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The Effects of Diet, Exercise, and Medication on Cholesterol Levels

How cholesterol, which is a waxy, fat-like thing that your body needs to make healthy cells, may affect your health and cholesterol. A short guide:

1. Cholesterol Basics: Cholesterol is a waxy, fat-like thing that your body needs to make healthy cells¹. But, too much cholesterol can make your risk of heart disease higher¹. Cholesterol moves through your blood, stuck to proteins. This mix of proteins and cholesterol is called a lipoprotein¹. There are different kinds of cholesterol, based on what the lipoprotein carries¹:

  • Low-density lipoprotein (LDL): Often called the “bad” cholesterol, LDL carries cholesterol particles throughout your body. LDL cholesterol builds up in the walls of your arteries, making them hard and narrow¹.
  • High-density lipoprotein (HDL): Called the “good” cholesterol, HDL takes extra cholesterol and brings it back to your liver¹.

The American Heart Association (AHA) says that adults should have their cholesterol checked every 4–6 years, starting at age 20 years¹. This is when cholesterol levels can start to go up¹. According to the 2018 rules on the control of blood cholesterol published in the Journal of the American College of Cardiology (JACC), these are the good, borderline, and high numbers for adults¹. All values are in mg/dL (milligrams per deciliter) and are based on fasting numbers¹:

  • Total cholesterol: Good is less than 200 (the lower, the better). Borderline to moderately high is 200–239. High is 240 or higher¹.
  • HDL cholesterol: Good is 60 or higher; but, 40+ for males or 50+ for females is okay¹. Low is less than 40 for men and less than 50 for women¹.
  • LDL cholesterol: Good is less than 100; below 70 if coronary artery disease is there¹. Borderline to moderately high is 130–159. High is 160 or higher; 190 is very high¹.
  • Triglycerides: Good is less than 149; best is under 100¹. Borderline to moderately high is 150–199. High is 200 or higher; 500 is very high¹.

High cholesterol has no signs, so a blood test is the only way to find out if you have it¹. Regular cholesterol checks are important, especially if you have a family history of high cholesterol, heart disease, or other problems, such as diabetes or high blood pressure¹.

(Note: This is a general guide and different people might need different things. Always talk to a doctor for advice that is right for you.)
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