Cholesterol is one of those buzz words that has always seemed to carry a negative connotation when it comes to your health. But how bad is it and does it deserve the negative reputation it has received over the years? Let's take a look. 

Cholesterol is a fat-like, waxy substance that your body uses to build cells and make hormones and vitamin D. Cholesterol travels through your body through your bloodstream. You get cholesterol from the foods you eat and your liver, which makes cholesterol. 

Your total cholesterol is made up of low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Problems can occur when LDL, or the commonly called "bad cholesterol," deposits in your arteries causing inflammation and blockages, which can raise your risk for heart attack and stroke. HDL, or the commonly called "good cholesterol," helps move the bad cholesterol to the liver where it can be cleaned out. 

"Cholesterol levels are affected by genes passed down in your family, an accumulation of the foods you eat, and the amount of exercise you get over your lifetime," says Amber Brown Keebler, MD, internal medicine specialist. Dr. Brown Keebler is also certified in lipidology, the study of fats in your blood and how they can be managed and treated. "Cholesterol is among one of the top risk factors for heart disease and stroke. The more risk factors you have, the higher your risk."

Dr. Brown Keebler recommends that Americans strive for a total blood cholesterol of 200mg/dl or less. Women should strive for HDL levels of 50mg/dl or higher, and men should strive for levels of 40mg/dl or higher. Your LDL levels should be 100mg/dl or less. "If you have other diseases, you may have different targets for your cholesterol," says Dr. Brown Keebler.

Lowering your cholesterol can be achieved by committing to healthy lifestyle habits. "Many people can lower their cholesterol levels by 20% to 30% through diet and exercise alone," says Dr. Brown Keebler. "Reducing your cholesterol will help lower your risk for heart disease, stroke and metabolic syndrome."

If you are unsuccessful at lowering your cholesterol, explains Dr. Brown Keebler, you are considered intermediate heart disease risk or higher, you have a family history of heart disease or autoimmune diseases like rheumatoid arthritis or metabolic syndrome, you may be a candidate for cholesterol-lowering drugs called statins, which can reduce cholesterol levels by up to 50%.

"It is important to remember that these numbers by themselves do not predict your risk for heart disease," says Dr. Brown Keebler. "They need to be evaluated as part of a bigger picture that also includes risk factors like age, smoking, diabetes, blood pressure, diet, exercise and metabolic syndrome." 

Metabolic syndrome is a condition in which a person has three of the following conditions: abdominal obesity, high blood pressure, high blood sugar, elevated triglycerides or low HDL cholesterol. 

Dr. Brown Keebler recommends that adults between the ages of 40 and 70 years old complete a heart disease risk assessment using the American College of Cardiology/American Heart Association (ACC/AHA) risk calculator, a tool designed to predict your risk of having a future heart attack or stroke.

You can take steps to lower your cholesterol by following these healthy lifestyle habits:

1. Increase fiber in your diet. Eat more high fiber grains like barley, bran, whole wheat and flax seeds and nuts like almonds, pecan, pistachios, and sunflower seeds. Also add more soluble fibers to your diet like beans, brussels sprouts, oatmeal, apples and pears, which can help reduce the absorption of cholesterol into your bloodstream. 

2. Replace unhealthy fats with healthy fats. Reduce your intake of saturated fats primarily found in red meat and full-fat dairy products, butter and coconut oil and prepackaged cookies, crackers and cakes that often contain trans fats or partially hydrogenated vegetable oil. Replace with canola, corn, safflower or olive oils. 

3. Choose lean proteins and foods rich in omega-3 fatty acids. Choose lean proteins like chicken and turkey as well as proteins with omega-3 fatty acids like salmon, mackerel, and herring and nuts such as walnuts, almonds, pecans and macadamia nuts. 

4. Exercise regularly. Aim to exercise up to at least 30 minutes five days a week. Exercise can help increase HDL cholesterol. 

5. Quit smoking. Quitting smoking will improve your HDL cholesterol level. 

6. Lose weight. If you are overweight, extra pounds can cause your cholesterol level to spike. Extra weight can also increase your risk for metabolic syndrome.  

7. Drink alcohol in moderation. Drinking in excess can lead to high blood pressure, heart failure and stroke. 

"Knowing your heart disease risk is the first step in heart disease prevention," says Dr. Brown Keebler. "Become familiar with your family history, get your cholesterol checked in your 20s, even if you have no family history and repeat every five years."