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Cholesterol: What’s Good and What’s Bad

Cholesterol is a soft, fat-like, waxy substance found in the bloodstream and in all your body’s cells. It’s normal to have cholesterol. Cholesterol is an important part of a healthy body because it’s used for producing cell membranes and some hormones, and serves other needed bodily functions.

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Foods with lots of sugar and flour are high in LDL, and are best avoided


Too much cholesterol in the blood, however, is a major risk for coronary heart disease (which leads to heart attack) and for stroke. Hypercholesterolemia is the medical term for high levels of blood
cholesterol.

Cholesterol can’t dissolve in the blood. It has to be transported to and from the cells by carriers called lipoproteins. Low-density lipoprotein, or LDL, is known as ‘bad’ cholesterol. High-density lipoprotein, or HDL, is known as ‘good’ cholesterol. These two types of lipids, along with triglycerides, contribute to your total cholesterol count, which is determined through a blood test.

LDL (Bad) Cholesterol
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, heart attack or stroke can result.

The lower your LDL cholesterol, the lower your risk of heart attack and stroke. In fact, it’s a better gauge of risk than total blood cholesterol. In general, LDL levels fall into these categories:

• Less than 100 mg/dL Optimal
• 100 to 129 mg/dL Near/Above Optimal
• 130 to 159 mg/dL Borderline High
• 160 to 189 mg/dL High
• 190 mg/dL and above Very High

HDL (Good) Cholesterol
About one-fourth to one-third of blood cholesterol is carried by high-density lipoprotein (HDL). HDL cholesterol is known as ‘good’ cholesterol, because high levels of HDL seem to protect against heart attack. Low levels of HDL (less than 40 mg/dL) also increase the risk of heart disease. Medical experts think that HDL tends to carry cholesterol away from the arteries and back to the liver, where it’s passed from the body. Some experts believe that that HDL removes excess cholesterol from arterial plaque, thus slowing its buildup.

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Infusing your diet with fruits and vegetables will keep your HDL levels high

Have a tough time remembering which is good and which is bad cholesterol? Here’s a tip: Think ‘L’ for ‘lousy,’ so LDL is bad; and ‘H’ for ‘happy,’ so HDL is good.

With HDL (good) cholesterol, higher levels are better. Low HDL cholesterol (less than 40 mg/dL for men; less than 50 mg/dL for women) puts you at higher risk for heart disease. In the average man, HDL cholesterol levels range from 40 to 50 mg/dL. In the average woman, they range from 50 to 60 mg/dL. An HDL cholesterol of 60 mg/dL or higher gives some protection against heart disease.

Triglycerides
Triglyceride is a form of fat made in the body. Elevated triglycerides can be due to overweight/obesity, physical inactivity, cigarette smoking, excess alcohol consumption and a diet very high in carbohydrates (60 percent of total calories or more). People with high triglycerides often have a high total cholesterol level, including a high LDL (bad) level and a low HDL (good) level. Many people with heart disease and/or diabetes also have high triglyceride levels.

Your triglyceride level (measured as mg/dL or milligrams per deciliter) will fall into one of these categories:
• Less than 150 mg/dL Normal
• 150 to199 mg/dL Borderline High
• 200 to 499 mg/dL High
• 500 mg/dL Very High

High triglycerides are a lifestyle-related risk factor; however, underlying diseases or genetic disorders can be the cause.

Your Total Blood (or Serum) Cholesterol Level

Less Than 200 mg/dL: Desirable
If your LDL, HDL and triglyceride levels are at desirable levels and you have no other risk factors for heart disease, total blood cholesterol below 200 mg/dL puts you at relatively low risk of coronary heart disease.

200 to 239 mg/dL: Borderline-High Risk
If your total cholesterol falls between 200 and 239 mg/dL, your doctor will evaluate your levels of LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. It’s possible to have borderline-high total cholesterol numbers with normal levels of LDL (bad) cholesterol balanced by high HDL (good) cholesterol.

240 mg/dL and over: High Risk
People who have a total cholesterol level of 240 mg/dL or more typically have twice the risk of coronary heart disease than people whose cholesterol level is desirable (200 mg/dL).

What might be ‘good’ blood test results for one might be different for another. Always consult with your physician.

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Lori Boxer is a nutritionist who can help you lose weight. She is the owner of Weight*No*More. There are offices in Long Island, Brooklyn and New Jersey.