Is Blood Cholesterol Still Relevant?
Is Blood Cholesterol Still Relevant?
Rates of hypertension and high total cholesterol are more elevated in adults with obesity than those at a healthy weight.
The 2020-2025 Dietary Guidelines also add these statistics:
More than 11% of adults have high total cholesterol, >240 mg/dl
More women (12%) than men (10%) have high total cholesterol, >240 mg/dl.
Children and adolescents (7%) have high total cholesterol, >200 mg/dl.
So it is important to note that people of all ages can have heart disease – including high cholesterol.
Two things to note for this article:
Even though there are some mentions of hypertension – or high blood pressure – in this article, that is not the focus here. I am specifically looking at blood cholesterol for this article.
The cholesterol found in food, only foods of animal origin, is not the same or interchangeable with the cholesterol found in the blood. So while in the “old days,” we thought that dietary cholesterol (as still seen on the Nutrition Facts panel) had a direct effect on our blood cholesterol levels, it turns out this is not the case. I will explain what does affect our blood cholesterol levels further down.
What is Blood Cholesterol?
Cholesterol is a fat-like substance in the blood made in your liver. It is also in some foods we eat.
As mentioned above, foods of animal origin are what contain cholesterol. If it is plant food, there is no cholesterol, and if it is a fat-free version of animal food, such as fat-free yogurt or fat-free milk, it will have no cholesterol.
And too much cholesterol can build up in arteries over time, potentially increasing the risk for heart attack and stroke.
When we have high blood cholesterol, it may cause damage to the blood vessels and may lead to a blockage and, depending on which vessels are blocked, can increase your chance of having a heart attack or stroke. Blockage of the blood vessels surrounding the heart can lead to heart attack and blocking of the blood vessels feeding the brain can lead to one type of stroke.
Lipid Profile
If you have ever had your cholesterol checked, there are four numbers. It is essential to know all the numbers because we don’t have the full context. Note: your cholesterol is also lipid (lipid = fat).
These four results include:
Total Cholesterol
LDL Cholesterol
HDL Cholesterol
Triglycerides
Total cholesterol by itself doesn’t tell us much. We need the other three numbers to have the complete picture.
Desirable: <200 mg/dl
Borderline High: 200-239 mg/dl
Undesirable: >240 mg/dl
LDL-Cholesterol is the cholesterol that builds up in the arteries and should be LOW. LDL is the so-called “bad” cholesterol. LDL means Low-Density Lipoprotein.
Optimal: <100 mg/dl
Near/Above Optimal: 100-129 mg/dl
Borderline High: 130-159
High: 160-189 mg/dl
Very High: >190 mg/dl
HDL-Cholesterol is the so-called “good cholesterol” and stands for High-Density Lipoprotein. HDL is the cholesterol that helps take excess cholesterol in the blood/body back to the liver and should be HIGH.
Desirable: >60 mg/dl
Undesirable: <40 mg/dl
In helping people better understand the difference between LDL and HDL, think of a street on trash pick-up day. There are all the trash cans on the street – the road is the blood vessels, and the trashcans are the LDL cholesterol. The HDL is the trash truck coming along and picking up on the excess LDL cholesterol and taking it to the dump or the landfill (or in the human body, the liver).
Don’t Forget Triglycerides.
These blood triglycerides are from fats eaten in foods or made in the body from other energy sources like carbohydrates and alcohol. However, too much can be harmful to the heart and may even signal untreated diabetes. Therefore, we must have our blood drawn in a fasted state; otherwise, this result will not be accurate and potentially throw off the other results.
Normal: <150 mg/dl
Borderline: 150-199 mg/dl
High: 200-499 mg/dl
Very High: >500 mg/dl
And how do triglycerides fit into the garbage can pick-up scenario above? I tend to think of them as weeds. They can pop up after a rain or accumulate when ignored for a week or two. We can clean them up to be okay. On the other hand, they can be very high – lots of weeds and need addressing. They are always there, but how much is up to us and how much we want to maintain them.
Many lifestyle changes can help improve cholesterol results.
Have a Healthy Eating Plan:
Include more fruits, vegetables, whole grains.
Choose low-fat or non-fat dairy
Include lean protein and protein with healthy fats including lean meat, skinless chicken and turkey, fish
Choose a moderate number of eggs – equal to up to one egg a day
Nuts, seeds, and nut butter
Choose Healthy Fats to Lower Cholesterol
Healthy Fats = Unsaturated Fats
Mono-unsaturated fats should equal about 10-12% of our total calories. This fat helps lower LDL and raises HDL and is found in olive, canola and peanut oils, and avocados.
Polyunsaturated fats should equal about 10% of our total calories. This fat helps lower LDL and is found in safflower, sesame, soy, corn & sunflower-seed oils, nuts, seeds, and cold-water fatty fish.
Less Healthy Fat = Saturated Fats
This fat should be <10% of calories, closer to about 7%, because this appears to raise LDL and is found mainly in animal foods such as whole milk, cream, ice cream, whole-milk cheeses, butter, lard, and meats. And it is in oils like palm, palm kernel, coconut oils, cocoa butter.
Most Unhealthy Fat = Trans-fats
Have this type of fat as little as possible in the diet. These raise LDL and lower HDL. Found in partially hydrogenated vegetable oils and cookies, crackers, cakes, French fries, fried onion rings, donuts.
What Else?
Lose Weight if Overweight: Losing even 7-10% of your current body weight can help raise HDL, Lower LDL, Lower Triglycerides
Be Physically Active since it decreases the risk of being overweight, AND walking 30-60 minutes a day helps Raise HDL, Lower LDL, Lower Triglycerides.
Limit Alcohol since heavy drinking (3 or more drinks/day) can damage your heart muscle. On the other hand, cutting back to a moderate level of drinking can lower your blood pressure.
Stop Smoking because smoking damages blood vessel walls and causes early hardening of the arteries. Nicotine narrows your blood vessels and forces your heart to work harder.
Managing High-Stress levels is vital since stress can temporarily cause a dramatic increase in blood pressure. Develop relaxation techniques to deal with stress.
Know Your Numbers regardless of age.
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