Q: What's the difference between "good" and "bad" cholesterol?

A: What is cholesterol? Cholesterol is a type of fat made by your liver. Some cholesterol comes from the food that you eat. Foods that come from animals – such as eggs, meat and dairy products – have cholesterol in them. Foods that come from plants don't have cholesterol. But it's not just the cholesterol in foods that counts. Foods high in saturated fat (hydrogenated vegetable fats, tropical fats (coconut and palm oil), and animal fats) can also raise your cholesterol level.

Why is a high cholesterol level unhealthy?

Some cholesterol is needed for good health. But too much cholesterol in your blood can raise your risk of having a heart attack or stroke. The extra cholesterol in your blood may be stored in you arteries (large blood vessels) and cause them to narrow. Large deposits of cholesterol can completely block an artery.

If an artery that supplies blood to your heart becomes blocked, a heart attack occurs. If an artery that supplies blood to your brain becomes blocked, a stroke occurs.

Cholesterol travels through the blood in different types of packages called lipoproteins. Low-density lipoproteins (LDL) deliver cholesterol to the body, and high-density lipoproteins (HDL) remove cholesterol from the bloodstream.
Too much LDL cholesterol is bad for the body because it builds up in the arteries, while the HDL form is good because it helps remove cholesterol from the bloodstream. It's the balance between the different forms of cholesterol that tells you what your cholesterol level means.

When should I start having my cholesterol level checked?

Talk to your family doctor to see whether you should have your cholesterol tested.
How often you have your cholesterol level checked depends on your family history and what other risk factors for heart disease you have. If your cholesterol is up, your family doctor can also advise you when to have follow-up cholesterol levels done.

What should my cholesterol level be?

Your doctor will measure your cholesterol level. If the total level is high, a second test may be done to measure the levels of HDL and LDL.

If your total level is high because of a high LDL level, you may be at higher risk of heart disease or stroke. If your total level is high only because of a high HDL level, you're not at higher risk.

For more information on this and other health topics, visit the College of Family Physicians of Canada's (CFPC's) Web site www.cfpc.ca or talk to your family doctor.

If you have questions on this or other health topics you'd like to see addressed in future articles, please e-mail healthtopics@CFPC.ca.