Everything You Should Know About Cholesterol (2023)

Types of Cholesterol and How They Work in Your Body

Cholesterol is carried through the circulatory system on two lipoproteins: high-density lipoproteins (HDL), often referred to as “good” cholesterol, and low-density lipoproteins (LDL), also called “bad” cholesterol.

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HDL has been labeled “good” cholesterolbecause it removes LDL cholesterol from the arteries and takes it to the liver, where it can be broken down and removed from the body, according to the AHA.

LDL is termed “bad” cholesterol because when there is too much of it circulating in the blood (more than the good HDL scavengers can scoop up and ferry away), it can eventually build up in the form of plaque on the walls of your arteries. This is called atherosclerosis. Over time, this narrows the arteries and raises the risk for heart attack, stroke, and peripheral artery disease, notes the AHA.

A high level of triglycerides — the most common type of fat in your body — can also lead to fatty buildups in your arteries and increase your risk of heart attack and stroke, if combined with high LDL or low HDL cholesterol levels, per the AHA.

Why Are Some People More Likely to Have High Cholesterol Than Others?

Understanding why some people have high cholesterol numbers and others don’t isn’t as simple as it might seem. For example, while overweight people are more likely to have high cholesterol, thin people can have it as well, notes the AHA.

Here are some factors that affect your cholesterol levels:

Heredity

A condition called familial hypercholesterolemia (FH) may make some people genetically prone to high levels of bad cholesterol. There are two types of FH: heterozygous, in which a person inherits the abnormal gene from one parent only; and homozygous, in which the person has two copies of the abdominal gene, one from each parent. Homozygous FH is both more rare and more dangerous. People with FH don’t recycle LDL cholesterol as effectively and end up with high levels of this type of cholesterol, making them more prone to atherosclerosis, often starting at far younger ages. About 1 in 200 adults have the FH genetic mutation, according to the AHA. If left untreated, these individuals have a 20 times higher risk of developing heart disease.

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If you have a parent, sibling, or child who has FH or who had a heart attack early in life, it’s recommended that you get tested for the condition. (The majority of FH patients need cholesterol-lowering drugs such as a statin to keep their cholesterol numbers in a healthy range.)

Smoking

While smoking doesn’t directly cause high cholesterol, it is by itself a major proven risk for heart disease and stroke. That risk rises if you also have high LDL cholesterol levels. One reason is that smoking lowers your levels of HDL, helping to diminish or erase that form of cholesterol’s protective effect, according to the AHA.

Quitting smoking has immediate benefits on your heart health. A research review published in the journal Biomarker Research found that HDL levels increase almost immediately in people who quit smoking.

Diet

When it comes to what you eat, the best way to lower your cholesterol is to reduce your intake of saturated fat and trans fat, according to the AHA, which recommends limiting saturated fat to less than 6 percent of daily calories and minimizing the amount of trans fat you eat. This means cutting back on red meat, tropical oils, fried foods, and full-fat dairy.

Instead, opt for low-fat or fat-free dairy products, fruits, vegetables, whole grains, poultry, fish, nuts, and nontropical vegetable oils. Healthier cooking oils include canola, corn, olive, peanut, safflower, soybean, sunflower, vegetable oil, and other specialty oils, notes the AHA. As a general rule, says Dr. Gutierrez, “consume a diet that is based mostly on whole, plant-based foods and is low in saturated and animal fats.”

Getting Tested: What Do Blood Cholesterol Test Results Mean?

The AHA recommends that all Americans over age 20 get their cholesterol levels tested every four to six years. Your doctor may recommend getting your cholesterol tested more frequently in middle age because your overall risk for heart disease starts to rise.

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Here’s what the test will reveal:

  • Total Blood CholesterolThink of this as your overall "score." This number is the result of a calculation that adds up HDL and LDL levels, plus 20 percent of your triglyceride level, according to the AHA. Although stated guidelines point to a total cholesterol of below 200 milligrams per decililter (mg/dL) as “desirable” and anything over 239 mg/dL as “high,” this number is less meaningful than it might appear, says Barbara Roberts, MD, a clinical associate professor emerita of medicine at Brown University in Providence, Rhode Island, and former director of the Women’s Cardiac Center at The Miriam Hospital. She adds that what’s important is the ratio of good to bad cholesterol.
  • HDLCholesterolYou want this number to be higher, as a high HDL level is linked with good heart health. An HDL level of 60 mg/dL or higher appears to be protective against heart disease, notes the Cleveland Clinic. In contrast, a level of less than 40 mg/dL appears to be nonprotective and may be harmful.
  • LDLCholesterol An LDL of less than 100 mg/dL is the holy grail; a number 129 mg/dL or lower is also good. A range of 130 to 159 mg/dL is borderline high, 160 to 189 mg/dL is high, and above 189 mg/dL is in the danger zone, per the Cleveland Clinic.
  • Triglycerides Normal levels of triglycerides vary by age and sex, according to the AHA. Risk factors that can lead to high triglycerides include having diabetes, being overweight or obese, being sedentary, drinking alcohol in excess, and consuming a diet that is high in sugar, processed foods, and saturated fat. A normal level is below 150 mg/dL; if your level is approaching 200 mg/dL, that is borderline high; and anything over 200 mg/dL is high and leaves you at greater risk for cardiovascular disease, per the Cleveland Clinic. A triglyceride level of 500 mg/dL or higher is considered dangerously high.

