Cholesterol testing, along with HDL, LDL and triglyceride testing is called the lipoprotein profile.

Cholesterol testing is done several times a year for individuals who are on a prescribed diet and for those who are taking cholesterol lowering medications.

Usually blood samples are drawn from the arm. Sometimes blood samples are taken from the fingertip. The samples are analyzed by a cholesterol testing device. Cholesterol tests are used to monitor the progress in lowering the cholesterol level.

Test results are grouped in three types:

• Desirable – the cholesterol level of 200 mg/dL below is regarded to be desirable because it has a low risk of heart disease.
• Borderline high – a total cholesterol level of 200 mg/dL to 240 mg/dL is at fair risk of having heart disease. Your doctor may decide to give you have a lipid profile in order to determine which cholesterol level is high.
• High Risk – a 240 mg/dL cholesterol level is considered to be at high risk of heart disease. Expect a lipid profiling if your cholesterol level is this high. It is more likely that you will be given a cholesterol lowering medication along with a low cholesterol diet.

Cholesterol tests are usually given when the individual is healthy because the blood cholesterol level of an individual who has an acute illness, (after a heart attack or after surgery or accident) is likely to be low. Individuals are advised to wait at least six weeks after any illness before taking cholesterol tests. Pregnant women are also advised to wait six weeks before having their cholesterol level measured.

A Brief Explanation of Cholesterol Ratios:

Cholesterol ratios consist of total cholesterol. Total cholesterol includes low level lipoprotein cholesterol levels (LDL cholesterol), triglycerides and high density lipoprotein cholesterol level (HDL cholesterol).

Cholesterol is measured by milligrams of cholesterol per deciliter of blood (mg/dL). Usually, only the total cholesterol amount is given when a person is tested for cholesterol. Sometimes you are given the HDL cholesterol and the total cholesterol results.

The desirable total cholesterol level is 200mg/dL and the beneficial amount of HDL is more than 40mg/dL.

There are two important cholesterol ratios. These they are LDL/HDL cholesterol ratios and total cholesterol/HDL cholesterol ratios.

In the latter cholesterol ratios, your cholesterol result is given by the total cholesterol divided by the HDL cholesterol. According to the American Heart Association, the desirable amount should be below 5:1 with the optimal amount of 3.5:1 or 3.5 to 1.

The LDL/HDL is done by dividing LDL cholesterol by the HDL cholesterol. The desirable amount in this ratio should be 3.5 below. The American Heart Association recommended that physicians must use complete numbers for total cholesterol/HDL cholesterol in determining the appropriate treatment.

A normal cholesterol level as suggested by the National Institute of Health:

• total cholesterol – 200mg/dL
• LDL – 100mg/dL
• HDL (man) – 40mg/dL above
• HDL (woman) – 50mg/dL above
• Triglycerides – 150mg/dL

It is important to remember to fast the night before, prior to taking a lipid profile test (a test that profiles the HDL cholesterol, triglycerides and total cholesterol) the next day.

Cholesterol is more abundant in tissues which either synthesize more or have more abundant densely-packed membranes, for example, the liver, spinal cord and brain.
The liver is the main processing center for cholesterol. When we eat animal fats, the liver returns the cholesterol it can not use to our bloodstream and when there is too much cholesterol circulating in our bloodstream, it can build up into fatty deposits. These deposits cause the arteries to narrow and can eventually block the arteries completely, leading to heart disease and stroke.

Cholesterol is produced by the liver and it is also made by most cells in the body. It is carried around in the blood by lipoproteins. We need blood cholesterol because the body uses it to build the structure of cell membranes, to produce hormones like testosterone, adrenaline and estrogen and to aid the metabolism.

Types of Cholesterol
There are two types of cholesterol, good and bad, the difference between them is:

• Low density lipoprotein (LDL) cholesterol called the bad cholesterol because it goes into the bloodstream and clogs up your arteries.
• High density lipoprotein (HDL) cholesterol called the good cholesterol because it helps to take the bad cholesterol out of the bloodstream.

Cholesterol is transported towards peripheral tissues by the lipoproteins chylomicrons, very low density lipoproteins (VLDL) and low-density lipoproteins (LDL).
Risks associated with high triglycerides.

According to the lipid hypothesis, abnormally high cholesterol levels (hypercholesterolemia), or more correctly, higher concentrations of LDL and lower concentrations of functional HDL are strongly associated with cardiovascular disease because these promote atheroma development in arteries (atherosclerosis). High cholesterol has also been linked to diabetes and high blood pressure.

