
Understanding Cholesterol
Cholesterol is a waxy, fat-like substance that is found in the cells of the body. It serves important functions, such as helping to build cell membranes and produce hormones. However, having too much cholesterol in the bloodstream can lead to serious health problems, like heart disease and stroke.
There are two main types of cholesterol – low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL cholesterol is often referred to as “bad” cholesterol because it can build up in the arteries, leading to blockages. HDL cholesterol is considered “good” cholesterol because it helps remove LDL cholesterol from the body.
Maintaining healthy cholesterol levels is crucial for your overall health and well-being. High cholesterol levels can increase your risk of developing cardiovascular diseases, which are a leading cause of death worldwide. By understanding cholesterol and taking steps to manage it, you can significantly improve your heart health and reduce your risk of these serious conditions.
Causes of High Cholesterol
There are several factors that can contribute to high cholesterol levels. Some of the most common causes include:
- Diet: Eating foods high in saturated and trans fats, such as fatty meats, full-fat dairy products, fried foods, and baked goods, can raise LDL cholesterol levels.
- Genetics: Some people are genetically predisposed to high cholesterol, a condition known as familial hypercholesterolemia. This can lead to elevated LDL levels even with a healthy lifestyle.
- Age and Gender: Cholesterol levels tend to rise as people get older, and men generally have higher cholesterol levels than women.
- Lifestyle Factors: Lack of physical activity, being overweight or obese, and smoking can all contribute to high cholesterol.
- Medical Conditions: Certain health conditions, such as diabetes, thyroid disorders, and liver or kidney disease, can also increase cholesterol levels.
Understanding the underlying causes of your high cholesterol is important, as it can help you develop a more targeted and effective plan to lower it.
Symptoms of High Cholesterol
One of the challenges with high cholesterol is that it often has no obvious symptoms. Many people with high cholesterol levels feel perfectly healthy and have no outward signs of the condition. This is why it’s so important to have your cholesterol levels checked regularly through a simple blood test.
However, in some cases, high cholesterol can lead to the development of fatty deposits, or plaque, in the arteries. As these deposits build up, they can cause the arteries to narrow and harden, a condition known as atherosclerosis. This can eventually lead to the following symptoms:
- Chest pain or discomfort (angina)
- Shortness of breath
- Numbness or coldness in the extremities
- Fatigue
- Irregular heartbeat
If the plaque buildup becomes severe enough to completely block an artery, it can result in a heart attack or stroke. These are serious medical emergencies that require immediate treatment.
It’s important to note that high cholesterol can be present for years without causing any noticeable symptoms. Regular cholesterol screenings are the best way to detect and monitor the condition before it leads to more serious health problems.
Diagnosing High Cholesterol
The only way to know if you have high cholesterol is through a simple blood test called a lipid panel or lipid profile. This test measures the levels of different types of cholesterol and triglycerides (a type of fat) in your blood.
The lipid panel typically includes the following measurements:
- Total Cholesterol: This is the overall amount of cholesterol in your blood, including both LDL and HDL.
- LDL (Low-Density Lipoprotein) Cholesterol: This is the “bad” cholesterol that can build up in your arteries and increase your risk of heart disease.
- HDL (High-Density Lipoprotein) Cholesterol: This is the “good” cholesterol that helps remove LDL cholesterol from your body.
- Triglycerides: These are a type of fat in the blood that can also contribute to heart disease risk.
Your doctor will use the results of your lipid panel to determine if your cholesterol levels are within a healthy range. The specific target levels may vary depending on your age, gender, and overall health status, but generally, the following guidelines are used:
- Total Cholesterol: Less than 200 mg/dL
- LDL Cholesterol: Less than 100 mg/dL (or less than 70 mg/dL for those at very high risk)
- HDL Cholesterol: 40 mg/dL or higher for men, 50 mg/dL or higher for women
- Triglycerides: Less than 150 mg/dL
If your cholesterol levels are outside of these healthy ranges, your doctor may recommend lifestyle changes, medication, or a combination of both to help lower your cholesterol and reduce your risk of heart disease.
Dietary Strategies to Lower Cholesterol
One of the most effective ways to lower cholesterol is through dietary changes. By making adjustments to the types of foods you eat, you can help reduce the amount of cholesterol and unhealthy fats in your body. Here are some key dietary strategies to consider:
Reduce Saturated and Trans Fats
Saturated fats and trans fats are the primary dietary culprits when it comes to raising LDL (bad) cholesterol levels. These unhealthy fats are often found in foods like fatty meats, full-fat dairy products, fried foods, and baked goods. Aim to limit your intake of these foods and instead choose healthier unsaturated fats, such as those found in olive oil, avocados, nuts, and fish.
Increase Fiber Intake
Soluble fiber can help lower LDL cholesterol by reducing the amount of cholesterol absorbed into the bloodstream. Good sources of soluble fiber include oats, beans, lentils, apples, and berries. Aim for at least 25-30 grams of fiber per day to help support healthy cholesterol levels.
Incorporate Plant Sterols and Stanols
Plant sterols and stanols are compounds that are structurally similar to cholesterol and can help block the absorption of cholesterol in the body. They are often added to foods like margarine, yogurt, and juices, and have been shown to lower LDL cholesterol by up to 10%.
Choose Lean Proteins
When it comes to protein sources, opt for lean meats, poultry, fish, and plant-based proteins like beans, lentils, and soy. These options are lower in saturated fat and can help support healthy cholesterol levels.
Limit Alcohol Intake
Excessive alcohol consumption can raise triglyceride levels, which are another type of fat in the blood that can contribute to heart disease risk. If you do drink alcohol, it’s recommended to limit your intake to no more than one drink per day for women and two drinks per day for men.
By making these dietary changes and incorporating more cholesterol-lowering foods into your daily routine, you can take a significant step towards improving your overall heart health.
Exercise and Physical Activity
Regular physical activity is another crucial component of lowering cholesterol and maintaining a healthy heart. Exercise can help in several ways:
Increase HDL (Good) Cholesterol
Engaging in aerobic exercise, such as brisk walking, jogging, swimming, or cycling, can help raise your HDL (good) cholesterol levels. HDL cholesterol helps remove LDL cholesterol from the bloodstream, reducing the risk of plaque buildup in the arteries.
Reduce LDL (Bad) Cholesterol
Physical activity can also help lower your LDL (bad) cholesterol levels by improving the body’s ability to metabolize and remove this type of cholesterol.
