The good, the bad, and the triglycerides

We hear so much about the evils of cholesterol, but in fact it is a necessary substance for bodily function.  Our bodies use it to make hormones, bile for digestion, cell walls, and vitamin D.  We get cholesterol by eating cholesterol-containing foods and by manufacturing it in our livers from simple nutritional building blocks.  

Unfortunately, some people make too much cholesterol in their liver.  Others have a relative lack of cholesterol receptors to get the cholesterol out of the bloodstream and into the cells.  These situations can be inherited through your family.  Individuals with inherited or familial high cholesterol have readings that are usually very high.  And, the numbers don’t budge no matter how much they try to control it.  

The rest of us just consume way too much cholesterol and fat through fatty foods.  High-fat foods, fast foods, processed foods, snack foods- these can elevate the blood cholesterol levels.  Adding to this is a general lack of regular exercise.  Regular exercise and dietary restraint can significantly lower the cholesterol levels in the general population.

The numbers by which we measure a person’s cholesterol refer to the cholesterol transport molecules in the bloodstream.  These are LDL (low-density lipoprotein), HDL (high-density lipoprotein), triglycerides, non-LDL particles, and total cholesterol.  From various studies, we know that people with a high LDL, the “bad” cholesterol, will have a higher risk for heart attacks and strokes.  Also, people with a high HDL, “good” cholesterol, will have less of a risk.  Therefore, you want your LDL to be low and your HDL to be high.  

Bad cholesterol particles are what bring about hardening of the arteries (atherosclerosis).  These molecules get into the artery walls and cause plaques.  Thickening plaques create blockages in the blood flow and this can result in heart attacks, strokes and arterial disease.  

So how do we improve our cholesterol levels?  Since we take in cholesterol from foods, we can eat less cholesterol-containing foods.  Diminish your intake of saturated fats (whole milk, cheese, red meat, ice cream, etc), fried foods, and processed foods.  Increase your intake of healthy fats like fish oils and unsaturated fats.  Increasing dietary fiber helps to lower the blood cholesterol levels.  Additionally, regular exercise can improve your good cholesterol and lower your bad cholesterol.  

Since the liver manufactures cholesterol, we can interrupt this process.  This is how many of the prescription pills work to lower cholesterol; they block liver cholesterol production.  In general, they lower your bad (LDL) and raise your good (HDL).  Other medicines can bind and remove cholesterol from your body’s digestive tract before it gets absorbed.

A high blood cholesterol level usually won’t give you symptoms in and of itself.  That’s why it’s important to have your cholesterol checked.  If you have a family history of very high cholesterol, you should have it checked early in life.  Cholesterol screenings are done frequently throughout the community.  You can take advantage of these to get a general idea of your cholesterol numbers.  However, the most accurate way to check cholesterol is a fasting lipid panel, through your doctor’s office.

Optimally, your LDL should be < 100; your HDL > 40; and your total cholesterol < 200.  Your doctor can discuss individual treatments and additional risk factor reduction based on your results, medical history and physical examination.

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.

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