Both heredity and diet have a significant influence on a person’s LDL, HDL and total cholesterol levels. Evidence strongly indicates that high cholesterol levels can cause narrowing of the arteries (atherosclerosis), heart attacks, and strokes.

Cholesterol in the bile can crystallize to form gall stones that may block the bile ducts. Cholesterol count also rises during pregnancy.

However, in recent years, scientists have come to realise that to decide whether an individual’s cholesterol levels are dangerous, these levels need to be considered in the light of the person’s overall risk of heart disease.The higher the risk of heart disease (for example, a male smoker with high blood pressure and diabetes), the greater the need to get cholesterol levels down.

Cholesterol tests
Cholesterol testing is recommended as a screening test to be done on all adults at least once every five years.

Foods that contain cholesterol
The cholesterol in your diet comes mainly from the saturated fats found in animal products. All foods from animals contain some cholesterol. Foods from plants do not contain cholesterol. Other sources of dietary cholesterol are full fat dairy foods, eggs and some seafood.

Safe blood cholesterol levels
Health authorities recommend that cholesterol levels should be no higher than 5.5mmols per liter. Approximately 50 per cent of adult Australians have a blood cholesterol level above 5mmols per liter. This makes high blood cholesterol a major health concern in Australia.

How to lower high cholesterol
The best way to maintain healthy levels of cholesterol in your diet is to limit foods high in saturated fats. Try to avoid: Fatty meats , full fat dairy products, processed meats like salami and sausages, snack foods like chips, most takeaway foods, especially deep fried foods, cakes, biscuits and pastries.

However the most important thing you can do to reduce your cholesterol level is to maintain a healthy lifestyle. You should try to:

• Limit the amount of cholesterol-rich foods you eat.
• Increase the amount and variety of fresh fruit, vegetables and wholegrain foods you have each day.
• Choose low or reduced fat milk, yoghurt and other dairy products or have added calcium soy drinks.
• Choose lean meat (meat trimmed of fat or labeled as heart smart).
• Limit fatty meats, including sausages and salami, and choose leaner sandwich meats like turkey breast or cooked lean chicken.
• Have fish (fresh or canned) at least twice a week. Replace butter and dairy blends with polyunsaturated margarines.
• Include foods in your diet that are rich in soluble fiber and healthy fats, such as nuts, legumes and seeds.
• Limit cheese and ice cream to twice a week

Some studies have suggested that eating oats and legumes may lower LDL cholesterol. Food components like saponins (found in chickpeas, alfalfa sprouts and other foods) and sulphur compounds (like allicin found in garlic and onions) may also have a positive effect on cholesterol levels.

Plant sterols can lower cholesterol levels,these are found naturally in plant foods including sunflower and canola seeds, vegetable oils and (in smaller amounts) in nuts, legumes, cereals, fruit and vegetables. Some margarine has concentrated plant sterols added to it. Plant sterol enriched margarines may help to lower LDL cholesterol.

Treatment for high cholesterol
Treatment of high cholesterol is aimed at lowering the low-density lipoproteins (LDL) or bad cholesterol, lowering triglyceride levels, and increasing the high-density lipoproteins (HDL) or good cholesterol.

Treatment will be most effective if it also includes appropriate diet, weight loss (if necessary) and physical activity.

The first steps in treating high cholesterol levels are: Regular physical activity and healthy eating.

There are also some foods that may help to lower cholesterol levels, particularly garlic, soya, oats, corn and selenium-enriched cereals.

Cholesterol-lowering foods are not suitable for children under five years or for pregnant or breastfeeding mothers.

Medication :Statin drugs work by interfering with the cholesterol-producing mechanisms of the liver and by increasing the capacity of the liver to remove cholesterol from circulating blood. Statins can lower LDL cholesterol by as much as 60 percent, depending on the drug and dosage.

Diabetes patients with elevated levels of triglyceride fats are at increased risk of developing a serious complication called neuropathy — the loss or damage of nerves that results in numbness, tingling and pain in the hands, arms, legs and feet, researchers say.

A study by U.S. researchers indicates that doctors need to monitor diabetes patients’ blood fat levels as well as their blood sugar levels. They noted a simple blood test for triglycerides can help doctors identify patients most at risk for neuropathy.

“In our study, elevated serum triglycerides were the most accurate at predicting nerve fiber loss, compared to all other measures,” study co-author Kelli A. Sullivan, an assistant research professor in neurology at the University of Michigan Medical School, said in a university news release.