Manage Weight
Maintaining a healthy weight through regular exercise can also contribute to lower cholesterol levels. Excess weight, especially around the midsection, is associated with higher LDL and triglyceride levels.
Improve Overall Cardiovascular Health
Beyond just cholesterol, exercise can also improve other risk factors for heart disease, such as high blood pressure, insulin resistance, and inflammation.
The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, along with two to three days of strength training. However, even small amounts of physical activity can be beneficial, so start where you are and gradually increase your exercise routine over time.
Remember, the key is to find activities that you enjoy and can stick with consistently. This will help you reap the long-term benefits of exercise for your cholesterol and overall heart health.
Lifestyle Changes to Lower Cholesterol
In addition to dietary and exercise modifications, there are several other lifestyle changes you can make to help lower your cholesterol levels:
Quit Smoking
Smoking is a major risk factor for heart disease, as it can significantly lower HDL (good) cholesterol and increase LDL (bad) cholesterol. Quitting smoking can have immediate and long-term benefits for your cholesterol and overall cardiovascular health.
Manage Stress
Chronic stress can contribute to unhealthy cholesterol levels by increasing the production of cortisol, a hormone that can raise triglycerides and LDL cholesterol. Practice stress-reducing activities like meditation, yoga, or deep breathing to help keep your cholesterol in check.
Get Enough Sleep
Lack of sleep has been linked to higher cholesterol levels, as it can disrupt the body’s natural processes for regulating cholesterol. Aim for 7-9 hours of quality sleep each night to support healthy cholesterol levels.
Limit Alcohol Consumption
As mentioned earlier, excessive alcohol intake can raise triglyceride levels and contribute to other heart health issues. If you do consume alcohol, it’s recommended to limit your intake to no more than one drink per day for women and two drinks per day for men.
Monitor Your Health
Regular check-ups with your healthcare provider, including cholesterol screenings, can help you stay on top of your cholesterol levels and make any necessary adjustments to your lifestyle or treatment plan. Be proactive about your heart health and don’t hesitate to discuss any concerns with your doctor.
By incorporating these lifestyle changes alongside dietary and exercise modifications, you can take a comprehensive approach to lowering your cholesterol and reducing your risk of heart disease.
Medical Treatment for High Cholesterol
While lifestyle changes are the primary focus for managing high cholesterol, in some cases, medication may also be necessary to help achieve and maintain healthy cholesterol levels. Your healthcare provider may recommend one or more of the following cholesterol-lowering medications:
Statins
Statins are the most commonly prescribed cholesterol-lowering drugs. They work by inhibiting the production of cholesterol in the liver, leading to a reduction in LDL (bad) cholesterol levels. Examples of statins include atorvastatin (Lipitor), simvastatin (Zocor), and rosuvastatin (Crestor).
Bile Acid Sequestrants
Bile acid sequestrants, such as cholestyramine (Prevalite) and colesevelam (Welchol), work by binding to bile acids in the intestines and preventing their reabsorption. This can help lower LDL cholesterol levels.
Cholesterol Absorption Inhibitors
Cholesterol absorption inhibitors, like ezetimibe (Zetia), block the absorption of cholesterol from the intestines, leading to a reduction in LDL cholesterol levels.
PCSK9 Inhibitors
PCSK9 inhibitors, such as alirocumab (Praluent) and evolocumab (Repatha), are a newer class of cholesterol-lowering medications that work by targeting a specific protein involved in the regulation of LDL cholesterol. These drugs are typically reserved for individuals with very high LDL cholesterol levels or those who cannot tolerate other cholesterol-lowering medications.
It’s important to note that while medication can be an effective tool for managing high cholesterol, it should be used in conjunction with lifestyle changes, such as a healthy diet and regular exercise. Your healthcare provider will work with you to determine the most appropriate treatment plan based on your individual needs and health status.
Monitoring and Maintaining Healthy Cholesterol Levels
Maintaining healthy cholesterol levels is an ongoing process that requires regular monitoring and a commitment to a healthy lifestyle. Here are some tips for monitoring and maintaining your cholesterol levels:
Regular Cholesterol Screenings
Get your cholesterol levels checked at least once every 4-6 years, or more frequently if you have a history of high cholesterol or other risk factors for heart disease. This will allow your healthcare provider to track any changes and make adjustments to your treatment plan as needed.
Set Cholesterol Goals
Work with your healthcare provider to establish specific cholesterol goals, such as target levels for LDL, HDL, and triglycerides. These goals may vary depending on your age, gender, and overall health status.
Stick to a Healthy Lifestyle
Maintain the dietary, exercise, and other lifestyle changes you’ve implemented to lower your cholesterol. Consistency is key, as these habits can help you sustain healthy cholesterol levels over the long term.
Monitor Your Progress
Track your cholesterol levels over time and celebrate your successes, even if they are small. This can help you stay motivated and identify any areas that may need more attention.
Communicate with Your Healthcare Provider
Be open and honest with your healthcare provider about any challenges you’re facing or changes in your health. They can provide guidance and support to help you stay on track with your cholesterol management plan.
By regularly monitoring your cholesterol levels and maintaining a healthy lifestyle, you can take an active role in managing your heart health and reducing your risk of cardiovascular disease.
Cholesterol Myths and Facts
There are many misconceptions and myths surrounding cholesterol that can often lead to confusion and misinformation. Let’s take a look at some common myths and the facts that debunk them:
Myth: Dietary cholesterol is the main driver of high cholesterol levels.
Fact: While dietary cholesterol can contribute to overall cholesterol levels, the main dietary culprits are actually saturated and trans fats. Limiting these unhealthy fats is more important for managing cholesterol than strictly avoiding foods high in dietary cholesterol, such as eggs.
Myth: Cholesterol-lowering medications are dangerous and should be avoided.
Fact: Cholesterol-lowering medications, particularly statins, have been extensively studied and are generally safe and effective when used as directed by a healthcare provider. While they may have some side effects, the benefits of reducing heart disease risk often outweigh the potential risks.
Myth: If my cholesterol is high, I will definitely develop heart disease.
Fact: High cholesterol is a risk factor for heart disease, but it does not guarantee that you will develop the condition. Other factors, such as lifestyle, genetics, and overall health status, also play a significant role in determining your heart disease risk.
Myth: I don’t need to worry about my cholesterol if I’m young and healthy.
