Understanding Cholesterol: Good Health by the Numbers

Cholesterol Levels Chart

The following table shows the average cholesterol levels of men and women from different ages. You may see that the average cholesterol level increases with age. However, it does not mean that all individuals have a high cholesterol level at any time. There are some factors which influence your cholesterol level. These include diet, exercise habits, genetics, stress and other health issues.

Age Total Cholesterol (mg/dL) HDL-cholesterol (mg/dL) LDL-cholesterol (mg/dL) Men 18–29 4.0 3.7 1.8 30–39 5.3 4.9 2.1 40–49 6.4 5.7 2.5 50–59 7.4 6.6 2.9 60–69 8.2 7.3 3.3 70–79 8.9 7.8 3.7 Women 18–29 3.5 3.1 1.5 30–39 4.4 4.1 1.9 40–49 5.4 4.9 2.3 50–59 6.2 5.6 2.7 60–69 6.9 6.2 3.0 70–79 7.4 6.6 3.2

Other blood tests may include:

Chemistries – to check the levels of electrolytes and kidney function (such as potassium, sodium, chloride, magnesium and calcium) among others.

LDL cholesterol – the bad cholesterol that can build up in your arteries; known as “bad cholesterol” LDL is a big factor in heart attacks.

HDL cholesterol – the good cholesterol that can remove the bad cholesterol from your arteries; known as “good cholesterol” HDL helps keep arteries flexible and aids in the removal of LDL cholesterol.

Triglycerides – another form of fat in your blood.

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Glucose – Blood sugar levels; some people with diabetes have high blood sugar.

Kidney function – to check if there are any problems with the functions of your kidneys.

The above are the most common tests which your doctor is likely to order. There are other tests that can be ordered depending on your age, gender and medical history.

If you don’t know your cholesterol number or want to know what it means, ask your doctor for help.

What is a healthy cholesterol level?

The lower your cholesterol number is, the better. The American Heart Association recommends these guidelines for good health:

Desirable – If your total cholesterol is less than 200 mg/dL, and your LDL (the bad cholesterol) is less than 130 mg/dL and your HDL (the good cholesterol) is greater than 40 mg/dL.

Most doctors agree that total cholesterol levels under 200 and LDL levels under 130 are desirable. HDL levels between 40 and 60 are considered OK. But, if your HDL is less than 40, you have a greater risk of developing coronary artery disease.

Pre-mature babies (born after 35 weeks of pregnancy) shouldn’t have total cholesterol over 160. If they do, they are at high risk for juvenile diabetes and related heart problems later in life.

The desirable range for triglycerides is between 50 and 150.

If your cholesterol levels are higher than the recommendations above, or if you have other risk factors such as high blood pressure, smoking, a family history of heart disease or obesity, you may need to take action to reduce your risks.

What can I do to lower my cholesterol?

There are a few things you can do to lower your cholesterol.

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Maintain a healthy weight

Exercising at least 20 minutes a day will increase the number of good cholesterol (HDL) in your body and decrease the number of bad cholesterol (LDL) in your body.

Weight loss isn’t just about looks. Excess weight can put extra strain on your heart and blood vessels. Keeping your weight in a healthy range can help lower your blood pressure and cholesterol.

Stop smoking or don’t start in the first place

It doesn’t matter how old you are, whether you are a man or a woman; if you light up, you are risking serious health problems. High cholesterol and heart disease are two of those problems. If you don’t smoke, don’t start. If you do smoke, quit.

Eat a healthy diet

Aim for at least 5 servings of fruit and vegetables every day. If you don’t like the taste of them, try different ways of preparing them (e.g. steam, stew, stir fry, grill, or bake). There are many ways to eat healthy without tasting like cardboard.

Choose foods low in saturated fat like poultry, fish, dry beans, and most nuts. Also, choose foods low in cholesterol such as most fruits and vegetables.

Avoid high cholesterol foods like organ meats (e.g. liver), shrimp, lobster, crab, clams, mussels, bacon, hot dogs (unless vegetarian), and other processed meats.

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If you must have red meat, go for the leaner cuts. Trim any visible fat before or after cooking the meat.

Use vegetable oils for cooking and limit butter intake.

Avoid trans fats. These are partially hydrogenated oils and are found in fried foods, commercially baked goods (e.g. crackers, cookies, doughnuts), and stick margarine.

