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Cholesterol: The Ultimate Frenemy

November 6, 2020

Let’s pause for a moment before the holiday season and talk about CHOLESTEROL.

What is cholesterol?

Cholesterol is an essential waxy substance that the body needs to perform important functions. Cholesterol comes from two sources: the liver and the food you eat.

So why does cholesterol have a bad reputation?

Cholesterol is well-known for causing heart attacks and strokes when the levels are high. It’s a disease known as Hyperlipidemia or dyslipidemia. But let's be fair! Not all cholesterol is bad. There are three types that your doctor may talk to you about:

  • LDL — the bad cholesterol that tends to build up on the walls of blood vessels, causing blockage to the heart and brain, which can result in heart attacks, heart failure, and strokes. The recommended level of LDL is less than 130, and if someone's risk for stroke or heart attack is higher, the level should be much less than that.
  • HDL — the good cholesterol. HDL removes the bad cholesterol from the bloodstream and the walls of the blood vessels and returns it to the liver. A good level is higher than 50 — the higher, the better.
  • Triglycerides — the fat stored in the body which is built from the extra calories we consume. High triglycerides may increase your risk for heart disease.

When should I have my cholesterol level checked?

Early detection of high cholesterol in people with high risk for heart disease is highly important, as it will enable your provider to make early treatment decisions to prevent the development of heart attacks, strokes, or other vessel blockages. You are at high risk if you have hypertension, smoking, diabetes, obesity, or a family history of heart disease at an early age.

For people with no high risk, testing starts at the age of 35 for males, and 45 for females during your routine physical or visit to your provider.

How can I reduce the "bad cholesterol" and increase the "good cholesterol?”

Depending on your cholesterol level, and the risk assessment for developing heart disease or strokes, your doctor will recommend one of two options:

  • Lifestyle changes (diet, exercise, smoking cessation, weight loss).
  • Avoid saturated fat (red meat, cheese, butter, cream, etc.) and avoid fried food. Replace butter with canola oil.
  • Eat more vegetables, fruit, fish, low-fat dairy, whole grains, and nuts.
  • Exercise, exercise, and more exercise! Aim for at least 30 minutes of moderate-intensity exercise 5 times a week. For example brisk walking — this means fast enough that you cannot talk on the phone, but not running or jogging.
  • Stop smoking! Ask your primary care provider about medications that help with smoking cessation. Quitting smoking will profoundly reduce your risk for heart attacks.

Last advice!

Studies have shown that, for most people, the level of cholesterol increases significantly after the holiday season. It is time to watch what you eat, talk with your primary care provider about your risk for heart disease, and to discuss ways to prevent it.

Stay healthy! Let Cholesterol stay a friend. Do not turn it into your enemy!

Dr. Yassin-Jioussy is a third-year internal medicine resident at the Mount Sinai Morningside-Mount Sinai West Internal Medicine residency program. She sees patients in the primary care center at Ryan Health | Adair.