An Introduction

Cholesterol is a soft, waxy substance found among the lipids (fats) in the bloodstream and in all your body's cells. It's an important part of a healthy body because it's used to form cell membranes, some hormones and is needed for other functions.
Cholesterol and other fats can't dissolve in the blood. They have to be transported to and from the cells by special carriers called lipoproteins. There are several kinds, but the ones to focus on are low-density lipoprotein (LDL) and high-density lipoprotein (HDL)

Low-density lipoprotein (LDL) is the major cholesterol carrier in the blood and is known as the "bad cholesterol," because it is known for causing heart disease, where as High-density lipoprotein (HDL) is known as the "good cholesterol," because high levels of HDL seem to protect against heart disease such as a heart attack or stroke.

Triacylglycerides or Triglycerides, is a form of fat that our bodies produce. People who have high levels of triglycerides often have a high total cholesterol level, including a high level of LDL's and low level of HDL's. People who have high levels of triglycerides can be due to the lack of physical activity, obesity/overweight, cigarette smoking, over consumption of alcohol, and a diet very high in carbohydrates.

According to the American Heart Association your total blood serum cholesterol level should be less than 200mg/dl. Anything above this number, you are at risk for heart disease and you should immediatly consult with your doctor.

Because HDL's are good for you, the more you have the better you are at reducing heart disease. Anything above 40mg/dl (for men) and 50mg/dl (for women) is satisfactory. Men on average usually have a HDL level between 40-50mg/dl and women a level between 50-60mg/dl.

LDL's on the other hand need to be at lower levels. The levels are as follows:

Less than 100 mg/dL Optimal

100 to 129 mg/dL Near Optimal/ Above Optimal

130 to 159 mg/dL Borderline High

160 to 189 mg/dL High

190 mg/dL and above Very High

Depending on other risk factors you have for heart disease and stroke will help determine at what LDL level you should be at as well as the treatment you should be receiving. To determine your HDL and LDL levels please see you doctor or health care provider so a simple blood test can be performed.

Regarding cholesterol levels, it is also important to understand the prevalence. According to the Centers for Diesease Control and Prevention about 17% of adult Americans aged 20 years and older have high total cholesterol (240 mg/dL or above). The average blood cholesterol level in adult Americans is about 203 mg/dL. Among whites, 17.4% of women and 17.0% of men have high cholesterol.

Heart disease is the leading cause of death of Americans 24 years of age and older, 30.3% or 724,269 annual deaths are due to heart disease. Sixteen percent of those deaths, 115,883, occur in smokers. Cancer is the second leading cause of death causing 23% or 538,947 deaths. Twenty-three percent of those are lung cancer, 83% of lung cancers occur in smokers and ex-smokers (101, 724).

F.A.Q.'s

1. Will using margarine instead of butter help lower my cholesterol?
Both margarine and butter are high in fat, so use both in moderation. From a dietary perspective, the major factor affecting blood cholesterol is how much saturated fat and trans fat is in the food. Limiting food high in saturated fat and trans fat may help lower your LDL (bad) cholesterol. Most vegetable oils and soft or liquid margarines have less saturated and trans fat than the solid spreads have, and are preferable to the stick forms of margarine for a heart-healthy diet. When selecting a margarine, it's best to choose one that has “0 g trans fat” on the Nutrition Facts label.

2. How can I increase my level of "good" cholesterol levels?
Good cholesterol or HDL levels can be increased by aerobic exercise, losing weight, stop smoking, cutting out trans fatty acids, adding soluble fiber to your diet, and adding other dietary means such as cranberry juice, and consuming fish and other foods containing omega 3-fatty acids. Remember that HDL levels below 40mg/dl can increase your chances of having heart disease. However levels above 60mg/dl may actually prevent heart disease.

3. Since the nutrition label on my favorite food says there’s no cholesterol, can be sure that it’s a “heart-healthy” choice?
Nutrition labels on food are very helpful when choosing heart-healthy foods, but you need to know what to look for. Many “low-cholesterol” foods contain high levels of saturated fat and/or trans fat — both of which contribute to high blood cholesterol. Even foods that claim to be “low-fat” may have a higher fat content than expected. Look for the amount of saturated fat, trans fat, cholesterol and total calories in a serving of the product.

