Healthy Cholesterol & Triglycerides

Healthy Aging

The Evolving Story of Cholesterol & Triglycerides

The American Heart Association recently published eight updated and enhanced health tips, called Life’s Essential 8, in the journal, Circulation. We are dedicating our latest round of newsletters to Life’s Essential 8.

Let’s talk lipids

Instead of defining whether or not you have heart disease, Life’s Essential 8 is used to define whether or not you have heart health. Meeting all of these essential 8 goals is expected to help us not only have healthier hearts, they can enable us to live longer, healthier lives.

This week, let’s talk about:

So, what is healthy cholesterol?

The American Heart Association uses non-HDL cholesterol as its primary measurement of healthy cholesterol. Specifically, they provide the following point system, with the goal of achieving the highest health points possible:

Non-HDL cholesterol

• < 130 mg/dl = 100 health points
• 130-159 mg/dl = 60 health points
• 160-189 mg/dl = 40 health points
• 190-219 mg/dl = 20 health points
• ≥ 220 mg/dl = 0 health points

What happened to “LDL is bad cholesterol, and HDL is good cholesterol’?

While this phrase had long been accepted as true, advances in technology have since complicated what once was a straightforward belief.

• Size matters. When LDL cholesterol particles are big and fluffy, they don’t appear to be harmful. If these same particles are small and dense, however, they are more susceptible to oxidation and can more easily invade vessels. This leads to atherosclerosis.
• Non-LDL particles can be bad apples, too. Traditional equations that measure LDL-cholesterol don’t include other lipids that contain apolipoprotein B (aka apoB), which can cause atherosclerosis.
• Association vs. causation. While higher HDL cholesterol is associated with a lower risk of atherosclerosis, high HDL does not appear to be the cause of reduced cardiovascular disease. Instead, high HDL may simply be an indicator of lower triglycerides, which more directly supports your heart health.

As a result of these latest studies, both non-HDL cholesterol and apoB have emerged as leading measurements of cardiovascular disease risk.

Wait, do triglycerides matter again?

Yes, they do. A review in Current Atherosclerosis Reports discusses how high triglycerides increase our risk of developing atherosclerosis. The Mayo Clinic provides the following reference ranges for triglycerides:

• Normal: Less than 150 mg/dL
• Borderline high: 150 to 199 mg/dL
• High: 200 to 499 mg/dL
• Very high: 500 mg/dL or above

High triglyceride levels occur when we eat more carbohydrate-rich calories than we burn. As such, you can help keep your triglycerides under control by minimizing your carbs and increasing your steps.

Take home message

When it comes to your lipid health, it is especially important to visit your doctor and get those blood tests routinely. Your physician will be most up to date on the evolving science defining healthy cholesterol and triglyceride levels.

Stay tuned for next week’s newsletter around our Healthy Heart series, which will focus on the latest scientific studies around healthy levels of blood glucose.