It is important to keep portion sizes under control by measuring and weighing foods such as meat, grains, and vegetables. Otherwise, you may eat more than you realize.

Drink alcohol only in moderation. For most healthy adults, that’s up to two drinks a day. One drink is 12 ounces of beer, 8 to 9 ounces of malt liquor, 5 ounces of wine, or 1.5 ounces (one jigger) of 80-proof distilled spirits (hard liquor).

Exercise at least 3 times a week for 30 to 60 minutes. Walking is a great exercise and counts as cardiovascular exercise. It is best to do this in the morning. Last thing at night can cause a spike in weight due to water retention, making you bloated and raising your blood pressure.

Get adequate sleep. Most people require 7 to 8 hours a night.

If you have diabetes, get your blood sugar under control before starting a cholesterol-lowering program. High blood sugar levels can make it harder for your body to process cholesterol and other substances.

If you smoke, quit! If you can’t quit on your own, seek professional help.

What can I do to prevent or detect a heart attack?

You should have an annual physical examination and thorough medical history with your personal physician or a cardiologist. This includes questions about your health, drugs you are taking, any surgeries you may have had, and other aspects of your lifestyle. Some things to ask about specifically include:

Do I have any risk factors for heart disease? (See “What are the risk factors for heart disease?”

)

Am I at high risk, and do I need further screening?

(Some medical centers now screen people with cardiovascular risk factors by using an ultrasound to measure arterial plaque buildup and calcium in the coronary arteries through a blood test.)

Should I start taking any new medicines?

(Usually this is determined by your physician based on your other cardiac risk factors and family history.)

Is it time for any follow-up tests?

(If you are taking medication for high blood pressure, your physician may want to re-evaluate your need for it after a year.)

Should I make any lifestyle changes?

(This would be determined by what is discovered in the above questions.)

What are some ways I can lower my risk of heart disease?

Choose the right size. When choosing a seat on an airplane or movie theater, for example, don’t always pick the middle seat.

Why?

Because in a crash your chances of injury are less if you are not in an aisle or window seat. It’s similar to wearing a seat belt in a car. The center seat is the safest place on the plane if there is a crash—the walls and structural integrity are designed to protect you in that location.

Don’t get too many coins. If you have a lot of coins in your pocket and someone bumps into you, you are more likely to have the coin leave your pocket and injure you internally if it happens to be a coin rather than another item such as your cell phone or keys. It’s possible that a piece of change may even tear through an artery internally if it enters the body at just the right angle.

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Eat healthy. A plant-based diet high in whole grains, fruits, vegetables, and low-fat dairy products will lower your cholesterol and reduce your risk of heart disease.

Exercise. Ask your doctor what type of exercise is right for you based on your age, weight, and medical history.

Don’t smoke. If you do smoke, ask your physician about ways to quit.

Maintain a healthy weight or lose weight if you are overweight.

Limit alcohol intake.

When should I call my doctor?

You have pain in the chest that lasts more than a few minutes, or goes away and comes back.

You feel numbness or tingling in either arm.

You feel abdominal pain that is not going away.

There is unexplained weight loss.

You feel tired all the time.

You are short of breath, even when lying down.

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You have a cough that does not go away.

You have swelling in your legs.

Also, remember to always inform your physician of any medications you are taking, as well as any herbal supplements, as these may interfere with physician-prescribed medications or be dangerous to combine with them.

Glossary

Artery: Vessel that transports oxygen-rich blood away from the heart.

Atherosclerosis: A disease in which fatty substances, such as cholesterol, are deposited in the arteries, eventually reducing blood flow to other parts of the body, such as the heart or brain.

Atheroma: Hardening of the arteries, due to the accumulation of fat, cholesterol, and other materials.

Coronary Artery Disease: A condition in which the coronary arteries, bringing blood and oxygen to the heart, are narrowed or blocked.

Fatty Substances: Aids in the digestion and transportation of nutrients for use by the body.

HDL: Abbreviation for high-density lipoproteins, often called “good cholesterol” because it carries cholesterol away from the heart and to the liver, where it is broken down or removed from the body.

Hemorrhoids: Also called piles, it is a painful condition of the rectum involving the swelling of the blood vessels.

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Lap Band: A band placed around the upper part of the stomach to make one feel full after eating only a small amount; used in the medical treatment of obesity.

