Understanding Lipids

Part 1: What it all means

Evaluating cholesterol and lipids has become a controversial topic over the last 10 years. There was a time where it seemed straightforward: If our cholesterol is high, you are at increased risk of heart attack.

Turns out this was never true.

A standard lipid panel has components which I will explain to you:

• Cholesterol - this is the total sum of cholesterols in the blood. It includes HDL, LDL, and triglycerides. The human body produces a majority of the cholesterol found within the bloodstream and approximately 20% comes from diet. The outdated way of thinking said that if you eat too many eggs (which contain cholesterol) you will be at higher risk of heart attack. False.

• Triglycerides (TG) - These are a type of fat which contain VLDL (very low density lipoprotein) which are considered unhealthy. When you eat excess calories, the body converts them into triglycerides. TG’s store the excess calories in the form of fat. Elevated TG’s do in fact increase your risk of heart attack. Excess calories in particular are converted to TG’s.

• Low density lipoprotein (LDL) - Often referred to as bad cholesterol. This form of cholesterol exists to transport cholesterol particles to the rest of the body. This is serving an important function. When the body needs cholesterol in order to create hormones, LDL is the mechanism. The problem with LDL is when you have too much it can build up in arteries and increase your risk of heart disease.

• High density lipoprotein (HDL) - Often referred to as good cholesterol. This form transports other forms of cholesterol (such as LDL) from the body back to the liver. This serves to remove excess LDL from the bloodstream, preventing damage to the lining of the blood vessels. It has also been shown to remove cholesterol deposits already existing on the vessel wall. These two functions combine to reduce your risk of heart disease.

Now that you have a good understanding of what these numbers mean in your lipid panel, we will discuss how to interpret them.