HDLP61 Cholesterol LM BCBSNE 101806

User Manual: HDLP61

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H A N D B O O KS f o r H E A LT H

MANAGING
CHOLESTEROL

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related to your symptoms or medical condition.

UNDERSTANDING

CHOLESTEROL
Getting Started

Too much cholesterol (ko-LES-ter-ol) in
the blood, or high blood cholesterol, can be
serious. People with high blood cholesterol
have a greater chance of getting heart disease.
Unfortunately, many people are unaware that
they have high blood cholesterol because the
condition does not cause any symptoms.

What is Cholesterol?

Here are some key facts about cholesterol:

»»Cholesterol is a waxy, fat-like substance
that is found in all cells of the body.
Your body needs some cholesterol to
properly function.

»»Cholesterol is also found in some of the

the LDL level in your blood, the greater
chance you have for getting heart
disease.

»»HDL (high density lipoprotein)

cholesterol is sometimes called “good”
cholesterol.
• HDL carries cholesterol from other
parts of your body back to your liver.
The liver removes the cholesterol from
your body. The higher your HDL
cholesterol level, the lower your chance
of getting heart disease.

BLOCKED
ARTERY

foods you eat.

»»Your body uses cholesterol to make

hormones, Vitamin D, and substances
that help you digest foods.

Blood is watery and cholesterol is fatty. Just
like oil and water, the two do not mix. So, in
order to travel in the bloodstream, cholesterol
is carried in small packages called lipoproteins
(lip-o-PRO-teens). The small packages are
made of fat (lipid) on the inside and proteins
on the outside. Two kinds of lipoproteins
carry cholesterol throughout your body. It is
important to have healthy levels of both:

»»LDL (low density lipoprotein)

NARROWED
ARTERY

HEALTHY
ARTERY

cholesterol is sometimes called “bad”
cholesterol.
• High LDL cholesterol leads to a buildup
of cholesterol in the arteries. The higher
M ANAGING CHOLESTEROL

What is High Blood
Cholesterol?

»»Too much cholesterol in your blood can

33%

build up in the walls of your arteries (blood
vessels that carry blood from the heart to
other parts of the body). This buildup of
cholesterol is called plaque. Over time, plaque
can cause narrowing of the arteries. This is
called atherosclerosis (ath-er-o-skler-O-sis) or
“hardening of the arteries.”

»»Special arteries, called coronary arteries,
DID YOU KNOW?
According to the Centers
for Disease Control and
Prevention (CDC), high
cholesterol affects about
33% of adults over the age
of 20 in the United States.
Unfortunately, less than
half of adults with high LDL
cholesterol get treatment.
People with high
total cholesterol have
approximately twice the
risk of heart disease as
people with optimal levels. A
desirable level is lower than
200 mg/dL.
The average total
cholesterol level for adult
Americans is about 200
mg/dL, which is borderline
high risk.

M ANAGING CHOLESTEROL

bring blood to the heart. Narrowing of your
coronary arteries due to plaque can stop or
slow down the flow of blood to your heart.
When the arteries narrow, the amount of
oxygen-carrying blood is decreased. This is
called coronary artery disease (CAD). Large
plaque areas can lead to chest pain called
angina. Angina happens when the heart does
not receive enough blood and the oxygen it
carries with it. Angina is a common sign of
CAD.

»»Some plaque has a thin covering and can burst
(rupture), releasing fat and cholesterol into the
bloodstream. The release of fat and cholesterol
may cause your blood to clot. A clot can block
the flow of blood. This blockage can cause
angina or a heart attack.

»»Lowering your cholesterol level decreases your

chance for having plaque burst and the chance
of a heart attack. Lowering cholesterol may
also slow down, reduce, or even stop plaque
from building up.

»»Plaque and resulting health problems can also
occur in arteries elsewhere in the body.

OTHER NAMES FOR
HIGH BLOOD CHOLESTEROL

99Hypercholesterolemia
99Hyperlipidemia

What Causes High
Blood Cholesterol?

