The Male Health Center - Cholesterol and Men

Cholesterol Confused? | Making Sense of LDL and HDL

Cholesterol Confused?

The straight story is good news indeed.
If you're confused about what you should (or shouldn't) do about cholesterol, you're in good company. Over the past few years, medical science has gotten a much better handle on this artery clogger. As a result, advice on the cholesterol has changed significantly.

For example, we now know that total cholesterol isn't as important as the balance between it and its components, HDL and LDL (high- and low-density lipoprotein) cholesterol. In the past, a total cholesterol measurement of 240 would have been cause for action. Today, we wouldn't be too concerned as long as your total cholesterol-to-HDL ratio is no less than 4.5—that is, your HDL measures at least 54. On the other hand, if your total cholesterol is only 200 but your HDL measures 40 (a ratio of 5.0), my brows might furrow a bit.

Likewise, we've learned a tremendous amount about how to control your cholesterol ratio. The biggest change is in our understanding of how diet affects the amount of cholesterol in your blood.

Although cholesterol in food (eggs, for example) can contribute to high blood cholesterol, it's not likely to be the most significant source. Dietary fat, which the body converts to cholesterol, plays a larger role for most people. Specifically, saturated fat (in meats and dairy products) and hydrogenated fat (in margarine and many baked goods) are the major culprits. Thus a package of donuts with a label that claims "cholesterol free" could, if it contains hydrogenated oil, be a land mine for your heart. Vegetable oils (especially olive and canola) are better choices.

The beneficial aspects of dietary fiber have also been confirmed—and not just oat bran. Beans, fruits such as apples and strawberries, and grains can all be helpful. There's also some evidence that people who eat lots of citrus fruits (grapefruit and oranges, for example) have higher HDL levels.

More good news for people who want to control cholesterol without resorting to drugs: Exercise can have a significant effect. Walking 30 to 45 minutes three times a week is enough to make a difference. Three golf games a week (no cart!) can significantly improve your cholesterol ratio. How's that for an excuse? Weight lifting, too, has been shown to raise HDL levels.

Diet and exercise are now the front-line treatment for people with mild-to-moderate cholesterol problems. But why wait until you have a problem? Start now—before your doctor sits you down for a serious talk—and you'll not only head off a heart-threatening situation. You'll look and feel better all the while.
[top]

Making Sense of LDL and HDL
If you're confused about cholesterol, you've got plenty of guys to keep you company. Over the past decade, medical science has become much more sophisticated in its understanding of how the various components of cholesterol interact to produce heart disease. Making sense of it all isn't simple.

Today, cholesterol is too general a term to tell the whole story. It's sort of like judging a quarterback solely by the number of games he wins. Sure, total wins is a good place to start, but you'd like to know who's running in his backfield, how many turnovers the team's defense forces, and so on.

Cholesterol is made up of a number of components. Two of the most important are called low-density and high-density lipoproteins, LDL and HDL for short. LDL is usually referred to as the "bad guy," because it's what causes plaque to form in your arteries. HDL, on the other hand, helps stop LDL from doing its dirty work.

The National Cholesterol Education Program recommends that everyone over the age of 19 be tested for total and HDL cholesterol every five years. I know that sounds awfully young to be worrying about heart attacks, but we've learned recently that the processes that can lead up to a heart attack often start in males in their teens.

If your total cholesterol is less than 200 and your HDL is at least 35, you're in good shape. If you fall into the borderline total-cholesterol group—201 to 239—with HDL of at least 35, you should have another test within two years.

Two conditions indicate that you need further testing. A total cholesterol level of 240 or greater points to an LDL test. And if your HDL is less than 35, you need an LDL test regardless of what your total cholesterol may be.

LDL levels higher than 160 are cause for an immediate change to a diet low in fat (and especially saturated fat) and cholesterol; if the number doesn't turn around within six months, medication is in order. Borderline LDL levels are those from 130 to 159; dietary changes may set you straight. But, depending on what other risk factors you may have, medication might be a good idea.

Today we know that, short of drugs, there are five basic ways you can affect your cholesterol levels. Limiting fat and cholesterol in your diet is the best way to reduce LDL levels. Loosing weight, which boosts HDL, should go hand in hand. Exercise will help you shed those pounds and will boost HDL of its own accord. And finally guys, here's another unlucky strike against tobacco: it lowers your HDL. Smoke and it's a race to see what gets you first.
[top]

Need more information on male health issues?
Click here for information on diet, nutrition and health resource books. Learn when to see the doctor and what causes symptoms.