We’ve probably all read or heard news stories about cholesterol or perhaps even know someone who has been told they have high cholesterol. Cholesterol, as much as we might fear it, is found in every cell in the body and is necessary for life.

The purpose of cholesterol is to help digest food, produce hormones and make Vitamin D. It is naturally manufactured by the body, specifically the liver, but can also be found in many of the foods we eat. If it’s necessary for life, what’s the big deal? Well, just like so much in life, there can be too much of a good thing. Too much cholesterol is called hyperlipidemia and affects 1 in 3 Americans.

How can this happen? There are actually a number of conditions that can lead to hyperlipidemia including a person’s genes, obesity, diet, smoking, hypothyroidism, and an inactive lifestyle. When the body cannot use or remove the excess cholesterol, it builds up in the blood, ultimately damaging arteries and internal organs, leading to heart disease. According to the American Heart Association, one third of all deaths in the United States are due to this.

Cholesterol is carried in the blood in one of two forms: LDLs or Low-density lipoprotein and HDLs or High-density lipoprotein. LDL is often called the “bad” cholesterol because it builds up in the walls of the blood vessels, causing them to narrow and stiffen. It reduces blood flow, increasing the risk of a heart attack or stroke. HDL, referred to as “good” cholesterol, helps move LDL from the blood to the liver where it is broken down and eliminated, reducing the total level.

Something else your doctor might be able to learn by testing your blood is your triglyceride level. Triglycerides are an additional type of fatty substance in the blood and although triglycerides are different from cholesterol, they also have a strong association with heart disease. Triglyceride levels are measured with HDL and LDL as an indicator of risk for having a heart attack or stroke.

To help determine someone’s risk from cholesterol and triglycerides, your health care provider can have a blood sample is taken. For the most accurate results, individuals are asked not to eat for 9 -12 hours before the test. Knowing specific numbers will better help your health care provider evaluate your cardiac risk and decide on a plan of care.

In adults, total cholesterol levels less than 200 mg/dL are considered healthy, above 240 is high. LDL levels should be less than 100 mg/dL, any number greater than 160 is considered too high. HDL levels ideally should be greater than 60 mg/dL. A result of less than 40 mg/dL is considered a major risk factor.

It is important to have cholesterol levels tested if: you are over the age of 40, have a family history of cardiovascular disease, are overweight, have high blood pressure, diabetes, hypothyroidism, smoke, or have a medical condition that can cause an increased level of cholesterol (kidney, liver or pancreas issues).

Lifestyle options are the best way to both prevent and treat hyperlipidemia. Research shows than just 150 minutes/week of moderate intensity exercise is enough to lower cholesterol and high blood pressure and encourage weight loss. Quitting smoking dramatically lowers a person’s risk factor.

A heart healthy diet includes: brightly colored fruits and vegetables, oats, whole grains, legumes (beans), poultry, fish high in Omega-3 fatty acids (salmon, fresh tuna, sardines, trout, herring, and halibut) and nuts (almonds, pecans, pistachios, and walnuts). When oil is used, it should be extra virgin olive or canola. Saturated fats should be limited to 5-6 percent of daily calories. A diet high in fiber can lower cholesterol levels by as much as 10 percent. Fast food and foods that do not offer good nutritional value should be eliminated or at least restricted. Reducing fat intake requires paying attention to food labels, especially saturated and trans fats, like those found in margarine and other processed foods.

What are your options if you have hyperlipidemia? Diet and lifestyle changes are a great place to start. Physicians may also prescribe “statins” which is medication that lowers cholesterol levels in the blood if necessary.