Although the body needs cholesterol to function, and it occurs naturally in every cell of the body, too much cholesterol can build up in the coronary arteries and increase the risk of heart disease. Cholesterol itself is not inherently “bad.” Rather, it's excess cholesterol that can cause problems in some people. Determine your level of cholesterol with a blood test and lower it naturally by eating more fruits, vegetables and fiber and by exercising more. Prescription medications also lower blood cholesterol levels.
Dietary cholesterol comes from animal-derived food, although your body also makes it. Total cholesterol consists of HDL, LDL and triglycerides, which represent the major form of fat in food and also the main storage form of fat in the body. LDL and HDL transport cholesterol to and from the cells, where it is used to strengthen cell membranes and make hormones and vitamin D.
High-density lipoprotein, called HDL or “good cholesterol," picks up cholesterol from the cells and transports it back to the liver for recycling or waste removal. “Good” refers not to the kind of cholesterol, but to the fact that this transport vehicle takes cholesterol out of circulation. So a higher HDL number means better cholesterol control and protection for the heart, according to Eleanor Whitney and Sharon Rolfes in “Understanding Nutrition.”
Low density lipoprotein, called LDL or “bad cholesterol,” carries cholesterol to every cell in the body for potential use in cell membranes or for making hormones and vitamin D. The cells take only what they need, so high levels of LDL can result in deposits of excess cholesterol in the arteries, causing restricted blood flow. Eventually, a blood clot may block a narrowed artery and result in a heart attack or stroke. A lower LDL number means better health.
Two types of blood tests detect cholesterol. The most common is a quick screening with a finger prick procedure that only provides the total amount of cholesterol in the blood. According to the National Heart, Lung and Blood Institute, total cholesterol is in milligrams per deciliter. Below 200 is desirable, 200 to 239 is borderline high and above 240 is high. If total cholesterol is high, follow up with a complete lipid blood panel test that a doctor orders.
The lipid blood panel requires fasting for 12 hours and a blood draw to detect the amount of HDL, LDL and triglycerides in addition to total cholesterol. For LDL, below 100 is optimal, 100 to 129 is near optimal, 130 to 159 is borderline high, 160 to 189 is high, and above 190 is very high. For HDL, below 40 is low and above 60 is desirable.
Test cholesterol levels every five years as an adult because high cholesterol can occur even without symptoms.
As a memory aid, the first letter in HDL and LDL can stand for “Healthy” and “Less healthy." For better health, keep the healthy one high and the less healthy one low.
- “Understanding Nutrition, Ninth Edition”; Eleanor Noss Whitney and Sharon Rady Rolfes; 2002
- National Cholesterol Education Program: Guidelines
- American Heart Association: Cholesterol
- Medline Plus: Cholesterol