Cholesterol’s had a bad rap for decades (just ask anyone who refuses to eat eggs). After all, you’ve probably heard that too much cholesterol can be one of the major risk factors for heart disease—the leading cause of death in American adults.
But is cholesterol as bad as its reputation? And how do you know your personal cardiac risk?
Contrary to what you’ve been led to believe, total cholesterol does not accurately predict heart disease! There’s a lot more to that total number than we’ve been taught.
This ultimate cholesterol guide will answer all your cholesterol questions. I’ll help you understand what cholesterol is, why it’s important, two critical measurements you need to know, and the best strategies you can start practicing today to manage your cholesterol.
Cholesterol is a waxy, fat-like substance made in your liver and also found in some of the food you eat. Egg yolks, meat, and whole-milk dairy contain cholesterol, hence the egg-white-only eaters.
Although high cholesterol has been linked with heart health issues, cholesterol itself is critical for good health. In fact, we couldn’t survive without it!
In the right amounts, cholesterol helps to keep you healthy and alive. Your body depends on cholesterol to make cell walls, tissues, hormones, vitamin D, and bile acid.
Sometimes, though, cholesterol in the blood may build up in blood vessel walls. Eventually, these fatty deposits grow, restricting blood flow through your arteries and blocking blood flow to your tissues and organs.
This blood blockade increases the risk of developing heart disease. The deposits can break suddenly and form a clot that causes a heart attack or stroke.
High blood cholesterol levels can raise your risk of heart attack and stroke, but you don’t want your levels to be too low either. Known as hypolipidemia or hypocholesterolemia, very low cholesterol isn’t common, but it can be a sign of many other health concerns.
Instead of banning cholesterol from your diet entirely, maintaining heart health is about finding a healthy cholesterol balance.
Your total cholesterol is an outdated and oversimplified way to assess cardiac risk. To truly know where you stand and determine your risk of developing cardiovascular disease, we have to take a closer look at two very important measurements.
You have two types of cholesterol in your bloodstream:
Triglycerides, another type of fat found in our bodies, are typically measured in the same blood test. Similar to cholesterol, your body needs some triglycerides for good health. However, high triglycerides in your blood can raise your risk of heart disease and stroke.
Now you can see why your total cholesterol can’t predict your risk of developing cardiovascular disease. The less high-density lipoprotein (the “good” cholesterol) there is in your blood, the less “bad” cholesterol you can clear from the body. An increase in HDL would benefit your health even while raising your total cholesterol. If you only looked at your total number, you could think that your health just took a turn for the worse when, in fact, it improved!
Rather than looking at your total cholesterol, focus mainly on your triglyceride and HDL numbers. The ratio between these two measurements offers a much more accurate picture of your cardiovascular health! Let’s dive into these factors more below.
It’s important to understand your cholesterol fully before taking cholesterol-lowering meds. These medicines tend only to be beneficial to people who have already had a cardiac event.
A simple blood test can show how much LDL and HDL you have, as well as your triglycerides. Adults over age 20 should get a blood test to check their cholesterol levels every four to six years.
Once you know these numbers, then you should be able to determine your Triglyceride to HDL ratio. Do this by taking your fasting triglyceride number and dividing it by your fasting HDL number.
If your blood test shows that your LDL is over 100 mg/dl, ask your doctor to run an NMR profile to determine your LDL particle size. Big fluffy LDL is typically not harmful. Small dense LDL, which more easily clogs arteries, can be harmful.
Achieving a good triglyceride-to-HDL ratio should be your main goal! Ideally, your triglycerides will fall under 100, and your HDL will be over 60.
Want to shoot for excellence? Try to reach an optimal ratio of 1:1! At this point, you’re most likely insulin sensitive and your risk for a cardiac event is very low.
A normal ratio falls between 1 and 1.9:1. A ratio of 2:1 or higher indicates significant insulin resistance and a high risk of cardiovascular disease.
Lifestyle factors play a significant role in cholesterol. In many cases, high LDL cholesterol and triglycerides can be lowered by making these four changes to your daily habits.
I’m no stranger to high cholesterol. 8 months after giving birth to my daughter, I was shocked to hear my doctor say “Your cholesterol is over 300!” I was healthy—or so I thought. I had lost the baby weight, I was eating a low-fat, low-calorie diet. I worked out regularly. But my cholesterol told a different story.
My doctor quickly recommended medication, but I asked for 6 months to try to rectify the situation by adjusting my diet and lifestyle. By practicing the four changes listed above, I reached a great cholesterol ratio and simultaneously sparked my passion for health and nutrition.
20 years later, thousands are improving their health, losing weight, and healing their cholesterol through my 6-week LEAN program.
If you need help getting your health in line, join LEAN. For more tips and tricks for health and wellness, hop on my weekly newsletter here.