Cholesterol 101

You likely know people should have their cholesterol levels checked periodically and need to keep them at certain levels to stay healthy, but what does it mean that some cholesterol is good and some is bad? What exactly is cholesterol and how do you maintain healthy levels in your body? To mark National Cholesterol Education Month, a local cardiologist shares answers to these questions and other important facts everybody should know about cholesterol.

Washington Township Medical Foundation (WTMF) cardiologist Sangeetha Balakrishnan, MD, calls herself a healer and an educator. She is board-certified in internal medicine and cardiology and certified in nuclear cardiology. Cholesterol is a regular topic of discussion between the doctor and her patients because it plays a big role in cardiovascular disease and can lead to heart attacks and stroke.

“Cholesterol is a waxy substance in our blood that is essential because our bodies need it to perform important jobs like building cells and making hormones,” explained Dr. Balakrishnan. “The body generally produces the right amount of good and bad cholesterol, so we don’t need to supplement it with our diet.”

That said, if we start making too much of the bad cholesterol, it can be dangerous. Low-density lipoprotein (LDL) cholesterol is known as the bad type of cholesterol. This is the one we want to keep low (at or below 100 milligrams per deciliter [mg/dl] of blood) to ward off heart disease. The good type of cholesterol is high-density lipoprotein (HDL) and higher levels can help reduce a person’s risk of heart disease and stroke (ideally above 70 mg/dl). Triglycerides are fats from the food we eat. Extra calories, alcohol, and sugar in your body turn into triglycerides. Too many triglycerides can contribute to problematic cholesterol buildup.

How and When to Check Levels

The American Heart Association recommends adults have their cholesterol and triglyceride levels tested every four to six years, and Dr. Balakrishnan recommends her higher risk patients test every year. Risk factors include a family history of high cholesterol or early heart disease and people’s risk for high cholesterol increases as they get older. Controllable risk factors include a diet high in sugar and fats, being overweight, low physical activity, smoking, high blood pressure, and type 2 diabetes.

Testing cholesterol levels entails a fasting blood draw, called a lipid panel, that your primary care physician can order from a medical laboratory to check your lipoprotein and triglyceride levels. Fasting usually means not eating, drinking certain beverages, and taking medications for 9 to 12 hours before the test. After the blood sample is taken, it is analyzed and levels of HDL cholesterol, LDL cholesterol, and triglycerides are measured. If the test results show higher levels of HDL or other red flags, it is a good idea to talk to your doctor or a cardiologist about considering lifestyle changes or medications.

Cholesterol Controlling Therapies

“For my patients who don’t have high risk factors but their LDL cholesterol is up, we discuss how making a few changes in their daily life can help improve their numbers,” said Dr. Balakrishnan. She recommends people eat a Mediterranean diet which includes lots of fruits and vegetables, cooking with olive oil, and eating fish one or two times a week.

The other way to increase your HDL and lower LDL cholesterol is exercise. Brisk walking or jogging, cycling, swimming and yoga several times per week will help keep your numbers in line, especially when combined with a healthy diet.

When changes in lifestyle are not enough, cholesterol-lowering medications may be recommended. Statins are suggested for most patients and have been directly associated with a reduced risk of heart attack or stroke. If this is the case for you, be sure to discuss the benefits and risks of statin therapy with your doctor.

For more information about cholesterol, find multiple videos on the Washington Hospital YouTube channel at www.YouTube.whhs/InHealth. To schedule an appointment with Dr. Balakrishnan, call WTMF Cardiology at 510.248.1670.