Cholesterol and how to control it

Heart disease is the No. 1 killer in the United States. According to the CDC, "About every 25 seconds, an American will have a coronary event, and about one every minute will die from one." One per minute works out to over half a million people dead from heart problems per year.

One of the leading causes of heart disease is cholesterol. The fact that cholesterol is the leading cause of the leading killer makes cholesterol important. So let's take a look at how cholesterol works.

What is cholesterol? It is a chemical that is essential to the cells in your body. If you were to hold a blob of pure cholesterol in your hand, it would look and feel waxy. Cells use cholesterol to make their membranes (the outer envelope that holds each cell together).

Because cholesterol is essential to your body, your liver and several other organs make the cholesterol you need - on the order of a gram per day. Then you add some extra cholesterol to the mix in your food - maybe 300 milligrams a day. Therefore plenty of cholesterol is floating in your bloodstream for your cells to use. When cells need it, cholesterol is readily available from a nearby capillary.

If cholesterol is essential to your body, how can cholesterol be bad? The very simplest explanation: cholesterol collects on artery walls and eventually clogs them up. When it clogs up the arteries on the heart, you have a heart attack which is frequently fatal. Why, you might ask, are the arteries on the heart so susceptible? They are not - all the arteries are clogging. It's just that the heart is one place where a clog causes an immediate and often deadly effect. If an artery in your leg clogs, it is known as peripheral artery disease. It's a problem, but not one that will kill you in a few minutes.

Because of the troubles associated with cholesterol, it is something your doctor thinks about. After all, a doctor's goal is to keep people from dying, and cholesterol is a leading cause of death. This is why you get tested for cholesterol. It used to be there was just one number - the amount of cholesterol in the blood, measured in milligrams per deciliter - and you needed to keep it below 200. Then came the differentiation between "good" and "bad" cholesterol, and then all the stuff with density and triglycerides, to the point where today a cholesterol report looks like a confusing bowl of alphabet soup.

But it is interesting, because it is the result of a better and better understanding of what actually seems to be going on with cholesterol inside the human body. The lipoproteins are there to transport things like cholesterol in the blood. Remember that cholesterol is waxy, and blood is watery. Wax and water don't mix, so cholesterol can't flow in the bloodstream and get where it needs to go without help. Lipoproteins provide the help. Low-density lipoproteins (LDL) are what cause artery walls to clog, and are therefore "bad". High-density lipoproteins (HDL) seem to prevent clogging, and are therefore "good". So you doctor is trying to keep overall cholesterol in the good range while decreasing LDL and increasing HDL.

What can you do about cholesterol? Your doctor can prescribe drugs like statins. Statins break a chain in the liver that creates cholesterol, so the amount of cholesterol goes down. They also can lower LDL levels.

In addition you have some dietary steps you can take. Eating low cholesterol foods and avoiding high cholesterol foods can help to some degree, although the body continues making cholesterol and will sometimes make more when you eat less.

There are also several foods you can start eating that affect cholesterol levels. You have probably heard about oat bran. It lowers LDL because it contains soluble fiber. So do fruits like apples. Walnuts also help. In some people, walnuts make a big difference. They contain "good fats" that push cholesterol numbers down. Omega-3 fatty acids, found in things like salmon, flax seed and fish oil pills, also help. And olive oil is a good thing to eat, especially if it is replacing unhealthy fats.