context: Cholesterol is a waxy, fat-like substance that occurs naturally in the body and is made by the liver. Cholesterol is also present in foods we eat. People need cholesterol for the body to function normally. Cholesterol is present in membranes (walls) of every cell in the body, including the brain, nerves, muscles, skin, liver, intestines, and heart. Too much cholesterol in your body means that you have an increased risk of getting cardiovascular diseases such as heart disease. If you have too much cholesterol in your body, the cholesterol can build up inside the walls of the arteries that carry blood to your heart. This buildup, which occurs over time, causes less blood and oxygen to get to your heart. This can cause chest pain and heart attacks. Too much cholesterol can also increase your risk of stroke. HDL (high density lipoprotein) cholesterol is known as "good" cholesterol. HDL takes the "bad," LDL (low density lipoprotein) cholesterol out of your blood and keeps it from building up in your arteries. LDL cholesterol is known as bad cholesterol because it leads to the development and build up of plaque on the walls of your arteries. That increase your chances of getting cardiovascular disease. When being tested for cholesterol, make sure you get numbers of total cholesterol, HDL cholesterol and LDL cholesterol. Doctors recommend your total cholesterol stay below 200 mg/d L. Here is the breakdown: Total Cholesterol Category Less than 200 Desirable 200 - 239 Borderline high 240 and above High An LDL (bad cholesterol) level of 190 or above is considered a serious risk factor for heart attack, stroke, and other problems caused by clogged arteries. In the past guidelines focused on lowering LDL levels to specific "target" numbers that were considered safer. Lowering cholesterol, though, is just one part of an overall strategy for reducing your risk for heart disease. HDL (good) cholesterol protects against heart disease, so for HDL, a higher number is better. A level less than 40 is low and is considered a risk factor because it increases your risk for developing heart disease. HDL levels of 60 or more help to lower your risk for heart disease. Your doctor will first work with you to determine your current level of risk, considering such things as your age, whether or not you smoke, and your blood pressure. Then based on your risk, the doctor will recommend healthy lifestyle changes and possibly medications to reduce your cholesterol level. But rather than giving you a target number to shoot for, your doctor will recommend a certain percentage you should use as a guide for lowering cholesterol. Then together, the two of you will consider the options you have for achieving that percentage Triglyceride levels that are borderline high (150-199) or high (200 or more) may require treatment in some people. Your risk for heart disease is lower when you have low total cholesterol and low LDL. Remember, a higher HDL number is better, however. Eating foods such as red meat, whole milk dairy products, egg yolks, and some kinds of fish can make your cholesterol levels go up. Being overweight can make your bad cholesterol go up and your good cholesterol go down. Also, after women go through menopause, their bad cholesterol levels tend to increase. You can lower your cholesterol levels by making changes to your lifestyle. Here are some tips. Eat foods with less fat, saturated fat, and cholesterol. Take off the skin and fat from meat, poultry, and fish. Eat food that has been broiled, baked, roasted, or poached instead of fried. Eat lots of fruits and vegetables everyday. Eat cereals, breads, rice, and pasta made from whole grains, such as whole wheat bread or spaghetti. Get at least 30 minutes of moderate to vigorous exercise everyday. Talk to your doctor about the safest and best ways for you to exercise. Lose weight if you are overweight. Stop smoking. Take your cholesterol medication as prescribed by your doctor. Cholesterol-lowering drugs include: Bile-acid resins Fibrates Niacin Proprotein convertase subtilisin kexin type 9 ( PCSK9) inhibitors Statins Cholesterol-lowering medicine is most effective when combined with a low-cholesterol diet. Not necessarily. Numerous foods marked "low cholesterol" can contain oils that may be high in saturated fats, which are not healthy. In addition, unsaturated fats like vegetable oil can also be high in calories. The total amount of fat in your diet should be kept to about 20% to 30% of your daily intake. It is important to have your cholesterol level checked when you are young, since clogging of the arteries (atherosclerosis) is a gradual process that takes many years. Total cholesterol should be measured at least every five years starting at age 20 and more often if you have a family history of high cholesterol. Note: If you have high cholesterol and your doctor has told you there may be an underlying genetic cause, you may want to have your children, under age 20, get their cholesterol levels tested. Talk to your children's health care providers about cholesterol testing.