Cholesterol ... the good, the bad, the facts

More than 2,000 Americans die of cardiovascular disease each day, an average of one death every 40 seconds—but you don't have to be one of them.

Cholesterol is a fatty, waxy substance produced naturally in the liver, and your body needs small amounts of it to function normally. But too much can lead to heart disease. The good news is that you can lower your cholesterol and reduce your risk of heart disease and stroke.

The place to start is getting a fix on the terminology and learning the simple steps you can take to make sure your diet is on the right track.

LDL (bad) cholesterol

LDL cholesterol is called the bad cholesterol because it contributes to plaque, a hard deposit that can clog arteries. Narrowed arteries increase your risk of heart attack and stroke.

HDL (good) cholesterol

HDL cholesterol is called the good cholesterol because it helps reduce levels of LDL cholesterol. Here's how: It acts as a scavenger, removing LDL cholesterol from the arteries and taking it back to the liver, where it is broken down and passed from the body.


Triglycerides are another type of fat in the body. High levels of triglycerides are associated with hardening of the arteries.

What should your numbers be?

Most doctors will recommend a fasting blood test called a lipoprotein profile, and that will give you the numbers you need to know. There are three levels of total cholesterol: desirable (less than 200 mg/dL), borderline high (200 to 239 mg/dL), and at risk (240 mg/dL or higher). HDL levels fall into two categories, which are different for men and women. The desirable level for both is 60 mg/dL or above, but the at-risk level for men is less than 40 mg/dL and for women, less than 50 mg/dL.

How to get healthy numbers

If your numbers are high, your doctor may prescribe lifestyle changes and medication. Diet changes will impact your cholesterol levels. Although some fat is healthy, you need to limit:

  • Saturated fats such as those found in meats, butters, cheeses, full-fat dairy products, and some oils, including palm, palm kernel, and coconut.
  • Trans fats such as those found in margarines and store-bought cookies, crackers, and cakes. Trans fats are bad because they also lower your HDL levels.

Add soluble fiber to your diet because it helps block the absorption of cholesterol and fats. Some sources of soluble fiber are:

  • Oatmeal and oat bran cereals.
  • Bananas, peaches, apples, berries, and oranges.
  • Lentils and beans such as black, kidney, white and pinto.

Read nutrition labels on food products

Nutrition labels are a valuable tool. You can use them to easily identify calories, saturated fats, trans fats, cholesterol, and dietary fiber. But remember that the front of the package saying "low cholesterol" does not mean it's good for you; many low-cholesterol foods contain high levels of saturated and/or trans fat, both of which raise bad cholesterol levels.

This information was provided to the Johns Hopkins Benefits Office by CareFirst.

Posted in Health+Well-Being