Fact: Cholesterol levels should be monitored at all ages, as high cholesterol can start to develop in childhood and adolescence. Early intervention through lifestyle changes and, if necessary, medication, can help prevent the buildup of plaque in the arteries and reduce the risk of heart disease later in life.
Myth: Lowering my cholesterol will make me feel tired and weak.
Fact: Properly managing cholesterol levels, whether through lifestyle changes or medication, should not make you feel tired or weak. In fact, adopting a healthier lifestyle with a balanced diet and regular exercise can actually improve your energy levels and overall well-being.
Myth: I can’t eat any foods with cholesterol if I’m trying to lower my levels.
Fact: While it’s important to limit foods high in saturated and trans fats, you don’t necessarily need to eliminate all foods containing cholesterol, such as eggs and seafood. These foods can be part of a healthy, cholesterol-lowering diet when consumed in moderation and as part of an overall balanced eating plan.
Myth: There’s nothing I can do to lower my cholesterol if it’s genetic.
Fact: Even if you have a genetic predisposition to high cholesterol, lifestyle changes can still make a significant difference in managing your cholesterol levels. While genetics play a role, diet, exercise, and other lifestyle factors can also have a substantial impact on your cholesterol profile.
Dispelling these myths and understanding the facts about cholesterol can help you make more informed decisions about your heart health and take the necessary steps to lower your cholesterol levels through a comprehensive approach.
Dietary Supplements for Cholesterol Management
In addition to making dietary and lifestyle changes, some people may also consider using dietary supplements to help manage their cholesterol levels. While these supplements should not be used as a replacement for a healthy lifestyle, they may provide additional support in certain cases. Some of the more commonly studied supplements for cholesterol include:</
Omega-3 Fatty Acids
Omega-3 fatty acids, found in fish oil and other marine sources, have been shown to help lower triglyceride levels and slightly increase HDL (good) cholesterol. Supplements like fish oil or krill oil may be beneficial for individuals with high triglycerides or those who don’t consume enough omega-3-rich foods in their diet.
Plant Sterols and Stanols
As mentioned earlier, plant sterols and stanols can help block the absorption of cholesterol in the body. Supplements containing these compounds may be a useful addition to a cholesterol-lowering diet, particularly for those with high LDL (bad) cholesterol levels.
Soluble Fiber Supplements
Supplements containing soluble fiber, such as psyllium, oat bran, or glucomannan, can help reduce the amount of cholesterol absorbed from the diet and lower LDL cholesterol levels.
Red Yeast Rice
Red yeast rice contains compounds that are similar to statins and may help lower LDL cholesterol levels. However, the quality and potency of red yeast rice supplements can vary, and they may interact with certain medications, so it’s important to consult with a healthcare provider before using them.
Garlic
Some studies have suggested that garlic supplements may have a modest effect in reducing LDL cholesterol and triglyceride levels. However, the evidence is mixed, and the optimal dosage and formulation are still being researched.
It’s important to note that the effectiveness and safety of these supplements can vary, and they should not be used as a substitute for prescribed cholesterol-lowering medications or a healthy lifestyle. Always consult with your healthcare provider before starting any new supplement regimen, especially if you are already taking medications or have other underlying health conditions.
Cholesterol and Heart Disease
High cholesterol is a major risk factor for the development of cardiovascular disease, which includes conditions like coronary artery disease, heart attack, and stroke. Understanding the link between cholesterol and heart disease is crucial for maintaining good heart health.
How Cholesterol Contributes to Heart Disease
When there is too much LDL (bad) cholesterol in the bloodstream, it can start to build up and form plaque in the arteries. This plaque buildup, known as atherosclerosis, can narrow and harden the arteries, making it more difficult for blood to flow freely. Over time, this can lead to the following heart health issues:
- Coronary Artery Disease: The narrowing and hardening of the arteries that supply the heart with blood and oxygen, which can increase the risk of a heart attack.
- Heart Attack: When the plaque buildup in the arteries completely blocks the flow of blood to the heart, causing damage to the heart muscle.
- Stroke: When the plaque buildup or a blood clot blocks the flow of blood to the brain, depriving it of oxygen and causing a stroke.
- Peripheral Artery Disease: The narrowing of the arteries that supply blood to the legs and arms, which can lead to pain, numbness, and even amputation in severe cases.
By managing your cholesterol levels through a combination of lifestyle changes and, if necessary, medication, you can significantly reduce your risk of developing these serious cardiovascular conditions and improve your overall heart health.
The Role of HDL (Good) Cholesterol
While LDL (bad) cholesterol is the primary culprit in the development of heart disease, HDL (good) cholesterol plays an important protective role. HDL cholesterol helps remove excess LDL cholesterol from the bloodstream and transports it to the liver, where it can be broken down and eliminated from the body.
Higher levels of HDL cholesterol are associated with a lower risk of heart disease, as they help prevent the buildup of plaque in the arteries. Maintaining a healthy balance between LDL and HDL cholesterol is crucial for maintaining good cardiovascular health.
Reducing Heart Disease Risk
By taking a comprehensive approach to managing your cholesterol levels, you can significantly reduce your risk of developing heart disease and other cardiovascular conditions. This includes:
- Adopting a heart-healthy diet low in saturated and trans fats, and high in fiber, plant-based foods, and lean protein sources
- Engaging in regular physical activity, such as aerobic exercise and strength training
- Maintaining a healthy weight through a balanced diet and active lifestyle
- Quitting smoking and limiting alcohol consumption
- Taking cholesterol-lowering medications as prescribed by your healthcare provider
- Regularly monitoring your cholesterol levels and working with your doctor to set and achieve your cholesterol management goals
By making these lifestyle changes and working closely with your healthcare team, you can take an active role in protecting your heart health and reducing your risk of developing serious cardiovascular diseases.
Cholesterol and Diabetes
Individuals with diabetes are at an increased risk of developing high cholesterol and associated cardiovascular diseases. Understanding the relationship between cholesterol and diabetes is crucial for managing both conditions effectively.
The Link Between Cholesterol and Diabetes
Diabetes, particularly type 2 diabetes, can have a significant impact on cholesterol levels. High blood sugar levels associated with diabetes can lead to the following changes in cholesterol:
- Increased LDL (Bad) Cholesterol: Diabetes can contribute to the production of small, dense LDL particles, which are more likely to contribute to the buildup of plaque in the arteries.
