130–159 mg/dL borderline-high; 160–189 mg/dL
high; 190 mg/dL and above very high.HDL Cholesterol less than 40 mg/dL as a major
heart disease risk factor; 60 mg/dL and above gives
some protection against heart disease.
OriginsCholesterol is a waxy substance found only in
foods of animal origin such as poultry, beef, fish,
eggs, and dairy products. Cholesterol can be made
from the liver and thus is not needed in the diet for
normal cellular processes. Cholesterol must be com-
bined withfats, proteins, and lipoproteins, before it
can be transported through the body within the blood.
There are many different lipoproteins that vary in size,
function and composition. One of which is low-density
lipoprotein (LDL). Commonly referred to as the
‘‘bad’’ cholesterol, it composes relatively two-thirds
of total circulating blood cholesterol. Because the
LDL transports cholesterol through the bloodstream,
in high levels, it is associated with plaque deposits on
the walls of the arteries resulting in a higher risk for
cardiovascular events. High-density lipoprotein
(HDL) referred to as the ‘‘good’’ cholesterol, scav-
enges excess cholesterol from the blood and brings it
back to the liver for excretion. Research! shows that
higher levels of HDL levels are related to lower levels
of certain cardiovascular events. Another class of lip-
oproteins, the very-low-density-lipoproteins (VLDL),
is responsible for carryingtriglyceridesthrough the
bloodstream.
Evidence is clear that the major dietary contrib-
utors to elevated cholesterol are saturated fat, trans
fat,dietary cholesterol, and an imbalance in caloric
intake and energy expenditure resulting in weight gain.
In some cases elevated cholesterol may be due to an
underlying medical condition or certain prescribed
medications as listed below, but not limited to:
Hypothyroidism
Nephrotic syndrome
Chronic liver disease
Cholestasis
Monoclonal gammopathy
Cushing’s syndrome
Oral contraceptive use
Anorexia nervosa
Acute intermittent porphyria
Protease inhibitor use
Other factors known to influence a persons blood
cholesterol level include:
Heredity. Genetic factors play a large role in the
amount of cholesterol in a person’s blood.
Age.As a person ages, their cholesterol level tends to
rise gradually.
Sex. Men tend to have higher LDL and lower HDL
than premenopausal women.
Menopause. After menopause, estrogen levels fall
and women’s LDL cholesterol levels tend to rise.
Weight. As weight rises, so does cholesterol. Usually
LDL levels rise as HDL levels lower.
Smoking. Smoking can lower a persons HDL levels.
Exercise. Regular exercise raises a persons HDL lev-
els. As well as help in weight loss or maintenance.
Alcohol. Studies suggest that no more than one drink
for women and two drinks for males may help in
raising HDL levels.
In November 1985, in order to standardize the
medical approach to treating high cholesterol blood
levels, The National Heart, Lung, and Blood Institute
(NHLBI) launched the National Cholesterol Educa-
tion Program (NCEP). The overall goal of the NCEP
is to ‘‘reduce illness and death fromcoronary heart
disease(CHD) in the United States by reducing the
percent of Americans with high blood cholesterol’’.KEY TERMS
Cholesterol—A soft, waxy substance found among
the lipids (fats) in the bloodstream and in all your
body’s cells.
Lipoprotein Particle—A lipoprotein particle is
composed of an outer shell of phospholipid,
which renders the particle soluble in water; a core
of fats called lipid, including cholesterol and a sur-
face apoprotein molecule that allows tissues to
recognize and take up the particle.
Lipoproteins—Their density characterizes types of
lipoproteins- high-density lipoprotein (HDL), low-
density lipoprotein (LDL), very-low-density lipo-
protein (VLDL).
Hypercholesterolemia—The presence of an abnor-
mal amount of cholesterol in the cells and plasma of
the blood is associated with the risk of atherosclerosis.
Hyperlipidemia—Presence of excess lipids in the
blood.
Coronary Heart Disease—A progressive reduction
of blood supply to the heart muscle due to narrow-
ing or blocking of a coronary artery.TLC diet