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The Total Cholesterol Story

With five kinds of blood cholesterol, its no wonder the numbers get confusing. Heres yourguide to how much of which ones spell trouble.

You may already know your cholesterol numbers, but if you dont, we suggest you find out what

they are right away. And why do we say numbers instead of number? Because there are differentkinds of cholesterol and different cholesterol numbers.

Lets start with the single number called total cholesterol. You were born with a total cholesterol

level of about 70, but as soon as you started eating, it started going up, reaching about 150 by the

time you had your first birthday.

After a childs cholesterol level reaches about 150, it usually stays there until he or she is about

17 years old. Then the level starts going up again, often reaching 210 to 220the average

cholesterol level of adults in the United States, Canada, and similar cultures.

Most people around the world dont have cholesterol levels that high, however. People in many

parts of the world have total cholesterol levels around 150and they dont get coronary arterydisease. The reason: They dont eat as much saturated fat as most North Americans.

While most adults around the world have cholesterol levels under 150, half of the children in theUnited States and Canada already have cholesterol levels higher than that.

The problem has been compounded because until recently, many doctors did not become excited

about a persons total cholesterol unless it exceeded 300. In the past, some cardiology textbookssaid not to worry unless a persons total cholesterol was over 250. But we know from studies like

the Framingham Heart Study that most people in our population who suffer a heart attack have

total cholesterol levels between 200 and 250.

Much of our knowledge of how cholesterol relates to coronary heart disease comes from studies

like the Framingham study. As data from this study show, at virtually any age, the heart attackrate rises 2 percent for each 1 percent rise in total blood cholesterol. This is even true for people

over age 65.

The average total cholesterol level of a man in the Framingham Heart Study who had a heartattack in the first 16 years of the study was 244and now, that level is about 235.

Knowing Your Cholesterols

But total cholesterol isnt the only indicator of risk. You have to consider kinds of cholesterolor more precisely, ways cholesterol is shuttled about inside your body. So, there are five kinds of

cholesteroldistinguished by the little fat droplets called lipoproteins that transport thecholesterol in your blood.

The largest droplet, or particle, is called a chylomicron. These chylomicrons appear in your

blood after you eat fat. The next smaller size particle is called a very-low-density lipoprotein(VLDL). These carry not only cholesterol but also fatty substances known as triglycerides.

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Until recently many doctors thought that triglycerides were not very important in relation to heart

disease. But you should know that some people with elevated triglycerides are headed for a heart

attack, especially if their triglycerides exceed 150 and their HDL cholesterol is less than

40. But hold on. We are getting ahead of our story. The next smaller particle is the intermediary-

density lipoprotein, called IDL. These particles are dangerous if their level becomes elevated, butyou probably dont need to worry about these, because few people have this problem.

The next smaller particle is the most dangerous of all because it carries over half the cholesterolin your blood stream. This is the low-density lipoprotein, or LDL. LDL is bad and is known as

the lousy lipoprotein or bad cholesterol!

The four cholesterols we just described (chylomicron, VLDL, JDL, and LDL) are bad for youand tend to collect in your blood vessels. Fortunately there is a fifth cholesterol- and it turns out

to be good. This good cholesterol is carried by high-density lipoproteins and is therefore called

I-IDL cholesterol. HDL apparently picks up cholesterol from deposits all over the body andbrings it back to the liver, where 95 percent of the cholesterol is excreted.

No wonder HDL is known as the good or healthy cholesterol! Research shows that the higher apersons HDL level, the lower the incidence of a heart attack.