Good vs. Bad Cholesterol: What’s the Difference?

Cholesterol is a waxy, fat-like substance found in all the cells in your body. It helps the body build cells and make vitamins and hormones. Cholesterol comes from two sources: the liver and the foods you eat.

Dietary cholesterol comes from animal-based foods. Full-fat dairy products, red meat, egg yolks, and processed meats contain dietary cholesterol and are often high in saturated and trans fats. A diet rich in these types of foods can increase the amount of cholesterol in your body.

Your cholesterol levels are important because they help you know your risk for heart disease. Cholesterol helps your body perform many important functions, however, too much cholesterol in your blood is harmful. It can enter your arteries and lead to a build-up of atherosclerotic plaque (hardened deposits).

Types of Cholesterol – What You Should Know

There are two types of cholesterol: LDL or low-density lipoprotein (“bad” cholesterol) and HDL or high-density lipoprotein (“good” cholesterol). Lipoproteins are a combination of fat (lipid) and protein. They carry cholesterol to and from cells. Too much LDL or insufficient HDL increases the risk of buildup in the artery walls. Cholesterol can also combine with other substances to form plaque.

A normal total cholesterol level is below 200 mg/dL. In the normal range:

HDL is 60 mg/dL or higher
LDL is below 100 mg/dL

You have high cholesterol (hyperlipidemia) if your total cholesterol level is 240 mg/dL or higher. In this range:

HDL is under 40 mg/dL (men) or under 50 mg/dL (women)
LDL is 160 mg/dL or higher

Triglycerides are the most common type of fat in the body. They store unused calories and provide your body with energy. Although triglycerides are not a type of cholesterol, a physician can check them with a cholesterol test. A high triglyceride level combined with high LDL or low HDL levels can increase the risk of heart attack and stroke.

“Your cholesterol is often checked as part of your routine blood work. It is important to know your cholesterol numbers because if they get to an unhealthy level, you may be at an increased risk of health problems such as heart attack and stroke.”

Jonathan Bass, DO, Catholic Health Physician

How Can You Maintain Good Cholesterol

Healthy lifestyle habits are essential to maintaining good cholesterol levels.

Eating heart-healthy foods like omega-3 fatty acids can help keep your LDL at bay. Omega-3 fatty acids can help lower blood pressure and decrease your risk of heart attack and stroke. You can get them from fatty fish, like salmon and mackerel, as well as flaxseed and chia seeds.

Talk with your physician to make sure you are getting enough physical activity and maintaining a healthy weight, which can improve your cholesterol. Smoking also impacts your cholesterol. Exercising and quitting smoking can improve your HDL levels.

What factors make someone at risk for high cholesterol?

Some people are genetically predisposed to high blood cholesterol levels. Some medications can raise your LDL or lower your HDL levels. There are also several risk factors for “bad” or high cholesterol:

Drinking too much alcohol
Eating a diet high in saturated and trans fats
Gaining weight
Not getting enough physical activity
Smoking (damages the blood vessels and makes them more likely to collect fatty deposits)

Your cholesterol levels tend to rise as you get older. Men have a greater risk of high total cholesterol between the ages of 40 – 59. Women have a higher risk after menopause when there are lower levels of hormones to protect against high blood cholesterol.

How is high cholesterol treated?

Maintaining a healthy diet and staying physically active can help keep your cholesterol under control. Medication can also help if lifestyle changes are not enough to manage your LDL or HDL levels.

Your physician may recommend statins if you cannot get your cholesterol into a normal range with diet changes and physical activity. Statins block an enzyme the liver needs to make cholesterol. Since your body will always produce cholesterol, it may return to a high level if you stop taking a statin. Dr. Bass added, “Many patients require long-term treatment with statins to maintain healthy levels of cholesterol.”

What are the risks of high cholesterol?

High cholesterol has no symptoms; you can have it for years without noticing. Over time, the buildup of plaque in the artery walls can lead to heart disease, heart attack or stroke. Left untreated, high cholesterol can lead to:

Atherosclerosis

Atherosclerosis occurs when cholesterol and other substances build up in the artery walls. This can cause complications such as chest pain, heart attack and stroke.

Coronary Artery Disease

Hyperlipidemia is an excess of lipids or fats in your blood that can lead to coronary artery disease, which is the most common form of heart disease in the U.S. Other conditions high cholesterol can cause include carotid artery disease and peripheral artery disease.

How often should you get your cholesterol checked?

The timing and frequency of blood tests to check your HDL and LDL levels depend on several factors.

Most healthy adults should check their cholesterol every 1 to 2 years, typically during an annual physical. More frequent testing is recommended if you are over the age of 40, since the risk increases with age. People with diabetes, heart disease, or a family history of coronary artery disease should talk to their PCP about checking it more often.

Most children should get their cholesterol checked at least once between the ages of 9 and 12. However, if your child has diabetes or obesity, they need more frequent screenings. Adolescents should get their cholesterol checked between the ages of 17 and 21.

Keeping up with your annual exam and routine bloodwork will help address any concerns about your cholesterol levels before further health complications occur.