Facts About Cholesterol-Lowering Medication

If you and your doctor feel it would be wise to lower your cholesterol levels, you may be prescribed a statin drug. Guidelines put out by the AHA and the American College of Cardiology in 2019 say that the decision to start statin therapy should be based on a calculation of your risk for cardiovascular disease over 10 years. (See the risk calculator here.)

Cholesterol numbers, says Gutierrez, are only part of the picture, “though the most current recommendations say that in the presence of diabetes you should start medication when LDL is higher than 70 mg/dL.”

He also points out that it’s important to first try making lifestyle changes, such as:

  • Consuming a healthier diet
  • Exercising
  • Quitting smoking
  • Getting blood pressure under control

It’s also important to note that those lifestyle changes should not be abandoned just because you’re taking medication.

Statin drugs work in two ways, says Gutierrez. “They block the enzyme that helps you produce cholesterol in the liver, and they activate the receptors for LDL in your liver cells, so that more cholesterol is ‘captured’ from your blood.”

(Video) Everything you need to know about cholesterol!

In addition to statin drugs, a new class of cholesterol-lowering drugs called PCSK9 inhibitorswas approved by theU.S. Food and Drug Administration (FDA) in 2015 to treat people with familial hypercholesterolemia and other risk factors. PCSK9 inhibitors are monoclonal antibodies that work to inactivate a protein in the liver called proprotein convertase subtilisin-kexin type 9 (PCSK9), reducing the amount of LDL circulating in your body.

Cholesterol and Heart Disease: Understanding the Connection

For years, it had been believed that there’s more or less a straight line between cholesterol and heart disease — but recent research suggests that this relationship may be more complex.

A Minneapolis Heart Foundation study, published in April 2017 in the Journal of the American Heart Association, found that many people who have heart attacks don’t have high cholesterol. “The link between cholesterol and heart disease is weak,” says Dr. Roberts, who places a large portion of the blame for the persistence of that link on pharmaceutical advertising for statin drugs. “Statins do lower cholesterol levels,” she says, “but atherosclerosis still progresses” due to factors like age, poor diet, smoking, and so on.

In addition, a review of studies of cholesterol and cardiovascular disease published in August 2015 in the American Journal of Clinical Nutrition found that no rigorous connection could be drawn between dietary cholesterol intake and the risk of CVD.

In contrast, the results of long-term research, published in September 2017 in the journal Circulation, concluded that statin use in men with high LDL cholesterol who had no other risk factors for heart disease reduced their rates of coronary heart disease death, cardiovascular death, and all-cause mortality by 28 percent over 20 years.

Furthermore, a study of more than 400,000 people published in December 2019 in The Lancet found a strong link between non-HDL cholesterol and long-term risk of cardiovascular disease.

(Video) LDL and HDL Cholesterol | Good and Bad Cholesterol | Nucleus Health

Still, when it comes to heart health, your biggest risk factor is age, says Roberts.

To keep your risk of high cholesterol as low as possible and your heart as healthy as you can for as long as you can, eat real (unprocessed) food, exercise regularly, don't smoke, and keep your blood pressure under control.

Additional reporting byAshley Welch.

FAQs

What is normal cholesterol level by age? ›

Optimal ranges
Age and sexTotal serum cholesterolTriglycerides
all aged 19 years and younger170 mg/dl at mostless than 150 mg/dl
females aged 20 years and older125–200 mg/dlless than 150 mg/dl
males aged 20 years and older125–200 mg/dlless than 150 mg/dl

What do I need to know about cholesterol levels? ›

Your cholesterol numbers show how much cholesterol is circulating in your blood. Your HDL (“good” cholesterol) is the one number you want to be high (ideally above 60). Your LDL (“bad” cholesterol) should be below 100. Your total should be below 200.

What reduces cholesterol quickly naturally? ›

Foods that make up a low cholesterol diet can help reduce high levels
  • Oats. ...
  • Barley and other whole grains. ...
  • Beans. ...
  • Eggplant and okra. ...
  • Nuts. ...
  • Vegetable oils. ...
  • Apples, grapes, strawberries, citrus fruits. ...
  • Foods fortified with sterols and stanols.

How can I reduce cholesterol quickly? ›

A few changes in your diet can reduce cholesterol and improve your heart health:
  1. Reduce saturated fats. Saturated fats, found primarily in red meat and full-fat dairy products, raise your total cholesterol. ...
  2. Eliminate trans fats. ...
  3. Eat foods rich in omega-3 fatty acids. ...
  4. Increase soluble fiber. ...
  5. Add whey protein.

