hdl

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But having too much cholesterol in your blood raises your risk of coronary artery disease.

HDL and LDL are two types of lipoproteins.They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. HDL and LDL have different purposes:

• HDL stands for high-density lipoproteins. It is sometimes called the "good" cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
• LDL stands for low-density lipoproteins. It is sometimes called the "bad" cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.

A blood test can measure your cholesterol levels, including HDL. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger::

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older::

• Younger adults should have the test every 5 years
• Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

With HDL cholesterol, higher numbers are better, because a high HDL level can lower your risk for coronary artery disease and stroke. How high your HDL should be depends on your age and sex:

If your HDL level is too low, lifestyle changes may help. These changes may also help prevent other diseases, and make you feel better overall:

• Eat a healthy diet. To raise your HDL level, you need to eat good fats instead of bad fats. This means limiting saturated fats, which include full-fat milk and cheese, high-fat meats like sausage and bacon, and foods made with butter, lard, and shortening. You should also avoid trans fats, which may be in some margarines, fried foods, and processed foods like baked goods. Instead, eat unsaturated fats, which are found in avocado, vegetable oils like olive oil, and nuts. Limit carbohydrates, especially sugar. Also try to eat more foods naturally high in fiber, such as oatmeal and beans.
• Stay at a healthy weight. You can boost your HDL level by losing weight, especially if you have lots of fat around your waist.
• Exercise. Getting regular exercise can raise your HDL level, as well as lower your LDL. You should try to do 30 minutes of moderate to vigorous aerobic exercise on most, if not all, days.
• Avoid cigarettes.Smoking and exposure to secondhand smoke can lower your HDL level. If you are a smoker, ask your health care provider for help in finding the best way for you to quit. You should also try to avoid secondhand smoke.
• Limit alcohol. Moderate alcohol may lower your HDL level, although more studies are needed to confirm that. What we do know is that too much alcohol can make you gain weight, and that lowers your HDL level.

Some cholesterol medicines, including certain statins, can raise your HDL level, in addition to lowering your LDL level. Health care providers don't usually prescribe medicines only to raise HDL. But if you have a low HDL and high LDL level, you might need medicine.

Taking certain medicines can lower HDL levels in some people. They include:

• Beta blockers, a type of blood pressure medicine
• Anabolic steroids, including testosterone, a male hormone
• Progestins, which are female hormones that are in some birth control pills and hormone replacement therapy
• Benzodiazepines, sedatives that are often used for anxiety and insomnia

If you are taking one of these and you have a very low HDL level, ask your provider if you should continue to take them.

Diabetes can also lower your HDL level, so that gives you another reason to manage your diabetes.

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But if you have too much cholesterol in your blood, you have a higher risk of coronary artery disease.

A blood test called a lipoprotein panel can measure your cholesterol levels. Before the test, you'll need to fast (not eat or drink anything but water) for 9 to 12 hours. The test gives information about your:

• Total cholesterol - a measure of the total amount of cholesterol in your blood. It includes both low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.
• LDL (bad) cholesterol - the main source of cholesterol buildup and blockage in the arteries
• HDL (good) cholesterol - HDL helps remove cholesterol from your arteries
• Non-HDL - this number is your total cholesterol minus your HDL. Your non-HDL includes LDL and other types of cholesterol such as VLDL (very-low-density lipoprotein).
• Triglycerides - another form of fat in your blood that can raise your risk for heart disease, especially in women

Cholesterol numbers are measured in milligrams per deciliter (mg/dL). Here are the healthy levels of cholesterol, based on your age and gender:

Anyone age 19 or younger:

Men age 20 or older:

Women age 20 or older:

Triglycerides are not a type of cholesterol, but they are part of a lipoprotein panel (the test that measures cholesterol levels). A normal triglyceride level is below 150 mg/dL. You might need treatment if you have triglyceride levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more).

