Understanding Cholesterol Numbers – LDL, HDL & Triglycerides

Many people receive their lipid profile, and are confused by the jargon and numbers. This post will help explain what the numbers mean and allow you to discuss them with your doctor. It should not be used to interpret your results.

Why this can be confusing.

There are multiple numbers in your lipid profile that are all abbreviated. On their own they do not give you much information and will only make sense with regards to your age, medical history and overall risk. This can mean that people with similar results get different advice. Use it as a starting point.

Understanding the numbers.

Cholesterol. Cholesterol is a natural wax in our bodies. We need it to produce cells and hormones. Cholesterol isn’t bad but is concerned about the levels within our blood.

LDL. Often referred to as bad cholesterol. LDL acts like a delivery truck, delivering cholesterol to where it is needed. However if levels are consistently high over a long period of time some can become deposited into the arteries causing fatty deposits. LDL is a bit of a misnomer as it does have a useful function. It is the quantity and how long it is high for that is an issue.

HDL. Often referred to as good cholesterol. HDL acts like a waste pick up, helping to deliver cholesterol to the liver. In reality there is no evidence to show increasing HDL levels with foods or supplements will help with heart protection.

Triglycerides. These are a form of fat in our blood that is used to store energy. Levels can increase due to consuming too many refined carbohydrates, fizzy drinks, alcohol and excess calories. It can also increase due to certain medical conditions.

Total & non-HDL Cholesterol. Total cholesterol is the total amount in your blood. Non-HDL takes the HDL away meaning we know how much cholesterol carrying particles you have which can lead to deposits. Your doctor may look at both or one of these.

Fasting/Non-Fasting. Some tests will require you to fast whilst others will not. Your doctor will advise on what you should do.

Why I have not included any ranges. Healthy levels depend on your age, family history, BP, diabetes, smoking, kidney function and more. Only a doctor can help interpret your numbers. Indians and South Asians are often highlighted as having a higher risk of heart disease at a younger age. This is another reason it is important to have regular check ups and know your family history. There is nothing to fear, just stay informed.

Factors that can affect your levels.

Genetics can have a big impact on your numbers. Some people can have familial high cholesterol which can be present even with a healthy diet. Age, hormonal changes, thyroid issues and diabetes can affect your numbers. Lifestyle factors such as sleep, stress, smoking, alcohol, exercise and weight can all impact your numbers. Diet is just one factor.

Foods to help your heart.

The following foods can help support your heart:

• Oats & Barley – High in soluble fibre. Can be eaten as porridge/upma or added to khichdi and rotis.

• Dals, Rajma & Chana – Cooked into normal dals and curries or eaten as sundal.

• Apples, Guava & Vegetables – Eat as whole fruits as a snack. Vegetables can be eaten in sabzi, soups & salads.

• Almonds & Walnuts – A small handful. Can be eaten plain or added to breakfasts.

• Flax & Sesame Seeds – Sprinkle on salads/curd or add to chutney powders.

• Fish – Steamed, grilled or light curry more often. Don’t overcook.

• Cooking Oils – Use sparingly for tadka and saute.

• Wholegrains & Millet – Ragi, Jowar & Bajra can be added to rotis, dosas & porridge.

Be cautious of foods containing trans fats (often in some pre-packed foods and fried foods), too much saturated fats (too much ghee/butter, coconut gravy, fatty meats and full fat processed foods), fizzy drinks, sweet foods, processed foods and alcohol.

Ghee, Coconut, Eggs and other traditional foods should be given a fair chance. Some research is conflicting or ongoing. Portion sizes and overall diet are the most important factor.

Myths & Facts.

Myth – Eating eggs will always increase cholesterol. Fact – Research is conflicting. It depends on your portion sizes and overall diet. Ask your doctor what is best for you.

Myth – Thin people don’t need to check cholesterol. Fact – Genetics, age and certain conditions can affect your cholesterol regardless of weight.

Myth – Food labelled cholesterol free is good for your heart. Fact – It can still contain refined carbs, sugar, saturated or trans fats. Check the whole label.

Myth – Taking supplements can help. Fact – There is no reliable supplement to help. Ask your doctor.

When to see a doctor.

Exercise, sleep, stress management and avoiding smoking are all as important as diet. It would be a good idea to have regular check ups especially if there is a family history of heart disease, diabetes, high blood pressure or high cholesterol. Ask your doctor when you should be tested. Don’t stop or alter any medication your doctor has prescribed.

See a doctor urgently.

If you are experiencing chest pain, pressure or tightness, pain radiating to your arm/jaw/back, shortness of breath, or sudden weakness or difficulty speaking seek immediate medical attention. Don’t wait for a blood test.

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