3 cholesterol myths

High cholesterol affects nearly one-third of all Americans, according to the Centers for Disease Control and Prevention, and half of them aren’t seeking treatment.

So is all cholesterol bad? Can it ever be good? How does it affect my diet?

Dr. Dean Ferrera, cardiologist on staff at Advocate South Suburban Hospital in Hazel Crest, Ill., debunks three common myths about cholesterol.

Myth 1: All cholesterol is bad
“Cholesterol is used by the body to support the structure of our cells.  We also use cholesterol to make hormones. Although we naturally make cholesterol in our liver, we do absorb it through the diet.  However, having too much cholesterol can promote disease,” he says. “In general, there are two types of cholesterol that we focus on, high density lipoprotein (HDL) and low density lipoprotein (LDL). HDL cholesterol is known as the good cholesterol. LDL is known as the bad cholesterol.”

Dr. Ferrera says that when too much LDL cholesterol or too little HDL circulates in the blood stream, it can put us at higher risk for heart attack and stroke.  That happens when the arteries become clogged with cholesterol, a disease process called atherosclerosis.

According to the American Heart Association (AHA), bad cholesterol is one of the major controllable risk factors for atherosclerosis, coronary heart disease, heart attack and stroke.

“HDL, the good cholesterol, helps prevent cholesterol from clogging the arteries,” Dr. Ferrera says. “The HDL cholesterol acts as a sponge and soaks up the cholesterol and delivers it to the liver to be disposed. Therefore, your body needs more HDL cholesterol.”

HDL can be increased through physical activity, reducing trans fats in your diet, and eating a balanced diet, advises Dr. Ferrera. He adds that for some patients this alone will not help to increase their HDL and medication may be needed.

Myth 2: Cholesterol is all about your diet.
LDL cholesterol is produced naturally by the body. Unfortunately for some, Dr. Ferrera says, they inherit a gene that causes their body to create too much LDL.

“Diet and exercise alone may not help this type of person. Other options in controlling their LDL levels may include medications such as cholesterol-lowering drugs, like statins,” he says. “Statins work in the liver to prevent the formation of cholesterol.”

Dr. Ferrera says, “We must also realize that our cholesterol levels are more influenced by the amount of consumed saturated fat than cholesterol. We have to read food labels and be sure to avoid the saturated fat, and of course trans fats.”

Myth 3: I take cholesterol lowering medication, so now I can eat anything.
“If you take a statin and continue a diet of foods that are high in saturated fat and cholesterol, the statin will not be as effective,” Dr. Ferrera says. “You still need to maintain a balanced diet in order to cooperate with the effects of the statin.  Otherwise, you and your statin are fighting an uphill battle.”

In fact, most of the major research trials that have been used to study the effectiveness of these drugs have been done on patients working to control their diet, he says.

“There have been significant changes to the cholesterol guidelines, which came out in late 2013. Overall, patients should work closely with their doctors to assess their heart disease risk and set cholesterol targets from there,” he says. “Depending upon a person’s age and risk for heart disease, the patient may need to be observed or medication therapy may be recommended.”

Dr. Ferrera adds that ultimately, we should all work to control our cholesterol levels with diet and exercise, in addition to keeping tight control on diabetes risk factors and not smoking.