What is cholesterol?

Heart Health
May 5, 2020

St. Joseph’s/Candler Primary Care Physician Dr. Francisco Fantauzzi explains the good and bad about cholesterol

In your bloodstream are fatty particles floating around. Sounds bad, right? Well, some are actually good particles. So much so that it’s their job to remove the bad ones. It’s how many of the good particles you have versus the bad ones that can contribute to your cardiovascular health.

We’re talking about cholesterol, the fat-like, waxy substance that can be found in many parts of your body, such as your bloodstream and cells.

Cholesterol comes from two sources: your liver and the foods you eat, explains St. Joseph’s/Candler Primary Care Physician Dr. Francisco Fantauzzi.

Cholesterol is the building block of our cells, Dr. Fantauzzi says. The cell walls are made out of molecules based on cholesterol. Cholesterol also makes many hormones that help regulate the thyroid, renal function and metabolism.

“So your body needs cholesterol,” Dr. Fantauzzi says. “The problem is your liver produces cholesterol and then you eat too much cholesterol, so it can accumulate in your arteries.”

The good and bad about cholesterol

Dr. Francisco Fantauzzi

Cholesterol and other fats are carried in your bloodstream as spherical particles called lipoproteins. Two common ones you may have heard of are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

LDL cholesterol, referred to as “bad” cholesterol, is a type of fat in the blood that contains the most cholesterol. When you have high amounts of this type of cholesterol in your body, it forms plaque in the arteries, Dr. Fantauzzi says.

HDL cholesterol is considered the “good” cholesterol. It travels the bloodstream to remove cholesterol that shouldn’t be there, Dr. Fantauzzi says. This keeps plaque from building up in your arteries.

Therefore you want your HDL to be as high as possible, while keeping your LDL low, Dr. Fantauzzi says.

How do I find out my cholesterol levels and what does it mean?

A cholesterol screening is an overall look at the fats in your blood. It can be checked through a fasting blood test. Dr. Fantauzzi tells patients to not eat or drink anything, except water, after midnight for a morning blood draw.

Dr. Fantauzzi says everyone older than 50 should have their cholesterol checked at least once a year. Adults under 50 should have theirs checked at least every five years or when they want to know their levels.

Cholesterol levels can vary by age, weight and gender. Genetics also can play a role in cholesterol.

Ideally, you want your total cholesterol levels to be less than 200 milligrams per deciliter. A reading between 200 and 239 mg/dL is considered borderline high and a reading of 240 mg/dL and above is considered high.

LDL cholesterol levels should be less than 100. Levels of 100 to 129 mg/dL may be acceptable for people with no health issues or family history of heart disease. A reading of 130 to 159 mg/dL is borderline high and 150 to 189 mg/dL is high. A reading higher than 190 mg/dL is considered very high.

An ideal reading for HDL cholesterol is 60 mg/dL or higher. A reading of 41 to 59 mg/dL is borderline low, while a reading less than 40 is considered a major risk factor for heart disease.

Your physician will use these numbers – along with many other factors such as family history, age and smoking status – to calculate your risk for serious heart problems.

Related Article: Do you know your numbers? Here’s an explanation of common lab work results.

What happens if my cholesterol is high?

High cholesterol can be caused by many things. Genetics certainly play a role, as well as poor diet and lack of exercise, Dr. Fantauzzi says. Smoking and excessive alcohol use also can contribute to poor cardiovascular health.

High cholesterol can lead to many cardiovascular problems. If there’s too much plaque in your arteries, it can obstruct blood flow and even rupture. That can lead to blood clots forming in your heart, which can cause a heart attack, or your brain, which can cause a stroke.

High cholesterol also can cause circulation and kidney problems, Dr. Fantauzzi adds.

How do you treat high cholesterol?

If you have high cholesterol, your doctor will mostly likely first recommend lifestyle modifications to include diet, exercise and stop smoking if you are a smoker.

Related Article: The two things you need to do to stop smoking

A diet high in fruits, vegetables, whole grains, beans and good fats (think avocados) can help lower LDL cholesterol.

“Substitute bad habits with good habits,” Dr. Fantauzzi says. “Instead of eating that big ol’ steak, eat a steak the size of the palm of your hand. Don’t eat it every day either. Eat more lean, skinless meats and seafood over beef or pork.”

If lifestyle modifications do not work, or if genetics are playing a large part in your high cholesterol levels, your doctor may prescribe medication.

Can high cholesterol be prevented?

It’s important to take steps to keep your total and LDL cholesterol low and your HDL high. Ways you can lower your risk of high cholesterol include:

  • Follow a proper diet with fruits, vegetables, lean meats and whole grains
  • Get plenty of exercise, at least 30 minutes a day, five days a week of moderate to rigorous exercise
  • Quit smoking or never start
  • Limit alcohol use
  • Know your family history, especially if you have a family member who had a heart attack, diabetes or other cardiovascular risks
  • See your doctor annually
Related Article: Here’s what you should look for when selecting a new primary care physician

“Like everything in life, good diet and exercise are important,” Dr. Fantauzzi says. “A lot of times when we eat, we’re not even hungry. Sometimes we do it out of habit. Really pay attention to your diet and be sure to exercise.”


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