“It’s a scientific fact that your body will not absorb cholesterol if you take it from someone else’s plate” – Dave Barry.

Don’t we all wish this were true? Bacon, cheese, butter, steak & burgers, heavy cream, shrimp! If you have high cholesterol, these items are the poster child of what to avoid, and you probably experience just a teensy bit of guilt when consuming these delicacies.

WHAT IS CHOLESTEROL?

Cholesterol is a type of lipid (fat) present in our bodies and is essential for various physiological functions. The body does not need cholesterol from food and can naturally manufacture it. The liver naturally produces cholesterol, a fatty substance that helps the body make hormones and digest fatty foods. However, there is also cholesterol in animal-based foods, such as the bacon, cheese, butter, and eggs we all love and consume, and may impact our cholesterol numbers.

Like many things, cholesterol has both positive and negative aspects. Here's an overview of the good, the bad, and the ugly sides of cholesterol:

The Good:

1. Cell Membrane Structure: Cholesterol is a vital component of cell membranes, providing structural integrity and fluidity to cell walls.

2. Hormone Production: Cholesterol is a precursor to essential hormones such as testosterone, estrogen, and cortisol, which play crucial roles in various bodily functions.

3. Bile Acid Synthesis: Cholesterol is used to produce bile acids in the liver, which are essential for the digestion and absorption of fats.

4. Vitamin D Synthesis: Cholesterol is a precursor for synthesizing vitamin D, essential for bone health, immune function, and other processes.

5. Understanding your Cholesterol Numbers is Easy: All that is needed is a simple blood test called a lipid profile. Cholesterol tests measure two types of cholesterol:

Low-density lipoprotein (LDL): This type of cholesterol is what many people consider the “bad” kind. Elevated levels of LDL can increase the risk of cardiovascular disease, clogged arteries, and other heart health issues.

High-density lipoprotein (HDL): This “good” cholesterol can help remove and carry it back to the liver. Higher levels of HDL may lower a person’s risk of cardiovascular disease.

Total cholesterol is a measure of HDL plus LDL and also triglycerides. Triglycerides are a type of fat or lipid most influenced by what we eat and are closely related to cholesterol. Triglyceride levels change throughout the day and can also be a risk factor for heart attack and stroke. If your cholesterol is high, steps can be taken to lower it — like eating healthy, getting more physical activity, and taking medicine if your doctor recommends it.

6. Sweating can raise your good cholesterol levels. Aside from eating a healthy diet, including foods like heart-healthy salmon and avocado, you can increase your HDL levels — which protect against heart disease — by working out. The key is to use interval training by exercising at a medium intensity, sprinkling in bouts of high intensity.

The Bad:

LDL Cholesterol: Low-density lipoprotein (LDL) cholesterol is often called "bad" cholesterol. Elevated LDL cholesterol levels in the bloodstream can lead to plaque buildup in arteries, increasing the risk of atherosclerosis (hardening and narrowing of the arteries) and cardiovascular diseases like heart attacks and strokes.

Atherosclerosis: Excess cholesterol, particularly LDL cholesterol, can contribute to the formation of atherosclerotic plaques in arteries, restricting blood flow and increasing the risk of cardiovascular events.

Genetics: High cholesterol can run in families. If someone in your family has high cholesterol or takes medicine to control cholesterol, you might need to get tested more often. Talk to your doctor about what is best for you.

The Ugly:

Heart Disease: The accumulation of cholesterol plaques in arteries can lead to coronary artery disease (CAD) and other forms of heart disease. This can result in serious health complications, including heart attacks and heart failure.

Stroke: Atherosclerosis can also affect arteries leading to the brain, increasing the risk of strokes.

Peripheral Artery Disease: Cholesterol buildup in peripheral arteries can reduce blood flow to the limbs, causing pain, numbness, and even tissue damage.

Even children can have high cholesterol: Most people think of high cholesterol as an adult issue. However, the healthcare community now knows that starting testing early is one key to keeping levels normal. The American Academy of Pediatrics recommends cholesterol screening for all kids between ages 9 and 11. Selective screening should be done even earlier — beginning at age 2 — for children at high risk of having cholesterol issues, including kids with:

• Obesity

• A family history of heart attacks

• A family history of high cholesterol

Managing Cholesterol: To maintain a healthy balance of cholesterol and minimize the negative effects, it is important to:

1. Monitor Levels: Regularly check your cholesterol levels and consult a healthcare professional to assess your risk factors for heart disease.

2. Be Conscious of Your Diet: Consume a diet low in saturated and trans fats, which can raise LDL cholesterol levels. Focus on a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats like those found in nuts, seeds, and fatty fish.

3. Get Physical: Engage in regular physical activity to help raise HDL (high-density lipoprotein) cholesterol (considered "good" cholesterol) levels and improve overall cardiovascular health.

4. Take your Medication: In some cases, medication such as statins may be prescribed by a healthcare provider to help manage cholesterol levels.

Do you know your cholesterol numbers? Celebrate National Cholesterol Education Month by finding out. Everyone can benefit from knowing their cholesterol numbers and doing what they can to prevent or reduce high cholesterol levels. High cholesterol has no symptoms, so individuals might not know their cholesterol is too high – unless it is measured by a doctor with a blood test.

For most people, Johns Hopkins recommends these healthy cholesterol levels. However, the numbers are general guidelines because actual target goals may depend on the number of risk factors you have for heart disease.

• Total cholesterol: less than 200 milligrams per deciliter

• LDL “bad” cholesterol: Optimal is less than 100 mg/dL.

• HDL “good” cholesterol: higher than 40 mg/dL

• Triglycerides: less than 150 mg/dL

Both you and your physician should review these numbers to assess potential health risks and whether lifestyle changes or medications may be needed to manage the levels.

Remember that cholesterol is a complex topic, and individual health needs vary. Consult a healthcare professional for personalized advice and recommendations based on your situation.

Want to learn more about cholesterol, global heart health, and recommendations by policy organizations to make inroads in the healthcare management of this health risk? Read the World Heart Federation (WHF) 2022 Cholesterol Road Map, setting out a framework for policymakers and healthcare professionals to address healthcare systems barriers and implement solutions to prevent undesirable exposure to cholesterol throughout the life course. The 2022 roadmap details WHF’s move from viewing high cholesterol not as the problem but lowering cholesterol throughout life with different approaches as the solution.