Keeping it safe in the cell walls

Cholesterol is a fat-like substance that is carried around the body in the blood. It is found naturally in our body’s cells and is essential for many metabolic processes, including the creation of hormones, bile and vitamin D. It is so vital to our health that the liver makes as much cholesterol as needed to be healthy; it can also be found in some animal-based foods.

Cholesterol is transported to and from our cells by little ‘couriers’ called lipoproteins. Lipoproteins are like tiny ‘taxi cabs’ that travel around the blood stream acting as transporters.

There are three types of lipoproteins; low-density lipoprotein, or LDL, high-density lipoprotein, or HDL and another blood fat called ‘triglycerides’. All three are important to our overall health, but when levels are too high, it can greatly affect our heart health. Our genes partly determine what our blood cholesterol levels are, along with lifestyle factors such as nutrition, physical activity, obesity, smoking and alcohol intake.

Diabetes can upset the balance between the 'healthy' (HDL) and 'lousy' (LDL) cholesterol. On average people with diabetes have higher levels of 'lousy' (LDL) cholesterol and higher levels of triglycerides than people without diabetes.

Using a blood sample after a period of fasting, a lipoprotein profile measured in millimoles per litre (mmol/L) reveals whether or not the body is over, or under producing cholesterol.

Low-Density-Lipoprotein (LDL) Cholesterol = "Lousy" Cholesterol

LDL cholesterol carries most of the ‘freshly made’ cholesterol from the liver to the cells of the body. A high LDL level is linked with a higher risk for cardiovascular disease.

Too much can slowly build up on the inner walls of the arteries and form plaque, a thick, hard deposit that can narrow the arteries (a condition known as atherosclerosis).

LDL is essential for the body and is usually healthy as long as it is kept in balance by a sufficient level of HDL. The goal for LDL-C is: 2.0mmol/L or below.

High-Density-Lipoprotein (HDL) Cholesterol = “Healthy" Cholesterol

HDL is the carrier of recycled cholesterol and helps remove the LDL-C from the arteries and carries it back to the liver where it is broken down and removed from the body.

A higher level of HDL cholesterol is associated with a lower risk of heart attack and stroke as it can also slow the build-up of arterial plaque. A healthy level of HDL cholesterol may also protect against heart attack and stroke, while low levels of this healthy cholesterol have been shown to increase the risk of heart disease.

The aim for our HDL is 1.0 mmol/L or greater.


Non-HDL cholesterol is your total cholesterol minus your HDL (healthy) cholesterol. This provides a more reliable indicator of heart health than looking at the total cholesterol or LDL figures.

In other words; a measure of cholesterol carried within all the 'Lousy' lipoproteins but not the 'Healthy' ones (which is only HDL). The aim for non-HDL-C is 2.5 mmol/L or below.


Triglycerides are a separate type of 'lipid’ to cholesterol. Rather than being used to build and maintain cells, triglycerides store excess energy as well as provide the body with energy.

Food is one source of triglycerides and your liver also makes them. Once food is digested, triglycerides circulate in the bloodstream to be used as energy by the cells or they are stored in fat cells for later use.

Lifestyle, diet and exercise all play a role in triglyceride levels and high levels are associated with atherosclerosis. Healthy lifestyle choices can keep triglyceride levels stable. The aim for triglycerides is 2.0 mmol/L or below.

Total cholesterol

Total cholesterol is the figure of all the different blood fats added together. The aim is for a total cholesterol less than 4.0 mmol/L.

High cholesterol does not usually present any symptoms itself, but having high or unbalanced cholesterol levels over a number of years can lead to the development of cardiovascular disease.

The balance of these cholesterol levels together is a better indicator of heart health rather than one in particular. This information is used in combination with a person’s overall ‘cardiovascular risk’ to determine the risk of an individual getting cardiovascular disease; this includes all heart, stroke and blood vessel diseases ( Many factors can determine a person’s risk; such as age, sex, smoking status, blood pressure and family history. Cholesterol levels are only one of these factors.

Your doctor will help determine your cardiovascular risk. If your risk is low, your lipid profile may be performed every three years. If you are considered to be at a medium or high risk your Doctor would likely check your lipid panel every year, or more often as necessary.


  • LDL-C = 2.0mmol/L or below
  • HDL =1.0 mmol/L or greater
  • Non-HDL-C = 2.5 mmol/L or below
  • Triglycerides = 2.0 mmol/L or below
  • Total cholesterol = 4.0 mmol/L or below


If your cholesterol levels are found to be unbalanced, discuss with your doctor about the best approach to manage it.

The most meaningful thing you can do to reduce your cholesterol level is to maintain a healthy lifestyle.

This includes eating healthily and regular movement. In some cases, cholesterollowering statin medications may also provide benefit, but even if this happens, it is still worth making lifestyle changes at the same time as they can improve the effect of the medication. If you need help with lifestyle modifications, consider arranging an appointment with your Doctor, Diabetes Educator, Dietitian or Exercise Physiologist.