Cholesterol Explained: Good, Bad, and What Your Report Actually Means

Decoding Your Lipid Profile Report

Most Indians get their cholesterol tested but don't truly understand the results. A lipid profile isn't a single number — it's a set of four measurements that together paint a picture of your cardiovascular risk.

The Four Numbers That Matter

• Total Cholesterol: Should be below 200 mg/dL. A general indicator, but not the whole story.
• LDL (Low-Density Lipoprotein): The "bad" cholesterol. Below 100 mg/dL is ideal. This is the number that builds plaque in your arteries.
• HDL (High-Density Lipoprotein): The "good" cholesterol. Above 40 mg/dL for men, above 50 for women. HDL actually removes plaque from arteries.
• Triglycerides: Should be below 150 mg/dL. Elevated triglycerides are extremely common in Indians due to high carbohydrate diets.

The Indian Cholesterol Paradox

Here's what surprises many patients: Indians often have heart attacks even with "normal" total cholesterol. This is because we tend to have a pattern of low HDL combined with high triglycerides — a combination called atherogenic dyslipidemia that's particularly dangerous.

So if your total cholesterol looks fine but your HDL is below 40 and triglycerides above 150, you're still at significant risk.

Dietary Changes for Better Numbers

Indian kitchens already have most of the answers:

• Increase fibre: Oats, dalia (broken wheat), rajma, chole, and green vegetables bind cholesterol in the gut and remove it.
• Healthy fats: Walnuts, almonds, flaxseeds (alsi), and fatty fish like sardines raise HDL.
• Reduce refined carbs: White rice, maida, sugar, and fruit juices spike triglycerides. Switch to millets — jowar, bajra, ragi are excellent alternatives.
• Cook wisely: Use mustard oil, sesame oil, or cold-pressed groundnut oil. Avoid reheating oil.
• Add garlic: 2-3 raw cloves daily have demonstrated cholesterol-lowering effects in clinical studies.

When to Consider Medication

Statins are recommended when LDL exceeds 160 mg/dL (or 130 if you have diabetes or other risk factors). Most patients tolerate statins well, though regular liver function monitoring is recommended. Your doctor will determine the right medication and dosage for your specific profile.

Get your lipid profile tested annually after age 25. If you have a family history of heart disease, start at 20. The test costs ₹400-600 and requires a 12-hour fast.