When and how often you should get a cholesterol test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger:

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older:

• Younger adults should have the test every 5 years
• Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

A variety of things can affect cholesterol levels. These are some things you can do to lower your cholesterol levels:

• Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level rise. Saturated fat is the main problem, but cholesterol in foods also matters. Reducing the amount of saturated fat in your diet helps lower your blood cholesterol level. Foods that have high levels of saturated fats include some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.
• Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL (bad) cholesterol, total cholesterol, and triglyceride levels. It also raises your HDL (good) cholesterol level.
• Physical Activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.
• Smoking.Cigarette smoking lowers your HDL (good) cholesterol. HDL helps to remove bad cholesterol from your arteries. So a lower HDL can contribute to a higher level of bad cholesterol.

Things outside of your control that can also affect cholesterol levels include:

• Age and Sex. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women's LDL (bad) cholesterol levels tend to rise.
• Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
• Race. Certain races may have an increased risk of high blood cholesterol. For example, African Americans typically have higher HDL and LDL cholesterol levels than whites.

There are two main ways to lower your cholesterol:

• Heart-healthy lifestyle changes, which include:
• Heart-healthy eating. A heart-healthy eating plan limits the amount of saturated and trans fats that you eat. Examples include the Therapeutic Lifestyle Changes diet and the DASH Eating Plan.
• Weight Management. If you are overweight, losing weight can help lower your LDL (bad) cholesterol.
• Physical Activity. Everyone should get regular physical activity (30 minutes on most, if not all, days).
• Managing stress. Research has shown that chronic stress can sometimes raise your LDL cholesterol and lower your HDL cholesterol.
• Quitting smoking.Quitting smoking can raise your HDL cholesterol. Since HDL helps to remove LDL cholesterol from your arteries, having more HDL can help to lower your LDL cholesterol.
• Drug Treatment. If lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines. There are several types of cholesterol medicines available, including statins. The medicines work in different ways and can have different side effects. Talk to your health care provider about which one is right for you. While you are taking medicines to lower your cholesterol, you should continue with the lifestyle changes.

NIH: National Heart, Lung, and Blood Institute

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But having too much cholesterol in your blood raises your risk of coronary artery disease.

LDL and HDL are two types of lipoproteins. They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. LDL and HDL have different purposes:

• LDL stands for low-density lipoproteins. It is sometimes called the "bad" cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.
• HDL stands for high-density lipoproteins. It is sometimes called the "good" cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.

If you have a high LDL level, this means that you have too much LDL cholesterol in your blood. This extra LDL, along with other substances, forms plaque. The plaque builds up in your arteries; this is a condition called atherosclerosis.

Coronary artery disease happens when the plaque buildup is in the arteries of your heart. It causes the arteries to become hardened and narrowed, which slows down or blocks the blood flow to your heart. Because your blood carries oxygen to your heart, this means that your heart may not be able to get enough oxygen. This can cause angina (chest pain), or if the blood flow is completely blocked, a heart attack.

A blood test can measure your cholesterol levels, including LDL. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger::

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older::

• Younger adults should have the test every 5 years
• Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

For people who are older than 65:

• They should have the test every year.

You may need to get your cholesterol checked more often if you have heart disease, diabetes, or a family history of high cholesterol.

Things that can affect your LDL level include:

• Diet. Saturated fat and cholesterol in the food you eat make your LDL level rise
• Weight. Being overweight tends to raise your LDL level, lower your HDL level, and increase your total cholesterol level
• Physical Activity. A lack of physical activity can lead to weight gain, which can raise your LDL level
• Smoking.Cigarette smoking lowers your HDL cholesterol. Since HDL helps to remove LDL from your arteries, if you have less HDL, that can contribute to you having a higher LDL level.
• Age and Sex. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women's LDL levels tend to rise.
• Genetics. Your genes partly determine how much cholesterol your body makes. High cholesterol can run in families. For example, familial hypercholesterolemia (FH) is an inherited form of high blood cholesterol.
• Medicines. Certain medicines, including steroids, some blood pressure medicines, and HIV medicines, can raise your LDL level.
• Other medical conditions. Diseases such as chronic kidney disease, diabetes, and HIV can cause a higher LDL level.
• Race or ethnicity. People from certain racial or ethnic groups may have an increased risk of high blood cholesterol. For example, African Americans typically have higher HDL and LDL cholesterol levels than White Americans. Asian Americans are more likely to have higher LDL levels than other groups.

