Cholesterol is a white, waxy substance. It is naturally found in all foods of animal origin --meat, poultry, fish, milk and milk products, and egg yolks. Cholesterol is needed by the body for many important functions, like making cell membranes and producing hormones.
Plant foods do not contain cholesterol. Not all cholesterol is beneficial to the body, as you are probably aware. Cholesterol may be deposited on the walls of arteries making the passageway narrower and the vessels harder and less pliable. Since heart disease and strokes are the number one killer of men and women, you need to be concerned about it. Certain factors put you at risk for developing heart disease. These include smoking, high blood pressure, obesity, sedentary lifestyle (lack of exercise), high blood cholesterol levels, family history of heart disease, diabetes, and age.

The American Heart Association recommends having cholesterol tested by the age of 20, and then every 5 years thereafter, if normal. The routinely checks cholesterol levels in all active people at the periodic physical and separation physical

Total Cholesterol:
Desirable - less than 200 mg/dl
Borderline high - 200-239 mg/dl
High risk - greater than 240 mg/dl

In our blood, cholesterol is combined with carrier proteins, called lipoproteins. There are two types: LDL cholesterol (low density lipoproteins) and HDL cholesterol (high density lipoproteins). Both types of lipoproteins contain cholesterol, but in different amounts, and both LDL and HDL cholesterol contribute to the total cholesterol level. LDL cholesterol is sometimes referred to as "bad cholesterol" as it tends to deposit cholesterol on artery walls. HDL cholesterol is referred to as "good cholesterol" because it seems to acts as a scavenger and carries cholesterol away from body tissues. Exercise has been found to increase HDL levels.

LDL Cholesterol
Desirable - less than 130 mg/dl
Borderline high - 130-159 mg/dl
High risk - greater than 160 mg/dl          

HDL Cholesterol
Desirable - greater than 60 mg/dl
High risk - less than 35 mg/dl

It is important to know that cholesterol numbers alone cannot predict who will develop heart disease. Instead, we need to look at a variety of factors that increase your risk for heart disease. Some of these are factors that cannot be changed, and others are factors that can be prevented.

Modifiable Risk Factors             Non modifiable Risk Factors
Cigarette smoking                       Age (males - greater than 45
High blood pressure                            females - greater than 55)
Obesity                                           Male sex
Physical inactivity                         Family history of premature coronary heart disease
Diabetes

Up to 75 percent of the cholesterol in our bloodstream is made by our liver, the rest comes from cholesterol and saturated fat in our diet. Some people have a "genetic" predisposition to having high cholesterol, as their liver makes too much cholesterol. Regardless of the reason for the high cholesterol level, a prudent diet is recommended for all.
Eating too much fat, especially saturated fat, increases cholesterol production. From Chapter 2 we learned that saturated fat is mostly animal fat or solid fat. All Americans, regardless of their cholesterol level, are recommended to follow a low fat diet of less than 30 percent calories, as previously discussed. Most foods that raise blood cholesterol are not necessarily high in cholesterol, but are high in saturated fat. Believe it or not, we can eat up to 300 mg per day of cholesterol and still be on a low cholesterol diet. There are a few foods that are very high in cholesterol, and recommendations for those foods are as follows:

Egg yolks - 4 per week or less
Liver or other organ meats - 3 oz per month or less

Otherwise, when we talk about eating a low-cholesterol diet, what we really are talking about is eating a low-fat diet, especially low in saturated fat. Recommendations for getting fat out of your diet include:

Limit or avoid high fat meats:
        Beef:

• Brisket
• Corned beef
• Ground hamburger (less than 85 percent lean such as 75-80percent lean)
• Club or rib steaks
• Pastrami
• Spare ribs
• Meats labeled "Prime"

        Pork:

• Bacon
• Deviled ham
• Cold cuts
• Hot dogs
• Loin
• Spare ribs
• Sausage
• Luncheon meats (bologna, salami)