A variety of things can affect the cholesterol
levels in your blood. Some of these things you
can control and others you cannot.
You CAN control:

99What you eat. Certain foods have

types of fat that raise your cholesterol
level.

»»Saturated fat raises your LDL

cholesterol level more than anything
else in your diet.

»»Trans fatty acids (trans fats) are made
when vegetable oil is “hydrogenated”
to harden it. Trans fatty acids also
raise cholesterol levels.

You CANNOT control:

99Heredity. High blood cholesterol

can run in families. An inherited
genetic condition (familial hypercholesterolemia) results in very high
LDL cholesterol levels. It begins at
birth, and results in a heart attack
at an early age.

99Age and sex. Starting at puberty,

men have lower levels of HDL than
women. As women and men get
older, their LDL cholesterol levels
rise. Younger women usually have
lower LDL cholesterol levels than
men, but after age 55 they usually
have higher levels than men.

»»Cholesterol is found in foods that

come from animal sources, for
example, egg yolks, meat, and cheese.

99Your weight. Being overweight

tends to increase your LDL level, lower your HDL level, and increase your
total cholesterol level.

99Your activity. Lack of regular exercise can lead to weight gain and raise
your LDL cholesterol level. Regular
exercise can help you lose weight and
lower your LDL level. It can
also help you raise your HDL
level.

CHOLESTEROL IS FOUND
IN FOODS THAT COME
FROM ANIMAL SOURCES
LIKE EGG YOLKS, MEAT,
AND CHEESE.

M ANAGING CHOLESTEROL

HOW DO I KNOW

IF I HAVE HIGH CHOLESTEROL?
What are the Signs
and Symptoms of High
Blood Cholesterol?

There are usually no signs or symptoms of high
blood cholesterol. In fact, many people don’t
know that their cholesterol level is too high.
Everyone age 20 and older should have their
cholesterol levels checked at least once every
five years. You and your doctor can discuss
how often you should be tested.

How is High Blood
Cholesterol Diagnosed?

High blood cholesterol is diagnosed by
checking levels of cholesterol in your blood. It
is best to have a blood test called a lipoprotein
profile to measure your cholesterol levels.
Most people will need to “fast” (not eat or
drink anything) for 9 to 12 hours before
taking the test.
The lipoprotein profile will give information
about your:

99Total cholesterol
99LDL (bad) cholesterol: the main

source of cholesterol buildup and
blockage in the arteries

THERE ARE USUALLY NO
SIGNS OR SYMPTOMS OF
HIGH BLOOD CHOLESTEROL.
IN FACT, MANY PEOPLE
DON’T KNOW THAT THEIR
CHOLESTEROL LEVEL IS
TOO HIGH.

99HDL (good) cholesterol: the good

cholesterol that helps keep cholesterol from building up in arteries

99Triglycerides: another form of fat in
your blood

If it is not possible to get a lipoprotein profile
done, knowing your total cholesterol and HDL
cholesterol can give you a general idea about
your cholesterol levels. Testing for total and
HDL cholesterol does not require fasting. If
your total cholesterol is 200 mg/dL or more,
or if your HDL is less than 40 mg/dL, you will
need to have a lipoprotein profile done.
Cholesterol levels are measured in milligrams
(mg) of cholesterol per deciliter (dL) of blood.
See how your cholesterol numbers compare to
the tables on the following page.

M ANAGING CHOLESTEROL

MEASURING CHOLESTEROL
Total Cholesterol Levels Category
Less than 200 mg/dL

Desirable level that
puts you at lower risk
for coronary heart
disease. A cholesterol
level of 200 mg/dL or
higher raises your risk.

200 to 239 mg/dL

Borderline high

240 mg/dL and above

High blood
cholesterol. A person
with this level has
more than twice the
risk of coronary heart
disease as someone
whose cholesterol is
below 200 mg/dL.

HDL Cholesterol Levels

Category

Less than 150 mg/dL

Normal

150 to 199 mg/dL

Borderline high

200 to 499 mg/dL

High

500 mg/dL or above

Very high

Source: American Heart Association Recommended
Cholesterol Levels
M ANAGING CHOLESTEROL

TREATMENT

AND RISK FACTORS
How is High Blood
Cholesterol Treated?

