Understanding Numbers Part 4: Cholesterol

This is part 4 of a 4-part series designed to help you better understand some of the tests that you get each year at your physical with your doctor. These numbers are important to your health, and understanding what they mean can help you to improve not only the numbers themselves, but your overall health and wellness.

Cholesterol is one of those things that you probably hear about almost daily….through TV commercials for medication, foods that claim to lower your cholesterol, your co-worker talking about their high cholesterol….it’s everywhere! But do you really understand what cholesterol is and why it’s important to your health?

Cholesterol is an important substance that your body needs in order to build cells. It’s not always “bad”, but too much of a certain type of cholesterol can lead to health risks. Cholesterol comes from two sources-your liver and the foods you eat. Some foods that are high in trans fats and saturated fats could cause your body to make more cholesterol than normal, thus increasing your levels. Cholesterol circulates through your blood, and if it starts getting too high, that’s when the risk to your health starts to increase. The risks associated with high cholesterol include:

  • Coronary Heart Disease
  • Heart Attack
  • Stroke

If you have other risk factors, such as high blood pressure or diabetes, your risk increases even more. Cholesterol is tested through a blood test called a “lipoprotein profile”.


Types of Cholesterol

High-Density Lipoproteins (HDL) Cholesterol: “The good kind”. HDL is considered the good type of chlolesterol because it “picks up” cholesterol from the blood vessel walls and brings it to the liver for disposal. You want this number to be HIGH (think: HDL = High)

Low-Density Lipoprotein (LDL) Cholesterol: “The bad kind”. LDL is considered the bad type of cholesterol because it deposits harmful fat in the blood vessel walls. If you have more LDL than HDL, your body will deposit fat in the blood cells faster than it can pick it up. You want this number to be LOW (think: LDL = Low)

Triglycerides: these are the most common type of fat in the body and they store excess energy form your diet. A high triglyceride number paired with a high LDL number can increase the risk of fatty build-ups in the artery walls. You want this number to be LOW.


Average Target Cholesterol Levels

CHOL – Total Cholesterol:

Desirable Less than 200 mg/dL
Borderline High 200-239 mg/dL
High 240 mg/dL or higher

This is your number of HDL, LDL, and Triglycerides combined.

HDL Cholesterol:

Health Risk Males Females
Optimal/Desirable Range >= 60 mg/dL
Acceptable Range > 40 mg/dL > 50 mg/dL
Abnormal Range/High Risk <= 40 mg/dL <= 50 mg/dL

This is the number you want to be HIGHER.

LDL Cholesterol:

Optimal Less than 100 mg/dl
Near Optimal/Above Optimal 100-129 mg/dL
Borderline High 130-159 mg/dL
High 160-189 mg/dL
Very High 190 mg/dL and above

This is the number that you want to be LOWER.

TRIG – Triglycerides:

Normal < 150 mg/dL
Increased Risk 150-199 mg/dL
High Risk 200-499 mg/dL

You also want this number to be LOW.

TC/HDL – Total Cholesterol/HDL Ratio:

Health Risk Males Females
½ Average Risk 3.4 3.3
Average Risk 5.0 4.4
2x Average Risk 9.6 7.1
3x Average Risk 23.4 11.0

The ratio of total cholesterol to HDL cholesterol should be small. This means that you  have a high level of the good cholesterol.

Your doctor may recommend different target levels based on your medical history. Always check your numbers with your doctor, and ask questions! They will typically take the averages of several tests to get an accurate picture of your total cholesterol levels.

Causes of High Cholesterol

High cholesterol is, unfortunately, most likely the cause of unhealthy habits. It can be affected by many different factors, including:

  • Diet: eating foods high in trans and saturated fats can increase cholesterol levels
  • Weight: excess weight gain tends to lower HDL and raise LDL levels
  • Smoking: this lowers HDL cholesterol
  • Alcohol intake: also lowers HDL cholesterol
  • Activity Level: if you are sedentary, you are more likely to have high LDL cholesterol
  • Medications You May Take: always talk with your doctor about new medications. Some meds can actually cause high cholesterol!
  • Genetics: the only thing you can’t change, if high cholesterol runs in your family, you may be more susceptible.


Improving High Cholesterol

Luckily, since high cholesterol is often caused by unhealthy habits, it’s easy to get your levels back on track!

  • Eat Heart Healthy Foods: choose leaner cuts of meat, low-fat dairy products, and monosaturated fats like olive oil and canola oil. Try to avoid red meat.
  • Eliminate Trans Fats: these are found in fried foods and many commercial food products like cookies, crackers, chips, and snack foods. In the US, if a food contains less than 0.5 grams of trans fats per serving, it can be labeled as “trans-fat free”.  Always read your food labels!
  • Eat Omega-3 Fatty Acids: O3FA don’t affect LDL cholesterol, but actually increase HDL cholesterol! These are found in salmon, mackerel, herring, walnuts, almonds, and flaxseeds.
  • Increase Fiber Intake: fiber can help lower LDL levels. Fiber is found in oats, fruits, brans, lentils, and green leafy veggies.
  • Add Whey Protein: when used as a supplement, whey protein lowers LDL and total cholesterol levels.
  • Quit Smoking: within one year of quitting smoking, your HDL levels will increase and your risk of heart disease will be lowered by 50%!
  • Drink in Moderation: while moderate alcohol intake has been linked with higher HDL levels, the benefits aren’t strong enough to recommend alcohol for someone who doesn’t already drink. If you do drink alcohol, do so in moderation.
  • Maintain a Healthy Bodyweight: excess weight gain leads to a lot of other problems besides high cholesterol, so work on maintaining a healthy weight
  • Exercise Regularly: try to get at least 150 minutes of moderate-intensity exercise per week. Be sure to include both cardio exercise and strength training exercise!


As always, the first rule of fighting high cholesterol is to know your numbers. Get your cholesterol tested at least once a year, and know where you stand. If it’s high, your doctor may suggest testing more often. Be sure to get your complete lipoprotein profile every time, and keep track from test to test. Lowering and reversing high cholesterol IS possible!




—American College of Cardiology: —https://www.cardiosmart.org/cholesterol

American Heart Association: http://www.heart.org/HEARTORG/Conditions/Cholesterol/Cholesterol_UCM_001089_SubHomePage.jsp


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