CHOLESTEROL 101

Striking the right balance

Two cartoon dots, one with wings and labelled HDL, the other horns and labelled LDL
Published By: Costco Wholesale Canada Pharmacy

You may have been lectured by your doctor to keep your cholesterol down, but it may come as a surprise to you to know that cholesterol itself isn’t bad. In fact, our bodies need the fatty substance to produce hormones and metabolize food. The problem arises when our body strikes the wrong cholesterol balance, resulting in dyslipidemia, which is a term that applies to various conditions of unhealthy cholesterol levels, including high cholesterol. About 39% of Canadians between the ages of 6 and 79 are living with this condition right now and it’s the leading cause of heart attack and stroke. While our genes may predispose us to high cholesterol, our environment (what we eat and how much we exercise) can also have an impact. Reaching a healthy and well-balanced cholesterol level is achievable.

Not all cholesterol is created equal

Cholesterol moves around the body packaged as a lipoprotein – a complex made up of protein and lipids (fats). Your doctor may have told you that you need to raise your good, high-density lipoprotein (HDL) and/or lower your bad, low-density lipoprotein (LDL). This lipoprotein earned its bad reputation because when there’s too much of it circulating, some of the cholesterol it carries is deposited into your blood vessels. This action may eventually narrow or even block an artery that supplies blood to the heart, leading to a heart attack, or to the brain, leading to a stroke. HDL is good cholesterol because it acts as a scavenger for extra cholesterol circulating around the body, sweeping it up and transporting it back to the liver to be broken down. Think of HDL as the clean-up crew for your blood vessels. Triglycerides are another type of fat in your blood used for energy. Having high triglycerides can also increase risks of other complications and heart disease. The goal is to strike the right balance between all of these in your body.

Making lifestyle changes

Healthy and well-balanced food choices, exercising regularly, weight loss (especially if you carry more weight around your waist), limiting alcohol use and quitting smoking can all help balance your cholesterol levels. More specifically, you should consider the following dietary recommendations:

  • Keep your dietary cholesterol intake to less than 300 mg/day (less than 200 mg/day if you are at a higher risk).
  • Increase the mono- and polyunsaturated fats in your diet by eating more fruits and vegetables and cooking with healthy oils such as olive oil.
  • Increase omega-3 fatty acids from fish and other sources.
  • Lower your saturated and trans-fatty acids by cutting back on red meat and high-fat dairy, and limiting processed foods.
  • Increase fibre intake.

What's my risk?

Your doctor or pharmacist can help set up your target cholesterol levels by using a 10-year risk assessment tool called the Framingham Risk Score (FRS). This indicates your percentage of risk of having a heart attack or stroke in the next 10 years. Depending on your score, your doctor may also advise you to adopt a number of lifestyle changes and/or to take a cholesterol-lowering medication (e.g., a “statin” such as atorvastatin or rosuvastatin) to help you achieve the right balance.