The Good, the Bad, and What to Do About It

Cholesterol has a bad reputation, but our bodies actually need it. Cholesterol is used to build healthy cells by keeping cellular walls flexible. It is also used for the production of several enzymes and hormones. But, high levels of cholesterol can lead to the development of fatty deposits in blood vessels, inhibiting the blood flow and increasing the risk of heart disease and stroke. According to the Centers for Disease Control and Prevention, nearly 94 million Americans over the age of 20 have high cholesterol. Here’s what you need to know to maintain healthy cholesterol levels.

What is Cholesterol?

Cholesterol is a type of lipid, or fat-like, waxy substance made in the liver and found in the blood. Cholesterol is carried through the blood attached to proteins. This combination of proteins and cholesterol is called a lipoprotein. Low-density lipoprotein, or LDL, transports cholesterol particles throughout your body and builds up in the walls of your arteries, making them hard and narrow. LDL is known as “bad cholesterol.” High-density lipoprotein, or HDL, picks up excess cholesterol and takes it back to your liver. HDL is known as “good cholesterol.” Triglycerides are a third type of fat found in the blood. A high triglyceride level can also increase the risk of heart disease.

What Causes High Cholesterol?

High cholesterol can be inherited, as a result of a condition called familial hypercholesterolemia, which makes it harder for the body to remove LDL cholesterol from the blood. It begins building up in the walls of blood vessels from an early age, increasing the risk of heart attack or stroke at a younger age. However, high cholesterol is not always genetic. It can also be a result of unhealthy lifestyle choices, which means it can be preventable and reversable through a healthy diet, regular exercise, and sometimes, with medication. Some medical conditions, such as kidney disease, diabetes, HIV/AIDS, Lupus or hypothyroidism, and certain medications, may also contribute to unhealthy cholesterol levels.

Dietary Cholesterol

Dietary cholesterol – that is, the amount of cholesterol consumed in the foods we eat – was once thought to have a profound impact on our cholesterol levels, but research has shown dietary cholesterol has a smaller impact on cholesterol levels than previously thought. This is because the more cholesterol the body absorbs from diet, the less it makes in the liver. However, a healthy diet can have a positive impact on overall cholesterol levels.

Cholesterol Testing

Because there are no symptoms of high cholesterol, a blood test is the only way to determine cholesterol levels. The blood test is typically performed after a nine to 12-hour fast, during which you do not eat or drink anything except water. The National Heart, Lung and Blood Institute recommends cholesterol screening begin at ages 9 to 11 and should be repeated every five years. Younger adults should be screened every five years as well, with men from ages 45 to 65 and women from ages 55 to 65 screened every one to two years. Adults over the age of 65 should test cholesterol levels every year.

Treatment and Prevention of High Cholesterol

Making heart-healthy lifestyle choices can both help to lower your cholesterol and prevent you from having high cholesterol in the first place by increasing levels of beneficial HDL and lowering levels of harmful LDL.

Make Healthy Diet Choices: Eating a diet low in sodium, saturated and animal fats and hydrogenated oils and high in fruits, vegetables, lean protein. whole grains and healthy fats can contribute to optimal cholesterol levels. The consumption of healthy fats, such as olive oil, nuts, avocados and fatty fish such as salmon, mackerel, herring and albacore tuna, has actually been shown to reduce overall cholesterol levels.

Maintain a Healthy Weight: Carrying excess bodyweight can contribute to elevated cholesterol and triglyceride levels. If you are obese, research shows that a weight loss of 5-10% can significantly reduce overall cholesterol levels.

Eat More Fiber: While humans cannot digest soluble fiber, the bacteria that live in our intestines can. This good bacteria, also called probiotics, can help to reduce LDL levels. Increasing your intake of soluble fiber, in the form of foods like whole grains, beans and lentils, fruit, brussels sprouts, peas and flaxseeds, has been shown to have a positive effect on overall cholesterol levels.

Exercise: We all know that getting at least 30 minutes of exercise per day is good for our overall health because it improves physical fitness and heart health and combats obesity, but it also can have a positive impact on overall cholesterol levels by reducing LDL levels and increasing HDL levels.

Quit Smoking: Smoking can actually change the way the body responds to cholesterol, impairing the ability of our cells to transport cholesterol and accelerating the development of clogged arteries. Acrolein, a chemical in cigarette smoke, has been shown to raise LDL levels and decrease HDL levels.