It’s easy to assume that breast cancer is the leading cause of death among women. However, the reality is much different—heart disease is the number one killer, not only for women but for men as well. Understanding how heart disease develops and its connection to cholesterol is vital in preventing this silent threat.
In recognition of American Heart Month, we reached out to spokeswomen from the American Heart Association’s Go Red campaign to answer key questions about cholesterol, its role in heart disease, and how we can take steps to protect ourselves from heart attack and stroke.
What is Cholesterol?
Cholesterol is a waxy, fat-like substance that’s found in every cell of the body. While it’s often portrayed negatively, cholesterol is essential for the production of hormones, vitamin D, and other important substances.
“Cholesterol is a fat and a waxy substance that’s found in all the cells of our human body, and we can’t live without it,” explains Layne Lieberman, nutritionist and author of Beyond The Mediterranean Diet: European Secrets Of The Super-Healthy. “Even if you avoid cholesterol-rich foods, your body will still produce the cholesterol it needs.”
However, the issue with cholesterol comes down to the types of lipoproteins that carry it through the bloodstream: Low-Density Lipoproteins (LDL) and High-Density Lipoproteins (HDL). Of these two, LDL is considered “bad cholesterol.”
The Difference Between LDL and HDL Cholesterol
- LDL (Low-Density Lipoprotein): Often referred to as “bad cholesterol,” LDL can build up in the walls of arteries and form plaque, which can limit blood flow and oxygen to the heart. Over time, this buildup can lead to atherosclerosis—a hardening and narrowing of the arteries—which increases the risk of heart attack and stroke.
- HDL (High-Density Lipoprotein): HDL is the “good cholesterol” that helps remove cholesterol from your arteries and transport it back to the liver, where it can be processed and eliminated from the body. High levels of HDL cholesterol offer protective benefits against heart disease by clearing excess cholesterol from the bloodstream.
What Are Healthy Cholesterol Levels?
Maintaining optimal cholesterol levels is essential for heart health. According to Dr. Sara Sirna, a cardiologist at Loyola University Medical Center specializing in preventive cardiology and heart disease in women, here are the recommended numbers:
- Total Cholesterol: Less than 200 mg/dL is considered optimal. Levels above 240 mg/dL can nearly double your risk of heart disease.
- LDL Cholesterol: For those without other heart disease risk factors, the goal is to keep LDL below 130 mg/dL. If you have additional risk factors (like a family history of heart disease or high blood pressure), your doctor may recommend keeping LDL even lower.
- HDL Cholesterol: Aim for HDL levels above 60 mg/dL. Higher levels of HDL are associated with a lower risk of heart disease, as it helps remove LDL cholesterol from the bloodstream.
It’s important to note that cholesterol levels alone do not determine your total risk for heart disease. Other factors, including family history, lifestyle habits, and diet, must be considered when assessing heart disease risk.
What Can You Do to Lower Cholesterol and Protect Your Heart?
While we can’t change certain risk factors like age or genetics, there are many modifiable risk factors that we can influence. Adopting healthy habits can significantly lower cholesterol levels and reduce the risk of heart disease.
Here are expert tips from Go Red spokeswomen and cardiologists on how to protect your heart:
1. Incorporate Plant Sterols and Soluble Fiber Into Your Diet
According to Layne Lieberman, nutritionist and author, plant sterols—found naturally in foods like oats, barley, beans, lentils, and citrus fruits—help lower LDL cholesterol.
“These foods work similarly to plant sterols but are natural and accessible,” says Lieberman. “Also, make sure to get trans fats out of your diet and focus on whole foods rich in omega-3 fatty acids, like fish and flaxseed.”
2. Exercise Regularly
Physical activity is crucial for heart health. Dr. Sara Sirna recommends 150 minutes of exercise per week, which breaks down to about 30 minutes five days a week.
“The heart is a muscle, and it needs to be exercised just like any other muscle,” she explains. “It doesn’t have to be strenuous—activities like walking, swimming, or cycling can make a big difference.”
3. Choose Heart-Healthy Fats
Dr. Nieca Goldberg, medical director of the Joan H. Tisch Center for Women’s Health at NYU Langone Medical Center, emphasizes the importance of choosing the right fats for heart health.
“Opt for low-fat dairy products, use olive oil or canola oil as salad dressing, and swap out simple sugars and starches for whole grains,” says Goldberg. “This can help lower triglyceride levels and improve overall cholesterol.”
4. Eat Healthy Fats and Vegetable Proteins
For a snack, Janet Brill, award-winning author and nutritionist, recommends reaching for unsalted, dry-roasted almonds. “Almonds contain healthy fats that can lower LDL cholesterol, and beans are an excellent source of vegetable protein without the saturated fat that comes with red meat,” she explains.
Conclusion: Take Charge of Your Cholesterol and Heart Health
Understanding how cholesterol affects your heart is an important step toward preventing heart disease, heart attack, and stroke. By focusing on lowering LDL cholesterol, raising HDL cholesterol, and adopting heart-healthy lifestyle habits, you can significantly reduce your risk.
Remember, while some factors are beyond our control, many aspects of heart health—such as diet, exercise, and avoiding trans fats—are within your reach. Take the time to evaluate your cholesterol levels and make changes that will help protect your heart for years to come.