- Decreased HDL (Good) Cholesterol: Diabetes can lower HDL cholesterol levels, reducing the body’s ability to remove excess LDL cholesterol from the bloodstream.
- Elevated Triglycerides: Diabetes is often accompanied by high triglyceride levels, another type of fat in the blood that can increase the risk of heart disease.
This combination of high LDL cholesterol, low HDL cholesterol, and elevated triglycerides is known as diabetic dyslipidemia, and it significantly increases the risk of cardiovascular disease in individuals with diabetes.
Managing Cholesterol in Diabetes
Effectively managing cholesterol levels is crucial for individuals with diabetes to reduce their risk of heart disease and other cardiovascular complications. The following strategies can help:
- Dietary Changes: Adopting a heart-healthy diet low in saturated and trans fats, and high in fiber, whole grains, fruits, and vegetables can help improve cholesterol levels.
- Physical Activity: Regular exercise, such as brisk walking, swimming, or cycling, can help raise HDL cholesterol and lower LDL cholesterol and triglycerides.
- Weight Management: Maintaining a healthy weight through a balanced diet and regular physical activity can help improve cholesterol and blood sugar control.
- Medication: In addition to lifestyle changes, your healthcare provider may prescribe cholesterol-lowering medications, such as statins, to help manage your cholesterol levels.
- Regular Monitoring: Frequent monitoring of your cholesterol, blood sugar, and other health indicators can help you and your healthcare team make informed decisions about your treatment plan.
By working closely with your healthcare provider and taking a comprehensive approach to managing both your cholesterol and diabetes, you can significantly reduce your risk of developing cardiovascular disease and other related complications.
Cholesterol and Pregnancy
Cholesterol levels can fluctuate during pregnancy, and understanding these changes is important for maintaining the health of both the mother and the developing baby.
Changes in Cholesterol During Pregnancy
Pregnancy can have a significant impact on a woman’s cholesterol levels:
- Total Cholesterol: Total cholesterol levels typically increase during pregnancy, with the highest levels occurring in the third trimester.
- LDL (Bad) Cholesterol: LDL cholesterol levels also tend to increase during pregnancy, reaching their peak in the third trimester.
- HDL (Good) Cholesterol: HDL cholesterol levels generally increase throughout pregnancy, providing some protection against the rise in LDL cholesterol.
- Triglycerides: Triglyceride levels can increase significantly during pregnancy, particularly in the third trimester.
These changes in cholesterol and triglyceride levels are a normal physiological response to support the increased metabolic demands and fetal development during pregnancy.
Cholesterol Management During Pregnancy
While the elevated cholesterol levels during pregnancy are generally not a cause for concern, it’s still important to monitor them and make appropriate lifestyle adjustments:
- Diet: Pregnant women should focus on a balanced, heart-healthy diet that is low in saturated and trans fats, and high in fiber, fruits, vegetables, and lean protein sources.
- Physical Activity: Regular, moderate-intensity exercise, such as walking, swimming, or prenatal yoga, can help manage cholesterol levels and support overall maternal health.
- Weight Gain: Maintaining a healthy weight gain during pregnancy, as recommended by your healthcare provider, can help prevent excessive increases in cholesterol and triglyceride levels.
- Medication: Cholesterol-lowering medications are generally not recommended during pregnancy, as their safety for the developing fetus has not been fully established. Your healthcare provider may suggest alternative approaches to manage high cholesterol if necessary.
- Postpartum Monitoring: After giving birth, it’s important to continue monitoring your cholesterol levels and work with your healthcare provider to ensure they return to a healthy range.
By adopting a healthy lifestyle and working closely with your healthcare team, you can effectively manage your cholesterol levels during pregnancy and support the health of both you and your baby.
Cholesterol and Aging
As we age, our cholesterol levels can undergo significant changes, which can impact our overall health and risk of cardiovascular disease. Understanding the relationship between cholesterol and aging is crucial for maintaining good heart health throughout the lifespan.
Changes in Cholesterol with Age
Cholesterol levels tend to change as we get older:
- Total Cholesterol: Total cholesterol levels generally increase with age, particularly in men. This is due to a combination of factors, including decreased liver function and changes in diet and physical activity.
- LDL (Bad) Cholesterol: LDL cholesterol levels also tend to rise with age, contributing to the increased risk of heart disease in older adults.
- HDL (Good) Cholesterol: HDL cholesterol levels may decrease with age, particularly in women, further increasing the risk of cardiovascular disease.
- Triglycerides: Triglyceride levels can also increase with age, often in conjunction with other changes in cholesterol levels.
These age-related changes in cholesterol can significantly impact an individual’s risk of developing heart disease, stroke, and other cardiovascular conditions as they get older.
Managing Cholesterol in Older Adults
Maintaining healthy cholesterol levels is just as important for older adults as it is for younger individuals. Here are some key strategies for managing cholesterol as you age:
- Healthy Diet: Older adults should focus on a heart-healthy diet that is low in saturated and trans fats, and high in fiber, fruits, vegetables, and lean protein sources.
- Regular Exercise: Regular physical activity, such as brisk walking, swimming, or low-impact aerobic exercises, can help improve cholesterol levels and overall cardiovascular health in older adults.
- Weight Management: Maintaining a healthy weight or losing any excess weight can help lower LDL cholesterol and triglyceride levels in older adults.
- Medication: If lifestyle changes alone are not enough to manage high cholesterol, your healthcare provider may prescribe cholesterol-lowering medications, such as statins, to help reduce your risk of heart disease.
- Regular Monitoring: Older adults should have their cholesterol levels checked regularly, as recommended by their healthcare provider, to ensure they remain within a healthy range.
By working closely with your healthcare team and adopting a proactive approach to managing your cholesterol as you age, you can significantly reduce your risk of developing cardiovascular diseases and maintain good heart health throughout your later years.
Cholesterol and Children
Cholesterol levels are not just a concern for adults; they can also be an important consideration for children and adolescents. Understanding the role of chol esterol in children’s health is crucial for promoting lifelong cardiovascular well-being.
Cholesterol Levels in Children
Cholesterol levels in children can vary depending on age, gender, and other factors. Generally, the recommended cholesterol levels for children are:
- Total Cholesterol: Less than 170 mg/dL
- LDL (Bad) Cholesterol: Less than 110 mg/dL
- HDL (Good) Cholesterol: Greater than 45 mg/dL
- Triglycerides: Less than 75 mg/dL for children under 9 years old, and less than 90 mg/dL for children aged 9-19 years
It’s important to note that these guidelines may vary slightly depending on the healthcare provider and the child’s individual circumstances.
