blue artichoke

I've only had my cholesterol checked twice. The first time I was tricked into it. I was in high school and my mom asked me to go to the grocery store with her; the store was offering cholesterol screenings and my mom made me wait in line while she shopped, then made me offer up my arm for a blood sample, "just for fun!" My cholesterol was fine. The second time I had it checked was a few months ago, at my doctor's recommendation. I fasted for 12 hours before the test, then my appointment was delayed. My stomach was growling loudly by the time it was my turn for the needle. I rewarded myself with a greasy bacon-egg-and-cheese biscuit from Hardee's. I don't remember my numbers, but they didn't seem to concern my doctor.

I hear a lot about cholesterol, the good kind and the bad kind, and know that too much bad cholesterol is bad for your heart. But I'm rather vague on what it is exactly or why we have it in the first place. So, I did a few hours of research this rainy Saturday morning and here's my simplified guide to cholesterol.

Cholesterol = chole (bile) + sterol (steroid + alcohol). It is a lipid that builds and maintains cell membranes, regulating fluidity through a range of temperatures. It is vital for proper brain function, nerve function, metabolism of fat-soluble vitamins (A,D,E and K) and production of sex hormones. It is produced in the liver and distributed throughout the body through the bloodstream. Blood is mostly water, and cholesterol can't swim, so it hops on rafts of lipoproteins to get where it needs to go. In the gall bladder, it helps manufacture bile.

There are two forms of this cholesterol-lipoprotein unit: LDL (low-density lipoprotein) and HDL (high-density lipoprotein). LDLs are the speedy movers, but they tend to drop bits of cholesterol along the way. HDLs are the perfectionists: slower, methodical and attentive to detail. They follow along and clean up the cholesterol debris left in the wake of the LDLs, then take the trash back to the liver, where the cholesterol bits are broken down and excreted. It's a pretty good system, but when the LDLs outnumber the HDLs, the HDLs get overwhelmed, frustrated and crabby. The LDLs never pick up after themselves; eventually all those dropped cholesterol bits clutter up the arteries and just make the place look junky. Those bits of cholesterol form a plaque that sticks to the artery walls, causing the arteries to narrow and become rigid (called atherosclerosis). When this happens, the clots that sometimes form in blood can't pass through the arteries, get stuck, block blood flow and cause heart attacks or strokes. That's reason enough to limit LDLs and increase the HDL cleaning crew, but there's more.

The plaque that forms along the artery walls injures the wall lining, setting in motion inflammatory processes. White blood cells move in to the injured area and transform into macrophages. Macrophages are bad influences; they lure even more LDL cholesterol to the injury and gobble them up. As the macrophages feast on LDLs, they grow into foam cells; a gathering of foam cells forms fatty streaks along the artery lining. That's right, your arteries turn into bacon. And bacon-arteries is a major marker for cardiovascular disease. This, of course, is not good. More plaque = more inflammation = more white blood cells = more macrophages = more foam cells = more fatty streaks = more plaque. It's a vicious cycle that, unchecked, will continue until it kills you.

So, what can you do? Easy, lower LDL and raise HDL. You can lower LDL by eating almonds, apples, bananas, berries, carrots, cold-water fish (salmon), dried legumes, garlic, grapefruit, oats, olive oil, omega-3 rich oils and walnuts. Your body makes all the cholesterol it needs (and some people inherit overproduction of cholesterol, poor souls), so adding even more cholesterol through a diet high in saturated fats overwhelms the HDL clean-up crew. Reducing foods that contain saturated fats and eliminating trans fats will go a long way toward lowering the LDL cholesterol burden. Egg yolks, whole milk and organ meats are some foods with the highest levels of saturated fats.

Some prescription drugs raise levels of the bad LDL, such as beta-blockers, high-dose oral contraceptives, furosemide (Lasix) and some other diuretics, levodopa (L-dopa drugs such as Dopar, Larodopa and Sinemet) and steroids. If you're taking any of those, you need to be more vigilant about keeping tabs on your cholesterol levels.

Increase HDL by eating avocado, eating bread high in beta glucan from oat fiber and drinking cocoa (polyphenols). The best and most effective ways to raise HDL, though, is through exercise and weight loss. Aerobic workouts get your heart pumping and circulates oxygen faster and more efficiently, which increases the effectiveness of HDL in removing LDL cholesterol. Aerobic exercise also reduces inflammation, halting the vicious cycle of plaque buildup.

Total Cholesterol Level

Less than 200: Desirable
200-239: Borderline-High Risk
240+: High Risk

HDL (Healthy) Cholesterol Level
60+: Desirable
Below 50: Risky for women
Below 40: Risky for men

LDL (Lousy) Cholesterol Level
Less than 100: Optimal
100-129: Near Optimal
130-159: Borderline High
160-189: High
190+: Very High Risk

Now, hopefully, you know a little bit more about cholesterol. And knowing is half the battle.