The Truth About Cholesterol

Dr. Osborn differentiates between "good cholesterol" (HDL) and "bad cholesterol" (LDL) and offers some strategies to better your lipid profile and minimize your risk for vascular disease, the most common cause of death worldwide.

Today we’re going to talk about cholesterol because there is so much confusion on the topic. But it’s really not that difficult to understand when you look at it from 30,000 feet. So, there’s “Good Cholesterol” and there’s “Bad cholesterol.”

Think of HDL cholesterol as the "good guy." It helps remove excess cholesterol from our bloodstream and takes it back to the liver for disposal. High levels of HDL cholesterol lower the risk of heart disease by preventing plaque buildup in our arteries. LDL cholesterol, on the other hand, is the "bad guy." It deposits cholesterol in our arteries in a reparative manner at sites of damage – from chronically high blood pressure, for example. Although this is well-intended, this repair process causes plaque buildup and can block blood flow. High LDL cholesterol levels increase the risk of heart disease, heart attacks, and strokes when there is arterial damage and inflammation. So, it’s not the LDL cholesterol itself that causes the problem. That’s a myth. So you don’t need to take a statin, for example, to drive your LDL levels down if you are otherwise healthy.

Some people, myself included, have a genetic predisposition to higher rather than lower LDL levels at baseline. Am I worried? Not in the least. That said, I would suggest keeping LDL levels within a reasonable range by exercising regularly, eating cleanly and avoiding unhealthy trans fats. Replace them with omega-3 and omega-9 rich foods such as cold water fish, walnuts, and avocadoes. As always, surveillance is key. Get regular check-ups with your doctor and consider getting a VAP (“V A P”) test – that will provide additional information about your blood fats - if you have high total cholesterol and a family history of heart disease or stroke. As is always the case, health is about risk factor identification, modification and repeating the process. It’s just that simple…