Did your doctor tell you that your cholesterol levels are a little high in your recent blood test, but not too high, and that you're in the 'borderline' range? It's normal to feel a little scared and worried when you hear that. "Oh, do I have high cholesterol now?" you might think. But don't worry. This is like a warning light turning yellow on a traffic light. Before it turns red, meaning your cholesterol levels are "high," you have the best chance to change your lifestyle and get back to a healthy level.
Simply put, if your total cholesterol level is between 200 and 239 milligrams per deciliter (mg/dL), that's what we call 'borderline' cholesterol. But a doctor doesn't make a decision based on that number alone. He or she will consider many factors, including your "bad" cholesterol ( LDL ), your "good" cholesterol (HDL), whether you have other conditions like diabetes , high blood pressure , and whether you smoke , to determine whether you need treatment or whether lifestyle changes will be enough.
Heart disease risk
Check the risk of developing a heart disease within the next 10 years with the Framingham Score
Why do we need to think so much about cholesterol?
Cholesterol is a waxy, fatty substance that our bodies need. Our liver produces the amount we need. But we also get cholesterol from things like animal products . Problems start when this cholesterol builds up in the body.
Think of it like dirt building up inside a water pipe, excess cholesterol starts to build up on the walls of our blood vessels. In medical terms, we call this ' atherosclerosis '. This is how cholesterol builds up and narrows the blood vessels. Then the heart doesn't get the blood it needs.
The sad thing is, we don't see any symptoms of high cholesterol. It's like a silent enemy. That's why it's recommended to have your cholesterol levels checked at least once every 5 years.
Some people may experience chest pain (angina). But by then, the blood vessels are quite narrow. If a blood vessel becomes completely blocked, the risk of a heart attack is much higher. Therefore, it is wise to know your level with a blood test before waiting for that to happen.
Let's understand the values in the cholesterol report.
When you do a cholesterol test (Lipid Profile), there are several values. Just looking at the total cholesterol value is not enough. The other values are what really matter. Let's see what they are.
| Cholesterol type | What happens to it? |
|---|---|
| LDL (Low-Density Lipoprotein) | This is the "bad cholesterol." It is this that builds up in the blood vessels and increases the risk of heart disease. It is best to keep this level as low as possible. |
| HDL (High-Density Lipoprotein) | This is the "good cholesterol." What it does is pick up the bad cholesterol in the blood vessels and deliver it to the liver. The liver then removes it from the body. So the higher this value, the better. |
| Triglycerides | This is another type of fat found in the blood. It is stored as fat cells in the body. An increase in this value also increases the risk of heart disease. |
Are the values in your report like this?
Now let's see what level of risk each of these values represents. You should definitely talk to your doctor about your risk based on these values.
Women: Should be above 50 mg/dL.
(Being below these values is risky)
| Test | Healthy level | Borderline | High risk |
|---|---|---|---|
| Total cholesterol | Less than 200 mg/dL | 200 – 239 mg/dL | Above 240 mg/dL |
| LDL (bad) cholesterol | Less than 100 mg/dL | 130 – 159 mg/dL | Above 160 mg/dL (above 190 is very high) |
| HDL (good) cholesterol | |||
| Triglycerides | Less than 150 mg/dL | 150 – 199 mg/dL | Above 200 mg/dL (above 500 is very high) |
Let's start the change in the kitchen!
The best place to lower your bad cholesterol (LDL) and increase your good cholesterol (HDL) is in the kitchen. Changing the way you eat can make a big difference.
- Reduce red meat: Limit meats that are high in saturated fat and cholesterol, such as beef and pork. Choose leaner cuts of meat instead. Stay away from processed meats, such as sausages and bacon.
- Remove the skin from chicken: The skin contains most of the fat in chicken, so remove the skin before cooking.
- Eat more fish: Include oily fish like salmon, tuna, mackerel, and sardines in your diet at least twice a week. The omega-3 fatty acids in these foods are very good for the heart.
- Limit saturated fat: Limit your intake of full-cream milk, cheese, butter, mayonnaise, margarine, and coconut oil.
- Eat foods rich in fiber: Eat more foods rich in fiber like oats, barley, apples, carrots, beans, and cabbage. These help lower bad cholesterol.
- Use good oils: Use unsaturated fats like olive oil and canola oil instead of butter and shortening for cooking. Nuts like almonds, cashews, and avocados are good sources of heart-healthy fats.
Exercise is essential.
Exercise can be a great help in bringing your cholesterol levels back from 'borderline' to healthy levels.
Engage in at least 30 minutes of moderate-intensity exercise a day, such as brisk walking, cycling , or swimming. Aim to complete 150 minutes per week.
When you exercise, your heart rate increases. This increases your “good” cholesterol (HDL). Doing some exercise is much better than doing nothing.
Let's remember other important things too.
Lose extra weight
If you are overweight, losing weight can help lower your cholesterol levels. Even losing as little as 5% of your body weight can have a positive impact on your cholesterol levels. When combined with diet and exercise, it can sometimes be as effective as taking medication.
Quit smoking today.
If you smoke, quitting the habit can increase your “good” cholesterol (HDL) levels by about 10%. That’s a huge help not only for your heart but for your entire body.
Stay in touch with the doctor.
Once you start making these lifestyle changes, you should have your blood tested again at the intervals your doctor recommends. This is important to see if your cholesterol levels are being controlled by these changes. Sometimes, lifestyle changes alone may not be enough. In such cases, your doctor may advise you to start taking medications (such as statins) .
Take-Home Message
- 'Borderline cholesterol' is not something to be afraid of, it's a warning of danger. Now is the best time to take action.
- Be sure to know the exact LDL, HDL, and Triglycerides values on your cholesterol report. Talk to your doctor about it.
- Change your diet. Reduce oil, red meat, and spicy foods, and eat more fish, vegetables, fruits, and fiber-rich foods.
- Exercise daily. Make it a habit to walk for at least 30 minutes a day.
- If you are overweight, lose weight. If you smoke, quit today.
- Follow the doctor's instructions exactly. If necessary, take medication as prescribed.
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