Cholesterol – The Good, the Bad, the Ugly


Have you wondered what your cholesterol numbers mean? Can the foods you eat really change your cholesterol levels? Cholesterol may have earned a reputation for being a danger to your health, but this is not always the case. In fact, your body produces its own cholesterol in the liver, and this waxy substance plays many essential roles in your body, from maintaining the structure of your cells, to helping produce vitamin D, to the digestive acids that help you break down fat.

Special proteins called ‘lipoproteins’ act as vehicles for cholesterol movement through the blood. Based on the lipoprotein that carries it, cholesterol is divided into two types of vehicles: low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.


Breaking down good and bad cholesterol

LDL cholesterol is what is commonly known as ‘bad cholesterol’, because it gets deposited in the walls of your arteries. This buildup is called plaque, causes a narrowing of your blood vessels which restricts and eventually blocks blood flow to and from your heart and other organs. This condition, called atherosclerosis, can lead to heart attacks or strokes by blocking blood flow to the heart or brain.

On the other hand, HDL or ‘good cholesterol’ transports other types of cholesterol from the walls of arteries to the liver where it can be removed from the body before it causes a narrowing of the arteries. Consequently, it is believed that higher levels of HDL have the potential to reduce your risk of heart disease.

What does your lipid profile mean?

Your body needs both cholesterol types at optimal amounts to ensure normal functioning. However, problems arise when there is excess cholesterol in the body. These problems can be identified by evaluating your lipid profile through a simple blood test.

The different components of a lipid profile can tell you a lot about your heart health; hence, it is essential to know their significance in relation to each other. Optimum cholesterol levels depend on your gender and age. Here are the normal values of lipid profile components for an individual over the age of 20:

LDL levels: Generally, if this number is low, your risk of developing heart disease is also low.
Below 100 mg/dL is ideal.
100 to 129 mg/dL can be good, depending on your health.
130 to 159 mg/dL is borderline high.
160 to 189 mg/dL is high.
190 mg/dL or more is very high.

HDL levels: A higher HDL value is a positive sign for heart health. For South Asians, the goal HDL should be 50-60, given their elevated risk for heart disease.
60 mg/dL or higher is good, and offers cardiovascular protection
40 to 59 mg/dL is considered moderate
Less than 40 mg/dL is low, and raises your chance of developing heart disease

Triglyceride levels: Most of the fat in your body is present in the form of triglycerides. Unused calories are converted to triglycerides and these are then stored in fat cells. So the lower your triglyceride levels are, the lower is the risk for heart disease. Desirable: Less than 200 mg/dL
Borderline high: 200-239 mg/dL
High: Over 240 mg/dL

Total cholesterol: Your total cholesterol level includes your HDL, LDL, and 20% of triglycerides. This value should typically be under 200 mg/dL.
Normal: Less than 200 mg/dL
Borderline high: 200 to 239 mg/dL
High: At or above 240 mg/dL

High levels of LDL and low levels of HDL are commonly noticed in the lipid profiles of several Indians. The likelihood of dying from a heart disease doubles with every 40 percent increase in total cholesterol levels.


Controlling your cholesterol levels

Cholesterol is within your control – with the correct implementation of certain long-term strategies, you can improve your levels of cholesterol. In addition to getting your cholesterol levels checked every 4-5 years (more frequently if you are a heart patient), here are some easy ways you can keep your cholesterol levels in check:

  • Make dietary changes by reducing your consumption of saturated fats and animal products. Try implementing more plant-based oils and food in your cooking. Additionally, to lower triglyceride levels, it is crucial to avoid processed carbohydrates such as white rice and naan. Instead, upma, brown rice, chapatis, and millets like ragi and jowar are all healthier alternatives.
  • Getting enough exercise and thus maintaining a healthy weight will also regulate your cholesterol levels and reduce your risk of heart disease.
  • For some people, making lifestyle changes might not be enough. Cholesterol medication would need to be prescribed by a doctor to reduce your LDL levels.

The general advice for healthy adults is to get a blood lipid profile once every five years. It may be recommended to get a lipid profile test done more frequently around middle age or if you have certain risk factors, including:

  • Total cholesterol of 200 mg/dL or more
  • HDL of less than 40 mg/dL
  • Risk factors such as diabetes or high blood pressure
  • Cholesterol is a normal component of your body and its levels are important indicators of heart health. In reality, you have a lot of control over the numbers of your lipid profile components. It is absolutely possible to reverse high levels of cholesterol before you develop a heart disease, and you can do this by taking simple lifestyle-related measures.

Results

#1. Which of these is considered 'healthy' cholesterol?

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