Cholesterol is a fat-like substance found in your blood. Your body needs cholesterol to build healthy cells, but high levels of cholesterol can increase your risk of heart disease.

With high cholesterol, you can develop fatty deposits in your blood vessels. Eventually, these deposits grow, making it difficult for enough blood to flow through your arteries. Sometimes, those deposits can break suddenly and form a clot that causes a heart attack or stroke.

High cholesterol can be inherited, but it’s often the result of unhealthy lifestyle choices, which make it preventable and treatable. A healthy diet, regular exercise and sometimes medication can help reduce high cholesterol. 

WHAT ARE THE DIFFERENT KINDS OF BLOOD FATS AND WHAT DO THEY DO? 

There are several kinds of fats in your blood:

• LDL cholesterol is sometimes called bad cholesterol. It can narrow or block your blood vessels. Blocked vessels can lead to a heart attack or a stroke. Reaching your LDL target is the best way to protect your heart and blood vessels;
• HDL cholesterol is sometimes called good cholesterol. It helps remove deposits from the insides of your blood vessels and keeps your blood vessels from getting blocked;
• Triglycerides are another kind of fat. High triglycerides raise your risk of a heart attack or stroke. 

WHAT ARE THE RECOMMENDED TARGETS FOR BLOOD FATS? 

Total Cholesterol (TC) 

It is directly linked to risk of heart and blood vessel disease. 

Goal values:

• 75-169 mg/dL for those age 20 and younger
• 100-199 mg/dL for those over age 21.

High Density Lipoprotein (HDL) “Good cholesterol” 

High levels are linked to a reduced risk of heart and blood vessel disease. The higher your HDL level, the better. 

Goal value: greater than 40 mg/dL.

Low Density Lipoprotein (LDL) “Bad cholesterol” 

High levels are linked to an increased risk of heart and blood vessel disease, including coronary artery disease, heart attack and death. Reducing LDL levels is a major treatment target for cholesterol-lowering medications. 

Goal values:

• Less than 70 mg/dL for those with heart or blood vessel disease and for other patients at very high risk of heart disease (those with metabolic syndrome);
• Less than 100 mg/dL for high risk patients (e.g., some patients who have multiple heart disease risk factors);
• Less than 130 mg/dL for individuals who are at low risk for coronary artery disease.

Triglycerides (TG) 

Elevated in obese or diabetic patients. Level increases from eating simple sugars or drinking alcohol. Associated with heart and blood vessel disease. 

Goal value: less than 150 mg/dL. 

WHAT ARE THE RISK FACTORS OF BAD CHOLESTEROL? 

Factors that can increase your risk of bad cholesterol include:

• Age: because your body’s chemistry changes as you age, your risk of high cholesterol climbs. For instance, as you age, your liver becomes less able to remove LDL cholesterol;
• Diabetes: high blood sugar contributes to higher levels of a dangerous cholesterol called Very-Low-Density Lipoprotein (VLDL) and lower HDL cholesterol. High blood sugar also damages the lining of your arteries. 

WHAT CAN I DO TO IMPROVE MY CHOLESTEROL? 

Here are some steps you can take to improve your cholesterol:

• If you smoke, quit. When you stop smoking, good cholesterol is likely to improve as much as 10%;
• Lose extra kilos and maintain a healthy weight. Watch food portions eaten, frequency of meals and snacking. Eat at least 3 meals per day on regular hours (breakfast, lunch, dinner);
• Eat foods which promote lowering cholesterol such as high fibre foods (legumes, vegetables and fruits) and whole grain foods (oat, barley and other cereals, grain breads, grain flour). Avoid foods high in sugar – soft drinks, cakes, cookies, ice cream and candies;
• Avoid foods high in fat, especially from animal Use good fats in moderation such as from fish, nuts, soy and high omega-3 oils. Preferred methods of cooking are steaming, boiling, baking, and grilling;
• Drink alcohol in moderation. Alcohol increases the fat absorption in the gastrointestinal system and reduces fat digestion that causes increased amounts of cholesterol and triglycerides in the blood;
• Exercise most days of the week. Brisk walking for 30 minutes a day, 5 days a week, is a good goal. Regular exercise can boost “good” cholesterol while lowering “bad” cholesterol.

The low cholesterol diet

Sample Menu:

Cholesterol Content of Common Foods (in milligrams):

MEDICINES

A healthy lifestyle is the first defence against high cholesterol. But sometimes diet and exercise aren’t enough, and you might need to take cholesterol medications. Cholesterol medications might help:

• Decrease your Low-Density Lipoprotein (LDL) cholesterol, the “bad” cholesterol that increases the risk of heart disease;
• Decrease your triglycerides, a type of fat in the blood that also increases the risk of heart disease;
• Increase your High-Density Lipoprotein (HDL) cholesterol, the “good” cholesterol that offers protection from heart disease.

• Nicotinic acid, also called niacin: these medicines lower triglycerides and LDL, and raise HDL levels. Main side-effects are facial and neck flushing, itching, stomach upset, blood sugar increase;
• Cholesterol absorption inhibitors: these medicines lower LDL cholesterol and triglycerides and raise HDL levels. Main side-effects are stomach pain, fatigue, muscle soreness ;
• Bile acid sequestrants: these medicines lower LDL cholesterol and can raise HDL levels. They either have no effect on triglycerides or, in some cases, they can raise triglyceride levels. Main side-effects are constipation, bloating, gas.