4. I’m a woman-Do I have to worry about high cholesterol?
Premenopausal women are usually protected from high LDL (bad) levels of cholesterol, because the female hormone estrogen tends to raise HDL (good) cholesterol levels. But cholesterol levels tend to increase as you age, and postmenopausal women may find that even a heart-healthy diet and regular physical activity aren’t enough to keep their cholesterol from rising. Learn more about women and cholesterol.

5. What kind of FATS are in food?
There are essentially 4 different kinds of fats found in our diet. Saturated, Trans, Hydrogenated and Unsaturated.

6.What can Cholesterol Do?
When too much LDL (bad) cholesterol circulates in the blood, it can slowly build up in the inner walls of the arteries that feed the heart and brain.

Together with other substances, it can form plaque, a thick, hard deposit that can narrow the arteries and make them less flexible. This condition is known as atherosclerosis. If a clot forms and blocks a narrowed artery, a heart attack or stroke can result. Other risk factors such as high blood pressure and diabetes can also increase your risk of having cardiovascular disease.

7. How is cholesterol tested?
A small sample of blood will be drawn from your arm. If your doctor has ordered other tests to be run at the same time as your cholesterol test, all the samples will usually be taken at the same time. Your blood sample is then analyzed by a laboratory.


8.Do thin people have to worry about cholesterol levels?
Any type of body can have high cholesterol. Overweight people are more likely to have high cholesterol, but thin people should also have their cholesterol checked regularly. Often people who don’t gain weight easily are less aware of how much saturated and trans fat they eat. Nobody can “eat anything they want” and stay heart healthy.

9.What kind of drugs are there to take for high cholesterol?
Some of the drugs that can be prescribed to you are for example is a Statin such as: Lipitor, and Crestor. Other drugs such as Resins, Fibrates and Niacins are also used to help lower cholesterol.

10.How often should I have my cholesterol checked?
The American Heart Association endorses the National Cholesterol Education Program (NCEP) guidelines for detection of high cholesterol: All adults age 20 or older should have a fasting lipoprotein profile — which measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides — once every five years.

Cooking for Lower Cholesterol

If you have high cholesterol you may want to start with what you are eating. A healthy and smart diet can make huge differences in your cholesterol health. If your worried about it being difficult and hard, don't worry, its not! It's actually quite simple to prepare healthy meals that can help lower your cholesterol. If you're pressed for time, there are a number of ways to make quick, easy meals that are heart healthy and will help you lower your cholesterol.

Salads are one very easy way to make a meal quickly. Pre-washed, bagged salad mix is very quick, but you might consider making your own salad dressing. Many bottled salad dressings are high in cholesterol or trans fat.

You can make your own by mixing olive oil and vinegar or lemon juice with your favorite seasonings. Be sure to avoid eggs, cheese, croutons, bacon, and other fatty meats. You can add meats such as skinless chicken, turkey, and grilled or broiled fish.

Don't forget about fruit salads. You can mix together all kinds of fruits for a delicious and healthful meal. You can try apples, berries, melon chunks, pineapple, grapes, peaches, pears, bananas, mandarin orange slices, mangos, and papaya.

Here are some cooking tips brought to you by The American Heart Association.

Reduce saturated fat in meat and poultry- The American Heart Association recommends eating no more than six ounces of cooked lean meat, poultry, fish or seafood a day for people who need 2,000 calories (learn how many calories you need ). Most meats have about the same amount of cholesterol, roughly 70 milligrams in each three-ounce cooked serving (about the size of a deck of cards). But the amount of saturated fat in meats can vary widely, depending on the cut and how it's prepared. Here are some ways to reduce the saturated fat in meat:

• Buy "choice" or "select" grades rather than "prime." Select lean or extra lean ground beef.
• Trim all visible fat from meat before cooking.
• Eat chicken and turkey rather than duck and goose, which are higher in fat.
• Limit processed meats such as sausage, bologna, salami and hot dogs. Many processed meats — even those with "reduced fat" labels — are high in calories and saturated fat. They are often high in sodium as well. Read labels carefully and choose such meats only now and then

Choose seafood at least twice a week- Fish can be fatty or lean, but it's still low in saturated fat. Prepare fish baked, broiled, grilled or boiled rather than breaded and fried.

