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The Skinny on Cholesterol

Here's what you need to know to keep yours low
By
WebMD Weight Loss Clinic - Expert Column

It can be a nightmare, trying to sort through all the news on good cholesterol, bad cholesterol, saturated fats, trans fats, and all those other hard-to-pronounce fats.

Fear no more. Read on for a primer on everything you need to know about cholesterol (Call it Cholesterol 101).

The Basics

Cholesterol is a type of waxy substance (called a lipid) that your body needs for many functions, including the production of new cells.

You get cholesterol from two sources: Internally, your body makes cholesterol; and externally, you get cholesterol from foods you eat.

Though it seems logical that foods containing cholesterol would raise levels of cholesterol in your blood, the worst dietary culprits are actually foods high in saturated fats (mostly from animal sources) and/or trans fats (often found in commercially prepared products).

Here are a few examples of foods high in those two types of fat:

Saturated FatsTrans Fats
Lard, shorteningProcessed foods
Butter, cheeseBaked goods, cookies, chips
Animal fatsProducts w/hydrogenated fats
Coconut and palm oilsFried foods
Meats, poultryMargarines, spreads

Think of cholesterol as sort of like a chocolate M&M in the blood: the center is the cholesterol, and the outer shell is a protein "carrier" that transports the molecule through the blood. The molecule it carries is called a lipoprotein, and it is classified as either a low-density lipoprotein (LDL), the so-called "bad" cholesterol, or high-density (HDL), the "good" cholesterol.

What makes them "good" or "bad" is determined by the amount of cholesterol center and protein shell. The good cholesterol has more protein and less cholesterol; the bad cholesterol has more cholesterol and less protein. The composition of the good cholesterol molecule prevents the buildup of cholesterol in your arteries. But the bad cholesterol molecule can lead to buildup, and eventual blockage, of your arteries.

The Problem With High Cholesterol

If your diet is too high in saturated and/or trans fats, or if you have an inherited condition, the cholesterol in your blood can reach dangerously high levels. Other factors, like diabetes and hypothyroidism, can also raise your blood cholesterol.

High levels of cholesterol can put you at risk for a host of life-threatening cardiovascular (heart and circulatory system) diseases. To reduce the risk of these diseases, your goal is to lower total cholesterol and to aim for high levels of good cholesterol and low levels of bad cholesterol. And one of the best routes to a healthier heart is a cholesterol-lowering diet.

Your doctor will determine if you are a candidate for cholesterol-lowering medication based on your blood cholesterol profile. But even those on medication can benefit from lifestyle changes such as a healthy diet, regular exercise, weight loss, and smoking cessation.

Indeed, one of the best ways to prevent and control high cholesterol is by eating healthy, exercising, and losing weight (if you're too heavy). The American Heart Association (AHA) recommends a diet that includes plenty of fruits, vegetables, whole grains, low-fat dairy, and lean protein, with a limit of 300 mg of cholesterol per day, and less than 30% of its calories from fat. The WebMD Weight Loss Clinic recommends a heart-healthy diet to all its members.

Is This Normal? Get the Facts Fast!

Is Your Cholesterol Level Heart Healthy?
What is your LDL (low-density lipoprotein) level?

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or
Answer:
Desirable
0-199
Borderline
200-239
High
240+

Your level is currently

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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