Good For You!

Understanding Cholesterol

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Overview
Cholesterol is a soft, waxy substance found among the lipids (fats) in the bloodstream, as well as in all of the cells that make up our bodies.  It's important to our health because it's used for various functions including the forming of cell membranes, and some hormones. But a high level of cholesterol in the blood — Hypercholesterolemia — is a major risk factor for coronary heart disease.

Cholesterol and other fats cannot dissolve in the blood.  They have to be transported to and from the cells by special carriers called lipoproteins.  There are several types of lipoprotien, but the ones to focus on are Low-Density Lipoprotein (LDL) and High-Density Lipoprotein (HDL).

What is LDL cholesterol?
Low-density lipoprotein is the major cholesterol carrier in the blood. If too much LDL cholesterol circulates in the blood, it can slowly build up in the walls of the arteries feeding the heart and brain. Together with other substances it can form plaque, a thick, hard deposit that can clog those arteries. This condition is known as Atherosclerosis.  A clot (thrombus) that forms near this plaque can block the blood flow to part of the heart muscle and cause a heart attack. If a clot blocks the flow of blood to the brain, the result is a stroke. A high level of LDL cholesterol (160 mg/dL and above) reflects an increased risk of heart disease. If you have heart disease, your LDL cholesterol should be less than 100 mg/dL and your doctor may even set your goal to be less than 70 mg/dL. This is why LDL cholesterol is called often referred to as "bad" cholesterol. Lower levels of LDL cholesterol reflect a lower risk of heart disease.

What is HDL cholesterol?
About one-third to one-fourth of blood cholesterol is carried by High-Density Lipoprotein. HDL tends to carry cholesterol away from the arteries and back to the liver, where it's passed from the body. HDL removes excess cholesterol from plaques and thus slows their growth. Because a high HDL level seems to protect against heart disease, HDL cholesterol is known as "good" cholesterol.  However, the opposite is also true. A low HDL level (less than 40 mg/dL in men; less than 50 mg/dL in women) indicates a greater risk for heart disease. A low HDL cholesterol level may also increase the risk of stroke.

What about cholesterol and diet?
People receive cholesterol in two ways.  The body — mainly the liver — produces varying amounts, usually about 1,000 milligrams a day. Foods also can contain cholesterol.   Animal-based food products (especially egg yolks, meat, poultry, shellfish, whole- and reduced-fat milk and dairy products) contain cholesterol.  Foods originating from plants (fruits, vegetables, grains, nuts and seeds) do not contain cholesterol.

Typically the body creates all of the cholesterol it needs, so consuming it from outside sources is not needed. Saturated fatty acids are the main culprit in raising blood cholesterol, which increases your risk of heart disease. Trans fats also raise blood cholesterol, however, dietary cholesterol also plays a part. The average North American man consumes about 337 milligrams of cholesterol a day; the average woman, 217 milligrams.

Some excess dietary cholesterol is removed from the body through the liver. Still, the American Heart Association recommends that you limit your average daily cholesterol intake to less than 300 milligrams and if you have heart disease, limit your daily intake to less than 200 milligrams. In addition to limiting cholesterol intake, it’s also important to remember that by maintaining a low dietary intake of saturated and trans fats, you can significantly lower your dietary cholesterol intake. Foods high in saturated fat generally contain substantial amounts of dietary cholesterol.

People with severe high blood cholesterol levels may require an even greater reduction.  Since cholesterol is found in all foods from originating from animals, care must be taken to eat no more than six ounces of lean meat, fish and poultry per day and to use fat-free and low-fat dairy products. High-quality proteins from vegetable sources such as beans are good substitutes for animal sources of protein.

Summary Table of Cholesterol Claims
Note: The claims in quotation marks in column 1 are those which are permitted by the Food and Drug Regulations. The reference amounts are found in Part D, Schedule M (FDR).

Claim	Conditions - Food	Conditions - Label or Advertisement
a) Free of Cholesterol "free of cholesterol" "cholesterol-free" "no cholesterol" "0 cholesterol" "zero cholesterol" "without cholesterol" "contains no cholesterol"	The food (a) contains less than 2 mg of cholesterol (i) per reference amount and serving of stated size, or (ii) per serving of stated size, if the food is a pre-packaged meal; and (b) meets the conditions set out in column 2 of the subject "low in saturated fatty acids".	Must comply with the general requirements for nutrient content claims. Nutrition Facts table required on products otherwise exempted by B.01.401(2)(a) and (b) When used in an advertisement, must comply with the requirements for advertisements.
b) Low in cholesterol "low in cholesterol" "low cholesterol" "low source of cholesterol" "little cholesterol" "contains only (number) mg of cholesterol per serving" "contains less than (number) mg of cholesterol per serving"	The food (a) contains 20 mg or less of cholesterol per (i) reference amount and serving of stated size and, if the reference amount is 30 g or 30 mL or less, per 50 g, or (ii) per 100 g, if the food is a pre-packaged meal; and (b) meets the conditions set out in column 2 of the subject "low in saturated fatty acids".	See conditions set out for item a) of this table.
c) Reduced in Cholesterol "reduced in cholesterol" "reduced cholesterol" "cholesterol- reduced" "less cholesterol" "lower cholesterol" "lower in cholesterol"	(1) The food is processed, formulated, reformulated or otherwise modified so that it contains at least 25% less cholesterol (a) per reference amount of the food, than the reference amount of a similar reference food; or (b) per 100 g, than 100 g of a similar reference food, if the food is a pre-packaged meal. (2) The similar reference food does not meet the conditions set out in column 2 of the subject "low in cholesterol" (item (b) of this table). (3) The food meets the conditions set out in column 2 of the subject "low in saturated fatty acids".	The following are identified: (a) the similar reference food; (b) the amounts of the food and the similar reference food being compared, if those amounts are not equal; and (c) the difference in cholesterol with the similar reference food, expressed by percentage or fraction or in milligrams per serving of stated size. See conditions set out for item a) of this table.
d) Lower in Cholesterol "lower in cholesterol" "lower cholesterol" "less cholesterol"	(1) The food contains at least 25% less cholesterol (a) per reference amount of the food, than the reference amount of a reference food of the same food group; or (b) per 100 g, than 100 g of a reference food of the same food group, if the food is a pre-packaged meal. (2) The reference food of the same food group does not meet the conditions set out in column 2 of the subject "low in cholesterol" (item (b) of this table). (3) The food meets the conditions set out in column 2 of the subject "low in saturated fatty acids".	The following are identified: (a) the reference food of the same food group; (b) the amounts of the food and the reference food of the same food group being compared, if those amounts are not equal; and (c) the difference in cholesterol with the reference food of the same food group, expressed by percentage or fraction or in milligrams per serving of stated size. See conditions set out for item a) of this table.