What are lipids and cholesterol?
Lipids (from the Greek word lipos or ‘fat’) are naturally occurring substances essential for normal body function, which can cause disease when too much is present.
Lipids do not mix with water.
Two important types of lipids are cholesterol and triglycerides:
- Cholesterol is a waxy material that supports the structure of the body at a microscopic level.
- Triglycerides are oil at body temperature and their function is to store energy inside fat cells.
Why is high cholesterol dangerous?
Cholesterol and triglycerides cause blockage of arteries when too much is present.
The buildup of lipids leads to plaque inside blood vessels.
High cholesterol itself does not have symptoms. Many people do not know that their cholesterol level is high. That’s why it’s important to schedule regular visits with Dr. Brewton who will order a simple blood test to check your cholesterol levels.
Virtually everyone in the U.S. has at least some plaque in their arteries, starting from a very young age.
The difference among individuals is whether the plaque is bad enough to cause blockages, and at what age that occurs.
When we check your cholesterol we may run a blood test called a lipid profile that measures the total cholesterol and well as the individual components:
- Total cholesterol is a measure of the total amount of cholesterol in your blood and is based on the HDL, LDL, and triglycerides numbers.
- LDL cholesterol makes up the majority of the body’s cholesterol. LDL is known as “bad” cholesterol because having high levels accelerates plaque buildup in your arteries which can result in heart disease and stroke.
- HDL cholesterol absorbs cholesterol and carries it back to the liver, which flushes it from the body. HDL is known as “good” cholesterol because it reduces the risk for heart disease and stroke, by scavenging cholesterol out of the arteries.
- Triglycerides are a type of fat found in your blood that your body uses for energy. The combination of high levels of triglycerides with low HDL cholesterol or high LDL cholesterol can increase your risk for heart attack and stroke.
What levels of cholesterol are desirable?
According to the Centers for Disease Control (CDC) these are the desired levels of cholesterol:
Less than 200 mg/dL*
LDL (“bad” cholesterol)
Less than 100 mg/dL
HDL (“good” cholesterol)
40 mg/dL or higher (NOTE: HDL over 60 reduces the risk of cardiovascular disease. The higher number the better.)
Less than 150 mg/dL
* Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.
Will you be able to control your cholesterol?
Cholesterol levels vary from person to person, based on genetics and individual health habits.
About one third of patients have genes that make them ‘lucky.’ They will have good cholesterol test results — whether or not they follow a healthy diet, maintain proper weight or exercise regularly.
Another third of patients have cholesterol results that depend on lifestyle ‘choices.’ These patients may be able to reduce their cholesterol to a normal level by following a healthy diet, maintaining proper weight and exercising regularly.
The final third of patients find it very difficult to reduce their cholesterol levels with lifestyle changes alone. These patients must take medication to control their lipid levels.
What kind of health habits can help reduce cholesterol levels?
Cigarette smoking damages your blood vessels, speeds up the hardening of the arteries, and greatly increases your risk for heart disease – regardless of your cholesterol levels. Stopping smoking is the most powerful thing a person can do to reduce the risk of cardiovascular disease.
If you don’t smoke, don’t start. If you do smoke, quitting will lower your risk for heart disease. Dr. Brewton can suggest ways to help you quit.
Eat a Healthy Diet
Cut down on carbs in your diet, especially “white” carbs:
- White flour breads and pasta
- White rice
- White potatoes
And replace them with high-fiber carbs, like:
- 100% whole wheat bread and pasta
- Brown rice
- Sweet Potatoes
- High-fiber beans and lentils
- Whole grains
- Green leafy vegetables
Limit fruit juices; eat whole fruit instead. Limit intake of agave nectar, honey and maple syrup.
Choose healthy monounsaturated fats, such as olive oil and canola oil over less healthy animal fats.
Avoid “trans” fats, which are unhealthy.
Polyunsaturated oils such as sunflower oil and corn oil reduce HDL “good” cholesterol.
Maintain a Healthy Weight
Being overweight or obese increases both LDL “bad” cholesterol and triglyceride levels.
To determine if your weight is in a healthy range, Dr. Brewton will calculate your body mass index (BMI).
Increase Physical Activity
Physical activity can help you maintain a healthy weight and lower your cholesterol, blood pressure and sugar levels. For adults, the Surgeon General recommends 2 hours and 30 minutes of moderate-intensity exercise, like brisk walking or bicycling, every week.
Recent studies show benefits even with short bursts of high-intensity exercise.
When lipid levels remain high, Dr. Brewton can discuss options for additional treatment, customized for each person’s needs.
The American Heart Association and American College of Cardiology have published recommendations to prevent Atherosclerotic Cardiovascular Disease (ASCVD). Their web site includes an online risk calculator where you can put in your individual health history and test results to calculate your individual risk for ASCVD in the next 10 years.
Medications that can help control cholesterol:
Several types of medications help lower LDL cholesterol.
Statin drugs lower LDL cholesterol by slowing down the liver’s production of cholesterol. They also increase the liver’s ability to remove LDL cholesterol that is already in the blood.
Bile acid sequestrants
Bile acid sequestrants help remove cholesterol from the blood stream by removing bile acids. The body needs bile acids and makes them by breaking down LDL cholesterol.
Niacin, or nicotinic acid
Niacin is a B vitamin that can improve all lipoprotein levels. Nicotinic acid raises high-density lipoprotein (HDL) cholesterol levels while lowering total cholesterol, LDL cholesterol, and triglyceride levels.
Fibrates mainly lower triglycerides and, to a lesser extent, increase HDL levels.
All drugs may have side effects, so speak with Dr. Brewton and your pharmacist on a regular basis. Once your cholesterol levels have improved, Dr. Brewton will monitor them to ensure they stay in a healthy range.
Dr. Brewton welcomes any questions you may have regarding lipids and cholesterol or any other health concern you may have. We consider the doctor-patient relationship to be a partnership – working together to help you achieve the best possible health.