With LDL cholesterol, lower numbers are better, because a high LDL level can raise your risk for coronary artery disease and related problems. The general ranges for healthy adults are:

If you have coronary artery disease or are at high risk for it, your health care provider may have different goals for your LDL level.

There are two main ways to lower your LDL cholesterol level:

• Heart-healthy lifestyle changes, which include:
• Heart-healthy eating. A heart-healthy eating plan limits the amount of saturated and trans fats that you eat. Examples of eating plans that can lower your LDL level include the Therapeutic Lifestyle Changes diet and the DASH eating plan.
• Weight management. If you are overweight, losing weight can help lower your LDL level.
• Physical Activity. Everyone should get regular physical activity.
• Drug Treatment. If lifestyle changes alone do not lower your LDL level enough, you may also need to take medicines. There are several types of cholesterol-lowering drugs available, including statins. The medicines work in different ways and can have different side effects. Talk to your provider about which one is right for you. While you are taking medicines to lower your LDL level, you still should continue with the lifestyle changes.

Some people with familial hypercholesterolemia (FH) may receive a treatment called lipoprotein apheresis. This treatment uses a filtering machine to remove LDL cholesterol from the blood. Then the machine returns the rest of the blood back to the person.

NIH: National Heart, Lung, and Blood Institute

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. Your body makes all the cholesterol it needs. Cholesterol is also found in foods from animal sources, such as egg yolks, meat, and cheese.

If you have too much cholesterol in your blood, it can combine with other substances in the blood to form plaque. Plaque sticks to the walls of your arteries. This buildup of plaque is known as atherosclerosis. It can lead to coronary artery disease, where your coronary arteries become narrow or even blocked.

HDL, LDL, and VLDL are lipoproteins. They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. Different types of lipoproteins have different purposes:

• HDL stands for high-density lipoprotein. It is sometimes called "good" cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
• LDL stands for low-density lipoprotein. It is sometimes called "bad" cholesterol because a high LDL level leads to the buildup of plaque in your arteries.
• VLDL stands for very low-density lipoprotein. Some people also call VLDL a "bad" cholesterol because it too contributes to the buildup of plaque in your arteries. But VLDL and LDL are different; VLDL mainly carries triglycerides and LDL mainly carries cholesterol.

The most common cause of high cholesterol is an unhealthy lifestyle. This can include:

• Unhealthy eating habits, such as eating lots of bad fats. One type, saturated fat, is found in some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods. Another type, trans fat, is in some fried and processed foods. Eating these fats can raise your LDL (bad) cholesterol.
• Lack of physical activity, with lots of sitting and little exercise. This lowers your HDL (good) cholesterol.
• Smoking, which lowers HDL cholesterol, especially in women. It also raises your LDL cholesterol.

Genetics may also cause people to have high cholesterol. For example, familial hypercholesterolemia (FH) is an inherited form of high cholesterol. Other medical conditions and certain medicines may also cause high cholesterol.

A variety of things can raise your risk for high cholesterol:

• Age. Your cholesterol levels tend to rise as you get older. Even though it is less common, younger people, including children and teens, can also have high cholesterol.
• Heredity. High blood cholesterol can run in families.
• Weight. Being overweight or having obesity raises your cholesterol level.
• Race. Certain races may have an increased risk of high cholesterol. For example, African Americans typically have higher HDL and LDL cholesterol levels than whites.

If you have large deposits of plaque in your arteries, an area of plaque can rupture (break open). This can cause a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block blood flow in a coronary artery.

If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, it can cause angina (chest pain) or a heart attack.

Plaque also can build up in other arteries in your body, including the arteries that bring oxygen-rich blood to your brain and limbs. This can lead to problems such as carotid artery disease, stroke, and peripheral arterial disease.

