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What’s the Difference Between ‘Good’ and ‘Bad’ Cholesterol?

by Shilpi Singh
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Cholesterol is a lipid-like (fatty) substance present in the blood that our body usually needs to act as precursors for the production of Vitamin D, hormones, digestive acids to help in the breakdown of fats in one’s diet, and other important biological substances. It is one of those terms that everyone may be aware of but doesn’t know its actual meaning when it comes down to their health.

To clearly understand cholesterol, one must know about triglycerides too. Triglycerides are the fatty components of the body or those fats that a person receives through food. Its levels in blood tests indicate the fats that the body has absorbed in the blood from the recently eaten foods. The triglycerides are later packaged by the liver as fats in adipose tissues and some of them are turned into cholesterol. So, cholesterol marks the fats that a person has received through diet over a long period. This means, after a few days or weeks of eating a fatty meal, an individual has high cholesterol levels in their blood.

As soon as people hear the word “cholesterol,” mostly they relate it to health issues. However, that’s not always true. Cholesterol can be bad and good and only when there is too much bad cholesterol in one’s body and less good cholesterol, there is a high risk of cardiac problems like stroke and heart attack. So, what’s the difference between the two types of cholesterol? How do keep the good and bad cholesterol in balance for maintaining good health? Continue reading to get into the heart of the matter. [1, 2, 3]

What do Good and Bad Cholesterol Mean?

Good cholesterol medically refers to the High-Density Lipoproteins (HDL) while Bad cholesterol is the Low-Density Lipoprotein (LDL) or Very Low-Density Lipoprotein (VLDL) produced in the liver. All these lipoproteins in blood together make up for one’s total cholesterol.

National Institute of Health has prepared a chart depicting the different levels of bad and good cholesterol as well as total cholesterol and the categories to which they belong. It is as follows:

Bad Cholesterol (LDL) Level

  • Less than 100 mg/dL: Optimal category
  • 100-129 mg/dL: Near-Optimal
  • 130-159 mg/dL: Borderline High
  • 160-189 mg/dL: High
  • 190 mg/dL and above: Very High.

Good Cholesterol (HDL) Level

  • Less than 40 mg/dL: It shows a greater possibility of having heart disease
  • 40-59 mg/dL: The higher the levels the better is heart health
  • 60 mg/dL and higher: It indicates minimal or no risk of heart disease.

Total Cholesterol Level

  • Below 200 mg/dL: Desirable category
  • 200-239 mg/dL: Borderline high
  • 240 mg/dL and above: High.

In a lipid profile test done on the patient’s blood sample, the healthcare provider can detect the levels of total cholesterol, LDL cholesterol, HDL cholesterol, and even triglycerides. After knowing that, the doctor can accordingly treat the patients and guide them on how to bring their cholesterol levels in balance. [3]

Good Cholesterol Vs Bad Cholesterol

The role of the good type of cholesterol is to transport the excess cholesterol from all the blood vessels throughout the body to the liver where it can be eliminated from the body. This way, it may protect the body against the narrowing of the blood vessels. However, its levels must be at least 60 mg/dL or higher otherwise those who have 40 mg/dL or below are at an increased risk for heart disease.

On the other side, a bad type of cholesterol is problematic as it can worsen the narrowing of arteries and blood vessels by building along their inner walls. The medical condition where this plaque build-up occurs and results in hard and narrow arteries is called atherosclerosis. It can result in reduced flow of blood to the heart, kidney disease, peripheral artery disease, and heart disease. Ideally, the levels of bad cholesterol must be as low as possible. A normal person usually would have LDL levels less than 100mg/dL while those who have above 100mg/dL of LDL or VLDL could be at high risk of developing severe health complications. [2]

Causes and Complications of Having High Levels of Bad Cholesterol:

The causes of having high levels of LDL cholesterol include:

  • A fat-rich diet
  • Sedentary lifestyle
  • Liver disease
  • Chronic kidney disease
  • Family history
  • Obesity or Syndrome X-a metabolic syndrome
  • Smoking
  • Excessive intake of alcohol
  • Hypothyroidism
  • Lupus
  • Diabetes
  • A side effect of the intake of certain medications to treat other health issues like acne, HIV/AIDS, hypertension, cancer, irregular heart rhythms, and organ transplants.

As, the presence of high levels of bad cholesterol obstructs the flow of oxygen-rich blood that the heart needs, it can result in:

  • Stroke
  • Chest pain (Angina)
  • Heart attack [1,3]

How to Balance HDL and LDL levels?

There are various ways that a person can raise the levels of good cholesterol (HDL) and lower the levels of bad cholesterol (LDL) to rebalance them to normal numbers and minimize the risk of heart disease and other health issues. These include:

  • Change in Diet- Adopt a heart-healthy diet that involves cutting down on trans fats like eating red meat, butter, and hydrogenated oils; limiting sugar intake, and increasing the intake of good fats as found in the fish, avocado, and flax seed, and even fibers that can be derived from plant-based foods. Mainly vegan diets can help in reducing the risk of cardiac problems.
  • Regular Exercises- Try for 30 minutes daily workout of moderate or high intensity for at least 5 days per week. This way one can maintain a body mass index of 30 or less and have a stable body weight.
  • Lifestyle Modifications- This includes quitting smoking, limiting excessive alcohol consumption, and managing stress through different relaxation techniques.
  • Intake of LDL-Lowering Medications- If natural ways don’t work out, the doctor can prescribe medications to normalize the cholesterol levels. [1,3]


In the majority of instances, elevated cholesterol is a warning indication. However, even if a diagnosis of high cholesterol does not guarantee heart disease or a stroke, it should be addressed carefully.

If a person has high cholesterol, they may take actions to lower it, which will likely lessen their risk of heart disease and stroke. Changes in lifestyle that lower cholesterol also improves general health.

Prevention Advice

  • One is never too young to consider avoiding high cholesterol levels. Eating a healthy, balanced diet is an essential first step. Here are some adjustments you can make immediately:
  • Replace white rice with brown rice and standard pasta with whole wheat pasta.
  • Instead of high-fat salad dressings, use olive oil and a dab of lemon juice to season salads.
  • Eat more seafood. At least two servings of fish should be consumed every week.
  • Substitute seltzer water or plain water flavored with fresh fruit slices for soda or fruit juice.
  • Instead of frying meats, bake them in the oven.
  • Substitute non-fat Greek yogurt for sour cream. Greek yogurt tastes similarly sour.
  • Choose whole grain cereals over sugar-filled ones. Try using cinnamon instead of sugar as a topping. [4]


  1. https://health.clevelandclinic.org/hdl-vs-ldl-cholesterol/
  2. https://akhealth.org/whats-the-difference-between-good-and-bad-cholesterol/
  3. https://www.medicinenet.com/ hdl_vs_ldl_cholesterol_differences/article.htm
  4. https://www.healthline.com/health/hdl-vs-ldl-cholesterol#outlook

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