PATIENT EDUCATION ON CHOLESTEROL: MYTHS AND FACTS
Even if you think you know everything there is to know about cholesterol, there may be a few more surprises in store. Check out these common myths about high cholesterol; find out who’s most likely to have it, what types of food can cause it, and why—sometimes—cholesterol isn’t a bad word.
What Is It? Cholesterol is a fatty substance that occurs naturally in the body. It performs several vital functions. It is needed to make the walls surrounding the body’s cells and is the basic material that is converted to certain hormones. Your body makes all the cholesterol you need. You need only a small amount of fat in your diet to make enough cholesterol to stay healthy.
What Do Your Cholesterol Numbers Mean? Everyone age 20 and older should have their cholesterol measured at least once every 5 years. It is best to have a blood test called a “lipid profile” to find out your cholesterol numbers. This blood test is done after a 9- to 12-hour fast and gives information about your:
- Total cholesterol
- LDL (bad) cholesterol – the main source of cholesterol buildup and blockage in the arteries
- HDL (good) cholesterol – helps keep cholesterol from building up in the arteries
- Triglycerides – another form of fat in your blood
What Affects Cholesterol Levels? A variety of things can affect cholesterol levels. These are things you can do something about:
- Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level.
- Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.
- Physical Activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.
Things you cannot do anything about also can affect cholesterol levels. These include:
- Age and Gender. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL levels tend to rise.
- Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
Symptoms Most people with high cholesterol don’t have any symptoms until cholesterol-related atherosclerosis causes significant narrowing of the arteries leading to their hearts or brains. The result can be heart-related chest pain (angina) or other symptoms of coronary artery disease, as well as symptoms of decreased blood supply to the brain (transient ischemic attacks or stroke). About 1 out of every 500 people has an inherited disorder called familial hypercholesterolemia, which can cause extremely high cholesterol levels (above 300 milligrams per deciliter). People with this disorder can develop nodules filled with cholesterol (xanthomas) over various tendons, especially the Achilles tendons of the lower leg. Cholesterol deposits also can occur on the eyelids, where they are called xanthelasmas.
Prevention You may help to prevent high cholesterol by staying on a healthy diet and exercising daily. Avoid processed foods, especially those that contain saturated fats. Instead eat more fresh fruits and vegetables, whole-grain breads and cereals, and low-fat dairy products.
Treatment: The initial treatment of high cholesterol should always be lifestyle changes. This means altering your diet and getting more exercise. Some people respond dramatically to dietary changes. In addition to dietary changes, you should get at least 30 minutes of moderate-intensity exercise, such as brisk walking, daily.
Medications Whether you need medication to lower your cholesterol level depends on how you respond to diet and your personal risk of heart attack and stroke. There are five types of cholesterol-lowering medications. However, a statin drug should almost always be the first choice to lower LDL cholesterol
Expected Duration If your cholesterol level is high, you will need to make a long-term effort to bring it down. You can significantly lower your cholesterol levels by sticking with a diet that is low in saturated fats, high in fruits and vegetables, and by substituting “good” fats for “bad” fats. The dietary changes need to be permanent to maintain lower cholesterol levels. Daily exercise also is important. Exercise can raise HDL (good) cholesterol and lower total cholesterol
Prognosis The effectiveness of following a healthy diet and using medications to lower cholesterol varies from person to person. On average, diet and exercise can lower LDL cholesterol by about 10%. Medications can lower LDL cholesterol by another 20% to more than 50%.