The main goal of a cholesterol-lowering
treatment is to lower your LDL level enough
to reduce your risk of having a heart attack
or other diseases caused by hardening of the
arteries. In general, the higher your LDL
level and the more risk factors you have, the
greater your chances of developing heart
disease or having a heart attack. Some people
are at high risk for heart attack because they
already have heart disease. Other people
are at high risk for developing heart disease
because they have diabetes or a combination
of risk factors for heart disease.

The Risk Factors

Your blood cholesterol level is affected
not only by what you eat but also by how
quickly your body makes LDL (“bad”)
cholesterol and disposes of it. In fact, your
body makes all the cholesterol it needs, and
it is not necessary to take in any additional
cholesterol from the foods you eat.
Many factors help determine whether your
LDL-cholesterol level is high or low. The
following factors are the most important:

99Heredity. Your genes influence how

high your LDL (“bad”) cholesterol is
by affecting how fast LDL is made and
removed from the blood. One specific
form of inherited high cholesterol that
affects one in 500 people is familial
hypercholesterolemia, which often leads
to early heart disease. But even if you
do not have a specific genetic form of
high cholesterol, genes play a role in
influencing your LDL cholesterol level.

99What you eat. Two main nutrients

in the foods you eat make your LDL
(“bad”) cholesterol level go up: saturated
fat, a type of fat found mostly in
foods that come from animals; and
cholesterol, which comes only from
animal products. Saturated fat raises
your LDL cholesterol level more than
anything else in the diet. Eating too
much saturated fat and cholesterol is the
main reason for high levels of cholesterol
and a high rate of heart attacks in the
United States. Reducing the amount of
saturated fat and cholesterol you eat is

M ANAGING CHOLESTEROL

a very important step in reducing your
blood cholesterol levels.

99Weight. Excess weight tends to increase
your LDL (“bad”) cholesterol level. If
you are overweight and have a high
LDL cholesterol level, losing weight may
help you lower it. Weight loss also helps
to lower triglycerides and raise HDL
(“good”) cholesterol levels.

99Physical activity/exercise. Regular

physical activity may lower LDL (“bad”)
cholesterol and raise HDL (“good”)
cholesterol levels.

high blood pressure and raise triglycerides.
Because of the risks, alcoholic beverages
should not be used as a way to prevent
heart disease.

99Stress. Stress over the long term has

been shown in several studies to raise
blood cholesterol levels. One way that
stress may do this is by affecting your
habits. For example, when some people
are under stress, they cope by eating
fatty foods. The saturated fat and
cholesterol in these foods contribute to
higher levels of blood cholesterol.

99Age and sex. Before the age of

menopause, women usually have total
cholesterol levels that are lower than those
of men the same age. As women and men
get older, their blood cholesterol levels rise
until about 60 to 65 years of age. After the
age of about 50, women often have higher
total cholesterol levels than men of the
same age.

99Alcohol. Moderate alcohol intake

increases HDL (“good”) cholesterol but
does not lower LDL (“bad”) cholesterol.
Doctors don’t know for certain whether
alcohol also reduces the risk of heart
disease. Drinking too much alcohol can
damage the liver and heart muscle, lead to

GET SCREENED! Make a point of getting
screened for high cholesterol regularly. If you’re
over the age of 20, you need to have your
cholesterol checked every five years. High
cholesterol can be managed—either with lifestyle
modification, medication, or both—but you must
know your cholesterol is high in order to address it
effectively.
M ANAGING CHOLESTEROL

MANAGING

YOUR CHOLESTEROL
Lowering Cholesterol
with TLC

Therapeutic lifestyle changes (TLC) is a set of
changes you can make to help lower your LDL
cholesterol. The components of TLC are diet,
weight management, and physical activity.

99Diet Recommendations
»»Limiting the amount of saturated fat
and cholesterol you eat.

»»Eating only enough calories to achieve
or maintain a healthy weight.