There are usually no signs or symptoms that you have high cholesterol. There is a blood test to measure your cholesterol level. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger::

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older::

• Younger adults should have the test every 5 years
• Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

You can lower your cholesterol through heart-healthy lifestyle changes. They include a heart-healthy eating plan, weight management, and regular physical activity.

If the lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines. There are several types of cholesterol-lowering drugs available, including statins. If you take medicines to lower your cholesterol, you still should continue with the lifestyle changes.

Some people with familial hypercholesterolemia (FH) may receive a treatment called lipoprotein apheresis. This treatment uses a filtering machine to remove LDL cholesterol from the blood. Then the machine returns the rest of the blood back to the person.

NIH: National Heart, Lung, and Blood Institute

Your body needs some cholesterol to work properly. But if you have too much in your blood, it can stick to the walls of your arteries and narrow or even block them. This puts you at risk for coronary artery disease and other heart diseases.

Cholesterol travels through the blood on proteins called lipoproteins. One type, LDL, is sometimes called the "bad" cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. Another type, HDL, is sometimes called the "good" cholesterol. It carries cholesterol from other parts of your body back to your liver. Then your liver removes the cholesterol from your body.

There are steps that you can take to lower your LDL (bad) cholesterol and raise your HDL (good) cholesterol. By keeping your cholesterol levels in range, you can lower your risk of heart diseases.

The main treatments for high cholesterol are lifestyle changes and medicines.

Heart-healthy lifestyle changes that can help you lower or control your cholesterol include:

• Heart-healthy eating. A heart-healthy eating plan limits the amount of saturated and trans fats that you eat. It recommends that you eat and drink only enough calories to stay at a healthy weight and avoid weight gain. It encourages you to choose a variety of nutritious foods, including fruits, vegetables, whole grains, and lean meats. Examples of eating plans that can lower your cholesterol include the Therapeutic Lifestyle Changes diet and the DASH eating plan.
• Weight Management. If you are overweight, losing weight can help lower your LDL (bad) cholesterol. This is especially important for people with metabolic syndrome. Metabolic syndrome is a group of risk factors that includes high triglyceride levels, low HDL (good) cholesterol levels, and being overweight with a large waist measurement (more than 40 inches for men and more than 35 inches for women).
• Physical Activity. Everyone should get regular physical activity (30 minutes on most, if not all, days).
• Managing stress. Research has shown that chronic stress can sometimes raise your LDL cholesterol and lower your HDL cholesterol.
• Quitting smoking.Quitting smoking can raise your HDL cholesterol. Since HDL helps to remove LDL cholesterol from your arteries, having more HDL can help to lower your LDL cholesterol.

For some people, making lifestyle changes alone does not their lower cholesterol enough. They may also need to take medicines. There are several types of cholesterol-lowering drugs available. They work in different ways and can have different side effects. Talk to your health care provider about which medicine is right for you.

Even if you take medicines to lower your cholesterol, you still need to continue with lifestyle changes.

Familial hypercholesterolemia (FH) is an inherited form of high cholesterol. Some people who have FH may get a treatment called lipoprotein apheresis. This treatment uses a filtering machine to remove LDL cholesterol from the blood. Then the machine returns the rest of the blood back to the person.

Some companies sell supplements that they say can lower cholesterol. Researchers have studied many of these supplements, including red yeast rice, flaxseed, and garlic. At this time, there isn't conclusive evidence that any of them are effective in lowering cholesterol levels. Also, supplements may cause side effects and interactions with medicines. Always check with your health care provider before you take any supplements.

Cholesterol is a waxy, fat-like substance that's found in all the cells in the body. The liver makes cholesterol, and it is also in some foods, such as meat and dairy products. The body needs some cholesterol to work properly. But if your child or teen has high cholesterol (too much cholesterol in the blood), he or she has a higher risk of coronary artery disease and other heart diseases.

Three main factors contribute to high cholesterol in children and teens:

• An unhealthy diet, especially one that is high in fats
• A family history of high cholesterol, especially when one or both parents have high cholesterol
• Obesity

Some diseases, such as diabetes, kidney disease, and certain thyroid diseases, can also cause high cholesterol in children and teens.