Causes of High Cholesterol in Children
There are several factors that can contribute to high cholesterol levels in children, including:
- Genetics: Some children may have a genetic predisposition to high cholesterol, a condition known as familial hypercholesterolemia.
- Diet: Consuming a diet high in saturated and trans fats, as well as added sugars, can lead to elevated cholesterol levels in children.
- Obesity: Excess weight, particularly around the abdomen, can increase a child’s risk of developing high cholesterol and other cardiovascular risk factors.
- Lack of Physical Activity: Sedentary lifestyles and insufficient physical activity can contribute to the development of high cholesterol in children.
- Underlying Medical Conditions: Certain medical conditions, such as diabetes, hypothyroidism, and kidney disease, can also affect cholesterol levels in children.
Early identification and management of high cholesterol in children are crucial to prevent the development of cardiovascular disease later in life.
Screening and Diagnosis
The American Academy of Pediatrics recommends that all children have their cholesterol levels checked at least once between the ages of 9 and 11, and again between the ages of 17 and 21. Children with a family history of high cholesterol or other risk factors may need more frequent screening.
If a child’s cholesterol levels are found to be outside the recommended range, further testing and evaluation by a healthcare provider may be necessary to determine the underlying cause and develop an appropriate treatment plan.
Managing High Cholesterol in Children
The primary approach to managing high cholesterol in children is through lifestyle modifications, including:
- Healthy Diet: Encouraging a diet low in saturated and trans fats, and high in fruits, vegetables, whole grains, and lean protein sources.
- Regular Physical Activity: Promoting at least 60 minutes of moderate-to-vigorous physical activity per day, such as brisk walking, swimming, or sports.
- Weight Management: Helping children maintain a healthy weight through a balanced diet and regular exercise.
In some cases, healthcare providers may also recommend cholesterol-lowering medications, such as statins, for children with very high cholesterol levels or those with a strong family history of heart disease. However, the use of these medications in children is typically reserved for more severe cases and is closely monitored by the healthcare team.
By addressing high cholesterol in children early on, parents and healthcare providers can help set the stage for a lifetime of good cardiovascular health and reduce the risk of developing heart disease later in life.
Cholesterol and Menopause
Menopause, the natural transition in a woman’s life when her menstrual periods cease, can have a significant impact on her cholesterol levels. Understanding the relationship between cholesterol and menopause is crucial for maintaining good heart health during this phase of life.
Changes in Cholesterol During Menopause
As women go through menopause, their cholesterol levels can undergo several changes:
- Total Cholesterol: Total cholesterol levels tend to increase during and after menopause, often reaching their highest levels in the years following the cessation of menstrual periods.
- LDL (Bad) Cholesterol: LDL cholesterol levels also typically rise during and after menopause, contributing to the increased risk of heart disease in postmenopausal women.
- HDL (Good) Cholesterol: HDL cholesterol levels may decrease after menopause, further exacerbating the imbalance between LDL and HDL cholesterol.
- Triglycerides: Triglyceride levels can also increase during and after menopause, adding to the overall cardiovascular risk profile.
These changes in cholesterol levels are largely due to the hormonal shifts that occur during the menopausal transition, particularly the decline in estrogen production.
Menopause and Cardiovascular Disease Risk
The changes in cholesterol levels that occur during and after menopause can significantly increase a woman’s risk of developing cardiovascular diseases, such as coronary artery disease, heart attack, and stroke. This increased risk is primarily due to the following factors:
- Unfavorable Cholesterol Profile: The rise in LDL cholesterol and the decrease in HDL cholesterol create an unfavorable cholesterol profile that promotes the buildup of plaque in the arteries.
- Hormonal Changes: The decline in estrogen production during menopause can also have direct effects on the cardiovascular system, contributing to the increased risk of heart disease.
- Other Risk Factors: Menopausal women may also experience other risk factors for cardiovascular disease, such as weight gain, high blood pressure, and insulin resistance, further compounding their heart health concerns.
Proactive management of cholesterol levels and other cardiovascular risk factors is crucial for postmenopausal women to maintain good heart health and reduce their risk of developing serious cardiovascular conditions.
Managing Cholesterol During and After Menopause
Women going through menopause can take several steps to manage their cholesterol levels and reduce their risk of heart disease:
- Healthy Diet: Adopting a heart-healthy diet that is low in saturated and trans fats, and high in fiber, fruits, vegetables, and lean protein sources can help improve cholesterol levels.
- Regular Exercise: Engaging in regular physical activity, such as brisk walking, swimming, or low-impact aerobic exercises, can help raise HDL cholesterol and lower LDL cholesterol and triglycerides.
- Weight Management: Maintaining a healthy weight or losing any excess weight can help improve cholesterol and other cardiovascular risk factors in postmenopausal women.
- Hormone Therapy: In some cases, hormone replacement therapy (HRT) may be considered to help manage the hormonal changes associated with menopause and their impact on cholesterol levels.
- Medication: If lifestyle changes alone are not enough to manage high cholesterol, healthcare providers may prescribe cholesterol-lowering medications, such as statins, to help reduce the risk of heart disease.
- Regular Monitoring: Postmenopausal women should have their cholesterol levels checked regularly, as recommended by their healthcare provider, to ensure they remain within a healthy range.
By taking a proactive and comprehensive approach to managing cholesterol during and after menopause, women can significantly reduce their risk of developing cardiovascular diseases and maintain good heart health throughout this important transition in their lives.
Cholesterol and Ethnicity
Cholesterol levels can vary among different ethnic and racial groups, highlighting the importance of understanding these differences and their potential impact on cardiovascular health.
Cholesterol Levels Across Ethnicities
Research has shown that there are some notable differences in cholesterol levels among various ethnic and racial groups:
- African Americans: On average, African Americans tend to have higher levels of LDL (bad) cholesterol and lower levels of HDL (good) cholesterol compared to other ethnic groups.
- Hispanic/Latino Americans: Hispanic and Latino Americans often have higher levels of triglycerides and lower levels of HDL cholesterol compared to non-Hispanic white Americans.
- Asian Americans: Some studies have suggested that certain Asian American subgroups, such as those of Chinese or South Asian descent, may have higher rates of elevated LDL cholesterol and lower HDL cholesterol levels.
