Cholesterol and knowing the good and bad

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Everyone’s body produces both good and bad cholesterol, but the lifestyle choices a person makes will play a big role in determining which one wins out in the end.

Cholesterol is a fatty material produced by the body and located in its bloodstream. The body needs some cholesterol for its most vital functions, but an excess of the wrong kind of cholesterol can cause hardening of the arteries, leading to a disease known as atherosclerosis, says Hema Pandrangi, MD, a cardiologist with Miami Valley Cardiologists.

According to the American Heart Association (AHA), cholesterol can’t dissolve in the blood. It must be transported through a person’s bloodstream by carriers called lipoproteins, which are made of fat (lipid) and proteins. There are two types of lipoproteins that carry cholesterol to and from cells. These are known as low-density lipoprotein, or LDL, and high-density protein, or HDL.

HDL, also known as “good” cholesterol, acts as a scavenger in the bloodstream by picking up bad cholesterol and carrying it to the body’s liver where it is metabolized and disposed. LDL, also known as “bad” cholesterol, sticks around in the body’s bloodstream and literally coats its walls, leading to atherosclerosis. The development of atherosclerosis is responsible for clogged arteries which can lead to heart attacks and strokes.

A person’s HDL and LDL blood levels can help provide a window into someone’s health. A high level of HDL cholesterol may protect against heart attack and stroke while low levels of HDL cholesterol have been shown to increase the risk for heart disease, the AHA says.

Many factors — such as genetics and age — play a significant role in a person’s cholesterol makeup. However, a person’s lifestyle choices may be just as powerful.

There are steps a person can take to help tip the scales in favor of good cholesterol:

Know your numbers: A simple blood test will determine your levels of HDL and LDL cholesterol. These numbers will dictate if treatment, whether it is medication or lifestyle changes, is needed.

Avoid tobacco smoke: Smoking can raise LDL and lower HDL, but numbers can improve if someone quits. A small study published in the American Heart Journal showed that participants saw their good cholesterol increase five percent a year after smoking cessation.

Eat the right foods: "You are what you eat" describes the relationship between diet and cholesterol levels, Dr. Pandrangi says. Diets high in animal fat contain a lot of saturated fat that raises LDL while a high-fiber diet has been proven to lower bad cholesterol. Likewise, consumption of polyunsaturated and monounsaturated fatty acids — like those found in walnuts, avocados and olive oil — help lower LDL.

Exercise regularly: A sedentary lifestyle contributes to higher levels of LDL, or bad cholesterol. Dr. Pandrangi recommends 40 minutes of exercise every day whether that includes a brisk walk around the neighborhood or a trip to the gym.

“The good news is that heart disease — clogging of the arteries — is actually reversible,” Dr. Pandrangi says.