The study included 427 diabetes patients with neuropathy. Those with elevated levels of triglycerides were significantly more likely to experience worsening neuropathy over one year. Other factors, including blood glucose levels, weren’t significant.

The findings appear online and in the July print issue of the journal Diabetes.

“These results set the stage for clinicians to be able to address lowering lipid counts with their diabetes patients with neuropathy as vigilantly as they pursue glucose control,” study senior author Dr. Eva L. Feldman, a professor of neurology at the University of Michigan Medical School, said in the news release.

“Aggressive treatment can be very beneficial to patients in terms of their neuropathy,” Feldman said. Blood triglyceride levels can be reduced using the same measures used to lower cholesterol levels — regular exercise and reducing consumption of harmful fats.

Of the 23 million people with diabetes in the United States, about 60 percent are affected by diabetic neuropathy, according to background information in the study.

Living with Type II Diabetes?

Because previous research had shown that reducing LDL cholesterol is significant in lowering coronary disease risks, the researchers said their findings could be clinically significant.

“Health practitioners should feel comfortable recommending barley to their patients to help reduce total cholesterol and LDL cholesterol concentrations,” they said.

Barley contains ß-glucan, an insoluble fibre which has already been shown to lower cholesterol in people who eat oats. But the effects indicated by eating barley have not received as much attention, the researchers said.

The researchers analyzed eight randomized controlled trials totalling 391 participants and evaluated the lipid-lowering effects of barley. Each study consisted of relatively few people (median 30), and had a short time duration (median four weeks).

The meta-analysis indicated that the participants who consumed barley regularly had significantly greater reductions in total cholesterol (-13 mg/dL), LDL cholesterol (-10 mg/dL), and triglycerides (-12 mg/dL) than the controls who did not eat any barley.

They found that the reduction in total and LDL cholesterol wass in line with the findings for oat-derived ß-glucan, which was expected – as both grains have similar concentrations of the fiber, at 3.5% to 5.9% of total dry matter.

However, there was no observed effect for HDL cholesterol — only a nonsignificant increase of 1 mg/dL.

The researchers could not establish a dose-response as only six of the eight studies reported the ß-glucan dose, meaning there wasn’t enough statistical data to draw any conclusions.

However, the few studies that did report doses had a range of 3 g to 10 g of ß-glucan per day.

The cholesterol-lowering effects of barley observed in this study are in line with the FDA recommendations of 3 g or more of soluble fiber daily to reduce the risk of heart disease, the researchers said.

They said the findings are also important as reductions were seen regardless of whether participants made substitutions in their diet. For example, if they replaced eggs with barley, it would be difficult to tell whether improvements in cholesterol resulted from a healthier diet or from barley.

“That significant reductions in total cholesterol and LDL cholesterol were seen regardless of whether diet modifications were mandated equally in both study groups helps guard against the issue of dietary substitution and strengthens the effects of barley use,” the researchers said.

The findings “support the routine use of soluble fibers in the diets of adult patients with and without hypercholesterolemia.”

Rice and wheat do not contain ß-glucan, but oats, psyllium, pectin, and guar gum do contain the soluble fiber.

The researchers said future studies should include larger trials to assess the dose-response relationship of barley ß-glucan.

Cholesterol is a waxy substance that is attached to the fats in our bloodstream and is present in all of the cells of the body. Cholesterol comes from food that we eat, as well as being manufactured directly by the liver. Cholesterol is an important regulator in the bloodstream, as it helps to regulate the formation of many cells as well as hormones. However, to have too high or too low of a cholesterol count in the blood can be a very dangerous factor, often leading to a heart attack or a stroke. Although cholesterol is prevalent in the blood stream, it cannot dissipate in the blood. The cholesterol maneuvers throughout the body attached to lipids (fats).

LDL cholesterol can build up on the artery walls reducing circulation and causing stress and damage to the heartThere are two main types of cholesterol. The first type is called LDL cholesterol, and the other is HDL cholesterol. LDL cholesterol, otherwise known as low-density lipoprotein, is considered the “dangerous” cholesterol. LDL cholesterol can build up on the artery walls. Over time this plaque build-up blocks blood flow, reducing circulation and causing stress and damage to the heart. This raises blood pressure, and eventually leads to heart disease or a heart attack. Individuals that have higher levels of LDL run a much higher risk of having heart disease. Although LDL is affected by genetics, there are several precautions that individuals can take towards keeping safe LDL levels.