Most people think that you need to avoid shellfish to follow a low cholesterol diet. This is not true. All fish, including shellfish is very low in fat, especially low in saturated fat (most fish and shellfish contain approximately 1 gram of total fat and less that 1/2 gram of saturated fat!) Cholesterol levels are also fairly low compared with beef, pork, and chicken, with the exception of shrimp. Shrimp does contain higher levels of cholesterol than red meat. However, because shrimp is so low in total fat and saturated fat, it is acceptable to include it as part of a low-fat, low cholesterol diet.
As with other meats, avoid frying! Fish and shellfish are also rich in Omega-3 fatty acids which have been shown to be protective against heart disease. Greenland Eskimos have 100 times less risk of heart disease than Americans due to their high fish consumption (also, there are no cows or fast food restaurants in their environment).

Cholesterol: Good or bad?
In today’s world, almost everything is free… not that everything has no price. It just seems that we have reached the era where we become more aware of our health conditions. Thus, it seems to be the era of everything that is -free. Try scanning every available product in your local grocery and you will see what I mean.

Your bread is bromate-free; your yoghurt is fat-free; your cooking oil is cholesterol-free; your canned soup is preservative-free; and the list goes on and on. Now you are beginning to wonder about the next -free commodity that you would encounter.

This is not exactly bad. In fact, health experts encourage us to be more sensitive about the foods we eat and the nutrients that we get from them. However, not everything that is –free is healthy. Our bodies need certain substances to be able to function well.
Let us take a look at cholesterol for instance. Very simply defined, cholesterol is a fatty substance that occurs naturally in the blood, cell walls, and most body tissues. Cholesterol is made by the liver, and it enters the body via foods rich in saturated fat.

There are two types of cholesterol; these are what they termed as the good and bad cholesterol. Like the literary split personality of Jekyll and Hyde, it has a good side because it is needed for certain important body functions. But for many people, cholesterol also has an evil side. When present in excessive amounts, it can injure blood vessels, cause heart attacks, and stroke.

Low Density Lipoprotein (LDL) is the "bad" cholesterol. This is the form in which cholesterol is carried into the blood and is the main cause of harmful fatty buildup in arteries. The higher the LDL cholesterol levels in the blood, the greater the heart disease risk.
On the other hand, High Density Lipoprotein (HDL) is the “good” cholesterol. This "good" cholesterol carries blood cholesterol back to the liver, where it can be eliminated. HDL helps prevent a cholesterol buildup in blood vessels. Low HDL levels increase heart disease risk.

So before you go into your cholesterol deprivation program, remember that cholesterol is essential for human life. It builds and repairs cells, it is used to produce sex hormones like estrogen and testosterone, it is converted to bile acids to help you digest food and it is found in large amounts in brain and nerve tissue.

The one which you really need to be aware of is Low Density Lipoproteins. A high level of Low Density Lipoproteins means that you have a bad cholesterol that here is too much of it to build up. High Density Lipoproteins means good cholesterol that they are used to carry cholesterol away from cells and to the liver.

The complicated thing about cholesterol is the right level you should belong. The doctor has the ability to tell you how low your cholesterol levels should be. The average person usually should have around 4.0mmol/l but if you have a low density lipoprotein count, then you should have around 2.0mmol/l. As mentioned, however, each person is different so you need to get your levels checked to see exactly what you should be aiming for.

Cholesterol is important and you should know what levels you have for you to know what you can do about it. More and more people are developing heart disease due to high levels of cholesterol so it is advisable to go to your doctors to know your cholesterol level.

There are many ways to improve your cholesterol level. Eat healthy food that can help lower your LDL cholesterol level. With a healthy diet, your body is protected from the damaging effect of cholesterol. You should quit smoking, lose weight and exercise to raise your HDL cholesterol level.

Following a healthy low fat diet can lower cholesterol levels. If healthy eating and exercising don't work after about six months, consult your family doctor of the medicine to lower your cholesterol level.