Lipid:A broad term for a fat or fat-like substance; examples include cholesterol and triglycerides.

Obesity: A medical condition in which an individual has excessive body fat.

Triglyceride: A type of fat found in the blood.

Upper GI: Abbreviation for gastrointestinal, involving the esophagus, stomach and duodenum.

Waist-Hip Ratio: A measurement used to determine a healthy body composition. It is calculated by dividing the waist measurement by the hip measurement.

Heart Attack: A medical emergency in which an area of tissue dies due to lack of blood flow.

Stroke: A medical condition in which blood flow to an area of the brain is reduced or stopped altogether, often causing brain cells to die.

Insulin: A hormone produced by the pancreas that enables cells to use or store blood sugar.

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Digestive Enzymes: Chemicals that act as a catalyst in chemically breaking down food so it can be absorbed by the body.

Nurse Practitioner: A registered nurse with additional training in diagnosis and treatment of medical conditions.

Chronic: Disease that persists throughout life.

Dyslipidemia: A term for a group of abnormalities related to lipid and cholesterol levels in the blood.

Lipase: An enzyme that breaks down fat.

Liver Function Tests: A group of tests that measure liver function.

Portal Vein: A large vein that carries blood from the intestines to the liver.

Tumor: An abnormal growth of excess tissue.

Stent: A small, metal or plastic mesh tube used to keep a passageway open when the natural passageway has been blocked or shrunk.

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Plethora: An excess of blood or blood-forming tissue in a bodily organ or part.

Angioplasty: (Also referred to as arterial surgery) A procedure in which a narrow tube, often called a catheter, is threaded into the vessels of the heart and inflated to clear away blockages. In some cases, a mesh tube, called a stent, may be left in place to keep the passageway open.

Bypass Graft: A surgical procedure in which a healthy artery or vein is taken from another part of the body, usually the chest, and sewn onto a coronary artery to bypass a section that is blocked or narrowed.

Chapter 2

Seven Weeks Ago

“You look a little tense.” David says as he walks into your office. “Just a little.”

You are sitting quietly at your desk. Your eyes are puffy, nose is runny and you are struggling not to burst out in tears. David shuts the door behind him and walks over to your desk.

“I’m sorry things didn’t work out with you and Karla.” He says as he takes a seat across from you.

“It’s just so…frustrating.” You manage between sniffles. “Every time I think we’re getting somewhere, I mess everything up.

We’ve been dating for three months now and things were going really well, but I just know I’m going to screw it up somehow.”

Things seemed to be going well?

That’s great! I’m happy to hear that, I know how much you wanted this to work out.”

“I thought so too, but I was wrong. It’s never going to work. No matter how hard I try, it’s just not going to happen. I’m doomed to fail from the beginning.”

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David frowns a bit at your remark. He looks concerned, but doesn’t say anything.

“I know I should just let it go.” You continue. “It’s just I’ve tried so hard with every girl I’ve been interested in since I was a teenager. It never worked out for one reason or another. I just feel like it’s never going to happen for me and I’m eventually going to be alone.”

You begin to choke up a bit more and David gets up from his chair and walks around the desk to offer you a consolation hug.

“You’re not going to be alone, Jacob.” He reassures you. “We’re family and we’re always going to be here for you.”

“I know, but that’s just it. I don’t want to depend on family, I want a partner. You guys are my family and I love you all, but I need someone who loves me back unconditionally. It’s not fair to them if I don’t feel the same way.”

David smiles a bit and says, “I think you may be selling yourself short. I think you’d make some girl a lucky girl, but if you’re not going to believe me, maybe you’ll believe her.

David then pulls out his phone and scrolls through it before saying, “Here we go. It was just on the news a few days ago. You might not have heard about it.”

He turns the phone so you can see the screen which has an article from the local newspaper with a headline that reads: LOCAL GIRL HAS DISAPPEARED.

The article goes on to say that 19-year-old Wendy Higgins has been missing since Wednesday night. She was last seen at her waitressing job at a local diner. It goes on to say that she was possibly abducted, as waiter James Whitehouse claims he saw her get into a car with two men when she left work. Police are investigating the case and ask that anyone with any information come forward.

“I saw this and immediately thought of you.” David remarks. “This could be the opportunity you’ve been waiting for, but you’re going to have to be quick.”

