Setting Your Cholesterol Management Targets
Guidelines | Calculate LDL Targets | Individualizing Targets | Engage Your Health Care Team
Guidelines for Cholesterol Levels
Managing your cholesterol is part of a lifelong commitment to staying healthy.
An evaluation of your cholesterol starts with a lipoprotein profile blood
test. This test measures the levels of total cholesterol, LDLs,
HDLs, and triglycerides. You should establish your profile by your early
twenties.
The levels are measured as milligrams of cholesterol per deciliter of blood,
or mg/dl. The NCEP has defined the following guidelines for cholesterol
levels:
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Individualizing Targets
Let’s take an example: you are 44 years old. You have not had a physical in 6 years. You believe that you are careful to avoid the saturated fats in cheese, red meat and whole milk (though you do love butter). You have friends who are careful about their diets, yet have discovered that they have heart disease. So you schedule an appointment with your doctor. As part of a physical, blood is drawn for a full blood lipid evaluation. The results: “borderline high” total cholesterol of 235mg/dl, LDLs of 162 ("high" per chart above) and HDLs of 39, a heart disease risk factor. Note that adding your LDLs and your HDLs does not add up to your total cholesterol. VLDLs make up the difference.
Based on your lifestyle and family history, your doctor indicates that he is not yet concerned, but recommends that you return for another test in 3-6 months.
You do some research, and decide that over the next 6 months, you will try natural cholesterol management. Getting the right daily levels of each nutrient proves challenging, but by the end of the period you’re getting into the swing. Three out of every four days you find that you are getting at least two grams of sterols. You have learned to use olive oil instead of butter (and find you love it!), so your saturated fat intake falls to 10% of your total calories, and your monounsaturated fat increases.
Getting 10-25 grams of soluble fiber each day is proving more difficult. But you are discovering a variety of morning cereals, snacks and recipes that help. You also start on niacin, but initially give it up because of the flushing. Mid-way through the period, you try niacin again. You start with 50 milligrams twice per day and work your way to 100 milligrams three times per day.
You return to your doctor for another blood test. Your LDLs are now 137 (about a 15% reduction). Meanwhile, your HDLs have risen to 42 (about a 7% increase). Overall, you find that your total cholesterol has fallen to 197. Total cholesterol has crossed from “borderline high” to “desirable” and your LDLs are moving toward “good, but above optimal”. Congratulations! What should be your next step?
As a healthy 44 year old, you and your doctor may determine that you have achieved appropriate targets. He encourages you to continue with your nutritional system, but also indicates that losing that extra 10lbs could reduce your LDLs by another 10%. He also suggests that exercise could raise your HDLs by 5-10%.
If you had a different profile, however, your doctor may recommend a far different approach. If you have had a heart attack, are diabetic, or have a family history of cardiovascular disease, you and your doctor may seek a much greater improvements in your various cholesterol levels.
Regardless of your profile, you also may seek to achieve these greater improvements. Research does indicate that some level of arterial plaque will continue to develop at LDL levels above 100mg/dl. Cardiovascular health also has been shown to improve with higher HDLs.
Click Here To Calculate LDL Targets Based on Your Profile
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Engage Your Health Care Team
The NCEP tools help define your targets. Individually, you
may consider taking a more aggressive approach. A lifelong commitment
to cholesterol management may serve to improve your overall cardiovascular
health.
Take some time to educate yourself. (Resources). You
then should develop a close working relationship with your doctors and other
health professionals. Together, your health team can work through your own
unique chemistry, lifestyle and personality to construct appropriate targets
and programs.
No doubt, some physicians are more knowledgeable than others about natural
nutritional approaches to cholesterol management. But most physicians,
when presented with the evidence, are willing to explore the options. To facilitate
this inquiry, we offer you and your physician a listing of in-depth resources
and studies found in the health professionals section of the Kardea
website.
At any and every stage of adjusting your diet, your success can
be facilitated by consultation with registered dietitians or nutritionists. These professionals will help you identify a natural
cholesterol management meal plan that meets your lifestyle, and they can
reinforce your efforts over time.