧𝗘𝗥𝗢𝗟?
1. Eat heart-healthy foods- Reduce saturated fat. Eat foods rich in Omega-3 fatty acids.
2. Exercise on most days of the week and increase your physical activity
3. Quit smoking
4. Lose weight
5. Drink alcohol only in moderation
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