Cholesterol and Your Health
Cholesterol is a natural substance that serves as a building block for cells and hormones. A certain amount is good for you. But, excess cholesterol can stick to the walls of vessels, making it harder for blood to move through them. Sometimes cholesterol blocks an artery. Then, the body part served by the artery cannot receive needed nutrients or oxygen. A heart attack can occur if an artery is blocked in the heart. If the blockage is in the brain, a stroke can result.
This pamphlet will explain:
Where It Comes From
Most of the cholesterol in your body is made by the liver. A small amount also comes from certain foods, such as meat, dairy products (such as butter, whole milk, and cheese), and eggs. The amount of cholesterol in your body depends partly on your diet and partly on factors passed on from your parents (heredity).
What It Does
The fat in the foods you eat is digested and sent to the liver. The liver then changes the fat into lipoproteins. Lipoproteins are made of cholesterol, other fats, and protein. Lipoproteins carry fat through your blood vessels for use or storage in other parts of the body. Without them, fat could not travel through the bloodstream. This is because blood is mainly made of water—and fat and water do not mix.
There are three kinds of lipoproteins:
HDL, sometimes called "good cholesterol," keeps cholesterol from building up in artery walls. It does this by picking it up and taking it back to the liver. Then, the liver breaks it down so that it can be passed out of the body. A high level of HDL helps to lower the level of LDL. The goal of a healthy diet is to keep HDL high and LDL low.
What Happens When You Eat Too Much Fat?
A high–fat diet causes too much LDL, or bad cholesterol, in the bloodstream. This can make it hard for the HDL, or good cholesterol, to do its job.
Too much cholesterol can clog blood vessels. This causes deposits that form a substance called plaque. Over the years, the plaque narrows and hardens the arteries. This is called atherosclerosis.
High blood cholesterol has no symptoms. A simple blood test can show whether your level is normal. Knowing how to keep a healthy cholesterol level through diet, exercise, and regular checkups will help you to lower your risk of cardiovascular disease.
Testing for Cholesterol Levels
A lipoprotein analysis may be done if the test shows that your cholesterol level is more than 200 mg/dL. This test breaks down the total cholesterol into LDL and HDL. Your level of VLDL may be tested, too. Even if your cholesterol level is less than 200 mg/dL, you may need a lipoprotein analysis if you have one of the following risk factors:
LDL cholesterol is key. When it's too high, your risk of heart attack, stroke, or other cardiovascular disease is increased.
All women aged 45 years and older should have their cholesterol levels checked every 5 years. Women with any of the following risk factors may need to be tested more often and at a younger age:
Risk Factors for Atherosclerosis
The amounts of total and LDL cholesterol in the blood are the best ways to predict whether a person will develop atherosclerosis. Other risk factors, though, also have an effect:
If you are very overweight or do not exercise enough, you add to your risk. Changes in your lifestyle can help you control some of these risk factors. The sooner you make changes, the better the chance you have to stay healthy.
Certain risk factors may be more key in women than in men. These include diabetes, high levels of triglycerides, and very low levels of HDL. If you have one of these risk factors as well as high cholesterol, your doctor may suggest you receive special care.
How High Cholesterol Affects Women
The leading causes of death in women are heart attack and stroke. In fact, cardiovascular disease causes twice as many deaths in women as cancer. The same number of women and men die from heart attacks, but women die at an older age.
The female hormone estrogen tends to protect a woman from the effects of too much cholesterol. But after menopause, the level of estrogen decreases. Then, a woman's risk of cardiovascular disease begins to increase. By age 65, women have nearly the same amount of heart disease as men.
Some women who have reached menopause have used hormone therapy (HT) to protect against heart disease. Today, HT is no longer recommended for this protection. Talk with your doctor about HT and menopause. He or she can advise you about the benefits and risks for you.
Lowering Your Cholesterol
You can lower your cholesterol level by eating foods low in fat (especially low in saturated fat) and cholesterol and by losing weight. Exercise helps, too. It raises the level of good (HDL) cholesterol in your blood, helps you lose weight, and lowers your blood pressure. The good news is that there is a two–for–one benefit: your risk of heart disease goes down by 2% for each 1% that your cholesterol level goes down.
Change Your Diet
You also should eat foods low in saturated fat because this fat affects how cholesterol breaks down in the body. Saturated fat is solid at room temperature. It includes animal fats (butter and lard) and some vegetable fats (coconut, palm, and those listed on labels as "partially hydrogenated" oils).
Monounsaturated fats (olive, peanut, and canola oils) and polyunsaturated fats (safflower, sunflower, and corn oils) are better choices than saturated fats. Monounsaturated fats do not raise your cholesterol as much as saturated fats.
The best choice, though, is to limit all fats. Fat should make up less than 30% of the total calories in your diet. Based on a 2,000–calorie diet, this is about 65 grams of fat a day (see box). Women who eat fewer calories should eat fewer grams of fat. See the table for suggestions for a low–fat diet.
Low–fat cooking methods help, too:
Aerobic exercise (such as walking, jogging, or swimming) raises your HDL (good cholesterol) level. It is best to exercise regularly, at least three times a week. Your doctor can help you choose a safe exercise plan.
Smoking lowers your HDL level and raises your risk of heart attack, heart disease, and stroke. It also increases your risk of lung cancer. If you smoke and are older than age 35, you should not use birth control pills. The combination greatly increases the risk of heart attacks, particularly in women older than 35 years.
If, after a few months, eating a healthy diet, exercising, and quitting smoking don't work, your doctor may prescribe medication to lower your cholesterol. While you are taking medication, you still should keep eating a low–fat and low–cholesterol diet.
Heart disease affects many women. You should be aware of the role that cholesterol plays in your health. Talk with your doctor about getting your cholesterol checked regularly. To keep your risk of cardiovascular disease as low as you can, exercise, stop smoking, and eat a low–fat and low–cholesterol diet.
Atherosclerosis: Narrowing and clogging of the arteries by a buildup of plaque deposited in vessel walls; also called hardening of the arteries.
Cardiovascular Disease: Disease of the heart and blood vessels.
Cholesterol: A natural substance that serves as a building block for cells and hormones and helps to carry fat through the blood vessels for use or storage in other parts of the body.
Estrogen: A female hormone produced in the ovaries.
Hormone Therapy (HT): Treatment in which estrogen, and often progestin, is taken to help some of the symptoms caused by the low levels of these hormones.
Lipoproteins: Substances that transport cholesterol to and from the liver throughout the blood