It’s American Heart Month – Cholesterol 101

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By Kathy Ferguson, RN, Parish Nurse

Create in me a pure heart, O God, and renew a steadfast spirit within me. Psalm 51:10. 

Every February is American Heart Month, a time dedicated to increasing awareness and urging Americans to develop healthy habits to decrease their risk of heart disease. This month’s column focuses on cholesterol and its role in heart disease. Cholesterol is on my mind today. I had a blood test this morning to check my cholesterol levels. Waiting for the results always makes me a little anxious. I have been on and off lipid-lowering medication for the last several years. I wonder what the results will be this time. Will I have to go back on medication? In the meantime, let’s get cholesterol basics. Let’s call it Cholesterol 101.
What is cholesterol?
 

First, the easy answer: Mayo Clinic tells us that, “cholesterol is a waxy substance that’s found in the fats (lipids) in your blood. While your body needs cholesterol to continue building healthy cells, having high cholesterol can increase your risk of heart disease. When you have high cholesterol, you may develop fatty deposits in your blood vessels. Eventually, these deposits make it difficult for enough blood to flow through your arteries. Your heart may not get as much oxygen-rich blood as it needs, which increases the risk of a heart attack. Decreased blood flow to your brain can cause a stroke.”
So, cholesterol is not necessarily a bad thing. Our livers make all the cholesterol our body needs to build healthy cells. The problem comes when the cholesterol we take in through food or drink causes the liver to work overtime and sends cholesterol that we don’t need into our bloodstream. Too much cholesterol in our blood is not a good thing.
Here is where it gets a little confusing. There are two types of proteins that carry the cholesterol in your body. The first is low-density lipoprotein (LDL), also known as “bad cholesterol”. It is considered “bad” because it can build up in the walls of our arteries, making them stiff and narrow. The other type of cholesterol you may have heard of is high-density lipoprotein (HDL) which is considered “good cholesterol”. It helps pick up extra cholesterol in your blood and bring it back to the liver. The goal should be to have as little LDL (“bad cholesterol”) in our bloodstream as possible. With HDL (“good cholesterol”), a higher value is better.
How about triglycerides?
Triglycerides are the most common type of fat in the body. Mayo Clinic tells us that when we eat, our body converts any calories it doesn’t use right away into triglycerides which are then stored in our fat cells. If you regularly eat more calories than you burn, particularly from high-carbohydrate foods, you may have high triglycerides (hypertriglyceridemia). When combined with a high LDL or low HDL level, high triglycerides can cause the buildup fatty deposits in the artery walls.
Why do I have elevated cholesterol and triglyceride levels?
According to Mayo Clinic, there are things that we can control that cause high LDL and low HDL levels. These include inactivity, obesity, and an unhealthy diet. However, genetics or family history can play a role too.
Can I do anything to improve lipid levels?
Of course, there are things that you can do! These will probably sound familiar to you.
• Eat a diet that includes many fruits, vegetables, and whole grains:
Fruits, vegetables and whole grains contain minimal to no fats.
• Limit the amount of animal fats and use good fats in moderation:
There are two types of fat that raise cholesterol, saturated fat, and trans fats. Saturated fat is found in animal products. Trans fats are found in baked goods, cookies, icings, crackers, packaged snack foods, microwave popcorn, and some margarines. Unsaturated fats are good fats and include things such as vegetable oil, olive oil, fatty fish (salmon, catfish), flaxseed and walnuts.
• Lose extra pounds and maintain a healthy weight:
Now, I know we have all heard this before. It is easier said than done though. Please be aware that having a body mass index (BMI) of 30 and a waist circumference of at least 40 inches for men or at least 35 inches for women puts you at risk for high cholesterol.
• Quit smoking:
Cigarette smoking damages the walls of your blood vessels, making them more likely to attract fatty deposits. Smoking may also lower your level of “good” cholesterol.
• Exercise on most days of the week for at least 30 minutes:
Exercise helps boost your body’s HDL, or “good,” cholesterol while increasing the size of the particles that make up your LDL, or “bad,” cholesterol, which makes it less harmful.
• Keep an eye on your blood sugar:
High blood sugar contributes to higher LDL cholesterol and lower HDL cholesterol.
Do I need medication?
The first step is making the lifestyle changes listed above. If after making these changes, the cholesterol level remains high, it is time to talk with your healthcare provider about medication. According to Mayo Clinic, the medication or medications chosen depends on your individual risk factors, your age, your current health, and possible side effects.
Those are the cholesterol basics. For more information, refer to the resources used for this article:
*Mayo Clinic, (2019). Patient Care & Health Information, Diseases & Conditions, High cholesterol. 
*American Heart Association, (2018). Questions about cholesterol? Here are some answers.
Have a Happy American Heart Month!