Managing cholesterol is important in order to minimize the risk of heart disease. According to the guidelines set forth by the National Cholesterol Education Program, a healthy cholesterol level is considered to be 200 mg/dL or less. Cholesterol ratios of high density lipoproteins (HDL) to low density lipoproteins (LDL) are also relevant, which should ideally be 100 mg/dL or less and 45 mg/dL (55 mg/dL for women), respectively.
There are many things that can affect cholesterol levels, most notably diet and lifestyle habits. However, even the most health-conscious individual can have elevated cholesterol and not even know it. For that matter, genetics may undermine efforts to achieve a healthy cholesterol level, in spite of adhering to a diet low in fat and regular exercise. In fact, the only two things that really exert any control over cholesterol levels are the liver and the intestines.
Cholesterol is a fatty substance manufactured by the liver for the purpose of producing bile acid to digest food. This organ also regulates cholesterol by removing it from the blood. This occurs because high density lipoproteins (HDL) carry low density lipoproteins (LDL) back to the liver. This is why an overall healthy cholesterol level translates to having more HDL cholesterol than LDL since the latter is responsible for the development of arterial plaque.
The intestines also absorb a certain amount of cholesterol, both from foods and from bile sent from the liver. Sometimes the intestines can’t keep up with the amount of cholesterol being made by the liver, and the unabsorbed cholesterol ends up in circulation in the blood. Again, HDL molecules will move LDL and triglycerides out of the blood, but only if they are present in sufficient amounts. However, the main factor that controls how well LDL cholesterol is moved out of the blood is a matter of genetics.
This explains why some people need additional help in reaching a healthy cholesterol level. The liver will continue to produce cholesterol in whatever amounts are needed by the body, regardless of diet and exercise. Other factors that can raise cholesterol levels include certain medications, such as birth control pills, steroids, and beta-blockers. Estrogen offers most women protection from elevated cholesterol, but this effect diminishes with age, especially after menopause.
It’s not necessary to wait until middle age to have a cholesterol screen, as many people believe. This is particularly true if there is a family history of heart disease or stroke. Blood tests can provide a lipoprotein analysis, broken down by serum levels of LDL, HDL, and triglycerides. Once this analysis is complete, a program designed to achieve and maintain a healthy cholesterol level can be developed to meet individual needs.