Good vs. Bad Cholesterol

Just uttering the word “cholesterol” can conjure up some frightening images: of waiting rooms, vials of blood, incomprehensible test results, and a scary prognosis from the doctor.

Though having high cholesterol is something most of us have grown to fear, there are actually two types: good and bad. For decades, health professionals have advised patients to keep a balance in their levels of HDL and LDL cholesterol, which can have a tremendous impact on your health.

We’re pulling back the curtain to take a closer look at both types of cholesterol.

What is cholesterol?

Cholesterol is a fat-like substance found in most of the body’s cells. It plays an important role in your health by creating hormones and synthesizing vitamin D, but certain types of it can also trigger some serious problems—particularly to the heart and circulatory system. When high levels build up in the blood, it begins to cling to the artery walls. This starts to narrow and clog the arteries, making it harder for blood to flow freely—a condition known as atherosclerosis. When blog clots form, they can get stuck in the thin passageways, and potentially cause heart attacks and strokes.

Good cholesterol

Good cholesterol is called high-density lipoprotein cholesterol, or HDL. Here are the key things to understand about HDL:

• Your body needs it to create hormones and vitamin D, as well as various compounds that aid in digestion.
• Your body actually creates all of the cholesterol it requires to function in a healthy way.
• HDL cholesterol carries LDL cholesterol (more on that below) to the liver from other areas of the body, where it’s removed. Higher levels of HDL can reduce the overall risk of heart attacks.

Generally speaking, the higher your HDL, the better. An HDL level of 60 milligrams or above are considered healthy; 40 milligrams or lower could put you at risk for developing complications.

Some conditions—like diabetes, a sedentary lifestyle—stop the body from producing enough HDL. And some people have such high levels of LDL, or bad, cholesterol that they need more HDL to balance it out.

Bad cholesterol

Low-density lipoprotein cholesterol (LDL), or bad cholesterol, on the other hand, can be incredibly dangerous. Here’s what you need to know:

• LDL cholesterol deposits itself on the walls of the arteries, which leads to a buildup of plaque, clogging and narrowing them in the process. The thick, brittle buildup makes it difficult for blood to move through the body—and that can lead to high blood pressure, heart disease, heart attacks, strokes, and other serious health concerns.
• As mentioned above, the body produces all the cholesterol it needs on its own, and it’ll never produce too much LDL. Instead, excess LDL comes from external food sources that are high in saturated fats, like chips, burgers, and fries. Lifestyle changes can really help keep LDL levels in check.
• In general, high LDL cholesterol levels don’t come with noticeable symptoms. Instead, the diseases and health conditions they cause (like a heart attack or stroke) will be the first sign of an issue—and at that point, the damage has already been done.

When a doctor tells you to “lower your cholesterol,” this is what he or she is talking about. A level of 100 milligrams or less is considered healthy, and anything above 130 milligrams is considered high.

Because LDL primarily comes from foods that are high in saturated fat, paying attention to what you eat is a key part of lowering your levels. But there’s also much more to it than that.

Balancing your cholesterol levels

So, it’s not only important to lower your bad cholesterol; you also need to increase the good. This is a tricky balancing act, and it seems really complicated. Luckily, many of the actions that help reduce bad cholesterol can also boost its good counterpart. Here are some ways to kill two birds with one stone as you work toward balancing your cholesterol levels and getting healthier.

• Lose weight. If you’re overweight, dropping a few pounds could help you improve your cholesterol dramatically. In fact, for every six pounds you drop, HDL could increase by 1 milligram.
• Reduce your intake of fats overall. The fact is that you need to choose healthier fats and a more balanced diet. According to most heart-healthy diets—which focus on cholesterol as well—your daily calorie intake should be about 25 to 35 percent fats. Saturated fats should make up less than 7 percent of your calorie intake for the day.
• Eat more omega-3s. Add foods rich in these fatty acids like olive or peanut oil, nuts, and fish into your diet. These are the best sources of healthy fats, and provide other minerals and vitamins that can improve your health and wellbeing.
• Get active. Physical activity makes a huge difference when you’re trying to improve cholesterol. Recent studies show that within two months of beginning frequent aerobic exercise and sticking with it, your HDL can increase by as much as 5 percent, and possibly lower LDL levels, too. You don’t have to go crazy with the exercise, either. Brisk exercise for 30 minutes a day, five times a week is all it takes. Biking, swimming, walking, and even chores mowing the lawn and raking leaves all count.
• Quit smoking. Giving up cigarettes can help reduce your levels of bad cholesterol dramatically, while boosting good cholesterol by as much as 10 percent. With the help of gums, patches, and even pills, it might be easier than you think to kick the habit.
• Pay attention to your drinking habits. Recent research suggests that moderate alcohol use can actually improve levels of good cholesterol. But you don’t want to go overboard—one to two drinks per day, max, is healthiest.
• Look into medication. Your doctor may also suggest prescription drugs to help control your cholesterol levels. Statins—probably the most popular drug in this category—block the substance in the liver that makes cholesterol. Niacin, a type of B vitamin, helps raise HDL and is often used in conjunction with medication that helps lower LDL.

Tips that can help you reach your goals

Making big lifestyle changes can be overwhelming—especially if you’re attempting to uproot habits you’ve followed for years. If you start feeling stressed, try one of the following tips.

• Rally support from others. You’re not in this alone, and you shouldn’t feel like it. Online support groups can be really helpful for people starting new diets, and friends and family can be invaluable as well—let those close to you know what you’re up to, and they’ll help keep you motivated.
• Be realistic. You’re not going to eradicate bad cholesterol overnight. Instead, you should plan on taking weeks or even months to get there. Remember—just because things aren’t going as fast as you would like, that doesn’t mean you’re not making progress.
• Talk to your doctor. A trusted medical professional can help guide you through this journey, too. It’s important to use online resources and plan a diet you can actually stick to, but definitely get advice from your doctor. They’ll often suggest additional steps that you might not have thought of on your own.

A healthier you

Though cholesterol isn’t something you can see or feel, your body certainly feels it when your levels are out of whack. The same strategies you’ll follow to balance your HDL and LDL will also benefit other aspects of your health. Getting plenty of exercise, losing weight, improving your diet, and quitting smoking have huge impacts on your overall fitness and wellbeing, too.

Illustration by Karley Koenig