There are usually no signs or symptoms that your child or teen has high cholesterol.

There is a blood test to measure cholesterol levels. The test gives information about:

• Total cholesterol - a measure of the total amount of cholesterol in your blood. It includes both low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.
• LDL (bad) cholesterol - the main source of cholesterol buildup and blockage in the arteries
• HDL (good) cholesterol - HDL helps remove cholesterol from your arteries
• Non-HDL - this number is your total cholesterol minus your HDL. Your non-HDL includes LDL and other types of cholesterol such as VLDL (very-low-density lipoprotein).
• Triglycerides - another form of fat in your blood that can raise your risk for heart disease

For anyone aged 19 or younger, the healthy levels of cholesterol are

When and how often your child or teen should get this test depends on his or her age, risk factors, and family history. The general recommendations are:

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

Lifestyle changes are the main treatment for high cholesterol in children and teens. These changes include:

• Being more active. This includes getting regular exercise and spending less time sitting (in front of a television, at a computer, on a phone or tablet, etc.)
• Healthy eating. A diet to lower cholesterol includes limiting foods that are high in saturated fat, sugar, and trans fat. It is also important to eat plenty of fresh fruits, vegetables, and whole grains.
• Losing weight, if your child or teen is overweight or has obesity

If everyone in the family makes these changes, it will be easier for your child or teen to stick to them. It is also an opportunity to improve your health, and the health of the rest of your family.

Sometimes these lifestyle changes are not enough to lower your child or teen's cholesterol. Your health care provider may consider giving your child or teen cholesterol medicines if he or she:

• Is at least 10 years old
• Has an LDL (bad) cholesterol level that is higher than 190 mg/dL, even after six months of diet and exercise changes
• Has an LDL (bad) cholesterol level that is higher than 160 mg/dL AND is at high risk for heart disease
• Has an inherited type of high cholesterol

Your body needs some cholesterol to work properly. But if you have too much in your blood, it can stick to the walls of your arteries and narrow or even block them. This puts you at risk for coronary artery disease and other heart diseases.

Cholesterol travels through the blood on proteins called lipoproteins. One type, LDL, is sometimes called the "bad" cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. Another type, HDL, is sometimes called the "good" cholesterol. It carries cholesterol from other parts of your body back to your liver. Then your liver removes the cholesterol from your body.

The treatments for high cholesterol are heart-healthy lifestyle changes and medicines. The lifestyle changes include healthy eating, weight management, and regular physical activity.

Heart-healthy lifestyle changes include a diet to lower your cholesterol. The DASH eating plan is one example. Another is the Therapeutic Lifestyle Changes diet, which recommends that you

Choose healthier fats.You should limit both total fat and saturated fat. No more than 25 to 35% of your daily calories should come from dietary fats, and less than 7% of your daily calories should come from saturated fat. Depending upon how many calories you eat per day, here are the maximum amounts of fats that you should eat:

Saturated fat is a bad fat because it raises your LDL (bad cholesterol) level more than anything else in your diet. It is found in some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.

Trans fat is another bad fat; it can raise your LDL and lower you HDL (good cholesterol). Trans fat is mostly in foods made with hydrogenated oils and fats, such as stick margarine, crackers, and french fries.

Instead of these bad fats, try healthier fats, such as lean meat, nuts, and unsaturated oils like canola, olive, and safflower oils.

Limit foods with cholesterol. If you are trying to lower your cholesterol, you should have less than 200 mg a day of cholesterol. Cholesterol is in foods of animal origin, such as liver and other organ meats, egg yolks, shrimp, and whole milk dairy products.

Eat plenty of soluble fiber. Foods high in soluble fiber help prevent your digestive tract from absorbing cholesterol. These foods include:

• Whole-grain cereals such as oatmeal and oat bran
• Fruits such as apples, bananas, oranges, pears, and prunes
• Legumes such as kidney beans, lentils, chick peas, black-eyed peas, and lima beans

Eat lots of fruits and vegetables. A diet rich in fruits and vegetables can increase important cholesterol-lowering compounds in your diet. These compounds, called plant stanols or sterols, work like soluble fiber.

