University of Iowa Health Science Relations and
Helmut Schrott, MD
Professor Emeritus of Epidemiology/Internal Medicine
First Published: November 2000
Peer Review Status: Internally Peer Reviewed
Having high cholesterol can lead to serious health problems such as
heart disease and stroke. We know that we should eat more fruits and
vegetables and watch our intake of red meats and other fatty foods.
And we know we should all have our blood cholesterol tested
regularly, especially if we have a family history of high
But did you know there are some good aspects of cholesterol?
Helmut Schrott, MD, a professor of epidemiology in the University
of Iowa College of Public Health and director of the UI Lipid
Research Clinic, said that the body needs a certain amount of
cholesterol to function properly.
"Cholesterol is needed for cell wall functioning and for the
production of hormones, such as estrogen and testosterone," said
Schrott. "However, the body naturally makes cholesterol in every
cell, so there is no absolute dietary need for it."
Cholesterol is naturally produced by the liver and located in cell
walls. Lipoproteins, a combination of lipids (fats) and proteins, are
made in the liver and carries cholesterol, fats and fat-soluble
vitamins, among many other substances, to different parts of the body
that need it for energy and repairs. When cholesterol rises above a
certain level, it can increase your risk for heart disease and
You often hear about "good" and "bad" cholesterol. Low-density
lipoprotein cholesterol (LDL-C) is known as the "bad" cholesterol,
and high-density lipoprotein cholesterol (HDL-C) is known as the
"good" cholesterol. Too much LDL-C circulating in the blood can start
to build up in the walls of the arteries, especially those leading to
the heart and brain.
HDL-C particles can unload cholesterol from other lipoproteins and
tissues like the arteries and carry the excess cholesterol to the
liver to be eliminated from the body. This removal of cholesterol is
sometimes referred to as the reverse cholesterol pathway.
According to the American Heart Association, there are three
levels of total cholesterol that relate to the amount of risk for
heart disease risk one may have. A desirable level of total
cholesterol is less than 200 mg/dL, meaning your risk for heart
disease is average. A borderline high risk level for total
cholesterol is 200-239 mg/dL, and a high-risk level for heart disease
occurs when the total cholesterol level is 240 mg/dL or greater.
If you are at high risk for heart disease because your cholesterol
is elevated, what can you do? If you are overweight, eat an unhealthy
diet, or have a family history of cholesterol, Schrott recommends
engaging in a healthier lifestyle.
"Although medication is a very effective way to treat high
cholesterol, diet and weight loss may be the only things you need to
do to lower your cholesterol," Schrott said. "Eating a diet low in
saturated fat and following an exercise program are also effective in
reducing the risk for other potential diseases such as diabetes and
Sometimes being on a diet is easier said than done. Schrott said
that staying on a regimented diet and exercise program is very hard
for many patients.
"It's easy to lose weight and eat right when you want to," Schrott
said. "It's harder when you have to."
Finding a diet and exercise plan that works for you and in which
you can see results is the key. Eating more fruits and vegetables and
less red meat, eggs and other foods high in saturated fat, and
getting regular exercise, will greatly improve cholesterol levels. If
you have high cholesterol or are at risk for high cholesterol, talk
to your doctor about a plan that works for you.