September is a wonderful month! Not only do we celebrate a couple birthdays in our family, but we get a chance to enjoy the pleasant early fall weather of Wisconsin. This is a great time of year to adopt healthy eating and exercise habits before heading into winter and the perpetual challenge of avoiding holiday gluttony! Along those lines, September is also National Cholesterol Education month, so let's explore the meaning and importance of cholesterol a bit further.
Recently, there has been a banking company with TV ads asking, "What's your number?". More and more, people are interested in "their number", referring to their cholesterol readings. Determining your cholesterol is relatively easy, usually done via a fasting blood test. The frequency and age at which this testing should be done can be influenced by criteria such as risk factors for heart disease, like hypertension (high blood pressure), diabetes, smoking, or family history of heart disease or high cholesterol.
Once the testing is complete, there are four main values to review. The total cholesterol, which is a compilation of the other values including LDL, HDL, and triglycerides.
LDL, or low-density lipoprotein, can accumulate on arterial walls, increasing risk for arterial blockages leading to heart attacks or strokes. Higher LDL values convey a higher risk. Most people should aim for an LDL level below 130. If you have other risk factors for heart disease, your target LDL may be below 100. If you have had previous heart disease, you may need to aim for an LDL level below 70. In general, the lower your LDL cholesterol level is, the better.
HDL, or high-density lipoprotein, is generally regarded to as "good cholesterol", as it can help prevent arterial narrowing by helping clear the LDL. In general, HDL values above 40 to 50 are desirable.
Triglycerides are a type of fat produced when we eat more than we need to. These extra calories are converted to triglyceride, stored in fat cells, to be used at a later time when needed, like between meals. Over time, if we consume more calories than needed, we can accumulate high levels of triglycerides. This is especially true if consuming foods high in simple sugars (sweets), fats and alcohol. Ideally, triglycerides would be less than 150. Values between 150-200 are borderline elevated, over 200 are considered high, and over 500 are very high. Sometimes high triglycerides can be a sign of other medical conditions, or a side effect of certain medications.
If your cholesterol is elevated, lifestyle changes are an integral part of reducing your cardiovascular risk. Consuming a diet rich in fruits, vegetables and whole grains, while trying to limit foods high in trans or saturated fat, is an important step. Exercising 30 minutes per day, with a goal of weight loss if you are overweight, is paramount. If you smoke, quitting can significantly reduce your overall risk as well. If your cholesterol is not at goal despite these steps, or if you have other risk factors for cardiovascular disease, your doctor may discuss medications with you.
So think about discussing your 'number' with your family doctor. Then get outside and enjoy these beautiful autumn days, and get in shape for the upcoming shoveling season!
Aaron S. Douglas, M.D.
Family Practice