Eat fish that are high in omega-3 fatty acids. These acids won't lower your LDL level, but they may help raise your HDL level. They may also protect your heart from blood clots and inflammation and reduce your risk of heart attack. Fish that are a good source of omega-3 fatty acids include salmon, tuna (canned or fresh), and mackerel. Try to eat these fish two times a week.

Limit salt. You should try to limit the amount of sodium (salt) that you eat to no more than 2,300 milligrams (about 1 teaspoon of salt) a day. That includes all the sodium you eat, whether it was added in cooking or at the table, or already present in food products. Limiting salt won't lower your cholesterol, but it can lower your risk of heart diseases by helping to lower your blood pressure. You can reduce your sodium by instead choosing low-salt and "no added salt" foods and seasonings at the table or while cooking.

Limit alcohol. Alcohol adds extra calories, which can lead to weight gain. Being overweight can raise your LDL level and lower your HDL level. Too much alcohol can also increase your risk of heart diseases because it can raise your blood pressure and triglyceride level. One drink is a glass of wine, beer, or a small amount of hard liquor, and the recommendation is that:

• Men should have no more than two drinks containing alcohol a day
• Women should have no more than one drink containing alcohol a day

Nutrition labels can help you figure out how much fat, saturated fat, cholesterol, fiber, and sodium is in the foods that you buy.

NIH: National Heart, Lung, and Blood Institute

Your body needs some cholesterol to work properly. But if you have too much in your blood, it can stick to the walls of your arteries and narrow or even block them. This puts you at risk for coronary artery disease and other heart diseases.

Cholesterol travels through the blood on proteins called lipoproteins. One type, LDL, is sometimes called the "bad" cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. Another type, HDL, is sometimes called the "good" cholesterol. It carries cholesterol from other parts of your body back to your liver. Then your liver removes the cholesterol from your body.

If you have high cholesterol, lifestyle changes can help you to lower your cholesterol level. But sometimes the lifestyle changes are not enough, and you need to take cholesterol medicines. You should still continue with the lifestyle changes even though you are taking medicines.

Your health care provider may prescribe medicine if:

• You have already had a heart attack or stroke, or you have peripheral arterial disease
• Your LDL (bad) cholesterol level is 190 mg/dL or higher
• You are 40-75 years old, you have diabetes, and your LDL cholesterol level is 70 mg/dL or higher
• You are 40-75 years old, you have a high risk of developing heart disease or stroke, and your LDL cholesterol level is 70 mg/dL or higher

There are several types of cholesterol-lowering drugs available, including:

• Statins, which block the liver from making cholesterol
• Bile acid sequestrants, which decrease the amount of fat absorbed from food
• Cholesterol absorption inhibitors, which decrease the amount of cholesterol absorbed from food and lower triglycerides.
• Nicotinic acid (niacin), which lowers LDL (bad) cholesterol and triglycerides and raises HDL (good) cholesterol. Even though you can buy niacin without a prescription, you should talk to your health care provider before taking it to lower your cholesterol. High doses of niacin can cause serious side effects.
• PCSK9 inhibitors, which block a protein called PCSK9. This helps your liver remove and clear LDL cholesterol from your blood.
• Fibrates, which lower triglycerides. They may also raise HDL (good) cholesterol. If you take them with statins, they may increase the risk of muscle problems.
• Combination medicines, which include more than one type of cholesterol-lowering medicine

There are also a few other cholesterol medicines (lomitapide and mipomersen) that are only for people who have familial hypercholesterolemia (FH). FH is an inherited disorder that causes high LDL cholesterol.

When deciding which medicine you should take and which dose you need, your health care provider will consider:

• Your cholesterol levels
• Your risk for heart disease and stroke
• Your age
• Any other health problems you have
• Possible side effects of the medicines. Higher doses are more likely to cause side effects, especially over time.

