Cholesterol belongs to the lipid or fat family; it is one of the components of the membrane of cells and is present in blood and all tissues. The body primarily produces it, while a small part is introduced through the diet.

In physiological amounts, it is essential for constructing cell membranes and is involved in several processes fundamental to the body’s functioning.

When levels are high, it constitutes one of the significant risk factors for cardiovascular disease.

LDL Cholesterol and HDL Cholesterol: What Are the Differences?

Cholesterol in the blood is transported within molecular structures called lipoproteins.

There are two main types of lipoproteins in the body: Low-density lipoprotein or LDL, also known as “bad” cholesterol, and high-density lipoprotein or HDL, known instead as “good” cholesterol.

Excess LDL cholesterol is a danger to arterial health because lipoproteins, which transport excess cholesterol from the liver to body cells through the arteries, can undergo structural changes, like oxidation, resulting in accumulation in the walls of large arterial vessels.

This process, called atherosclerosis, can lead to the formation of plaques that obstruct or occlude blood flow, posing risks to the cardiovascular system.

In contrast, HDL promotes cholesterol disposal from the blood and its elimination via bile salts.

When to Measure Cholesterol Levels?

If the patient is at low risk for heart disease, cholesterol measurement should begin at about age 40.

Cardiovascular risk factors include diabetes, obesity, smoking habits, elevated blood pressure, and a family history of heart disease, such as heart attack or stroke. In that case, it is necessary to anticipate and implement screening.

The decision on when to start cholesterol screening should be discussed with the primary care physician, despite the general recommendations, as the timing of screening varies by patient and different medical history.

Indeed, some patients are genetically predisposed to develop hypercholesterolemia, or “hereditary or familial hypercholesterolemia,” associated with several genetic mutations.

What Are the Optimal Cholesterol Levels?

Blood tests allow us to know total cholesterol, LDL cholesterol, and HDL cholesterol levels. The values are expressed in milligrams per deciliter (mg/dl) and are associated with different degrees of cardiovascular risk. 

Low levels of total cholesterol and LDL cholesterol are desirable, as well as high HDL cholesterol levels.

Total cholesterol (optimal values) < 190 mg/dL

LDL cholesterol (optimal values) < 55 mg/dL

HDL cholesterol (optimal values) > 40 mg/dL

LDL Cholesterol Levels and Type of Cardiovascular Risk

Cardiovascular risk

55 – 69 mg/dL Low risk

70 – 99 mg/dL Moderate risk

100 – 115 mg/dL High risk

(baseline level to be reduced by at least 50%)

> 115 mg/dL Very high risk

(baseline level to be reduced by at least 50%)

High Cholesterol: What Food to Eat and What to Avoid?

In case of high cholesterol levels, the first thing to do is to analyze one’s diet with the help of a specialist.

In general, the intake of the following foods should be limited: 

  • Butter
  • Lard
  • Cream 
  • Eggs
  • Offal (liver, brain, kidney)
  • Sausages high in saturated fats
  • Saturated vegetable oils (palm and canola)

Whole or condensed milk should be limited in favor of skim or semi-skim milk), whole yogurt, and cheese high in saturated fat.

Fish, cereals, legumes, fruits, and vegetables (at least five servings per day of the latter) should be preferred.

As for cooking foods, boiling, steaming, grilling, and microwaving do not require the addition of extra fat, so they should be considered ideal. Frying, on the other hand, should be avoided.

High Cholesterol and Lifestyle

It is essential to make an effort to correct one’s lifestyle as well as one’s diet to avoid incurring issues related to high cholesterol-

It is recommended to perform regular aerobic exercise for at least half an hour daily (cycling, gymnastics, dancing, swimming, brisk walking), avoid smoking, and eliminate excess pounds.

These are the first steps in preventing cardiovascular disease, even though sometimes lifestyle intervention is not enough to control cholesterol levels, and drug treatment may be necessary.