Hodges and Russell Insurance Services

So, you want to know about cholesterol?

If one topic is guaranteed to burn up an hour at a dinner party, it's cholesterol. It usually goes like this: " They tell me you're a doctor. Do you mind if I ask a quick question about my cholesterol? " This harmless opener is followed rapid-fire by: "How do I know if I have " good " cholesterol? Do I need to treat it? How? Are cholesterol drugs dangerous? " I guess I should be grateful for conversations like that, because they insure that I eat less. But in fairness, some information about cholesterol is confusing.

What is cholesterol?

From all the bad press cholesterol gets, you would think it's our body's worst enemy. Not true. In fact, the waxy, fatty substance called cholesterol is vital for our existence. It's necessary for healthy cell membranes, brain cells, digestion and adrenal glands (to make hormones), just to name a few reasons.

A fabulous system is in place to ensure cholesterol is circulated wherever it is needed. The action begins in the liver, where cholesterol is packaged for delivery. Think of the liver as the cholesterol manufacturer's warehouse. From the warehouse, trucks carry a cargo of cholesterol all over the body. The predominant member of this fleet, low density lipoprotein (LDL), carries cholesterol away from the warehouse out to the body. Another fleet of trucks, headed up by high-density lipoprotein (HDL), ship cholesterol back to the warehouse, where it is repackaged and sent out again as needed.

Problems occur when too much LDL hauls cholesterol out while too little HDL brings it back in. When that happens LDL trucks dump their excess cholesterol on the road (i.e., the arteries). Eventually, this causes a traffic jam in the arteries. Nothing gets through, including blood that carries oxygen to all of our cells. Deprived of oxygen, cells die. The most common outcome is a heart attack.

How does it get out of balance?

Some people have a genetic cholesterol problem. They are born with a liver warehouse that simply makes too much cholesterol and therefor ships out too many LDL trucks. These folks need careful follow-up with doctors, and they most likely need medication.

For others, problems are brought on by bad behaviors. For example, diets high in saturated fats, cholesterol and sugar can increase LDL. Obesity does the same, while lowering HDL. Physical inactivity and smoking are associated with low HDL. Many of the effects of cholesterol cannot be blamed on genetics.

What's my cholesterol level?

If you haven't had your cholesterol checked, do. It's a simple blood test. Ideally, total cholesterol (measured in milligrams per deciliter of blood) should be less than 180. Aim for "bad" LDL to be less than 100. For "good" HDL, men's levels should be more than 45; women's, more than 55.

Once you know your numbers, you and your doctor can make an informed decision about how best to improve your cholesterol balance.

How can I improve my numbers?

Let's assume your cholesterol is abnormal, but not so out of whack that your doctor won't allow you to work on it on your own for a while. What next?

First evaluate your habits. Regular exercise, weight control and a diet low in saturated fats, cholesterol and sugar are given. You need to minimize your junk food intake, and if you smoke, quit.

Doctors and patients alike are interested in foods that can benefit the cholesterol balance, called "nutraceuticals" or functional foods. These include soluble fiber (as in oatmeal), niacin, stanol esters (in margarine's such as Take Control and Benecol ), nuts, green tea, soy, garlic, olive oil and avocado.

Now you know what cholesterol is, why your body needs it, how your habits affect it and some tricks to improve it.

So next time you are at a dinner party, head to the buffet line and look for foods that can lower your cholesterol. I'll be over by the guacamole if you have any questions.