»»Increasing the soluble fiber in your

diet. For example, oatmeal, kidney
beans, and apples are good sources of
soluble fiber.

99Weight Management

Losing weight if you are overweight can
help lower LDL. Weight management
is especially important for those with a
group of risk factors that includes high
triglyceride and/or low HDL levels and
being overweight with a large waist
measurement (more than 40 inches
for men and more than 35 inches for
women). We’ll cover how you can
determine your ideal weight in the next
section.

99Physical Activity

Regular physical activity is recommended
for everyone. It can help raise HDL and
lower LDL and is especially important
for those with high triglyceride and/
or low HDL levels who are overweight
with a large waist measurement. Tips
and helpful hints on how to start a basic
exercise program are covered later in this
handbook.

Determine Your Ideal
Weight with the Body
Mass Index

Body Mass Index (BMI) is one of the
best measures of our true weight status.
Put simply, BMI is a common measure
expressing the relationship of weight-toheight, and is an easy calculation using
inches and pounds.

M ANAGING CHOLESTEROL

When calculated, your BMI will help you
determine your true weight status as either
underweight, normal, overweight, or obese.
Generally, as a person’s BMI increases,
so does their risk for a number of health
conditions and diseases. These include the
risk of premature death, heart disease, high
blood pressure, osteoarthritis, cancer, and
diabetes.

Calculating Your BMI

The BMI Chart found on page 10 (Chart 2)
makes determining your BMI easy. Simply
find your height and weight and circle the
number where the two lines intersect. This is
your BMI. Once you have determined your

BMI, you can use this number to determine
weight status (using Chart 1—underweight,
normal, overweight, or obese). BMI values for
adults are interpreted using a fixed number,
regardless of age or gender.
CHART 1

BMI

Weight Status

Below 18.5

Underweight

18.5 - 24.9

Normal

25.0 - 29.9

Overweight

30.0 and above

Obese

Using Chart 1, we can tell that a BMI of 25.0
is defined as being overweight.

M A N A G I N G C H O L E S T E R O L 10

CHART 2

HEIGHT 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
(INCHES)

SEVERE OBESITY

OBESE

OVERWEIGHT

NORMAL

BMI
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54

BODY WEIGHT (POUNDS)

91
96
100
105
110
115
119
124
129
134
138
143
148
153
158
162
167
172
177
181
186
191
196
201
205
210
215
220
224
229
234
239
244
248
253
258

94
99
104
109
114
119
124
128
133
138
143
148
153
158
163
168
173
178
183
188
193
198
203
208
212
217
222
227
232
237
242
247
252
257
262
267

97
102
107
112
118
123
128
133
138
143
148
153
158
163
168
174
179
184
189
194
199
204
209
215
220
225
230
235
240
245
250
255
261
266
271
276

100
106
111
116
122
127
132
137
143
148
153
158
164
169
174
180
185
190
195
201
206
211
217
222
227
232
238
243
248
254
259
264
269
275
280
285

104
109
115
120
126
131
136
142
147
153
158
164
169
175
180
186
191
196
202
207
213
218
224
229
235
240
246
251
256
262
267
273
278
284
289
295

107
113
118
124
130
135
141
146
152
158
163
169
175
180
186
191
197
203
208
214
220
225
231
237
242
248
254
259
265
270
278
282
287
293
299
304

11 M A N A G I N G C H O L E S T E R O L

110
116
122
128
134
140
145
151
157
163
169
174
180
186
192
197
204
209
215
221
227
232
238
244
250
256
262
267
273
279
285
291
296
302
308
314

114
120
126
132
138
144
150
156
162
168
174
180
186
192
198
204
210
216
222
228
234
240
246
252
258
264
270
276
282
288
294
300
306
312
318
324

118
124
130
136
142
148
155
161
167
173
179
186
192
198
204
210
216
223
229
235
241
247
253
260
266
272
278
284
291
297
303
309
315
322
328
334

121
127
134
140
146
153
159
166
172
178
185
191
198
204
211
217
223
230
236
242
249
255
261
268
274
280
287
293
299
306
312
319
325
331
338
344