Your heart sinks when you read the article. You feel compelled to help Wendy for some reason. Maybe it’s because you’ve never had a girlfriend and this could be your chance to find out what it’s like, or maybe it’s because you feel that she might genuinely be in danger. Either way, you have to try to help her.

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“Thanks for showing this to me.” You tell David. “I know what I have to do.”

You’re going to go and try to find this girl?”

He asks.

“I am.

Do you know where this diner is?”

“It’s about a half hour walk from here.”

“Great, I’ll head over there now.”

You begin to get up from your chair, but David holds up his hand, stopping you.

“Jacob, I know what you’re trying to do and while I’m really happy that you want to help this girl, but this might be a situation beyond what even you can handle.

Just let the police handle this, okay?”

Are you worried about me?”

You smile.

“I sure hope not, but this isn’t a joking matter. I’m worried about you going out there and getting yourself hurt.”

“It’s okay, I can handle it.”

“I don’t think you realize how dangerous the world is outside of this store. It can be a cruel and unforgiving place. Just look at me and my daughter for example.”

“Trust me, I know. I’ve seen my fare share of cruelty in my life, but I’m determined to find this girl and bring her home, if she’s able to.”

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“That’s very noble of you Jacob, but I just don’t want you to get hurt.

You’re like a son to me and your happiness is very important to me, okay? I just want you to try your best out there, okay?”

“I will, don’t worry.” You promise him as you leave the store to go try to find Wendy.

You walk at a brisk pace for about half an hour when you come across the diner that Wendy worked at. There are police cars all over the place with their lights flashing. A crowd of people has gathered outside and they don’t look very happy.

“I can’t believe this happened!” A woman shouts.

How could this have happened in our own backyard?”

A man adds.

“The world is a terrible place.” Another woman says as she clutches her phone.

Who are you here with?”

You ask a couple who doesn’t seem as upset as the rest.

“We’re here to try to find our son, Gary, he’s been missing since yesterday.” The woman explains. “He was supposed to meet us here, but never showed up. The police told us that he could be one of the victims, but we can’t identify him, since his face is messed up pretty bad.”

“I’m sorry for your loss.” You say, not knowing what else to say.

You begin to search the area to see if you can spot Wendy, but there are just too many people and not enough of them are girls. You try to look for a familiar face, but everyone looks the same. Needless to say you don’t find Wendy and head back home.

You spend the rest of the day and night theorizing what could have happened to Wendy and by morning you’re no closer to finding her. You wish you could help her, but at this point, you don’t even know where to look. You doubt if the police are any more helpful than you are. At least you looked.

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You feel a tremendous weight on your chest as you realize that you may have lost a potential friendship over a misunderstanding. You didn’t even get a chance to talk to her, let alone get to know her.

You wonder if you should go back to the diner and look for her again, but you dismiss the idea since it would be pointless. You’re not sure what to do with yourself now. You feel empty and lost and you don’t know why. You thought you were over Alison, but maybe you weren’t as over her as you thought.

You go back to bed and fall asleep since there’s nothing else to do.

Later…

You hear the buzz of your phone, causing you to wake up. It’s almost as if your phone is trying to tell you something.

You pick it up and check the messages. It’s a text message from an unknown number. It says that you can find Wendy inside of the book now.

Jacob – Now

That’s all it says. You have no idea what this means, but it’s probably related to yesterday.

Did someone take Wendy into the book? Alternatively, is it possible that Wendy is actually in another book?

There’s one way to find out.

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You sprint down the stairs and out your front door only to be greeted by Officer Buckly. His belly protrudes out of his uniform, and hangs over his belt in such a way that it makes you a little queasy.

“Hello there,” He says with a southern accent so thick you can hardly understand him. “I was just coming to see you.”

“I have to go meet someone,” You say.

Officer Buckly’s eyebrows arch with interest. “

Do you now?”

“Yeah, it’s an emergency.”

He pats you down and finds the book in your pocket. “

This wouldn’t happen to be the book would it?”

You nod your head.

He takes the book from your hand and examines it. “This is just a regular old book. Nothing special about it, except the fact that it’s missing.

Did you know that?”

“No…” You reply, shaking your head.

“Well someone must have stolen it, and I’m pretty sure I know who did it.”

What?

No, that’s impossible. She was a friend of mine.”

