[C1064]Coronary Heart Disease Risk

But there's a lot more to the story.

The truth is, cholesterol is just one risk factor for heart disease. And it's not even the most important one. You see, cholesterol isn't all bad. In fact, you'd die without it.

This fatty substance produced by the liver helps keep your body running smoothly by building cell membranes and maintaining hormone levels.
Even more surprising, lowering cholesterol doesn't necessarily improve health.

Research has even linked LOW levels of cholesterol to a higher risk of death in older people. For some of us, lowering cholesterol may do more harm than good, since higher amounts of cholesterol may actually protect against death.

When it comes to cholesterol, its role in heart disease isn't the only myth. Here's another one: "A high-fat diet causes cholesterol problems." Again, the truth is more complicated than that. That's because the TYPE of fat you consume matters much more than how MUCH of it you eat.

Trans fats or hydrogenated fats and saturated fats promote abnormal cholesterol, while omega-3 fats and monounsaturated fats can help lower cholesterol and improve the type you do have. Fat isn't the bad guy here. Instead, it's sugar. And your body turns sugar into fat.The biggest source of abnormal cholesterol is not fat -- it's sugar, which your body converts to fat.

One kind of sugar is worse than the others. That's high-fructose corn syrup, or HFCS. You'll find HFCS in sodas, many juices, and most processed foods. But HFCS isn't so sweet: It's the main dietary cause of cholesterol problems.

While we're on the subject of myths, let's talk about total cholesterol. It is NOT the most critical aspect of cholesterol. And lowering cholesterol may not be the answer. That's because you want your HDL ("good") cholesterol levels to be higher, not lower.

It turns out that many different facets of cholesterol make a difference in your health. These include your levels of HDL ("good") vs. LDL ("bad") cholesterol; your triglyceride levels; your ratio of triglycerides to HDL; and your ratio of total cholesterol to HDL. That's a lot of things to consider -- but there's more.

When it comes to cholesterol and triglycerides, size matters, too. In this case, bigger is better. Cholesterol particles that are large and fluffy are generally safe, even if you have high cholesterol. Smaller particles are more dangerous because they can easily penetrate arteries. Your cholesterol can also become rancid, or oxidized, which can be unhealthy. Oxidative stress and free radicals can trigger inflammation. And when small LDL particles become rancid, they lead to plaque and cholesterol buildup in your arteries.

So cholesterol isn't the only cause of cardiovascular disease. And lowering cholesterol doesn't always make a difference in your risk. Instead, cardiovascular problems occur when your body functions get out of whack. The result: Inflammation, blood sugar imbalances, and oxidative stress. Simply put, your risk is determined by the way that your genes interact with your lifestyle and environment. These factors need to stay balanced, or your risk for heart disease will increase. One major risk factor for heart disease is inflammation.

In one major study, Harvard researchers found that people with high levels of a marker called C-reactive protein (CRP) had higher risks of heart disease than people with high cholesterol. People who had lower cholesterol levels didn't protect those with high CRP. The risks were greatest for those with high levels of both CRP and cholesterol.

Insulin resistance (also called metabolic syndrome or pre-diabetes) also increases the risk of heart disease, by causing blood sugar imbalances and high levels of insulin. High levels of a substance called homocysteine may also lead to cardiovascular illness.

All of these conditions can lower cholesterol, but not the way you'd like. The cholesterol that they lower is the good kind -- and lowering that is bad! They also boost your triglycerides, increasing inflammation and oxidative stress -- and triggering cardiovascular disease. So what can you do?

There is good news. These factors can arise from poor diet, nutritional imbalances, stress, and lack of activity -- all of which are under your control. Changing these factors can help lower cholesterol, as well as other risks for heart disease. But before you can start a comprehensive program to lower your risk of heart disease, you need to determine your overall risk. Ask your doctor about the following tests.

* Total, HDL, and LDL cholesterol, and triglycerides. Your total cholesterol should be under 200; triglycerides under 100; HDL over 60; LDL under 80. Your ratio of total cholesterol to HDL should be less than 3.0. Your ratio of triglycerides to HDL should be no greater than 4.

* NMR Lipid Profile. This looks at your cholesterol under an MRI scan to assess the size of the particles.

* Cardio C-reactive protein. This should be less than 1.

* Homocysteine. Your homocysteine should be between 6 and 8.

* Lipid peroxides or TBARS test, which looks at the amount of oxidized or rancid fat.

* Fibrinogen, which looks at blood clotting. It should be less than 300.

* Lipoprotein (a), can promote the risk of heart disease, often in men. It should be less than 30.

* Genes or SNPs including Apo E, cholesterol ester transfer protein, and MTHFR genes.

* High-speed CT or (EBT) scan of the heart may be helpful. Scores higher than 100 are a concern.

As you can see, cholesterol is important -- but it isn't the most important risk for heart disease. Likewise, lowering cholesterol isn't the only answer. By getting tested, you'll get a better picture of your true heart disease risk. Then you'll be ready to start lowering cholesterol AND your other risk factors so you can improve your health -- today.