Cook fresh vegetables the low-fat, low-salt way- Try cooking vegetables in a tiny bit of vegetable oil, adding a little water during cooking if needed, or use a vegetable oil spray.

Substitute egg whites for whole eggs- The cholesterol in eggs is all in the yolks ― without the yolk, egg whites are a heart-healthy source of protein. Many recipes calling for whole eggs come out just as good when you use egg whites or cholesterol-free egg substitute instead of whole eggs. Replace each whole egg with two egg whites. For baking, you may want to add a tablespoon or less of liquid vegetable oil such as canola, safflower, sunflower or soybean for a moister consistency.

If you are interested in more ways to help lowering your cholesterol, Click Here for great recipe ideas : Featured Recipe

Using Medication for Cholesterol

Sometimes for an individual, lifestyle changes such as eating healthy and exercising isn't enough. If this is the case, your doctor may start you on some form of drug therapy to help fight your high cholesterol and prevention of heart disease.
Statins (also known as HMG CoA reductase inhibitors)
This class of drugs works in the liver to prevent the formation of cholesterol. Statins are most effective at lowering the LDL (bad) cholesterol, but also have modest effects on lowering triglycerides (blood fats) and raising HDL (good) cholesterol.

Most of statins' side effects are mild and generally go away as your body adjusts. Muscle problems and liver abnormalities are rare, but your doctor may order regular liver function tests. Patients who are pregnant or who have active or chronic liver disease should not take statins.

Selective cholesterol absorption inhibitors
This relatively new class of cholesterol-lowering medications works by preventing the absorption of cholesterol from the intestine. Selective cholesterol absorption inhibitors are most effective at lowering the LDL (bad) cholesterol, but may also have modest effects on lowering triglycerides (blood fats) and raising HDL (good) cholesterol.

The first medication of this class, ezetimibe (Zetia®)**, was approved in 2002 for the treatment of high cholesterol and certain inherited lipid abnormalities.

Resins (also known as bile acid sequestrant or bile acid-binding drugs)
This class of LDL-lowering drugs works in the intestines by promoting increased disposal of cholesterol. Your body uses cholesterol to make bile, an acid used in the digestive process. These medicines bind to bile, so it can't be used during digestion. Your liver responds by making more bile. The more bile your liver makes, the more cholesterol it uses. That means less cholesterol is left to circulate through your bloodstream.

Fibrates (fibric acid derivatives)
Fibrates are best at lowering triglycerides and in some cases increasing HDL (good cholesterol) levels. These drugs are not very effective in lowering LDL (bad) cholesterol. That's why fibrates are generally used in people whose triglycerides are high or whose HDL is low, after reaching LDL goal. Fibrates are most effective at lowering triglycerides (blood fats). Additionally, they act to raise the levels of HDL (good) cholesterol. Fibrates may be used in combination therapy with the statins.

Niacin (nicotinic acid)
This drug works in the liver by affecting the production of blood fats. Niacin is prescribed to lower triglycerides and LDL cholesterol and raise HDL ("good") cholesterol.

Niacin side effects may include flushing, itching and stomach upset. Your liver functions may be closely monitored, as niacin can cause toxicity. Nonprescription immediate release forms of niacin usually have the most side effects, especially at higher doses. Niacin is used cautiously in diabetic patients as it can raise blood sugar levels.

Niacin comes in prescription form and as “dietary supplements.” Dietary supplement niacin must not be used as a substitute for prescription niacin. It should not be used for lowering cholesterol because of potential serious side effects. Dietary supplement niacin is not regulated by the U.S. Food and Drug Administration (FDA) the same way that prescription niacin is. It may contain widely variable amounts of niacin — from none to much more than the label states. The amount of niacin may even vary from lot to lot of the same brand. Consult your doctor before starting any niacin therapy.

