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Top 6 Cholesterol FAQs

Top 6 cholesterol faqs large

1. Where does cholesterol come from?

 Your liver produces most of the cholesterol in your body. Cholesterol from food provides only a very small portion of total cholesterol in your blood. Your liver manufactures cholesterol from dietary fat, protein, and carbohydrate to be used as a building block for steroid hormones (vitamin D, estrogen, testosterone), bile (needed for digestion), and in the building of cell membranes.

LDL cholesterol, or “bad” cholesterol is manufactured from dietary fat, carbohydrate and protein as a way to get fat out of the liver and into the blood stream for delivery to cells. When you eat too much saturated fat or trans fat, LDL builds up in the blood and deposits on artery walls, causing plaque.

2. How does my diet affect my cholesterol levels?

Although your liver is responsible for manufacturing most of the body’s cholesterol, cholesterol that you eat does play a minor role (a big role for diabetics). But, believe it or not, your intake of cholesterol is not nearly as risky as your intake of saturated fats, trans fats and excess carbohydrate.

Years ago, when low fat diets were first recommended, manufacturers capitalized on this and started replacing fat in foods with carbohydrate sources. People trying to eat a lowfat diet would eat fat-free and low-fat foods and ate diets high in carbohydrate to avoid fat. Cholesterol levels actually increased.

It seems that fat and cholesterol aren’t independent villains – it’s the type of fat. When “good fats” like those found in nuts, olive oil, fish, etc. replace saturated fats in the diet, total cholesterol goes down (this includes HDL), but when good fats replace carbohydrate in the diet, LDL goes down and HDL goes up. Omega-3 fats, like those found in fish, have a profound effect on supporting healthy triglyceride levels, another measure in your lipid panel.* If you want to lower your cholesterol, replace saturated and trans fats with good fats instead of carbohydrate fillers.

3. How can I raise my good cholesterol, HDL?

 The best ways to raise your HDL are to give up the starchy carbs, aka the white stuff in exchange for fruits, vegetables and healthy fats from nuts, fish, and olive oil. You also need to exercise. Daily exercise is one of the best ways to raise your HDL. If you do not have trouble with alcohol, no more than one glass of red wine nightly will also help.

4. My doctor says my cholesterol is high. What does that mean?

Your doctor will usually complete a full lipid panel (measure of blood cholesterol and fat) at least annually. On that report, you’ll see at minimum your total cholesterol, LDL, HDL and triglycerides. Total cholesterol is a combination of LDL, HDL and VLDL (a carrier of triglycerides). LDL is “bad cholesterol.” You need some, but too much is dangerous. HDL is “good cholesterol.” It sweeps LDL from the blood and plaque. Triglycerides measure fat in your blood.

What is a healthy range?

• Total cholesterol – less than 200mg/dL

• LDL cholesterol – less than 100 mg/dL or less than 70 mg/dL if you have heart disease or diabetes.

• HDL cholesterol – you need a minimum of 40mg/dL for men and greater than 50mg/dL for women. The higher the better.

• Triglycerides – less than 150mg/dL.

The same strategies work to lower LDL, total cholesterol and triglycerides and to raise HDL. If you smoke, quit. Limit your intake of saturated fats, avoid trans fats and replace them with monounsaturated fats and omega-3s. Avoid white flour, pasta and bread and other simple sugars in favor of complex carbohydrates found in vegetables and fruits. Exercise – every day. Drink alcohol only in moderation. No more than one drink per day for women and no more than two drinks per day for men. Consuming omega-3 fats, DHA and EPA from fish and fish oil supplements daily can significantly help support healthy triglyceride levels.*

5. How much of a role does heredity play?

Heredity definitely plays a role in cholesterol levels, but you can fight back. By eating a diet rich in fruits and vegetables, lean protein and “good fats” found in nuts, fish, avocadoes and olive oil, and by steering clear of trans fats and limiting saturated fats, plus daily exercise, you can avoid many of the problems your family may have had.

It’s important for everyone, but especially those with hereditary risk factors to stay in the know – know your numbers and keep records. See your physician regularly and ask questions if you don’t understand. Your physician may recommend supplements and/or prescription medications to help.

6. I’m watching my diet and my cholesterol is still high – what can I do?

Your doctor may recommend statin therapy. Statins are inexpensive, but effective drugs that lower LDL and can help raise HDL. There are also natural ways to lower your cholesterol, using diet, exercise and some supplements.

These are just a handful of the questions I receive from my patients. I hope you found them helpful. 


In Good Health,

James O'Keefe, MD

Photo credit:  Pixabay Creative Commons