Understanding Cholesterol Numbers
Here are some cholesterol numbers you should know in case your doctor presents them to you and you wonder what they mean:
Total cholesterol
• Desirable: less than 200 milligrams (preferably 180)
• Borderline: 200-239 milligrams
• High: 240 milligrams and above
LDL cholesterol
• Desirable: less than 130 milligrams
• Borderline-high: 130-159 milligrams
• High: 160 milligrams or above
HDL cholesterol
• Low: less than 35 milligrams
• Desirable: 50 or above
Heart-healthy numbers
• Triglycerides: under 150 mg.
• Cholesterol: under 200
• LDL: under 130
• HDL: above 50
• Cholestrol/HDL: <3.5
What the cholesterol numbers mean and what you should shoot for
Doctors use these numbers both as a guide to predicting a person’s risk of heart disease and as blood tests to monitor the effects of treatment. Rather than using absolute numbers, cardiologists use ratios, both of LDL to HDL and of total cholesterol to HDL. An ideal ratio is 3.5 to 1 or less. For example, if your LDL is 130 and HDL is 40, your ratio is 3.3 to 1. As the ratio rises above 3.5 to 1, the risk of coronary artery disease increases. The number that seems to be the most predictive of heart disease is the ratio of total cholesterol to HDL. For example, a cholesterol of 200 and HDL of 50 would give you a cholesterol-to-HDL ratio of 4 to 1. A cholesterol-to-HDL ratio greater than 4.5 to 1 increases a person’s risk of coronary artery disease. The risk doubles at a ratio of 5 to 1 and doubles again at a ratio of 7 to 1. Best is a ratio of less than 3.5 to 1.
The heart-healthy magic number is 3.5 or less.
Cardiologists pay a lot of attention to the level of HDL as a predictor of heart disease. One study showed that the risk of heart disease was 38 percent higher in men with HDL under 35, even if their total cholesterol was below 200. So, shoot for a high HDL and a low total cholesterol.
NUTRITIP: Prepare For Your Test
Several things can affect the accuracy of cholesterol blood tests: fluctuations in weight, changes in diet, pregnancy, and excessive alcohol intake. The most accurate results are obtained when your weight has been stable for at least two weeks and you are eating your usual diet. While total cholesterol and HDL are fairly accurate without fasting, the most accurate measurements of triglycerides and LDL can be obtained first thing in the morning after a 12- hour, overnight fast. (To avoid the discomfort of an overnight fast, get a routine non-fasting blood cholesterol. If it’s borderline or high, get the complete profile, which needs to be done after fasting.)
Dr. Sears, or Dr. Bill as his “little patients” call him, has been advising busy parents on how to raise healthier families for over 40 years. He received his medical training at Harvard Medical School’s Children’s Hospital in Boston and The Hospital for Sick Children in Toronto, the world’s largest children’s hospital, where he was associate ward chief of the newborn intensive care unit before serving as the chief of pediatrics at Toronto Western Hospital, a teaching hospital of the University of Toronto. He has served as a professor of pediatrics at the University of Toronto, University of South Carolina, University of Southern California School of Medicine, and University of California: Irvine. As a father of 8 children, he coached Little League sports for 20 years, and together with his wife Martha has written more than 40 best-selling books and countless articles on nutrition, parenting, and healthy aging. He serves as a health consultant for magazines, TV, radio and other media, and his AskDrSears.com website is one of the most popular health and parenting sites. Dr. Sears has appeared on over 100 television programs, including 20/20, Good Morning America, Oprah, Today, The View, and Dr. Phil, and was featured on the cover of TIME Magazine in May 2012. He is noted for his science-made-simple-and-fun approach to family health.