The High Cost of Cholesterol

Cholesterol: It's Just a Number. Or is it?

/ Author:  / Reviewed by: Joseph V. Madia, MD

It seems like just another blood test. Then there's the results: only a number followed by that typical doctor lecture of getting more exercise and eating healthier.

For most, that brief lecture isn't enough to generate a real plan of action for lowering cholesterol. In fact, a lot of patients have all but forgotten the warning by the time they've made the walk to their car to head home.

But the truth of the matter is that high cholesterol is a real danger than can lead to a serious risk of heart disease. It's a major risk factor for a heart attack.

So with the possibility of major health problems and presented with a seemingly simple plan to lower cholesterol, why aren't Americans willing to take action?

Carol Wolin-Riklin, a registered dietitian at The University of Texas Health Science Center at Houston Medical School, said patients seem to more aware that they should maintain their cholesterol levels. But that doesn't mean they're doing anything about it.

"People are more aware of it but the issue is changing your diet and your lifestyle. Obesity is such a problem. This really is a global issue," Wolin-Riklin said. "Metabolic syndromes are popping up in countries where we've not seen it before like Asia.

Wolin-Riklin said though patients have awareness, most still aren't developing action plans following diagnosis of high cholesterol.

"They're confused about how to go about it," she said. "A lot of times the answer I hear is 'Oh, I didn't think of that.'"

So what is cholesterol?

All bodies need cholesterol. About 75 percent of it is produced naturally by the body while the remainder is affected by food choices. Cholesterol is only found in animal products, according to the American Heart Association.

There are two types of cholesterol -- the LDL, or bad cholesterol, and HDL, or good cholesterol. Keeping your LDL low and HDL high helps to fight against heart disease.

When cholesterol is too high, the fats are more likely to build up and stick to the arteries. This hard deposit narrows the arteries and makes them less flexible. A clot in that narrowed area can result in a heart attack or stroke.

Eating saturated fats, trans fats and dietary cholesterol can increase cholesterol while healthier food choices like lean meats, fruits and vegetables can help lower it.

The diagnosis

Ideally everyone above the age of 20 should have their cholesterol checked at least once every five years, according to the National Cholesterol Education Program. In most cases a lipoprotein panel is conducted, which provides information about all available cholesterol numbers.

Though recommended only every five years, a cholesterol check is usually part of an annual physical.

Ideally total cholesterol should be below 200 mg. A cholesterol reading between 201 and 239 is considered borderline high while cholesterol above 240 is cause for concern.

LDL should be below 100 mg. A reading of 160 is considered high and 190 is considered very high. Though this type is produced naturally by the body, certain genes can be inherited from parents that cause bodies to produce too much cholesterol.

Additionally, patients should try to maintain a HDL reading above 40 mg. Raising it to above 60 helps your body better fight against heart disease.

What it means for your health

Patients with high cholesterol in their blood have twice the risk for cardiovascular disease, according to the American Heart Association. It's especially important since maintaining blood cholesterol level is one of few ways that you can actually lower your heart risk.

The risk for coronary artery disease is even more substantial in patients with diabetes or high blood pressure. Those who smoke also have a higher risk.

Cardiovascular disease is the No. 1 cause of death in the United States with 2,200 Americans dying of heart disease every day, according to the American Heart Association. That's an average of one death every 39 seconds.

It is especially important to get cholesterol checked regularly because there are no signs or symptoms of high cholesterol. Patients can go long periods without even being aware that their cholesterol has reached a dangerous level.

Lowering cholesterol

Lowering cholesterol isn't really as hard as it sounds. Diet, exercise, weight control and avoiding tobacco are the primary methods for controlling it though some patients may have to resort to prescription medications if they are unable to reduce it enough on their own. Medication is usually a last resort since there can be side effects.

"You want to keep fat down. You want to keep the balance of fat to 25 to 30 percent every day," Wolin-Riklin said, noting that choosing lean meats also is important.

She said that in addition to regular exercise and weight control, nutrition counseling can be helpful, especially for those who have trouble getting started on their own. She said such programs are especially beneficial since many primary care doctors don't have the time to adequately educate patients about lowering cholesterol.

Just last week the US Department of Agriculture revamped the food pyramid in hopes of helping Americans better understand how to control their diet. The new site -- -- features visuals and more focus on portion sizes. A plate full of food demonstrates how much of each category Americans should be eating per meal. For example, meat makes up about a quarter of the plate. About half of each plate should be full of fruits and vegetables. It also suggests cutting portions and eliminating sugary drinks.

Review Date: 
June 7, 2011