Signs, Signs, Everywhere A Sign…

Deep breath.  And another one.  Okay.  We’re going to have a look at the world of cholesterol numbers and signs.  It will be brief, we promise.  But for our own health’s sake – and our sanity, too, for that matter – we should at least have a basic familiarity with the concepts.  If not for you, then for a family member or loved one.

Cholesterol is a typically described as a waxy substance, a compound of the sterol type, found in most body tissues.  It is important in metabolism.  Cholesterol is needed to produce hormones, vitamin D and bile; it helps protect nerves and is important for cell structure.   Most of the body’s cholesterol is made in the liver, though some may come from food.

High cholesterol is called hypercholesterolemia and this condition increases the risk of cardiovascular disease.  Fatty deposits develop in blood vessels, eventually making it difficult, if not impossible,  for enough blood to flow through the arteries.  When this happens, the heart may not be getting enough of the oxygen-rich blood that it needs, which increases the risk of heart attack.  Decreased blood flow to the brain can result in a stroke.

Cholesterol is carried to the rest of the body from the liver in LDL, low density lipoproteins, or ‘bad’ cholesterol; it goes back to the liver in HDL, high density lipoproteins, or ‘good’ cholesterol.  HDL is considered to be a good guy because it helps prevent the arteries from clogging.  A diet high in saturated fats and trans fats may increase your blood cholesterol level, while a high-fiber diet with plenty of fruits, vegetables, legumes, nuts and seeds may decrease high cholesterol levels.  High cholesterol can be inherited, but is often very treatable and preventable.

Cholesterol levels are checked with a blood test, called a lipid panel or lipid profile.  Such a test usually reports:

• Total cholesterol
• LDL cholesterol
• HDL cholesterol
• Triglycerides, a type of fat increased by alcohol and sweets

LDL targets, something you will go over with your doctor, vary.  LDL cholesterol is one of the major risk factors for heart disease and is thus the main focus of cholesterol-lowering treatment plans. Your particular target number will depend on your heart disease risk.  In general, the lower your LDL, the better.  You are considered to be at high risk for heart disease if you have:

• A previous stroke or heart attack
• Artery blockages in your neck (carotid artery disease)
• Artery blockages in your arms or legs (peripheral artery disease)

Additionally, two of more of these risk factors could land you in a very high risk group:

• High blood pressure
• Smoking
• Diabetes
• Low HDL cholesterol
• Family history of early heart disease
• Elevated lipoprotein (a), another type of fat (lipid) in the blood

Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.  This applies to the United States and a few other countries.  In Canada and most of Europe, cholesterol is measured in millimoles (mmol) per liter (L) of blood.  

Here are some general guidelines to help you interpret cholesterol test results in the US:

Total Cholesterol

• Desirable: below 200 mg/dL
• Borderline high: 200 – 239/dL
• High: 240 mg/dL and above

LDL (bad) Cholesterol

• Below 70 mg/dL: ideal for people at very high risk of heart disease
• Below 100 mg/dL: ideal for people at risk of heart disease
• 100 – 129 mg/dL: near ideal
• 130 – 159 mg/dL: borderline high
• 160 – 189 mg/dL: high
• 190 mg/dL and above: very high

HDL (good) Cholesterol

• Below 40 mg/dL (men): poor
• Below 50 mg/dL (women): poor
• 50 – 59 mg/dL: better
• 60 mg/dL and above: best

Triglycerides

• Below 150 mg/dL: desirable
• 150 – 199 mg/dL: borderline high
• 200 – 499 mg/dL: high
• 500 mg/dL and above: very high

The American Heart Association (AHA) considers a triglyceride level of 100 mg/dL or lower to be ‘optimal’.  This optimal level improves heart health.  They do not, however, recommend drug treatment to reach this level, preferring lifestyle changes to lower triglycerides.  It has been shown repeatedly that triglycerides respond well to diet and lifestyle changes and options.   While you surely know all of these by heart (!) now, lifestyle choices that will help everything cholesterol related include:

• Quitting smoking
• Losing weight
• Exercising at least 30 minutes per day
• Eating far less fat and cholesterol from meat and dairy products
• Eating far more soluble fiber, such as that found in oatmeal, legumes, fruits and veggies