- Native Americans: Native American populations have been found to have higher rates of elevated triglycerides and lower HDL cholesterol levels compared to other ethnic groups.
These differences in cholesterol profiles can contribute to the varying rates of cardiovascular disease observed among different ethnic and racial groups.
Factors Contributing to Cholesterol Differences
The reasons for the disparities in cholesterol levels across ethnicities are multifaceted and can include a combination of genetic, environmental, and socioeconomic factors:
- Genetic Factors: Certain genetic variations and predispositions may influence an individual’s susceptibility to high cholesterol and associated cardiovascular diseases.
- Dietary Patterns: Cultural and regional differences in dietary habits, such as the consumption of certain foods high in saturated and trans fats, can impact cholesterol levels.
- Physical Activity Levels: Variations in physical activity patterns and exercise habits among different ethnic groups can contribute to differences in cholesterol profiles.
- Socioeconomic Status: Factors such as access to healthcare, education, and healthy food options can also play a role in the cholesterol levels of different ethnic and racial groups.
Understanding these factors is crucial for healthcare providers to develop tailored strategies for cholesterol management and cardiovascular disease prevention in diverse populations.
Addressing Cholesterol Disparities
To address the disparities in cholesterol levels and cardiovascular disease risk among different ethnic and racial groups, a multifaceted approach is necessary:
- Culturally Sensitive Interventions: Developing and implementing cholesterol management programs that are culturally relevant and tailored to the specific needs and preferences of different ethnic communities.
- Improved Access to Healthcare: Ensuring that all individuals, regardless of their ethnic or racial background, have access to quality healthcare services, including regular cholesterol screenings and appropriate treatment options.
- Education and Awareness: Promoting educational campaigns and outreach efforts to increase awareness about the importance of cholesterol management and cardiovascular health within diverse communities.
- Collaborative Research: Encouraging and supporting research that explores the underlying genetic, environmental, and socioeconomic factors contributing to cholesterol disparities, with the goal of developing more effective prevention and treatment strategies.
By addressing these disparities and taking a comprehensive, culturally sensitive approach to cholesterol management, healthcare providers and policymakers can help reduce the burden of cardiovascular disease and promote better health outcomes for individuals of all ethnic and racial backgrounds.
Cholesterol and Genetics
Genetics play a significant role in an individual’s cholesterol levels and their risk of developing cardiovascular diseases. Understanding the genetic factors that influence cholesterol can help inform personalized prevention and management strategies.
Genetic Factors Affecting Cholesterol
Several genetic variations and mutations can contribute to the development of high cholesterol, including:
- Familial Hypercholesterolemia (FH): This genetic condition is characterized by extremely high levels of LDL (bad) cholesterol, often from birth. FH is caused by mutations in genes responsible for regulating cholesterol metabolism.
- Polygenic Hypercholesterolemia: This type of high cholesterol is caused by the combined effect of multiple genetic variants, each with a small impact on cholesterol levels.
- Genetic Variants Affecting Cholesterol Metabolism: Certain genetic variations can influence the production, absorption, or clearance of cholesterol in the body, leading to high or low cholesterol levels.
Individuals with a strong family history of high cholesterol or early-onset cardiovascular disease may be at an increased risk of having an underlying genetic predisposition to the condition.
Genetic Testing and Cholesterol Management
Genetic testing can play a valuable role in the management of high cholesterol and the prevention of cardiovascular diseases:
- Identification of Genetic Conditions: Genetic testing can help diagnose conditions like familial hypercholesterolemia, allowing for early intervention and targeted treatment approaches.
- Personalized Risk Assessment: Understanding an individual’s genetic profile can help healthcare providers better assess their risk of developing high cholesterol and cardiovascular disease, enabling more personalized prevention and management strategies.
- Tailored Treatment Approaches: Genetic information can guide the selection of cholesterol-lowering medications and help predict an individual’s response to certain treatments, allowing for more effective management of high cholesterol.
- Cascade Screening: Genetic testing can also identify family members who may be at risk of inherited high cholesterol, enabling early detection and intervention within the family.
By incorporating genetic testing and information into the management of high cholesterol, healthcare providers can take a more personalized and proactive approach to reducing an individual’s risk of developing cardiovascular diseases.
Lifestyle Modifications for Genetically-Influenced Cholesterol
Even for individuals with a genetic predisposition to high cholesterol, lifestyle modifications can still play a crucial role in managing their cholesterol levels and reducing their cardiovascular disease risk:
- Healthy Diet: Adopting a heart-healthy diet low in saturated and trans fats, and high in fiber, fruits, vegetables, and lean protein sources can help lower cholesterol levels, regardless of genetic factors.
- Regular Exercise: Engaging in regular physical activity, such as aerobic exercise and strength training, can help improve cholesterol profiles and overall cardiovascular health, even in those with a genetic predisposition to high cholesterol.
- Weight Management: Maintaining a healthy weight or losing any excess weight can help mitigate the impact of genetic factors on cholesterol levels and reduce the risk of cardiovascular disease.
- Medication Management: For individuals with a strong genetic component to their high cholesterol, healthcare providers may recommend more aggressive treatment with cholesterol-lowering medications, such as statins, to help manage their elevated risk.
By combining genetic information with a comprehensive approach to lifestyle modifications and medical management, individuals with a genetic predisposition to high cholesterol can take proactive steps to protect their heart health and reduce their risk of developing cardiovascular diseases.
Cholesterol and Mental Health
Emerging research suggests that there may be a connection between cholesterol levels and mental health, highlighting the importance of considering the potential impact of cholesterol on overall well-being.
Cholesterol and Depression
Several studies have explored the relationship between cholesterol levels and the risk of depression:
- Low HDL (Good) Cholesterol: Some research has indicated that low levels of HDL cholesterol may be associated with an increased risk of depression, particularly in older adults.
- High LDL (Bad) Cholesterol: High levels of LDL cholesterol may also be linked to an increased risk of depression, although the evidence is less consistent.
The exact mechanisms behind the relationship between cholesterol and depression are not fully understood, but some proposed explanations include:
- Inflammation: Both high cholesterol and depression have been associated with increased inflammation in the body, which may contribute to the development of both conditions.
- Neurotransmitter Regulation: Cholesterol may play a role in the regulation of neurotransmitters, such as serotonin, which are involved in mood regulation and the development of depression.