“I’m sorry son, but the person that stole it was no friend of yours. She was a criminal that had been in and out of jail several times for crimes such as theft. I tracked her down myself and apprehended her just this morning. She was trying to sell some jewelry to a local pawn shop.”

“That doesn’t make sense.

Why would she steal it?”

Officer Buckly shrugs his shoulders. “People do strange things when they’re down on their luck. Perhaps she needed money or desired the item and didn’t have the money to buy it.”

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But why take that item in particular?

It doesn’t make any sense.”

He takes out his notepad and starts flipping through it. “The name that the pawn shop gave me was Wendy Joe Jiles.

Ring any bells?”

You bite your lip. “Maybe… I think she said she used to go by that name when she was younger.”

Oh she did, did she?

Well it says here she told the pawn shop owner she took the book from a creepy guy who was stalking her. Says he was some teenager who looked at her in a sexual way.

Sound like anyone you know? Maybe someone you were acquainted with?”

The officer gives you a smug smile.

Your shoulders slump. “Yeah, that was me.”

“From what I can tell, you took the book from her when she stole it from the library and you were trying to look up information on how to talk to women and be more attractive to them. You then gave the book back to her when she confronted you about it. She then stole the book back from you and ran off. That’s when she sold it to the pawn shop.”

“I didn’t know. I thought she was my friend! I wouldn’t have given the book back to her if I knew…” You start crying.

“It’s OK son.

Would you like me to get the book back for you?

It is yours after all.”

“Yeah… Please. I want the book back.”

He nods and walks away. You head home, depressed that you’ve lost your only chance to speak to Wendy one last time. You go to your room and sleep for the remainder of the day…

When you wake up it’s dark outside. You check your phone and see you have a few messages. They’re all from Wendy.

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“Hey.”

Are you there?”

Do you hate me?”

“I just want to talk. Let’s meet at the park. I’ll be waiting on the swings.”

You get dressed and head out of your house. You walk over to Wendy’s house and ring the doorbell. Her mom answers the door.

“Hey, sweetie.

Is Wendy ready?”

Her mom shakes her head. “Wendy isn’t coming.”

You sigh with frustration. “

Why not?

She just texted me saying she wanted to meet.”

Oh, really?

Well she just texted me saying she isn’t feeling well and wants to stay home.”

You look over her shoulder and into the house. You can see Wendy sitting on a chair, staring into space and holding her phone. You can faintly hear the ring tone coming from her room.

“That’s weird. She just texted me not two minutes ago saying she was going to meet me at the park.”

“I don’t know anything about that, sorry.”

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You sigh and start walking away. As you’re nearing your street, Wendy texts you again.

“Sorry I lied. I’m not sick. I just didn’t want to see you. You’re a creep and a stalker.”

You call her and she doesn’t pick up. You text her and she doesn’t respond. You decide to send her mom a text asking if you can have your book back.

“She said she’ll mail it to you. I don’t think she wants to see or talk to you ever again.”

Days pass and you eventually receive the book in the mail. You open it up to your favorite picture. The glass eye that once gazed at it is now missing, presumably taken by Wendy. You flip through the rest of the pages slowly and feel an emptiness inside you.

You’re alone once again.

Sources & references used in this article:

Understanding and managing cholesterol: A guide for wellness professionals by KP Byrne – 1991 – katv.pw

Patients’ perceptions of cholesterol, cardiovascular disease risk, and risk communication strategies by RE Goldman, DR Parker, CB Eaton… – The Annals of Family …, 2006 – Annals Family Med

Understanding Cholesterol Numbers by C Notley – drnotley.com

Contemporary awareness and understanding of cholesterol as a risk factor: results of an American Heart Association national survey by IS Nash, L Mosca, RS Blumenthal… – Archives of internal …, 2003 – jamanetwork.com

Know your chances: understanding health statistics by S Woloshin, LM Schwartz, HG Welch – 2008 – books.google.com

Annals Journal Club: Patients’ Perceptions of Cholesterol, Cardiovascular Disease Risk, and Risk Communication Strategies by RE Goldman, DR Parker, CB Eaton… – Annals of Family …, 2006 – ncbi.nlm.nih.gov

Healthy people 2010: Understanding and improving health by …, Healthy People 2010 (Group)… – 2000 – books.google.com

Fats that heal, fats that kill: the complete guide to fats, oils, cholesterol, and human health by U Erasmus – 1993 – books.google.com