Cholesterol: the Good, the Bad, the Ugly

Q: I have heard about “good” and “bad” cholesterol. What’s the difference and how do I know which one I’m eating?

A: Way to be a buzz kill on Thanksgiving week!  Just kidding – great question.  Let’s begin with a little chemistry lesson.



Fat doesn’t dissolve in water and blood, so it has to get chauffeured around your body by cholesterol.  There are two main types of cholesterol: high density lipoprotein (HDL, “the good guy”) and low density lipoprotein (LDL, “the bad guy”).

HDL acts like a scavenger or vacuum cleaner, picking up cholesterol and transporting it back to the liver, where it is processed and put to many necessary uses like building cell walls and membranes, bile acids and hormones.

On the other hand, LDL picks cholesterol up from the liver and drops it off throughout the body. This is especially problematic in blood vessels where the excess cholesterol can form plaques. The blood vessels around your heart (“coronaries”) are the diameter of spaghetti; a little plaque in them can mean a lot of trouble, like a heart attack. Too much plaque in the vessels supplying your brain can mean a stroke.

How do you know when your LDL is too high? Unfortunately, high cholesterol has no specific symptoms so a blood test is the only way to find out.  While healthy eating and exercise can go a long way towards keeping your cholesterol in check, high cholesterol can have a genetic component so you should talk to your doctor about when you need to start screening.

Certain foods, like trans fats, can actually increase LDL and decrease HDL. On the other hand, fatty fish (like salmon), walnuts and oatmeal can actually decrease LDL.  If you’re a smoker, quitting can also improve the amount of HDL in your blood (among a host of other improvements to your health). To see more tips on cholesterol and what you can do to improve yours, check out the websites below:

American Heart Association

U.S. National Institutes of Health

The Mayo Clinic

Cheryl Czapla, Med IV
College of Medicine
The Ohio State University

Victoria Rentel, MD
Student Health Services
The Ohio State University