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A Primer on Cholesterol Cholesterol. You've heard about it for years, but what is it and what does it do? Cholesterol is a soft, waxy substance found in all of your body's cells and in the blood. It is used by your body to make many hormones, vitamin D and bile acids, which help digest fat. Your body needs only a small amount of cholesterol to accomplish these tasks. Any excess cholesterol is deposited in the arteries. Over time, this buildup causes "hardening of the arteries," so that the arteries become narrowed and blood flow to heart, brain, and other organs is slowed down or blocked. The blood carries oxygen to these organs. If enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart or brain is completely cut off by a blockage, the result is a heart attack or a stroke. The good, the bad and the excess Cholesterol has to be carried to and from cells in the body by substances in the blood called lipoproteins. Lipoproteins come in several types. Important ones are low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides. LDL is often thought of as "bad cholesterol." It carries most of the cholesterol, as well as triglycerides and other fat molecules, in the blood. If too much LDL cholesterol circulates in the blood, it can slowly build up in the walls of the arteries leading to the heart and brain. There, it can form plaque, a thick deposit that can clog the arteries. Higher levels of LDL cholesterol put a person at higher risk for heart disease. LDL levels above 160 mg/dL are considered high, according to the American Heart Association (AHA), although levels below 100 mg/dL are considered optimal. HDL is often called "good" cholesterol." It carries cholesterol from cells to the liver. The liver then eliminates this cholesterol from the body. HDL also may pull cholesterol from plaques that have built up in the arteries. Normal HDL levels are 40 to 50 mg/dL in men and 50 to 60 mg/dL in women, according to the AHA. Higher HDL levels appear to reduce the risk of heart attack and stroke. Triglycerides are form of fat in the body. Most of these are stored in fat tissue, with only a small amount circulating in the blood. A high triglycerides level may put you at risk for developing heart disease. A normal triglyceride level is less than 150 mg/dL. Like high blood pressure, high cholesterol levels do not cause symptoms. That's why it's important to find out what your cholesterol levels are. If you have high cholesterol and triglyceride levels, you can take steps to lower them and reduce your risk of developing heart disease. If you already have heart disease, you can reduce your risk of dying of heart disease by lowering your cholesterol levels. The AHA recommends that everyone 20 and older have his or her cholesterol checked at least once every five years. It's best to have a blood test called a lipoprotein profile or lipid profile to find out your levels. This blood test is done after you have fasted for nine to 12 hours. The test will determine your total cholesterol; your LDL cholesterol; your HDL cholesterol; and your triglycerides. The best total cholesterol level is under 200 mg/dL. Borderline high levels are 200 to 239 mg/dL. High is considered 240 mg/dL and higher. Reducing cholesterol levels The main goal of cholesterol-lowering treatment is to lower your LDL level enough to reduce your risk of developing heart disease or having a heart attack. The higher your risk, the lower your LDL goal will be. There are several methods used to reduce high cholesterol levels, including following a healthy diet, getting plenty of exercise, and achieving a healthy weight. Drug therapy is also available. Talk to your doctor to see if such therapy might be appropriate for you. The National Heart, Lung, and Blood Institute (NHLBI) recommends that you follow a diet that is low in saturated fat and cholesterol. You should aim for less than 7 percent of your calories from saturated fat and less than 200 mg of dietary cholesterol each day. If these changes do not lower your LDL level enough, you can boost the amount of soluble fiber in your diet. You can also add food products that contain plant stanols or sterols (special margarines and salad dressings) to your diet. The American Heart Association recommends choosing lean meats and poultry without skin and preparing them without added saturated and trans fat, and using low-fat, 1 percent fat, and fat-free dairy products. Protein from animal products can be partially replaced by protein from vegetables, such as beans. Weight management Dropping extra pounds if you're overweight can help lower your LDL level, the NHLBI says. This is especially important if you have a high triglyceride level or low HDL level and your waist measurement is more than 40 inches for men or more than 35 inches for women. Physical activity Physical activity is another important component in lowering cholesterol, according to the NHLBI. It can boost HDL cholesterol levels and reduce the risk for heart disease. Exercise also often helps control weight, diabetes, and high blood pressure. These factors can also contribute to heart disease. Exercise is especially important if you have a high triglycerides level or low HDL level and a large waist measurement. You should try for 30 minutes of exercise on most, if not all, days. Jogging, swimming and brisk walking all can help condition your heart and lungs. Moderate daily exercise -- walking, housework, gardening and dancing -- is also beneficial. Use these tips to increase your level of physical activity:
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