Nothing says “I love you” quite like listening to your parents recap the stats from their latest doctor visit. But perhaps it’s time you listened up — cholesterol isn’t just for old folks to worry about. According to the CDC, about one-third of Americans have higher than optimal levels, putting them at greater risk for heart disease and stroke.
Check Yourself: LDL and HDL Cholesterol
Anyone over the age of 20 should get their levels checked, recommends the AHA.
There’s no denying the “c” word often gets a bad rap. But at face value, the waxy substance isn’t all bad. Cholesterol is naturally found throughout the body and in foods from animal sources, like eggs and meat. And your body needs some cholesterol to function properly — it helps form cell walls and aids the body in making vitamin D and hormones.
So when do cholesterol levels go from optimal to a cause for concern? “Cholesterol testing should start in your twenties and, if in a healthy range, should be retested in five years, provided there’s no change in your health,” says Dr. Nieca Goldberg, MD, National Spokesperson for the American Heart Association. A desirable cholesterol level is less than 200 mg/dL, although target levels depend on other heart disease risk factors, like medical history, heredity, and other lifestyle factors.
When you go in to see your doctor, the process will start with a blood test to measure several substances. The first two are lipoproteins — both low-density lipoproteins (LDL) and high-density lipoproteins (HDL) — which carry cholesterol throughout your body. Your total cholesterol is the combination of your LDLs, HDLs and one-fifth of your triglyceride levels (triglycerides are another type of fat found in the blood).
Cause for Concern
Sure, there are plenty of medical tests you know you “should” get, but do you really need this one? Actually, yes. Cholesterol plays a key role in your heart health, and it’s never too early to start taking note.
Cholesterol in the blood combines with other substances to create plaque, which then sticks to the walls of arteries. Over time, plaque buildup causes arteries to become blocked completely or too narrow for blood to flow easily from your heart to the rest of the body. This is known as atherosclrosis, a common form of heart disease. In the case of narrow passageways, chest pain (also know as angina) is common, and when arteries are blocked completely, a heart attack occurs.
The Cholesterol Myths
Healthy HDL levels may also protect against heart attacks and strokes, while low levels are actually associated with increased risk.
If you’re stressing over that cheeseburger you ate yesterday, don’t worry. The idea that consuming high cholesterol foods automatically leads to higher cholesterol levels isn’t gospel, especially if you eat a fairly healthy diet.
Why the confusion? The difference between LDL and HDL may be to blame. You’ve probably heard of “bad” and “good” cholesterol. LDL is what’s known as bad cholesterol, because it contributes to plaque buildup, while HDL is the so-called good kind. According to the AHA, “Experts believe HDL acts as a scavenger, carrying LDL cholesterol away from the arteries and back to the liver.” Healthy HDL levels may also protect against heart attacks and strokes, while low levels are actually associated with increased risk. Earlier understandings of cholesterol and health didn’t necessarily take this important distinction into account.
There’s also the question of what impact eating cholesterol has on your blood cholesterol levels. One recent review of the research suggests that while cholesterol consumption does increase LDL levels, it also increases HDL levels equally, keeping the ratio of the two the same, and ultimately having little impact on health. Still the evidence isn’t conclusive, and U.S. medical recommendations err on the side of reducing cholesterol intake overall. The AHA recommends a diet of fruit, veggies, whole grains, poultry, fish and nuts to keep your cholesterol levels in check.
Forming Healthy Habits
Like everything relating to your health, there are a lot of factors that play into reducing your risk of heart attack or stroke. Where blood lipids are concerned, increasing your HDLs and decreasing your LDLs may lower your heart disease risk, Mayo Clinic says.
Smoking, high blood pressure, and being overweight, all increase your bad cholesterol levels. The good news? Exercise both helps you lose weight and decreases your LDL. A healthy diet with a moderate amount of fat (mostly unsaturated fat from sources like olive oil, and little saturated fat from meat and dairy) can increase your HDL levels. “Overall it is better to have higher levels of HDL [than lower levels of LDL],” Dr. Goldberg adds. Whole grains, nuts and seafood — among other foods — may also contribute to a healthier heart.
Of course, there are many other things that impact your heart health. Unfortunately, you can’t control risk factors like heredity and gender, says the National Heart, Lung and Blood Association. Men are predisposed to have lower HDL levels than women, and high blood pressure can run in families. Moreover, your LDL levels rise with age; for men, risk increases around 45 years old, and for women at 55.
Perhaps most important to keep in mind: There are no symptoms of high cholesterol, says the CDC. So anyone age 20 or older should have their cholesterol checked. If you have high cholesterol or other risk factors, you may need to be screened more often, though — ask your doctor to know for sure.
Want to learn even more? Check out the AHA’s interactive cholesterol library.