Cholesterol 101: Understanding the Basics

You've likely heard the word cholesterol and seen it on your blood work results, but do you actually know what cholesterol is, how it affects the body, and the importance of keeping it in check?

If not, you've come to the right place. In light of September being National Cholesterol Education Month, this article will share information about cholesterol and empower you to take control of your health.

Here's what you need to know.

Cholesterol is a waxy, fat-like substance that's found in your bloodstream and cells. Your liver naturally produces cholesterol, but it can also be found in animal-derived foods, such as meat, eggs, and dairy products.[1]

Despite its reputation, cholesterol isn't inherently bad. Your body requires some cholesterol to build cells, support digestion, and produce hormones. Cholesterol becomes a concern when you have too much in your blood (more on this shortly).

Cholesterol doesn't dissolve in water, so it's unable to travel through the bloodstream on its own. To help transport cholesterol through the bloodstream, the liver produces lipoproteins—particles made from fat and protein.[2]

There are two major forms of lipoproteins: low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

There are two types of cholesterol: LDL cholesterol and HDL cholesterol.

LDL cholesterol, which makes up most of your body's cholesterol, is any cholesterol carried by low-density lipoproteins. You've probably heard LDL cholesterol referred to as "bad cholesterol."[3]

That's because it contributes to fatty buildup (called plaque) in the arteries around the heart—a condition referred to as atherosclerosis. As more plaque accumulates, blood vessels become narrowed or blocked, preventing blood from flowing through as easily. Like a clogged drain, the blood vessels may still work for a long time, but they won't work as efficiently as they should.

Atherosclerosis raises your risk of:[4]

• Coronary artery disease (CAD): When your heart doesn't get enough blood, it gets weaker and stops working as it should. CAD can lead to heart attack, stroke, or heart failure.
• Peripheral artery disease (PAD): PAD occurs when atherosclerosis affects the arteries in the legs or arms. If left untreated, it can lead to serious health challenges, including heart attack, stroke, and amputation.
• High blood pressure: Cholesterol plaque causes your arteries to become hard and narrow. This causes the heart to work much harder to pump blood through the arteries. The result is high blood pressure, a major risk factor for heart disease.

Conversely, cholesterol carried by high-density lipoproteins is called HDL cholesterol. It's thought of as "good cholesterol" because it helps carry LDL (bad) cholesterol away from the arteries and back to the liver, where the LDL is broken down and expelled from the body. This lowers your risk of heart disease, heart attack, and stroke.[3]

HDL cholesterol doesn't completely eliminate LDL cholesterol, though. Only one-third to one-fourth of LDL cholesterol is carried away by HDL.[5]

In order to keep your heart healthy and reduce your risk of heart-related conditions, the goal is to have higher HDL (good) levels and lower LDL (bad) levels. A simple blood test ordered by your doctor can measure the amount of each type of cholesterol in your blood.

It's recommended that all adults age 20 or older have their cholesterol checked every four to six years.[6] If you're at a higher risk of heart disease, or if you already have heart disease, your doctor may suggest that you have it checked more often.

Regular testing is especially important because, in most cases, high cholesterol is a "silent" condition, meaning it doesn't cause any symptoms. Most people don't even realize they have high cholesterol until they develop serious complications, such as heart attack or stroke.

A person's cholesterol levels should follow these guidelines:[7]

• LDL "bad" cholesterol: under 130 mg/dL
• HDL "good" cholesterol: 40 mg/dL or greater
• Total cholesterol (LDL & HDL combined): under 200 mg/dL

Having high cholesterol is a common issue in the United States. Let's take a look at some startling statistics regarding cholesterol:[8]

• Nearly 94 million U.S. adults ages 20 or older have total cholesterol levels higher than 200 mg/dL.
• Around 28 million U.S. adults have total cholesterol levels higher than 240 mg/dL.
• Seven percent of U.S. children and adolescents ages 6 to 19 have high total cholesterol.
• More than half of U.S. adults (around 47 million people) could benefit from cholesterol medication or are currently taking it.

Simply put, it's a widespread, serious public health concern that affects millions of families across our Community.

Your liver produces all the cholesterol your body needs.[9] As such, consuming too much of the wrong foods can easily lead to high cholesterol levels. That's why diet is a major factor for keeping your cholesterol levels in check.

• Reduce your intake of saturated and trans fats: Saturated and trans fats tend to raise LDL (bad) cholesterol levels.[10] Reducing these fats means limiting your intake of red meat, fatty cuts of meat, processed meat, full-fat dairy products, fried foods, certain baked goods, and solid fats like shortening, margarine, and lard. If you eat animal products, opt for shellfish, lean meats, low-fat dairy products, and a moderate amount of eggs.
• Eat a diet centered around fruits, vegetables, and whole grains: Make plant-based foods the stars of your meals. These foods don't contain saturated fats and are high in vitamins, minerals, and fiber.

