Deciphering Cholesterol

Cholesterol: What Is It and What Can You Do About It?

By Riya Chacko

Heart disease is the leading cause of death in women in the United States, the culprit behind one third of deaths of American women.

Coronary artery disease is the leading cause of heart disease, a disease chiefly caused by cholesterol plaque that deposits in arteries. Cholesterol is a waxy, fat-like substance that travels in blood on carriers called lipoproteins. Nearly half of American women have high cholesterol. In fact, more women than men have high cholesterol in the United States. It’s important to understand what your cholesterol means – both the good and the bad — what contributes to it and the things you can do to improve it.

First, how do you know what your cholesterol level is?

Have your fasting cholesterol/lipid panel checked with your doctor. The American Heart Association recommends all adults older than 20 have their cholesterol checked at least every four to six years.

Then, get to know your numbers. A desirable total cholesterol level is less than 200 mg/dL. Your total cholesterol takes into account your high-density lipoprotein, low-density lipoprotein and triglycerides. You want your high-density lipoprotein — good cholesterol — to be high. You want your low-density lipoprotein — bad cholesterol — to be low. A high low-density lipoprotein is associated with increased cardiovascular risk. Triglycerides are the most common form of fat in the body, and their level should also be low.

What causes high cholesterol?

Inactivity, obesity, poor dietary habits and genetics, to name a few things. What raises your high-density lipoprotein? Exercise, good dietary fats and moderate alcohol consumption.

What raises your low-density lipoprotein?

A chief cause is saturated and trans fat in your diet. Examples of foods with high saturated fat are: coconut oil (12 grams/tablespoon), cheese (6 grams/tablespoon), butter (7 grams/tablespoon) and shortening (12 grams/tablespoon). A fat that is solid at room temperature is likely high in saturated fat. Limit your saturated fat intake to less than 12 grams per day. Trans fat is found in animal fat, vegetable shortening, commercially baked goods containing partially-hydrogenated oils and fast food.

Trans fat not only raises your bad cholesterol (the low-density lipoprotein), but also lowers your good cholesterol (the high-density lipoprotein). It also increases the risk of inflammation, which contributes to cardiovascular disease. For every two percent of daily calories obtained from trans fat, your risk for heart disease increases by 23 percent.

What causes high triglycerides?

Excess carbohydrates or cheese and high levels of alcohol, for example.

What are things you can do to improve your cholesterol?

Eat a heart-healthy diet and increase your daily activity.

A heart-healthy diet includes more fish, mono and polyunsaturated fats, legumes, vegetables, low-fat dairy products and whole grains with less sugar, saturated and trans fat (less than five to six percent of your total calories). Have good fats — monounsaturated and polyunsaturated fats — instead of saturated fats.

Monounsaturated fats include olive oil, canola oil, avocados and most nuts. Polyunsaturated fats include omega-3 and omega-6 fatty acids. Omega-3 fatty acids are found in salmon, mackerel, sardines, walnuts, canola oil and flaxseed. They decrease your low-density lipoprotein and reduce inflammation. Omega-6 fatty acids are found in vegetable oils like sunflower oil, soybean, safflower and corn oil.

What are the benefits of exercise?

Moderate exercise has been shown to reduce cardiovascular events by as much as 30 percent. The American Heart Association and American College of Cardiology recommend 150 minutes of moderate-intensity physical activity per week and 75 minutes of vigorous activity. The American College of Cardiology estimates that moderate exercise reduces your low-density lipoprotein by three to six mg/dL on average. If diet and exercise don’t improve your cholesterol to target levels, your doctor may recommend medication.

It’s important to understand the importance of heart disease in women’s health and how to prevent it. More women than men die of heart disease each year. It kills one American woman every minute. Understanding what cholesterol is, what your numbers mean and how you can make simple changes with diet and exercise can dramatically affect your risk of developing coronary disease. SWM

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Riya Chacko, MD, is an American Heart Association board member and cardiologist with Crouse Health. 

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