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Cholesterol, its types and how to reduce its levels

Updated on December 24, 2014

Cholesterol is a waxy, fat-like substance, which is found in all cells of the body. Our body needs some cholesterol to make hormones, vitamin D, and substances that help us digest foods. The body makes all the cholesterol it needs in the liver and cells. However, it is also found in some of the foods we eat such as dairy products, eggs and meat. Cholesterol travels through our bloodstream in small assemblies called lipoproteins. A lipoprotein is a biochemical assembly that contains protein and lipids, lipids being inside covered by protein on outside. Lipoproteins allow cholesterol to move through water inside and outside cells. Basically, there are three kinds of lipoproteins that carry cholesterol throughout the body –

Low density lipoproteins (LDL) – They are also called bad cholesterol because a high level of them leads to a buildup of cholesterol in the arteries.

High density lipoproteins (HDL) – They are also called good cholesterol because they carry cholesterol from other parts of the body back to the liver, where it is removed from the body.

Very low density lipoproteins (VLDL) – They are similar to LDL in that they contain mostly fat and not much protein.

Triglycerides – This is another type of fat, which is carried in the blood by VLDL. Excess calories, alcohol, or sugar in the body are converted into triglycerides and stored in fat cells throughout our body.

Normal levels of different types of cholesterol – The following are the normal levels of different types of cholesterol, which are accepted by the majority of experts -

Total cholesterol –

Below 200 mg/dl
200 to 239 mg/dl
Borderline high
240 mg/dl and above

LDL cholesterol –

Below 70 mg/dl
Ideal for persons at very high risk of hear disease
Below 100 mg/dl
Ideal for persons at high risk of heart disease
100 to 129 mg/dl
130 to 159 mg/dl
Borderline high
160 to 189 mg/dl
190 mg/dl and above
very high

A person is considered to be at a very high risk of heart disease if the person has any of these – previous heart attack or stroke, artery blockage in a carotid artery or peripheral artery, and diabetes.

A person is considered to be at a risk for heart disease if any of the following and at a very high risk if two or more of the following are present –

  • Smoking
  • Low HDL cholesterol
  • High blood pressure
  • Older than 40 if man or older than 55 if women
  • A family history of heart disease
  • Elevated lipoprotein (a) in the blood

HDL cholesterol –

Below 40 mg/dl (men) and 50 mg/dl (women)
40 to 49 mg/dl (men) and 50 to 59 mg/dl (women)
60 mg/dl and above

Triglycerides –

Below 150 mg/dl
150 to 199 mg/dl
Boredrline high
200 to 499 mg/dl
500 mg/dl and above
Very high

Lifestyle changes for cholesterol reduction –

By introducing simple lifestyle changes people can effectively lower the high levels of cholesterol to normal ones provided the changes are followed consistently. Such lifestyle changes have been enumerated below -

  • Do exercise regularly - The benefit of cholesterol reduction can even accrue from moderate exercise such as brisk walking performed regularly. Regular moderate exercise lowers LDL (bad) cholesterol but in addition, it can also raise HDL (good) cholesterol by up to as much as 10%. Aerobic exercise also lowers another type of bad fat in the blood called triglycerides. It is recommended that any brisk aerobic physical activity performed regularly for 30 minutes every day is quite effective. But it will be more effective if it is done 45 to 60 minutes daily. One can aim for a minimum of 10,000 steps a day, which one can measure correctly by wearing a pedometer. Strength training has also been found to be effective in lowering LDL cholesterol and raising HDL cholesterol, if done regularly. Therefore, it is recommended that one should incorporate both in a daily exercise schedule to derive more benefit of cholesterol reduction.
  • Consume good fats – Unsaturated fats are good fats because they can improve blood cholesterol levels. Unsaturated fats are predominantly found in foods from plants, such as vegetable oils, nuts, and seeds. They are liquids at room temperature. There are two types of unsaturated fats viz. monounsaturated fats and polyunsaturated fats. Many studies have shown that consumption of good fats decreased levels of harmful LDL and increased protective HDL. No definite guidelines are available for their intake. But a prudent target for their daily consumption is 10 to 15 % of daily calories.
  • Consume fatty fish - Oily fish such as salmon, tuna, sardines, mackerel, and trout are full of omega-3 fatty acids that are good fats unlike the bad saturated fat that is found in most meats. Omega-3 fatty acids have been shown to lower triglycerides levels in the blood by as much as 25 to 30%. But it is not exactly known how they lower triglycerides. The American Heart Association recommends that people get at least two servings of fatty fish amounting to 8 ounces a week. We should remember that fatty fish are rich in calories and, therefore, one will gain weight, if one eats more than recommended amount of fatty fish. For people, who don’t like fatty fish, other sources of omega-3 fatty acids include walnuts, flaxseeds, canola oil and omega-3 enriched eggs.
  • Eat more fiber – Soluble fiber can help lower high cholesterol levels. It acts like a sponge to absorb cholesterol in digestive tract. Fruits and vegetables are good sources of cholesterol lowering dietary fibers.
  • Eat more fruits and vegetables – Eat plenty of fruits and vegetables since they are not only low in calories and fat but they will not raise cholesterol levels. Most fruits and veggies are rich in phytosterol and polyphenols, which can help keep the cholesterol levels in check.
  • Consume low fat dairy – Consume low fat or skimmed dairy products instead of regular full fat ones. This will keep the cholesterol level in check.
  • Consume lean meat – Use lean meat such as chicken, fish or turkey instead of red meat since lean meat will not raise the cholesterol level as much as red meat.

Having a high cholesterol level puts an individual at risk of developing heart disease and stroke than the people with optimal levels. The people of all ages and backgrounds can have high cholesterol. The prevalence of high cholesterol levels is also noticeably related to the income level of the country. In high-income countries, over 50% of adults have raised total cholesterol that is more than double the level of the low-income countries. So, the significance of having optimal cholesterol levels cannot be overlooked. If lifestyle modifications are not enough to lower the high cholesterol levels to normal, one may consider taking medications under the guidance of a physician.


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    • Dr Pran Rangan profile imageAUTHOR

      Dr Pran Rangan 

      4 years ago from Kanpur (UP), India

      Thanks for the comments. One has to be more careful if heart disease and high BP run in the family.

    • Dana Tate profile image

      Dana Tate 

      4 years ago from LOS ANGELES

      I have been trying to stop smoking . Heart disease and high blood pressure run in my family. Lately I have been exercising regularly and eating more fruits and vegetables.


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