Medicines can help control your cholesterol, but they don't cure it. You need to keep taking your medicines and get regular cholesterol checks to make sure that you cholesterol levels are in a healthy range.

Metabolic syndrome is the name for a group of risk factors for heart disease, diabetes, and other health problems. You can have just one risk factor, but people often have several of them together. When you have at least three of them, it is called metabolic syndrome. These risk factors include:

• A large waistline, also called abdominal obesity or "having an apple shape." Too much fat around the stomach is a greater risk factor for heart disease than too much fat in other parts of the body.
• Having a high triglyceride level. Triglycerides are a type of fat found in the blood.
• Having a low HDL cholesterol level. HDL is sometimes called the "good" cholesterol because it helps remove cholesterol from your arteries.
• Having high blood pressure. If your blood pressure stays high over time, it can damage your heart and lead to other health problems.
• Having a high fasting blood sugar. Mildly high blood sugar may be an early sign of diabetes.

The more factors you have, the higher your risk for heart disease, diabetes, and stroke is.

Metabolic syndrome has several causes that act together:

• Overweight and obesity
• An inactive lifestyle
• Insulin resistance, a condition in which the body can't use insulin properly. Insulin is a hormone that helps move blood sugar into your cells to give them energy. Insulin resistance can lead to high blood sugar levels.
• Age - your risk goes up as get older
• Genetics - ethnicity and family history

People who have metabolic syndrome often also have excessive blood clotting and inflammation throughout the body. Researchers don't know whether these conditions cause metabolic syndrome or worsen it.

The most important risk factors for metabolic syndrome are:

• Abdominal obesity (a large waistline)
• An inactive lifestyle
• Insulin resistance

There are certain groups of people who have an increased risk of metabolic syndrome:

• Some racial and ethnic groups. Mexican Americans have the highest rate of metabolic syndrome, followed by whites and blacks.
• People who have diabetes
• People who have a sibling or parent who has diabetes
• Women with polycystic ovary syndrome (PCOS)
• People who take medicines that cause weight gain or changes in blood pressure, blood cholesterol, and blood sugar levels

Most of the metabolic risk factors have no obvious signs or symptoms, except for a large waistline.

Your health care provider will diagnose metabolic syndrome based on the results of a physical exam and blood tests. You must have at least three of the risk factors to be diagnosed with metabolic syndrome:

• A large waistline, which means a waist measurement of
  • 35 inches or more for women
  • 40 inches or more for men
• A high triglyceride level, which is 150 mg/dL or higher
• A low HDL cholesterol level, which is
  • Less than 50 mg/dL for women
  • Less than 40 mg/dL for men
• High blood pressure, which is a reading of 130/85 mmHg or higher.
• A high fasting blood sugar, which is 100 mg/dL or higher

The most important treatment for metabolic syndrome is a heart-healthy lifestyle, which includes:

• A heart-healthy eating plan, which limits the amount of saturated and trans fats that you eat. It encourages you to choose a variety of nutritious foods, including fruits, vegetables, whole grains, and lean meats.
• Aiming for a healthy weight
• Managing stress
• Getting regular physical activity
• Quitting smoking (or not starting if you don't already smoke)

If making lifestyle changes is not enough, you may need to take medicines. For example, you may need medicines to lower cholesterol or blood pressure.

The best way to prevent metabolic syndrome is through the heart-healthy lifestyle changes.

NIH: National Heart, Lung, and Blood Institute

The B vitamins are:

• B1 (thiamine)
• B2 (riboflavin)
• B3 (niacin)
• B5 (pantothenic acid)
• B6
• B7 (biotin)
• B12
• Folic acid

These vitamins help the process your body uses to get or make energy from the food you eat. They also help form red blood cells. You can get B vitamins from proteins such as fish, poultry, meat, eggs, and dairy products. Leafy green vegetables, beans, and peas also have B vitamins. Many cereals and some breads have added B vitamins.

Not getting enough of certain B vitamins can cause diseases. A lack of B12 or B6 can cause anemia.