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Diet and Nutrition

Ratio vs. total cholesterol?

03/30/2000

Question:

Is there a new study on cholesterol that indicates ratio is more important than total cholesterol?

Answer:

Thanks for your question. Evaluating the ratio of HDL ("good") cholesterol to total cholesterol is not new per se, but is more important than just looking at the total blood cholesterol level.

Ideally, the ratio between total cholesterol and HDL should be 4.0 or below. Research has indicated that a level above 4.0 is indicative of higher risk of developing coronary artery disease.

For example, if your total cholesterol was 180 (which is desirable), but your HDL was only 10, then your ration would be 18 (180/10). So, although your total cholesterol is low, your HDL level is not in a healthy range, and therefore you may have a higher risk for heart disease.

Say hypothetically your total cholesterol was 220, and your HDL was 50. Then your ratio would be 4.4, which would indicate less risk of developing artery disease. Even though your total cholesterol is elevated, the total cholesterol number takes into account HDL.

Cholesterol synthesis takes place in the liver and is affected by diet. A diet high in saturated fat (from beef, bacon, sausage and whole milk dairy foods) or trans fat (from margarine, fast foods, and processed crackers and cookies) will raise total cholesterol. Some people have high cholesterol levels due to heredity, and a low fat diet would be beneficial in this case.

HDL is the "good" cholesterol in your body that helps the liver get rid of excess cholesterol in the blood. This level should be 34 or above to prevent heart disease. The higher it is, the better.

LDL is "bad" cholesterol. This type of cholesterol makes the body deposit cholesterol in the arteries. This level should be below 160 in most people. If you have coronary artery disease already, or risk factors for artery disease, this level should actually be lower (130 in most people, or 100 in high risk individuals).

Methods to lower total cholesterol and raise HDL cholesterol include:

* Low fat, low cholesterol diet

* Regular exercise (30 minutes 3-5x/week)

* Diet high in soluble fiber (oats, fresh fruits, dried beans & peas)

* Moderate red wine consumption (1 drink/day for women, 2 drinks/day for men)

* Foods high in Omega-3-fatty acids (mackerel, salmon, herring, soybean oil, canola oil)

* Medication (doctor prescribed)

* Diet high in soy products (soy protein and soy isoflavones)

If you've never had a cholesterol profile done, talk to your doctor. Everyone should be screened for cholesterol at least once by the age of 25 (more often if the condition is hereditary or levels are elevated). For more information on cholesterol and ways to reduce it, search previously answered questions in the Diet and Nutrition section of Netwellness. I hope this information was helpful. Take Care!

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Response by:

Lisa Cicciarello Andrews, MEd, RD, LD Lisa Cicciarello Andrews, MEd, RD, LD
Adjunct Faculty
University of Cincinnati