125
131
138
144
151
158
164
171
177
184
190
197
203
210
216
223
230
236
243
249
256
262
269
276
282
289
295
302
308
315
322
328
335
341
348
354

128
135
142
149
155
162
169
176
182
189
196
203
209
216
223
230
236
243
250
257
263
270
277
284
291
297
304
311
318
324
331
338
345
351
358
365

132
139
146
153
160
167
174
181
188
195
202
209
216
222
229
236
243
250
257
264
271
278
285
292
299
306
313
320
327
334
341
348
355
362
369
376

136
143
150
157
165
172
179
186
193
200
208
215
222
229
236
243
250
257
265
272
279
286
293
301
308
315
322
329
338
343
351
358
365
372
379
386

140
147
154
162
169
177
184
191
199
206
213
221
228
235
242
250
258
265
272
279
287
294
302
309
316
324
331
338
346
353
361
368
375
383
390
397

144
151
159
166
174
182
189
197
204
212
219
227
235
242
250
257
265
272
280
288
295
302
310
318
325
333
340
348
355
363
371
378
386
393
401
408

148
155
163
171
179
186
194
202
210
218
225
233
241
249
256
264
272
280
287
295
303
311
319
326
334
342
350
358
365
373
381
389
396
404
412
420

152
160
168
176
184
192
200
208
216
224
232
240
248
256
264
272
279
287
295
303
311
319
327
335
343
351
359
367
375
383
391
399
407
415
423
431

156
164
172
180
189
197
205
213
221
230
238
246
254
263
271
279
287
295
304
312
320
328
336
344
353
361
369
377
385
394
402
410
418
426
435
443

Lowering
Cholesterol with TLC:
START A WALKING PROGRAM

Walking does wonders in helping to reduce
the harmful effects of high cholesterol. But
you have to leave time in your busy schedule
to follow a walking program that will work
for you. In planning your walking program:

99Choose a safe place to walk. Find

a partner or group of people to walk
with you. Your walking partner(s) should
be able to walk with you on the same
schedule and at the same speed.

99Wear shoes with thick flexible

soles that will cushion your feet and
absorb shock.

99Wear clothes that will keep you
dry and comfortable. Look for
synthetic fabrics that absorb sweat and
remove it from your skin.

99For extra warmth in winter, wear
a knit cap. To stay cool in summer,
wear a baseball cap or visor.

99Do light stretching before and after
you walk.

99Think of your walk in three parts.
Walk slowly for five minutes. Increase
your speed for the next five to 20 minutes.
Finally, to cool down, walk slowly again
for five minutes.

99Try to walk at least three times

per week. Add two to three minutes per
week to the fast walk. If you walk less than
three times per week, increase the fast
walk more slowly.

99To avoid stiff or sore muscles or

joints, start gradually. Over several
weeks, begin walking faster, going further,
and walking for longer periods of time.

The more you walk, the better you will feel.

M A N A G I N G C H O L E S T E R O L 12

IS IT OK FOR ME TO WALK?
Answer the following questions before you begin a walking program.
your health care provider
  Has
ever told you that you have heart

your health care provider
  Has
told you that you have high blood

you are physically active,
  When
do you have pains in your chest or

your health care provider
  Has
told you that you have bone or

YES NO

trouble?

on your left side (neck, shoulder,
or arm)?

you often feel faint or have
  Do
dizzy spells?
YES NO

you feel extremely breathless
  Do
after you have been physically
YES NO

active?

YES NO

pressure?

joint problems, like arthritis,
that could get worse if you are
physically active?

you over 50 years old and not
  Are
used to a lot of physical activity?
YES NO

you have a health problem or
  Do
physical reason not mentioned
YES NO

here that might keep you from
starting a walking program?