Non-diet-related tips that can further help you maintain healthy cholesterol levels include:

• Being active daily: A sedentary lifestyle lowers HDL (good) cholesterol.[11] Aim to get at least 150 minutes of moderate physical activity each week.
• Avoiding smoking: Smoking damages your blood vessels, speeds up the hardening of arteries, and dramatically increases your risk of heart disease.[12]
• Maintaining a healthy weight: Being overweight tends to raise bad cholesterol and lower good cholesterol.[13]
• Asking your doctor about medication: While lifestyle changes are always the best option, medication can help support your cholesterol levels while you work on improving your diet and lifestyle.

High cholesterol is a serious, common medical condition, but the good news is that, in most cases, it's manageable with healthy lifestyle changes and proper support.

If you're looking for a way to take charge of your cholesterol levels and overall health, consider becoming a Knew Health Member. With Knew Health, standard preventative care, including blood work, is eligible for sharing thanks to medical cost sharing—an arrangement whereby Members agree to share Medical Needs through voluntary giving.

Knew Health Members also receive a number of perks , including discounted supplements, discounted blood work, and health coaching. Make healthy lifestyle changes now and take steps toward preventing costly, chronic medical conditions with the support of Knew Health.

1. What is cholesterol? www.heart.org. (2022, June 2). Retrieved August 30, 2022, from https://www.heart.org/en/health-topics/cholesterol/about-cholesterol
2. Cholesterol, triglycerides, and associated lipoproteins – NCBI bookshelf. (n.d.). Retrieved August 30, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK351/
3. Centers for Disease Control and Prevention. (2020, January 31). LDL & HDL: Good & Bad Cholesterol. Centers for Disease Control and Prevention. Retrieved August 30, 2022, from https://www.cdc.gov/cholesterol/about/ldl-and-hdl-cholesterol-and-triglycerides.html
4. High cholesterol: Causes, symptoms and how it affects the body. Cleveland Clinic. (n.d.). Retrieved August 30, 2022, from https://my.clevelandclinic.org/health/articles/11918-cholesterol-high-cholesterol-diseases
5. HDL (good), LDL (bad) cholesterol and triglycerides. www.heart.org. (2022, June 20). Retrieved August 30, 2022, from https://www.heart.org/en/health-topics/cholesterol/hdl-good-ldl-bad-cholesterol-and-triglycerides
6. What your cholesterol levels mean. www.heart.org. (2022, May 12). Retrieved August 30, 2022, from https://www.heart.org/en/health-topics/cholesterol/about-cholesterol/what-your-cholesterol-levels-mean
7. Lipid panel. Johns Hopkins Medicine. (2020, December 4). Retrieved August 30, 2022, from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lipid-panel#:~:text=Here%20are%20the%20ranges%20for,or%20above%20240%20mg%2FdL
8. Centers for Disease Control and Prevention. (2022, July 12). High cholesterol facts. Centers for Disease Control and Prevention. Retrieved August 30, 2022, from https://www.cdc.gov/cholesterol/data-research/facts-stats/index.html
9. Cholesterol in the blood. Johns Hopkins Medicine. (2021, August 8). Retrieved August 30, 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/high-cholesterol/cholesterol-in-the-blood#:~:text=Your%20liver%20makes%20all%20the,low%2Ddensity%20lipoprotein)%20cholesterol%3F
10. Mayo Foundation for Medical Education and Research. (2021, April 8). Learn the facts about fat. Mayo Clinic. Retrieved August 30, 2022, from https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fat/art-20045550#:~:text=The%20American%20Heart%20Association%20recommends,of%20heart%20disease%20and%20stroke.
11. Prevention and treatment of high cholesterol (hyperlipidemia). www.heart.org. (2022, August 23). Retrieved August 30, 2022, from https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia#:~:text=A%20sedentary%20lifestyle%20lowers%20HDL,cholesterol%20and%20high%20blood%20pressure
12. Products, C. for T. (n.d.). How smoking affects heart health. U.S. Food and Drug Administration. Retrieved August 30, 2022, from https://www.fda.gov/tobacco-products/health-effects-tobacco-use/how-smoking-affects-heart-health
13. Common misconceptions about cholesterol. www.heart.org. (2021, May 7). Retrieved August 30, 2022, from https://www.heart.org/en/health-topics/cholesterol/about-cholesterol/common-misconceptions-about-cholesterol

Disclaimer: This information is being provided to you for educational and informational purposes only. It is being provided to educate you about how to take care of your body and as a self-help tool for your own use so that you can reach your own health goals. It is not intended to treat or cure any specific illness and is not to replace the guidance provided by your own medical practitioner. This information is to be used at your own risk based on your own judgment. If you suspect you have a medical challenge, we urge you to take appropriate action by seeking medical attention.