The cholesterol you get from your diet doesn't directly translate into the blood cholesterol that is measured by your doctor. So there are two sets of recommendations about you and cholesterol: dietary cholesterol and optimal blood cholesterol readings. The Dietary Guidelines for Americans 2010 calls dietary cholesterol a "concern," and says most Americans should reduce their intake. About 16 percent of the American adult population has high blood cholesterol, which puts them at increased risk of coronary heart disease, or CHD. Your blood cholesterol reading goals are different if you have CHD or more than one risk factor for it.
Dietary Cholesterol
The Dietary Guidelines for Americans recommends that most healthy people should consume less than 300 mg each day of cholesterol from dietary sources. People at risk of CHD should aim to eat less than 200 mg. Cholesterol is found in animal foods. In the typical American diet, you probably get most of your dietary cholesterol from eggs, chicken, beef and burgers. Your cholesterol level can be affected by eating these foods, but that relationship is moderated by the amount of saturated fat in your diet. When your intake of saturated fat is low, the negative effect of dietary cholesterol is also low. The Institute of Medicine, which sets recommended intakes of nutrients, did not set an intake level for cholesterol, saying you have no need for dietary cholesterol -- your body makes its own.
Blood Cholesterol in Healthy People
Your blood cholesterol is transported via special carriers called lipoproteins, which are used to take your cholesterol readings. The most important ones are high-density lipoprotein -- also known as HDL or good cholesterol, and low-density lipoprotein or LDL, cholesterol. Both serve important functions in your body, but LDL can clump up in your blood vessels and potentially blood the flow of blood to your heart and brain. So high HDL is good, and low LDL is good. The American Heart Association says your desirable total cholesterol profile is less than 200 mg/dL; 200 to 239 is considered borderline high and any more than that and you're have twice the risk of CHD as a person with desirable cholesterol. A reading of 60 mg/dL for HDL is considered the most desirable for its protective effect from CHD. If you're a woman, your HDL is considered low when it's below 50 mg/dL, and below 40 mg/dL for a man. For LDL, an optimal reading is less than 100 mg/dL; 130 to 159 is borderline high; 160 to 189 is high and above 190 is very high.
Cholesterol Levels for People at Risk
There are broad guidelines about what your blood cholesterol levels readings should be. Your specific desirable numbers are determined by other risk factors for heart disease and stroke. For example, if you smoke, have diabetes or a family history of early CHD, your optimal LDL readings are lower than the guidelines for the general population. Your doctor will base your goal LDL levels on whether you have only one, multiple risk factors or a diagnosis of CHD.
Keep Your Cholesterol in Check
You can control some factors, like diet, that determine your cholesterol levels. Others, like family history, age and sex, are out of your control. The National Heart, Lung, and Blood Institute says keeping your intake of saturated fat down to about 7 percent of your total calories helps if you have risk factors. In addition, lifestyle modifications, such as losing weight and increasing your physical activity, also help. Some people, despite dietary and lifestyle changes, won't be able to bring their cholesterol levels down. In that case, prescription medication may be needed to resolve the problem.
References
- American Heart Association: What Your Cholesterol Levels Mean
- National Heart, Lung, and Blood Institute; High Blood Cholesterol: Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III); May 2001
- Centers for Disease Control and Prevention: Cholesterol Facts
- Institute of Medicine: Dietary Reference Intakes: Macronutrients
- Harvard Medical School: LDL Cholesterol: Low, Lower, and Lower Still
- Harvard School of Public Health: Fats and Cholesterol: Out with the Bad, In with the Good