If you answered yes to any of these questions, please check with
your health care provider before starting a walking program
or other form of physical activity.
Source: http://win.niddk.nih.gov/publications/walking.htm

13 M A N A G I N G C H O L E S T E R O L

Cholesterol-Lowering
Medicines

Along with changing the way you eat
and exercising regularly, your doctor
may prescribe medicines to help lower
your cholesterol. Even if you begin drug
treatment, you will need to continue TLC.
Drug treatment can control but does not
“cure” high blood cholesterol. Therefore,
you must continue taking your medicine and
make changes to your lifestyle to keep your
cholesterol level in the recommended range.
There are five major types of cholesterollowering medicines:

99Statins

»»Very effective in lowering LDL
(“bad”) cholesterol levels

»»Safe for most people
»»Rare side effects to watch for are
liver and muscle problems

99Bile Acid Sequestrants
(seh-KWES-trants)

»»Help lower LDL cholesterol levels
»»Sometimes prescribed with statins
»»Not usually prescribed as the only

»»When used with a statin, may increase
the chance of muscle problems

99Ezetimibe

»»Lowers LDL cholesterol
»»May be used with statins or alone
»»Acts within the intestine to block
cholesterol absorption

When you are under treatment, you will be
checked regularly to:

99Make sure your cholesterol level
is in control

99Check for other health problems
You may take medicines for other health
problems. It is important that you take ALL
medicines as prescribed by your doctor. The
combination of medications may lower your
risk for heart disease or heart attack.
When trying to lower your cholesterol or keep
it low, it is important to remember to follow
your treatments for other conditions you may
have such as high blood pressure. Get help
with quitting smoking and losing weight if they
are risk factors for you.

medicine to lower cholesterol

99Nicotinic (Nick-o-tin-ick) Acid

»»Lowers LDL cholesterol and

triglycerides, and raises HDL (“good”)
cholesterol

»»Should only be used under a doctor’s
supervision

99Fibrates

»»Lower triglycerides
»»May increase HDL (good) cholesterol
levels

M A N A G I N G C H O L E S T E R O L 14

FREQUENTLY
ASKED QUESTIONS

Do I need to worry
about lowering my blood
cholesterol now that I’m
over 65?

Yes. Older Americans have the nation’s highest
rate of coronary heart disease (CHD) and
can benefit greatly from lowering elevated
cholesterol. Cholesterol lowering also has
been shown to reduce the risk of strokes.
For seniors who do not have heart disease,
cholesterol lowering will reduce their high risk
of developing CHD. Older Americans should
have their total cholesterol and, if possible, their
high density lipoprotein (HDL, the “good”
cholesterol) tested once every five years. Older
Americans should keep their cholesterol low by
following an eating pattern lower in saturated
fat, total fat, and cholesterol, being physically
active, and maintaining a healthy weight.

Should I be concerned
about my child’s blood
cholesterol?

Yes. Everyone older than age 2 should
care about cholesterol to reduce the risk of
developing heart disease as an adult. Children
as well as adults can improve the health of
their hearts by following a low-saturated fat
and low-cholesterol diet, avoiding obesity, and
being physically active. Only children from
families in which the father or grandfather has
had heart disease at the age of 55 or younger,
or the mother or grandmother has had heart
disease at the age of 65 or younger, or in which
a parent has high blood cholesterol (240 mg/dL
or higher), should have their cholesterol levels
15 M A N A G I N G C H O L E S T E R O L

tested. If a child from such a “high-risk” family
has a high cholesterol level, it should be lowered
under medical supervision, primarily through
dietary changes and increased physical activity.

How useful is it to know
my cholesterol ratio?

Although the cholesterol ratio can be a useful
predictor of heart disease risk, especially in
the elderly, it is more important for treatment
purposes to know the value for each level
separately because both LDL and HDL
cholesterol separately affect your risk of heart
disease and the levels of both may need to be
improved by treatment. The ratio is useful if
it helps you and your doctor keep the entire
picture of your LDL and HDL levels in mind,
but it should not take the place of knowing
your separate LDL and HDL levels.

What is a heart-healthy
diet?

A heart-healthy diet emphasizes foods low
in saturated fat, total fat, and cholesterol
to help lower blood cholesterol. This is the
recommended eating pattern for Americans
older than 2:

»»Less than 10 percent of calories from
saturated fat;

»»An average of 30 percent of calories or
less from total fat; and

»»Less than 300 mg a day of dietary
cholesterol.

