Browse Archives > Dr. Fitness Talks
Men’s Health – Getting a Better Understanding of Your Cholesterol Numbers
January 30 , 2005 by Doctor FitnessThe number one killer of men in America is heart disease. It is a main concern for all Americans as we get older. All of us know someone who has died from cardiovascular problems, either heart disease or stroke.
Cardiovascular problems claim over 1 million Americans a year.
What about cholesterol? Is it really that important?
Government statistics show that over 37 million Americans have high cholesterol, or hyperlipidemia; 40% of men have cholesterol over 200mg/dl, with 13% having cholesterol over 240 mg/dl.
Keeping Up with Medication Dosage and Frequency is Vital to Your Health
Understanding Your Test Results
Just a few years back, new guidelines were suggested, dropping the recommended levels down to the 160 mg/dl range, particularly if you have insulin resistance (NB: 100 million Americans are insulin resistant).
Changing the level at which lipids are considered elevated nearly doubled the number of Americans listed in the category of having elevated cholesterol.
Lipids are blood fats and include total cholesterol represented by the highest number (e.g. 200). LDL, low density lipoprotein, is the second highest number—(e.g.100). HDL, high density lipoprotein, is usually the third highest number (e.g. 50). VLDL, very low density lipoprotein, is often the fourth highest number and the one that is not normally listed by itself.
Most Americans don’t know what VLDL comes from and what role it plays in heart disease. VLDL is the protein carrier for triglycerides. To find yours, simply take your total triglyceride number and divide it by 5. This will give you your total VLDL. So, if you have a triglyceride reading of 100, your VLDL is 20 mg/dl.
We make VLDL into IDL (i.e Intermediate Density Lipoprotein) then into LDL, the so-called bad cholesterol.
The higher the VLDL and triglycerides, the more bad or oxidized LDL you are most likely to have. Oxidized LDL, small dense particles, adhere to the artery wall when damage is occurring.
Because cholesterol is like the glue for all our cells—it holds them together—it makes sense that cholesterol adheres to the artery wall when it has been damaged and inflammation has occurred.
Another role for cholesterol
Cholesterol has also been implicated in controlling infection or the spread of infection into neighboring cells. According to Ulf Ravnskov, M.D., Ph.D, in 19 large studies of more than 68,000 deaths, reviewed by Professor David R. Jacobs and his co-workers from the Division of Epidemiology at the University of Minnesota, low cholesterol predicted an increased risk of dying from gastrointestinal and respiratory diseases.1 Lance, what “low cholesterol” number is dangerous? 160? The new guideline number? Maybe make that connection?
Most gastrointestinal and respiratory diseases have an infectious origin. Therefore, a relevant question is whether it is the infection that lowers cholesterol or the low cholesterol that predisposes one to infection. To answer this question, Professor Jacobs and his group, together with Dr. Carlos Iribarren, followed more than 100,000 healthy individuals in the San Francisco area for fifteen years. At the end of the study, those who had low cholesterol at the start of the study had been admitted to the hospital with an infectious disease more often than those with higher cholesterol.2, 3 This finding cannot be explained away with the argument that the infection had caused cholesterol to go down: how could low cholesterol, recorded when these people were without any evidence of infection, be caused by a disease they had not yet encountered? Isn’t it more likely that low cholesterol in some way made them more vulnerable to infection, or that high cholesterol protected those who had not become infected? Much evidence exists to support the latter interpretation.
Weston A. Price Foundation/Benefits of High Cholesterol
Association of Physicians/High cholesterol may protect against infections and atherosclerosis
Just having high cholesterol does not mean you have heart disease
Just to say that you have high LDL is not an indication that you have heart disease or a risk of it.
There is a better way is to look at the relationships of lipids. This is helpful to determine if you have active infection/inflammation and possibly artery disease.
Compare your lipids
Compare the following: total cholesterol to HDL (i.e. first number/highest with third number/good cholesterol). HDL should be a minimum of 25% of the total number. A minimum. The higher the better.
Now look at triglycerides. Elevated triglycerides indicate insulin resistance and an independent risk factor for of heart attack.
Persistent Elevation of Plasma Insulin Levels Is Associated With Increased Cardiovascular Risk in Children and Young Adults
Fasting Plasma Insulin Modulates Lipid Levels and Particle Sizes in 2- to 3-Year-Old Children
Triglycerides come from carbohydrate resistance! The body is not metabolizing sugars well and converts them to triglycerides--most of the body fat stored comes from triglycerides—and then stores them as fat in the adipose cells. The protein carrier for triglycerides remains in circulation and eventually turns to LDL cholesterol.
When comparing triglycerides to other lipids, they should never be more then twice your HDL. For example: if your HDL is 40, then the triglycerides should not be over 80! That’s right 80. Normal ranges are usually recommended to be under 200 mg/dl. Usually, as triglycerides go up, the HDL goes down. Having low HDL and triglycerides considered normal (unclear) could tell you if you have insulin resistance. Attention to the problem should be addressed immediately.
References Ranges
In accordance with the new National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATPIII) Guidelines the laboratory report no longer contains the HDL/Cholesterol ratio calculation, as this is not a recommended value for making therapeutic decisions. Instead the recommended ranges from the NCEP will be used on the lipid profile report. These ranges are listed here:
NATIONAL CHOLESTEROL EDUCATION PROGRAM ADULT TREATMENT PANEL GUIDELINES (ATPIII)
LDL CHOLESTEROL TOTAL CHOLESTEROL TRIGLYCERIDE HDL CHOLESTEROL
<100 mg/dL <200 mg/dL <150 mg/dL <40 mg/dL
Optimal Desirable Normal Low
100-129 mg/dL 200-239 mg/dL 150-199 mg/dL >60 mg/dL
Near optimal/ Borderline Borderline High Desirable
Above optimal
130-159 mg/dL >240 mg/dL 200-499 mg/dL
Borderline High High High
160-189 mg/dL >500 mg/dL
High Very High
>190 mg/dL
Very High
Doctor Fitness Talks – Cholesterol is very important. It plays many roles, and without cholesterol we would die. Before making a decision that affects your life, consider the consequences. Could Statins, the cholesterol drugs, be the next Vioxx? Only time will tell. Wouldn’t an attitude change be a healthier choice?
Note: No one chooses to be fat and unhealthy. It is not a lifestyle of choice. If you have a cholesterol concern and would like to change your health attitude, contact Lance Dreher for your free assessment at any of the Fitness Institutes by calling 480-951-7177.
Additional references
1. Jacobs, D and others. Report of the conference on low blood cholesterol: Mortality associations. Circulation 86, 1046–1060, 1992.
2. Iribarren C and others. Serum total cholesterol and risk of hospitalization, and death from respiratory disease. International Journal of Epidemiology 26, 1191–1202, 1997.
3. Iribarren C and others. Cohort study of serum total cholesterol and in-hospital incidence of infectious diseases. Epidemiology and Infection 121, 335–347, 1998.
Lance Dreher, Ph.D.
Doctor Fitness
Visit pH-aT Living for Doctor Fitness' Newsletter and other health articles. For more information about Lance Dreher, visit The Fitness Institute or contact him by email at DoctorFitness @ EVLiving.com.
Lance Dreher is a frequent contributor to East Valley Living and his articles are regularly featured in Doctor Fitness Talks.
