The difference between good and bad cholesterol

  • Published
  • By Maj. Sheri Webb
  • 23rd Medical Group
It may surprise you, but cholesterol itself is not bad. In fact, cholesterol is just one of the many substances created and used by our bodies to keep us healthy. 

Some of the cholesterol we need is produced naturally (and can also be affected by our family health history) while some of it comes from the food we eat. 

There are two types of cholesterol: "good" and "bad." It is important to understand the difference and to know the levels of "good" and "bad" cholesterol in your blood. Too much of one type - or not enough of another - can put you at risk for coronary heart disease (CHD), heart attack or stroke. 

Cholesterol is a soft, fat-like, waxy substance found in the bloodstream and in all your body's cells. It is a normal and very important part of a healthy body. Cholesterol is used for producing cell membranes, some hormones and serves other needed bodily functions. It is only when your body has too much cholesterol in the blood that it becomes a major risk for CHD (which leads to heart attack) and for stroke. The medical term for high levels of cholesterol in your blood is hypercholesterolemia.
As mentioned previously, cholesterol comes from two sources: your body and food. Your liver and other cells in your body make up about 75 percent of blood cholesterol. The other 25 percent comes from the foods you eat. 

LDL cholesterol is the "bad" cholesterol. When too much of it circulates in the blood, it can clog arteries, increasing your risk of heart attack and stroke. LDL cholesterol is produced naturally by your body. How much your body produces is determined from genes you inherited from your biological parents or even grandparents. How much saturated fat, trans fats and dietary cholesterol you eat also affects how much you have circulating in your body. 

If high blood cholesterol runs in your family, lifestyle modifications alone may not be enough to lower or keep your LDL blood cholesterol at an acceptable level. You may need to add one of the lipid lowering medications which are available to help. Everyone is different. For this reason, it is essential that you follow up with your healthcare provider to create an action plan specific for you. 

The American Heart Association (AHA) endorses the National Cholesterol Education Program guidelines for detection of high cholesterol: everyone age 20 and older should have a fasting "lipoprotein profile" every five years (this test is done after a nine to 12-hour fast without any food or drinks other than plain water). This test gives information about total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. Not fasting prior to the test interferes with the accuracy of the lipid profile, depending upon the results your medical provider may need to repeat the test. Most medications can be taken with sips of water when fasting, although some may interfere with the results. It is best to discuss this with your medical provider prior to the test. 

Your total cholesterol levels will be evaluated in addition to other risk factors such as age, family history, smoking and high blood pressure, which are all associated with heart disease. If your values are at a desirable level and there are no other risk factors for heart disease, you are considered to be at a relatively low risk of CHD. The AHA still recommends everyone, even those with low risk of CHD, strive to control their weight, eat a heart-healthy diet, get regular physical activity, avoid tobacco smoke, limit alcohol to no more than one drink per day for women or two drinks per day for men, and limit beverages and foods with added sugars.

For more information, please contact you primary care provider. The Health and Wellness Center also offers a monthly Healthy Heart Class. Please call 257-4292 to register or to receive more information.