Cholesterol is a fatty substance produced by the liver. Our bodies need it to function normally. Too much of it can cause health problems, however.
Cholesterol comes from two sources. Our bodies make all the cholesterol it needs and circulates it through the blood. Cholesterol is also found in animal-based foods and tropical oils that are high on unhealthy fats. Eating too much of these foods can raise your cholesterol to unhealthy levels.
“Having high cholesterol increases your risk for heart disease and stroke, which is why it’s important to watch what you eat and make healthy choices,” says Poulina Uddin, MD, a cardiologist at Scripps Clinic Anderson Medical Pavilion in La Jolla.
Other risk factors for high cholesterol include:
“Knowing your cholesterol level, along with other aspects of your health, can help you understand your risk for heart disease. It can also help you make better choices for your diet and lifestyle,” Dr. Uddin says.
There are four types of dietary fats in foods.
Monounsaturated and polyunsaturated fats are considered “good fats.”
Saturated fats and trans fats are considered “bad fats.” A diet high on these fats can raise the bad cholesterol levels in your blood.
Lipoproteins carry cholesterol through your bloodstream. There are two types of lipoproteins: low-density lipoprotein (LDL), or “bad" cholesterol, and high-density lipoprotein (HDL), or “good" cholesterol.
LDL cholesterol is bad because it can lead to plaque buildup in your arteries. This, in turn, raises your LDL levels in the blood and increases the risk of heart disease.
HDL cholesterol is good because it helps transport LDL cholesterol to your liver, where it can be removed. High levels of HDL cholesterol can lower your risk of heart disease.
“Bad cholesterol can clog your arteries. Good cholesterol removes the bad cholesterol and protects the arteries,” Dr. Uddin says.
High cholesterol can lead to the buildup of plaques in your blood vessels, a condition known as atherosclerosis. These plaques can reduce blood flow through your arteries, causing complications, such as chest pain or heart problems.
“If left untreated, plaque will keep growing, leading to the narrowing or complete blockage of the arteries,” Dr. Uddin says. “This can disrupt blood flow, which increases the chance of chest pain, heart attack, or stroke.”
Triglycerides are a type of fat (lipid) found in your blood. When you eat, your body turns extra calories into triglycerides, which are stored in fat cells. Between meals, hormones release triglycerides for energy.
Eating too many calories, especially from saturated fats, can raise your triglyceride levels and increase the chance of heart disease.
LDL cholesterol, HDL cholesterol, and 20 percent of your triglyceride level make up the total cholesterol level. Normal range levels vary and are based on age and sex.
According to the Centers for Disease Control and Prevention (CDC), high or borderline high cholesterol is having a total cholesterol above 200 mg/dL.
Optimal cholesterol levels:
- Total cholesterol: less than 150 mg/dL
- LDL bad cholesterol: less than 100 mg/dL
- HDL good cholesterol: greater than 40 mg/dl in men and 50 mg/dL in women
- Triglycerides: Less than 150 mg/dL
Eating a heart-healthy diet can help lower your levels of bad cholesterol and raise your good cholesterol.
A heart-healthy diet means consuming fewer saturated fats found in red meat and full-fat dairy products. It also means avoiding trans fats commonly found in fried and processed foods.
Consuming foods rich in omega-3 fatty acids, such as salmon, mackerel, herring, walnuts, and flaxseeds, can help lower your cholesterol levels. Eating foods like oatmeal, apples, prunes and beans with soluble fiber can lower your bad cholesterol levels.
“Try basing your diet on whole foods and complex carbs that are rich in fiber and nutrients and low in fat,” Dr. Uddin says.
Eating vegetarian is optional, not necessary for a healthy heart, Dr. Uddin adds. If you choose to eat meat, choose lean protein like chicken and fish and limit red meat.
Eating monounsaturated and polyunsaturated fats can help increase your HDL cholesterol. You can find these healthy fats in plant-based foods, such as avocados, olives and walnuts.
“Keep in mind that all fats are high in calories, so use them in moderation,’’ Dr. Uddin says.
Regular exercise can help lower your bad LDL cholesterol while boosting your good HDL cholesterol. Doing activities like walking, jogging, swimming, and cycling for 30 minutes daily can improve your cholesterol levels.
“Exercise can help lower LDL cholesterol and strengthen your heart,” Dr. Uddin says.
Aim to get about 30 minutes of physical activity most days of the week. If lifestyle changes are not enough to manage your cholesterol levels, prescription medications like statins may help.
Most healthy adults should have their cholesterol checked every four to six years, according to the CDC.
More frequent cholesterol tests may be necessary if you have:
- A family history of high cholesterol
- Heart disease
- Other risk factors, such as smoking, high blood pressure, or being overweight
“Talk to your doctor about how often to have your cholesterol levels tested and how you can keep them at optimal levels,” Dr. Uddin says.
If lifestyle modifications and you are prescribed statins, make sure to have a discussion about potential side effects. Work with your physician to make any adjustments to your medication, if you experience side effects.