- Vascular Effects: High cholesterol can contribute to the narrowing and hardening of blood vessels, which may impact blood flow and oxygen delivery to the brain, potentially affecting mood and cognitive function.
It’s important to note that the relationship between cholesterol and depression is complex, and more research is needed to fully understand the underlying mechanisms and establish causality.
Cholesterol and Cognitive Function
In addition to the potential link with depression, cholesterol levels have also been studied in relation to cognitive function and the risk of dementia:
- High Midlife Cholesterol: Some studies have suggested that high cholesterol levels in middle age may be associated with an increased risk of developing Alzheimer’s disease and other forms of dementia later in life.
- Low HDL Cholesterol: Low levels of HDL cholesterol have been linked to poorer cognitive performance and an increased risk of cognitive decline and dementia.
- Vascular Effects: As with depression, the vascular effects of high cholesterol, such as the narrowing and hardening of blood vessels, may also contribute to cognitive impairment by reducing blood flow and oxygen delivery to the brain.
However, the relationship between cholesterol and cognitive function is complex, and other factors, such as age, genetics, and overall cardiovascular health, also play a role in the development of cognitive decline and dementia.
Addressing Cholesterol and Mental Health
Given the potential links between cholesterol and mental health, it’s important to consider the following strategies:
- Comprehensive Cholesterol Management: Adopting a comprehensive approach to managing cholesterol levels, including a healthy diet, regular exercise, and, if necessary, cholesterol-lowering medications, may have positive impacts on both physical and mental health.
- Screening and Monitoring: Regular screening and monitoring of cholesterol levels, as well as mental health assessments, can help identify any potential connections and guide appropriate interventions.
- Integrated Care: Collaboration between healthcare providers, such as cardiologists, primary care physicians, and mental health professionals, can help ensure a holistic approach to managing the potential interplay between cholesterol and mental health.
- Lifestyle Interventions: Promoting healthy lifestyle habits, such as a balanced diet, regular physical activity, and stress management techniques, may have benefits for both physical and mental well-being.
By considering the potential links between cholesterol and mental health, and taking a comprehensive approach to managing both, individuals can work towards optimizing their overall health and well-being.
Cholesterol and Liver Health
The liver plays a crucial role in the production, regulation, and metabolism of cholesterol, highlighting the importance of understanding the relationship between cholesterol and liver health.
The Liver’s Role in Cholesterol Metabolism
The liver is the primary organ responsible for the production and regulation of cholesterol in the body. It performs the following key functions related to cholesterol:
- Cholesterol Synthesis: The liver is the main site of cholesterol production, synthesizing the majority of the body’s cholesterol.
- Cholesterol Regulation: The liver regulates cholesterol levels by controlling the production, uptake, and excretion of cholesterol through various metabolic pathways.
- Bile Acid Production: The liver produces bile acids, which are necessary for the digestion and absorption of dietary fats, including cholesterol.
- Cholesterol Excretion: The liver is responsible for the removal of excess cholesterol from the body, primarily through the production of bile acids and their excretion in the bile.
Given the liver’s central role in cholesterol metabolism, any liver dysfunction or disease can have a significant impact on an individual’s cholesterol levels and overall cardiovascular health.
Liver Diseases and Cholesterol
Various liver diseases and conditions can affect cholesterol levels in different ways:
- Nonalcoholic Fatty Liver Disease (NAFLD): NAFLD is characterized by the accumulation of fat in the liver, which can lead to inflammation and liver damage. NAFLD is often associated with insulin resistance and metabolic syndrome, which can contribute to changes in cholesterol levels, including elevated triglycerides and low HDL cholesterol.
- Cirrhosis: Cirrhosis, or the scarring and hardening of the liver, can impair the liver’s ability to regulate cholesterol metabolism, leading to changes in cholesterol levels, such as decreased HDL cholesterol and increased LDL cholesterol.
- Biliary Obstruction: Conditions that obstruct the bile ducts, such as gallstones or bile duct cancer, can disrupt the liver’s ability to excrete bile acids, which can result in elevated cholesterol levels.
- Liver Cancer: Certain types of liver cancer, such as hepatocellular carcinoma, can also affect cholesterol metabolism and lead to changes in cholesterol levels.
It’s important to note that the specific effects of liver diseases on cholesterol can vary, and the relationship is often complex, with other factors, such as diet, genetics, and overall health status, also playing a role.
Managing Cholesterol in Liver Disease
Individuals with liver disease or dysfunction may require a tailored approach to managing their cholesterol levels:
- Dietary Modifications: Adopting a heart-healthy diet that is low in saturated and trans fats, and high in fiber, fruits, vegetables, and lean protein sources can help manage cholesterol levels in those with liver disease.
- Medication Considerations: Certain cholesterol-lowering medications, such as statins, may need to be used with caution or adjusted in individuals with liver disease, as the liver’s ability to metabolize these drugs may be impaired.
- Liver-Targeted Treatments: In some cases, treatments that specifically target the underlying liver condition, such as medications for NAFLD or surgical interventions for biliary obstruction, may also help improve cholesterol levels.
- Regular Monitoring: Individuals with liver disease should have their cholesterol levels monitored regularly, and work closely with their healthcare team to manage any changes in their cholesterol profile.
By addressing the underlying liver condition and taking a comprehensive approach to cholesterol management, individuals with liver disease can help protect their overall cardiovascular health and reduce their risk of related complications.
Cholesterol and Cancer
Emerging research has suggested a potential link between cholesterol levels and the risk of certain types of cancer, highlighting the importance of understanding this relationship and its implications for overall health.
Cholesterol and Cancer Risk
Several studies have explored the association between cholesterol levels and the risk of developing various types of cancer:
- Prostate Cancer: Some research has indicated that higher levels of LDL (bad) cholesterol may be associated with an increased risk of prostate cancer, particularly more aggressive forms of the disease.
- Breast Cancer: The relationship between cholesterol and breast cancer risk is more complex, with some studies suggesting a link between low HDL (good) cholesterol and an increased risk of breast cancer, especially in postmenopausal women.
- Colorectal Cancer: Elevated levels of LDL cholesterol and triglycerides have been linked to a higher risk of colorectal cancer in some studies, though the evidence is not as consistent as for prostate and breast cancer.
- Liver Cancer: High cholesterol levels, particularly elevated LDL cholesterol, have been associated with an increased risk of developing hepatocellular carcinoma, the most common type of liver cancer.
