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Why Is Cholesterol Important?
Your blood cholesterol level has a lot to do with your
chances of getting heart disease. High blood cholesterol is one of the
major risk factors for heart disease. A risk factor is a condition that
increases your chance of getting a disease. In fact, the higher your
blood cholesterol level, the greater your risk for developing heart
disease or having a heart attack. Heart disease is the number one killer
of women and men in the United States. Each year, more than a million
Americans have heart attacks, and about a half million people die from
heart disease.
How Does Cholesterol Cause Heart
Disease?
When there is too much
cholesterol (a fat-like substance) in your blood, it builds up in the
walls of your arteries. Over time, this buildup causes “hardening of the
arteries” so that arteries become narrowed and blood flow to the heart
is slowed down or blocked. The blood carries oxygen to the heart, and if
enough blood and oxygen cannot reach your heart, you may suffer chest
pain. If the blood supply to a portion of the heart is completely cut
off by a
blockage, the result is a heart attack.
High blood cholesterol itself does not cause symptoms, so many people
are unaware that their cholesterol level is too high. It is important to
find out what your cholesterol numbers are because lowering cholesterol
levels that are too high lessens the risk for developing heart disease
and reduces the chance of a heart attack or dying of heart disease, even
if you already have it. Cholesterol lowering is important for
everyone–younger, middle age, and older
adults; women and men; and people with or without heart disease.
What Affects Cholesterol
Levels?
A variety of things can affect cholesterol levels.
These are things you can do something about:
- Diet. Saturated fat
and cholesterol in the food you eat make your blood cholesterol
level go up.
- Saturated fat is the
main culprit, but cholesterol in foods also matters. Reducing the
amount of saturated fat and cholesterol in your diet helps lower
your blood cholesterol level.
- Weight. Being
overweight is a risk factor for heart disease. It also tends to
increase your cholesterol. Losing weight can help lower your LDL and
total cholesterol levels, as well as raise your HDL and lower your
triglyceride levels.
- Physical Activity.
Not being physically active is a risk factor for heart disease.
Regular physical activity can help lower LDL (bad) cholesterol and
raise HDL (good) cholesterol levels. It also helps you lose weight.
You should try to be physically active for 30 minutes on most, if
not all, days.
Things you cannot do anything about also can affect
cholesterol levels. These include:
- Age and Gender. As
women and men get older, their cholesterol levels rise. Before the
age of menopause, women have lower total cholesterol levels than men
of the same age. After the age of menopause, women’s LDL levels tend
to rise.
- Heredity. Your genes
partly determine how much cholesterol your body makes. High blood
cholesterol can run in families.
Lowering Cholesterol With
Therapeutic Lifestyle Changes (TLC)
TLC is a set of things you can do to help lower your
LDL cholesterol. The main parts of TLC are:
- The TLC Diet. This
is a lowsaturated-fat, low-cholesterol eating plan that calls for
less
than 7 percent of calories from saturated fat and less than 200 mg
of dietary cholesterol per day. The TLC diet recommends only enough
calories to maintain
a desirable weight and avoid weight gain. If your LDL is not lowered
enough by reducing saturated fat and cholesterol intakes, the amount
of soluble fiber in your diet
can be increased. Certain food products that contain plant stanols
or plant sterols (for example, cholesterol lowering margarines) can
also be added to the TLC diet to boost its LDL-lowering power.
- Weight Management.
Losing weight if you are overweight can help lower LDL and is
especially important for those with a cluster of risk factors that
includes high triglyceride and/or low HDL levels and being
overweight with a large waist measurement (more than 40 inches for
men and more than 35 inches for women).
- Physical Activity.
Regular physical activity (30 minutes on most, if not all, days) is
recommended for everyone. It can help raise HDL and lower LDL and is
especially
important for those with high triglyceride and/or low HDL levels who
are overweight with a large waist measurement.
- Drug Treatment
Even if you begin drug treatment to lower your cholesterol, you will
need to continue your treatment with lifestyle changes. This will
keep the dose of medicine as low as possible, and lower your risk in
other ways as well. There are several types of
drugs available for cholesterol lowering including statins, bile
acid sequestrants, nicotinic acid, fibric acids, and cholesterol
absorption inhibitors.
Your doctor can help decide which type of drug is best for you. The
statin drugs are very effective in lowering LDL levels and are safe
for most people. Bile acid
sequestrants also lower LDL and can be used alone or in combination
with statin drugs. Nicotinic acid lowers LDL and triglycerides and
raises HDL. Fibric acids
lower LDL somewhat but are used mainly to treat high triglyceride
and low HDL levels. Cholesterol absorption inhibitors lower LDL and
can be used alone or in
combination with statin drugs Once your LDL goal has been reached,
your doctor
may prescribe treatment for high triglycerides and/or a low HDL
level, if present. The treatment includes losing weight if needed,
increasing physical activity, quitting smoking, and possibly taking
a drug.
- Foods low in
saturated fat include fat-free or 1 percent dairy products, lean
meats, fish, skinless poultry, whole grain foods, and fruits and
vegetables. Look for soft margarines (liquid or tub varieties) that
are low in saturated fat and contain little or no trans fat (another
type of dietary fat that can raise your cholesterol level). Limit
foods high in cholesterol such as liver and other organ meats, egg
yolks, and full-fat dairy products.
Good sources of soluble fiber include oats, certain fruits (such as
oranges and pears) and vegetables (such as brussels sprouts and
carrots), and dried peas and beans.
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