The Skinny on Cholesterol

So many things can affect our heart health—blood pressure, inflammation levels and, of course, cholesterol levels. In case you need a reminder of how cholesterol functions in the body (and why it’s important to our cardiovascular health), here’s a little primer.

Cholesterol is a waxy substance that helps to build cells, produce hormones and aid in digestion. Cholesterol is naturally manufactured by the liver, and our bodies actually make all the cholesterol they need—about 1,000 mg per day. That’s why the USDA recommends a dietary intake of no more than 300 mg of cholesterol per day for healthy individuals, and no more than 200 mg for those at high risk for cardiovascular disease. (For comparison’s sake, one large egg contains about 185 mg).

But if cholesterol is so important in the body, why is too much of it a bad thing? In order to get to where it’s needed, cholesterol has to attach itself to proteins to take it out of the liver and into the bloodstream. In combination with these proteins, this cholesterol becomes low-density lipoprotein, or LDL cholesterol, which circulates throughout the body to drop off cholesterol where it’s needed.

When there’s too much LDL cholesterol in the body—more than is necessary to do its daily cell-building work—it circulates in the bloodstream and begins to build up under the linings of our blood vessels. These deposits are called plaques, and too many plaques can narrow the vessels and block blood flow, leading to coronary artery disease.

High-density lipoproteins, on the other hand, are the scavengers of circulating cholesterol, collecting and returning it to the liver where it can be broken down. That’s why higher HDL levels and lower LDL levels are best.

Cholesterol levels are most often measured in milligrams of cholesterol per deciliter (mg/dL) of blood, so here’s how the target numbers break down:

Optimal total cholesterol: ≤ 200 mg/dL
Optimal HDL: ≥ 60 mg/dL
Optimal LDL: ≤ 100 mg/dL

But because of how LDL and HDL relate to each other, the ratio of the two can be more important than your total cholesterol. For example, if you have an HDL level of 65 but your total cholesterol is 225—over the recommended limit—you get a ratio of about 3.5:1, an ideal ratio according to the American Heart Association.

The most effective way to lower LDL cholesterol, says Dr. Brad Jacobs, MD, chair of Pharmaca’s Integrative Health Advisory Board, is through regular exercise and diet modifications, such as replacing saturated and trans fats (found in animal protein and processed foods) with healthy unsaturated fats such as nuts, avocado and fish oils. He adds that supplementation with garlic, fiber and plant-based sterols can also help lower LDL cholesterol. On the other tack, exercise can help raise HDL, says Dr. Jacobs, as can moderate alcohol intake (a glass of wine or beer per day) and supplementation with niacin. (Explore more of Dr. Jacobs’ recommendations for cholesterol management.)

Speak with a Pharmaca practitioner or your health care provider about prescription statins or natural supplements that can help you control your cholesterol.