Myths -- and Facts -- About Lowering High Cholesterol
Myth: You Need Your First Cholesterol Test When You're in Your 40 s
Truth: Experts agree that’s too long to wait to get a baseline screening, especially if you have a family history of heart disease, heart attack or stroke. Get your first cholesterol test no later than age 20 to measure total cholesterol: triglycerides (fat in the blood); LDL ("bad cholesterol"), which joins with fat to build up and clog arteries, and HDL ("good cholesterol"), which carries harmful cholesterol away from arteries. “Knowing your numbers early on can help you understand your risk factors and make lifestyle changes so you stay healthy,†says Jorge Plutzky, M.D., spokesperson for the American Heart Association.
Myth: Kids Don’t Get High Cholesterol
Truth: Absolutely anyone, at any age, can have high cholesterol. Just like adults, a lack of exercise, being overweight and unhealthy eating habits can affect a child’s cholesterol levels. And it’s no surprise that kids in families with a history of heart disease are at greater risk for developing heart disease as adults. All kids, regardless of family history, should be screened for cholesterol levels between ages 9 and 11, and again between 17 and 21, according to new guidelines endorsed by the American Academy of Pediatrics.
Myth: The Only Number that Matters Is Your Total Cholesterol
Truth: While your total cholesterol should be less than 200 mg/dL, each component (LDL, HDL, triglycerides) is just as important for determining your risk for heart attack and stroke. For example, if your total cholesterol is less than 200 but you have very low HDL, your body’s ability to fight off “bad†cholesterol is low. In this case, you’ll need to work on improving your numbers. Target ranges for LDL are 70-130 (lower numbers are better), 40-60 md/dL for HDL (higher numbers are better) and 150 or less for triglycerides. If your levels are normal, retest every five years. Retest sooner if your total cholesterol is more than 200, your HDL is less than 40, or you have other risk factors for heart disease and stroke.
Myth: Thin, Fit People Don’t Get High Cholesterol
Truth: “Being thin is no guarantee you won’t have high cholesterol,†says Fred Ralston, Jr., M.D., an internist at Fayetteville Medical Associates in Fayetteville, Tenn. “We know genetics, poor diet and lack of exercise are components that contribute to high cholesterol. While you can change your diet and exercise more, you can’t do anything about family history.†Get your cholesterol checked regardless of your weight, diet or exercise routine.
Myth: You Need to Avoid All Fats to Lower Your Cholesterol
Truth: “That’s not necessarily helpful because not all fats are created equal,†says Yul Ejnes, M.D., FACP, chair of the American College of Physicians Board of Regents and an internist in Cranston, Rhode Island. Saturated fats (such as butter and fatty cuts of meat) and transfats (found in commercial baked goods and fast food) should be limited or avoided when possible. But polyunsaturated and monounsaturated fats in foods such as fish, nuts and olive oil may lower cholesterol and should be used to replace other fats when possible.
Myth: Cholesterol Is Always a Bad Thing
Truth: Cholesterol is actually a building block your body needs to make cell membranes and hormones. “Your body makes cholesterol, and the fats and cholesterol you eat also raise your cholesterol level,†says Dr. Ejnes. Keep your cholesterol intake to less than 300 mg per day or 200 mg if your LDL is above 100. Moderation is key: Eating an egg (about 213 mg of cholesterol) is fine, even if you have high cholesterol. It’s the butter you fry it in and the side of bacon that’s the problem.
Truth: There’s insufficient evidence to recommend using supplements to lower cholesterol. “The doses are not clear and the products are unregulated, meaning you really don’t know what you’re getting in terms of content and safety,†says Dr. Plutzky. “If you need a cholesterol-lowering medication, it doesn’t make sense to use supplements instead of prescription drugs, like statins, with which we have a considerable amount of experience and success.
