Everyone has cholesterol in his or her body. This soft, waxy, fat-like substance is essential for the body to build new cells, produce hormones, and perform other necessary functions. Too much cholesterol, however, increases a person’s risk of developing heart disease and stroke.  

 
The body gets cholesterol in two ways. The liver manufactures most of the body’s cholesterol — about 80 percent. The remaining cholesterol comes from eating animal products, such as meat, poultry, dairy products and eggs. Foods from plant sources do not contain cholesterol. Plant products, like animal products, can contain saturated fats, the main culprit in elevated cholesterol levels.

Cholesterol is carried through the bloodstream attached to different types of lipoproteins, low-density (LDL or “bad” cholesterol) and high-density (HDL or “good” cholesterol) being the most important. LDL particles deliver cholesterol from the liver to the body’s cells. When the level of LDL in the bloodstream is elevated, plaque (cholesterol and other substances) accumulates on the artery walls. Over time, the buildup of plaque can cause the arteries to narrow and harden, reducing blood flow to the heart.

HDL particles carry the bad cholesterol from the bloodstream back to the liver, where it is removed from the body. This helps keep the cholesterol from building up in the arteries. Triglycerides, another form of fat, are carried by very low-density lipoproteins. A high level of triglycerides, which is often found in combination with a high total cholesterol level, is also thought to increase the risk of heart disease. Foods high in saturated fats and carbohydrates are known to raise triglyceride levels.  

A blood test called a lipoprotein profile is used to measure cholesterol levels. This test provides information about levels of LDL cholesterol, HDL cholesterol, and triglycerides, as well as total cholesterol levels. It is desirable to have a total cholesterol level below 200 mg/DL. A total cholesterol level between 200 mg/dL and 239 mg/dL is considered borderline high, while a level of 240 mg/dL and above is high. An LDL cholesterol level of less than 130 mg/dL is optimal, although persons with two or more risk factors for heart disease should keep their LDL level below 100 mg/dL. LDL levels between 130 mg/dL and 159 mg/dL are borderline high, and levels 160 mg/dL and above are high. HDL cholesterol levels should be above 40 mg/dL.

Cholesterol levels are affected by a diet high in cholesterol and saturated fats, obesity, sedentary lifestyle, and heredity. Appropriate lifestyle modifications are the first step to lowering cholesterol. Cholesterol lowering medications may also be necessary to keep cholesterol levels in check. Statins, bile acid sequestrants, nicotinic acid and fibric acids are also medications used to lower cholesterol.  

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