Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body and is made by the liver. Cholesterol also is present in foods we eat. People need cholesterol for the body to function normally. Cholesterol is present in the cell walls or membranes everywhere in the body, including the brain, nerves, muscles, skin, liver, intestines, and heart.

Too much cholesterol in your body means that you have an increased risk of getting cardiovascular diseases such as heart disease. If you have too much cholesterol in your body, the cholesterol can build up on the walls of the arteries that carry blood to your heart. This buildup, which occurs over time, causes less blood and oxygen to get to your heart. This can cause chest pain and heart attacks.

HDL (high density lipoprotein) cholesterol is known as good cholesterol. HDL takes the bad cholesterol out of your blood and keeps it from building up in your arteries. LDL (low density lipoprotein) cholesterol is known as bad cholesterol because it can build up on the walls of your arteries and increase your chances of getting cardiovascular disease. When being tested for high cholesterol, you want a high HDL number and a low LDL number.

Doctors recommend your cholesterol stay below 200. Here is the breakdown:

HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL levels of 60 or more help to lower your risk for heart disease.

Triglyceride levels that are borderline high (150-199) or high (200 or more) may require treatment in some people.

Your risk for heart disease is lower when you have low total cholesterol and low LDL.

Eating foods such as meats, whole milk dairy products, egg yolks, and some kinds of fish can make your cholesterol levels go up. Being overweight can make your bad cholesterol go up and your good cholesterol go down. Also, after women go through menopause, their bad cholesterol levels tend to go up.

You can lower your cholesterol levels by making changes to your lifestyle. Here are some tips.

• Eat foods with less fat, saturated fat and cholesterol.
• Take off the skin and fat from meat, poultry and fish.
• Broil, bake, roast, or poach instead of frying foods.
• Eat lots of fruits and vegetables everyday.
• Eat lots of cereals, breads, rice, and pasta made from whole grains, such as whole wheat bread or spaghetti.
• Get lots of exercise everyday. Talk to your doctor about what are the safest and best ways for you to exercise.
• Lose weight if you are overweight.
• Stop smoking.
• Take your high blood cholesterol medication as prescribed by your doctor.

Cholesterol-lowering drugs include:

• Statins
• Niacin
• Bile-acid resins
• Fibric acid derivatives

Cholesterol-lowering medicine is most effective when combined with a low-cholesterol diet.

Not necessarily. Numerous foods marked "low cholesterol" can contain oils that may be high in saturated fats, which are not considered healthy. In addition, unsaturated fats like vegetable oil also can be high in calories. The total amount of fat in your diet should be kept to about 20-30 percent of your daily intake.

It is important to have your cholesterol level checked when you are young, since clogging of the arteries (atherosclerosis) is a gradual process that takes many years. Total cholesterol should be measured at least every five years starting at age 20.

Note: If you have high cholesterol and your doctor has told you there may be an underlying genetic cause, you may want to have your children, under age 20, get their cholesterol levels tested. Talk to your children's health care providers about cholesterol testing.

Reviewed by the doctors in the Department of Preventive Cardiology and Rehabilitation at The Cleveland Clinic Heart Center.

SOURCE: American Heart Association
Edited by Cynthia Dennison Haines, MD on November 01, 2005
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