Saturated fat increases blood cholesterol more
than anything else you eat, so choose foods low
in saturated fat to reduce blood cholesterol. If
you are overweight, losing weight is important
for lowering blood cholesterol. Being physically
active also helps improve blood cholesterol
levels because it can raise HDL (“good”)
cholesterol and lower LDL (“bad”) cholesterol,
as well as help you lose weight, lower your
blood pressure and improve the fitness of your
heart and blood vessels.

In a cholesterol-lowering
eating pattern, is it
healthier to eat butter or
margarine?

Use butter sparingly—opt for buttery-tasting
spreads or better yet, extra virgin olive oil.
In lieu of stick margarine, which is packed
with trans fats, you can choose from a
delicious array of “tubbed” spreads like
Smart Balance. Whatever alternative you

My last cholesterol level
was within my goal.
Does that mean I do not
have to worry about my
cholesterol any more?

High cholesterol and heart disease are not
cured but are only controlled by diet and drug
therapy. Stopping your treatment quickly
returns your cholesterol to the level that existed
before therapy was started.

M A N A G I N G C H O L E S T E R O L 16

choose, be sure to check the label to ensure
that it lists “0” grams of trans fat and is free
of “partially hydrogenated oil.”

Source: Dr. Ann’s Eat Right For Life

Yes. Young adults 20 years of age and older
should have their cholesterol measured.
Studies have shown that the buildup of plaque
in the arteries that supply the heart begins in
late adolescence and early adulthood, and a
cholesterol level measured at age 22 predicts
the risk of a heart attack over the following 30
to 40 years. Waiting until midlife to measure
and lower cholesterol reduces the benefit that
can be obtained. Checking your cholesterol
and discussing it with your doctor can help you
make lifestyle changes—eating right, being
physically active, and controlling weight—to
maintain good health now and prevent heart
disease later in life.

How does smoking affect
my cholesterol?

Smoking has several harmful effects on
cholesterol. Smoking reduces HDL (“good”)
cholesterol and in all likelihood changes LDL
(“bad”) cholesterol to a form that promotes the
buildup of deposits in the walls of the coronary
arteries. In addition, smoking has harmful
effects on the heart and blood vessels. In these
ways, smoking substantially raises the risk
for coronary heart disease if you are healthy
and multiplies that risk many more times if
you have other risk factors such as high blood
cholesterol. All in all, smoking is the leading
preventable cause of death.

17 M A N A G I N G C H O L E S T E R O L

I’m young and healthy.
Do I need to have my
cholesterol checked?

Questions About Cholesterol Testing
NO MATTER WHICH TESTING SYSTEM IS USED, YOU MAY WANT TO ASK:

99What is being measured—total
cholesterol, HDL cholesterol,
LDL cholesterol, and/or
triglycerides?

99Do I need to fast before the test?
99How long will it take to get the
test results?

99Will someone be available to

explain the results and whether I
need further testing?

99Will I receive educational

materials with my test results?

99How reliable are the results? Is
the lab certified?

The accuracy and reliability of cholesterol tests vary from lab to lab. Labs
participating in the U.S. Centers for Disease Control and Prevention (CDC)
standardization testing should be used.

M ANAGING CHOLESTEROL
The information contained in this guide is based on the best health
information available and has been reviewed for accuracy. This
170 0 2 M A R C Y S T R E E T, S U I T E 14 0
O M A H A , N E 6 8118 | 4 0 2- 8 27- 3 59 0
welcoa.org

information is not intended to replace the advice of your healthcare
provider. If you have any questions about managing your own health
and/or seeking medical care, please contact a medical professional.

© 2 0 16 W E L L N E S S C O U N C I L O F A M E R I C A • I N F O R M A T I O N M A Y N O T B E R E P R O D U C E D , C O P I E D , C I T E D , O R
C I R C U L AT E D I N A N Y P R I N T E D O R E L E C T R O N I C F O R M W I T H O U T W R I T T E N P E R M I S S I O N FR O M T H E P U B L I S H E R .

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