For more information on drug therapy Read the latest FDA Drug Safety Newsletter

Taking medicine may be new to you, and there may be a lot to remember. For example, why are you taking it? What time should you take it? How often do you take it and how many pills do you take? It's important to take medicine the right way — just as prescribed. For quick tips on how you should manage your medicines click here.

"Moving" your way to lowering your cholesterol

Physical inactivity is a major risk factor for heart disease!

For some people, regular physical activity affects blood cholesterol level by increasing the level of HDL (good) cholesterol. A higher HDL level is linked with a lower risk of heart disease. Physical activity can also help control other risk factors for heart disease: weight, diabetes and high blood pressure. Aerobic exercise (exercise that uses oxygen to provide energy to large muscles) raises your heart and breathing rates, which help your heart to work more efficiently at rest as well as during physical activity. Vigorous, regular physical activity such as brisk walking, jogging and swimming also condition your lungs.

Even mild activities, if done daily, can help. You can benefit from simple things like walking, gardening, housework or dancing. Talk to your doctor about getting started, especially if you've been inactive.

Here are 10 Tips for starting a physical activity program!

1. Wear comfortable clothes and sneakers or flat shoes with laces.
2. Start slowly. Gradually build up to at least 30 minutes of activity on most or all days of the week (or whatever your doctor recommends).
3. Exercise at the same time of day so it becomes a regular part of your lifestyle. For example, you might walk every Monday, Wednesday, Friday and Saturday from noon to 12:30 p.m.
4. Drink a cup of water before, during and after exercising (but check with your doctor, because some people need to limit their fluid intake).
5. Ask family and friends to join you — you'll be more likely to stick with it if you have company. Or join an exercise group, health club or the YMCA. Many churches and senior centers offer exercise programs too. (Remember to get your doctor's permission first.)
6. Note your activities on a calendar or in a logbook. Write down the distance or length of time of your activity and how you feel after each session. If you miss a day, plan a make-up day or add 10–15 minutes to your next session.
7. Use variety to keep your interest up. Walk one day, swim the next, then go for a bike ride on the weekend.
8. Look for chances to be more active during the day. Walk the mall before shopping, take the stairs instead of the escalator or take 10–15 minute breaks while watching TV or sitting for walking or some other activity.
9. Don't get discouraged if you stop for a while. Get started again gradually and work up to your old pace.
10. Don't exercise right after meals, when it's very hot or humid, or when you just don't feel up to it.

The American Heart Association recommends that all adults get at least 30 minutes of physical activity every day, or at least more days than not. If you're trying to lose weight or maintain weight loss, you should get at least 60 minutes each day. If you can't find 30 minutes or an hour in your schedule, break up your activity into 15-minute increments.

Here are some other great resources that will help you be on your way to lowering your cholesterol and to a healthy heart!

Physical Activity Tips for Older People

Tips for Raising Heart-Healthy, Active Children

Start! is the American Heart Association's movement that encourages everyone to live longer, more heart-healthy lives through walking and other healthy habits.

Choose To Move is a free 12-week physical activity program for women featuring a personal handbook, nutrition tips and new recipes, e-mails with physical activity tips to keep you motivated, workout clothing information and much more.

One-Mile Fitness Calculator

Real People with Real Stories

A lot of times in our life we put off making serious life changes, especially regarding our health. Usually when we do make those changes its because we personally know somebody that has been effected one way or the other, for the good or bad.
These stories are real, from real patients, people just like you and me. They suffered from high cholesterol or other related health conditions. They made a choice. Will you?


Sometimes a picture is worth a thousand words. Ron and Janie James made a commitment to their heart health after seeing a photo of themselves hugging at a party. "We looked like sumo wrestlers," Janie said. Read Ron and Janie's story.

Jim thought he was healthy until he had a cholesterol screening. Then he knew he had to make some changes. "A lot of people take the 'I don't want to know' approach with their health," Jim said. Read Jim's story.