It’s important to note that the relationship between cholesterol and cancer is complex and not fully understood, with various factors, such as genetics, lifestyle, and other health conditions, also playing a role in cancer development.
Potential Mechanisms Linking Cholesterol and Cancer
Several proposed mechanisms have been suggested to explain the potential link between cholesterol and cancer:
- Inflammation: Both high cholesterol and cancer have been associated with increased inflammation in the body, which may contribute to the development and progression of both conditions.
- Oxidative Stress: Elevated cholesterol levels can lead to increased oxidative stress, which can damage cells and DNA, potentially contributing to the development of cancer.
- Cell Signaling: Cholesterol and its metabolites may influence various cell signaling pathways involved in cell growth, proliferation, and survival, which could impact cancer development and progression.
- Hormone Regulation: Cholesterol is a precursor for the synthesis of steroid hormones, and disruptions in hormone regulation have been linked to certain types of cancer, such as prostate and breast cancer.
While these proposed mechanisms provide some insight into the potential links between cholesterol and cancer, more research is needed to fully understand the underlying relationships and their clinical implications.
Cholesterol Management and Cancer Prevention
Given the potential connections between cholesterol and cancer, it’s important to consider the following strategies:
- Comprehensive Cholesterol Management: Maintaining healthy cholesterol levels through a combination of dietary changes, regular exercise, and, if necessary, cholesterol-lowering medications may have benefits for both cardiovascular and cancer risk reduction.
- Regular Screening and Monitoring: Regular screening and monitoring of cholesterol levels, as well as cancer screening tests, can help identify any potential connections and guide appropriate interventions.
- Integrated Care: Collaboration between healthcare providers, such as cardiologists, oncologists, and primary care physicians, can help ensure a holistic approach to managing the potential interplay between cholesterol and cancer risk.
- Lifestyle Interventions: Promoting healthy lifestyle habits, such as a balanced diet, regular physical activity, and maintaining a healthy weight, may have benefits for both cholesterol management and cancer prevention.
By considering the potential links between cholesterol and cancer, and taking a comprehensive approach to managing both, individuals can work towards optimizing their overall health and reducing their risk of developing these serious conditions.
Cholesterol and COVID-19
The COVID-19 pandemic has brought to light the potential connections between cholesterol levels and the severity of the disease, highlighting the importance of understanding this relationship and its implications for public health.
Cholesterol and COVID-19 Severity
Several studies have explored the relationship between cholesterol levels and the severity of COVID-19 infections:
- Low LDL (Bad) Cholesterol: Research has suggested that lower levels of LDL cholesterol may be associated with more severe COVID-19 illness and a higher risk of hospitalization and mortality.
- Low HDL (Good) Cholesterol: Similarly, low levels of HDL cholesterol have been linked to an increased risk of severe COVID-19 outcomes, including the need for mechanical ventilation and a higher mortality rate.
- Triglyceride Levels: Elevated triglyceride levels have also been observed in individuals with severe COVID-19 infections, potentially contributing to the overall cardiovascular risk profile.
The exact mechanisms behind the relationship between cholesterol and COVID-19 severity are not yet fully understood, but several hypotheses have been proposed, including the potential role of cholesterol in viral entry, immune response, and inflammation.
Cholesterol, COVID-19, and Cardiovascular Risk
The COVID-19 pandemic has also highlighted the importance of managing underlying cardiovascular risk factors, including high cholesterol, in the context of the disease:
- Increased Cardiovascular Complications: COVID-19 has been associated with an increased risk of cardiovascular complications, such as myocarditis, heart failure, and stroke, particularly in individuals with pre-existing cardiovascular conditions, including high cholesterol.
- Disruption of Cholesterol Management: The COVID-19 pandemic has also led to disruptions in healthcare access and routine cholesterol monitoring, which may have resulted in suboptimal management of high cholesterol for some individuals.
- Importance of Proactive Cholesterol Management: The COVID-19 pandemic has underscored the importance of maintaining good cardiovascular health, including through the management of high cholesterol, to reduce the risk of severe COVID-19 outcomes and related complications.
By understanding the potential connections between cholesterol, COVID-19, and cardiovascular health, individuals and healthcare providers can take a more proactive and comprehensive approach to managing these interrelated conditions during the pandemic and beyond.
Cholesterol Management Strategies in the COVID-19 Era
To address the challenges posed by the COVID-19 pandemic in the context of cholesterol management, the following strategies may be considered:
- Telehealth and Remote Monitoring: Increased utilization of telehealth services and remote cholesterol monitoring can help ensure continuity of care and facilitate the management of high cholesterol during periods of limited in-person healthcare access.
- Medication Adherence: Encouraging and supporting individuals to maintain adherence to their cholesterol-lowering medications, even during the pandemic, can help prevent the worsening of their cardiovascular risk profile.
- Lifestyle Modifications: Promoting healthy lifestyle habits, such as a balanced diet, regular physical activity, and stress management, can help individuals manage their cholesterol levels and overall cardiovascular health during the COVID-19 pandemic.
- Integrated Care Coordination: Collaboration between healthcare providers, including cardiologists, primary care physicians, and public health experts, can help ensure a comprehensive and coordinated approach to managing cholesterol and cardiovascular health in the context of the COVID-19 pandemic.
By implementing these strategies and maintaining a proactive approach to cholesterol management, individuals and healthcare systems can work to mitigate the potential impacts of the COVID-19 pandemic on cardiovascular health and overall well-being.
Cholesterol and Kidney Health
The relationship between cholesterol and kidney health is complex, with both conditions often coexisting and influencing each other. Understanding this connection is crucial for maintaining overall health and preventing the development of chronic kidney disease and other related complications.
The Link Between Cholesterol and Kidney Disease
High cholesterol levels and kidney disease can have a bidirectional relationship, where one condition can contribute to the development or worsening of the other:
- High Cholesterol and Kidney Disease: Elevated levels of LDL (bad) cholesterol and triglycerides have been associated with an increased risk of developing chronic kidney disease, as well as the progression of existing kidney disease. The underlying mechanisms may involve inflammation, oxidative stress, and the accumulation of cholesterol-rich deposits in the kidneys.
- Kidney Disease and Cholesterol: Chronic kidney disease can also lead to changes in cholesterol levels, including increased LDL cholesterol and decreased HDL (good) cholesterol. This is