We hear it all the time: high cholesterol causes health problems. According to the CDC, 78 million U.S. adults (nearly 37%) have cholesterol levels where experts recommend cholesterol medicine or had other health conditions putting them at high risk for heart disease and stroke. We know that too much cholesterol is bad, but what exactly is cholesterol and how can we keep it under control?

We sat down with Dr. Shelley Roque of SIMEDHealth Gainesville Primary Care to learn more.

What is cholesterol?

A substance found in the blood that your body uses to build cells. The liver makes all the cholesterol for your body, the rest comes from animal products, such as meat, poultry, butter, cheese, and milk.  Some oils, such as palm oil, palm kernel oil, and coconut oil, can also trigger your liver to make more cholesterol. Foods high in saturated and trans fats cause your liver to make more cholesterol than normal, potentially bringing a person’s cholesterol level from a normal one to an unhealthy one.

How does it affect our health?

Since cholesterol circulates in the blood, if you have too much of the bad kind or not enough of the good kind, the cholesterol can slowly build up in the inner walls of arteries. This cholesterol build-up in the arteries can join with other substances to form a thick, hard deposit, potentially blocking arteries.  The narrowing  and decreased flexibility of arteries from the cholesterol build up is called "atherosclerosis". Atherosclerosis causes decreased blood flow to the organs that the arteries feed, putting people with atherosclerosis at a higher risk of heart attacks, strokes, and other health problems .

Is there good cholesterol and bad cholesterol?

Some call LDL cholesterol the “bad” cholesterol because having high levels can lead to atherosclerosis, and  increases your risk of heart attacks, strokes, and peripheral vascular disease (disorder of the circulatory system outside of the brain and heart) .

Some call HDL the “good” cholesterol because people with high HDL levels tend to have a decreased risk of heart attacks, strokes, and peripheral vascular disease. It is believed that HDL helps  carry excess LDL cholesterol away from arteries and back to the liver, where LDL is broken down and removed from the body. But only 1/3-1/4 of blood cholesterol is carried by HDL so it does not completely remove LDL.

What are symptoms of high cholesterol?

Sometimes people do not have any symptoms of high cholesterol since it can take time for cholesterol to build up enough in the arteries to become those hard atherosclerotic plaques, and start to cause significant blockages in the circulatory system. Overtime, however, as the blood flow to certain organs starts to decrease, organs will receive less and less oxygen. Your body needs oxygen, so when parts of your body do not get the oxygen it needs, it will not work as well.

So, for instance, if there is decreased blood flow to the heart, a person may start to feel chest pain. If there is decreased blood to the brain, depending on which part of the brain is affected, a person may start to feel numbness, tingling, weakness, slurred speech. If there is decreased blood flow to the legs, a person may start to notice skin changes, such as darker skin, less hair, pain. There is a wide array of symptoms a person can feel from high cholesterol. It all just depends on the extent of build up in the arteries, and which organs are being affected by the blockages.

What are common myths (if any) associated with cholesterol?

LDL is not really a bad cholesterol. We actually need that cholesterol  to help make protective walls around cells and certain hormones, so it is necessary for our body to have. However, having too much of it is what makes it “bad” since its build up in the arteries is what can set off the cascade of events that cause atherosclerosis  (i.e. plaque build up in arteries, see above ).

Are their any foods that might help to lower cholesterol?

There are foods you can avoid, and those are the ones that have a lot of saturated fat, such as red meat, butter, fried foods, cheese. Foods that can help lower your cholesterol are those that have more soluble fiber, such as fruits, oats, barley, beans, peas.

Technically, a vegan diet doesn’t have any animal products, so that could help lower your cholesterol if you really wanted to avoid dietary cholesterol. However, being vegan is not for everyone,  so generally a healthy diet includes a lot of fruits, vegetables, whole grains, beans, peas, lentils, chickpeas, nuts, some fish, and some milk and milk products.

I often recommend a Mediterranean-style diet for my patients with high cholesterol because it is the closest to the American Heart Association’s dietary recommendations.

What tips can you provide to help patients keep their cholesterol in check?

Stay active, try to exercise regularly. Work on losing weight if you are overweight. Avoid foods high in saturated fats. Avoid other risk factors that can make cholesterol build up in arteries worse, such as cigarette smoking and high blood pressure. Finally, follow up with your primary care physician regularly to see if you need to have your cholesterol checked.

If you need help keep your cholesterol in check, be sure to request an appointment with your SIMEDHealth physician.