The other form of cholesterol is HDL, or high-density lipoprotein. HDL is considered the “good” cholesterol. HDL cholesterol is important for the body to have as this type of cholesterol helps filter out LDL cholesterol from the lining of the arteries, as well as transporting fat in the bloodstream (triglycerides) to the liver so that it can be excreted from the body. It is believed that even having high levels of HDL is safe, as it can help protect one’s heart from a heart attack or stroke. Low counts of HDL could potentially lead to a heart attack and stroke, however this is rare for people eating a western-style diet, which is typically high in both forms of cholesterol.

Most of the cholesterol in our bodies comes from the foods we eat. Foods high in fats, particularly saturated and trans fats, contribute to high levels of LDL cholesterol. Meat and dairy products are the main sources of LDL cholesterol, while leafy vegetables, fruits, and nuts are more nutritious alternatives that have higher levels of HDL cholesterol. While genetics does play a role in cholesterol levels, a change in diet is the most effective way to lower dangerous cholesterol levels, and reduce your risk of heart disease and associated health problems.

Certain natural substances found in Vasacor, including plant sterols, fish oils, and policosanol have been shown in numerous clinical studies to be highly effective in promoting healthy cholesterol levels, particularly when combined with a healthy diet and exercise. If you are concerned about your cholesterol levels, now is the time to make a change, and Vasacor can help.

Less than 200 mg/dL* (5.2 mmol/L) – Desirable:- This is where your cholesterol level should be. Even so, to ensure that you have the right balance – more HDL than LDL cholesterol – you should follow the Guidelines for Healthy Living.

200-239 mg/dL (5.2-6.1 mmol/L) – Borderline:- Consult your doctor. Your doctor will be best equipped to interpret the results and test further for LDL andHDL levels.

240 mg/dL (6.2 mmol/L) and above – High:- People with cholesterol levels over 240mg/dL (6.2 mmol/L) are at increased risk for heart attack and stroke. If your cholesterol level is 240 mg/dL or greater, consult your doctor and follow his/her advice on lowering that level.

The LDL cholesterol level is a more important indicator of overall cardiovascular healthAlthough these levels are important guidelines, they do not give the whole picture – they are really just rough guidelines. The LDL cholesterol level is a more important indicator of overall cardiovascular health, but having your cholesterol level checked will not necessarily give you your LDL cholesterol number.

LDL Levels
Less than 100 mg/dL (2.6 mmol/L);
100-129 mg/dL (2.6-3.3 mmol/L) near to above optimal;
130-159 mg/dL (3.3-4.0 mmol/L) is high, increasing your risk for heart disease;
160 mg/dL (4.0 mmol/L) is very high and puts you at greater risk for heart disease.

HDL Levels
60 mg/dL (1.5 mmol/L) and above is desirable;
40-59 mg/dL (1.0-1.5 mmol/L) is normal;
Less than 40 mg/dL (1.0 mmol/L) is low and increases your risk of heart disease.

Triglycerides
Less that 150 mg/dL (1.7 mmol/L) – Normal;
150-199 mg/dL (1.6-2.2 mmol/L) – Borderline-High;
200-499 mg/dL (2.3-5.6 mmol/L) – High ;
500 mg/dL (5.7 mmol/L) and above – Very high

Traditional cholesterol testing is a good indicator for assessing heart disease and stroke risk; however, there are many variables that can not be controlled in this traditional testing, such as genes, race, age and past medical history. A person may appear ‘heart healthy’, at a good weight, fit, and eating a balanced diet, and still have unacceptable cholesterol levels. On the other hand, another person may have acceptable cholesterol levels – even acceptable HDL cholesterol levels – and still be at risk for heart disease. There is still much research to be done on cholesterol and our bodies’ manufacture and control of cholesterol levels.

Fortunately, there is another test available, rather than the traditional cholesterol testing, which provides a more in-depth study of cholesterol levels. This is the VAP, or Verticle Auto Profile. This test not only indicates the HDL and LDL cholesterol levels, but also provides an analysis of the many subclasses of cholesterol and it offers a more comprehensive indication of who may be at an increased risk of heart disease. In fact, statistics show that the VAP has a 90% detection rate for persons at risk for heart disease, whereas traditional cholesterol testing may miss up to 60% of the patients at risk! Please see the VAP website for more information on the importance of this test, especially for anyone at risk for heart disease, and for information on taking the VAP.

Note: These categories apply to adults aged 20 and older

*mg/dL = milligrams per deciliter of blood (mmol/L= millimoles per liter of blood)