Do eggs raise cholesterol? ›

Answer From Francisco Lopez-Jimenez, M.D. Chicken eggs are an affordable source of protein and other nutrients. They're also naturally high in cholesterol. But the cholesterol in eggs doesn't seem to raise cholesterol levels the way some other foods, such as those high in trans fats and saturated fats, do.

What is stroke level cholesterol? ›

Levels of LDL cholesterol higher than 130 milligrams per deciliter (mg/dL) are linked to an increased risk for ischemic stroke.

Does exercise Lower cholesterol? ›

Exercise works to eliminate the dangerous, fatty LDL cholesterol by increasing HDL cholesterol. Losing weight also increases HDL. According to the American Heart Association, high cholesterol is caused by two lifestyle elements that happen to go hand-in-hand: lack of exercise and being overweight (among other factors).

Does stress cause high cholesterol? ›

Is stress linked to high cholesterol? The short is yes. Feeling under pressure for a long time can raise your risk of high cholesterol and even heart disease. But you can take steps to get your stress under control and protect your heart.

Is walking good for high cholesterol? ›

A person can combat high cholesterol by exercising regularly. Forms of exercise that help a person lower their total and LDL cholesterol levels include walking, running, cycling, and swimming. Often, these exercises can also help raise the levels of a person's HDL cholesterol.

Are bananas good for cholesterol? ›

The fiber and potassium in bananas can reduce the level of cholesterol and blood pressure. Banana is especially known as a good source of soluble fibre which will gives one a healthy body and good immune system.

What drinks are good for cholesterol? ›

Best drinks to improve cholesterol
  • Green tea. Green tea contains catechins and other antioxidant compounds that seem to help lower “bad” LDL and total cholesterol levels. ...
  • Soy milk. Soy is low in saturated fat. ...
  • Oat drinks. ...
  • Tomato juice. ...
  • Berry smoothies. ...
  • Drinks containing sterols and stanols. ...
  • Cocoa drinks. ...
  • Plant milk smoothies.

How does high cholesterol make you feel? ›

With this heart condition, excess LDL builds up as plaque in your heart's small arteries, causing them to narrow and stiffen. This reduces blood flow, which can make you feel tired or short of breath and cause chest pain, notes the NHLBI.

Does water reduce cholesterol? ›

Serum analysis showed that consumption of H2-rich water for 10 weeks resulted in decreased serum total-cholesterol (TC) and LDL-cholesterol (LDL-C) levels.

Which vegetables reduce cholesterol? ›

Some vegetables are particularly high in pectin, the same cholesterol-lowering soluble fiber that occurs in apples and oranges ( 21 ). Pectin-rich vegetables also include okra, eggplants, carrots and potatoes.

Is peanut butter good for cholesterol? ›

Helps heart health

Due to its high amount of unsaturated fats, peanut butter may help reduce a person's LDL cholesterol levels. Having optimal LDL levels is linked with a lower risk of heart disease. A 2015 study found that people who had a high intake of nuts may have a lower risk of cardiovascular disease mortality.

Do nuts raise cholesterol? ›

Can eating too many nuts raise cholesterol? Yes, it is possible that eating nuts in excess may increase LDL cholesterol levels due to their saturated fat content. Eating nuts in excess may also exceed a person's daily calorie needs, leading to increased LDL cholesterol levels.

Is yogurt good for cholesterol? ›

Heart Health

Greek yogurt has been connected to lower cholesterol and triglyceride levels, which can reduce your risk of heart disease. Cholesterol and triglycerides can harden or block your arteries over time, leading to heart disease or atherosclerosis.

Does cheese raise cholesterol? ›

Cheese is high in cholesterol, but, according to the USDA Dietary Guidelines from 2015 , there is no clear link between the cholesterol-rich foods that a person eats and their blood cholesterol levels. Instead, it is the saturated fat in cheese that is responsible for raising cholesterol levels.

Does olive oil raise cholesterol? ›

Olive oil is packed full of beneficial antioxidants that can lower your "bad" (LDL) cholesterol while leaving your "good" (HDL) cholesterol untouched.

Does butter raise cholesterol? ›

Examples: butter, lard, bacon grease, dairy fat

Saturated fats raise the total blood cholesterol by raising the harmful LDL (low-density lipoprotein), but they also raise beneficial HDL (high-density lipoprotein) in comparison to carbohydrates, although researchers dispute how helpful this increase is.

How long does it take to get cholesterol down? ›

How long does it take to reduce cholesterol? Cholesterol drops over time, not suddenly, after a few days of healthier living. There is no set period in which cholesterol is guaranteed to drop. Cholesterol-lowering drugs usually produce a change in LDL within 6 to 8 weeks.

Can high cholesterol be reversed? ›

Completely reversing it isn't possible yet. But taking a statin can reduce the risk of complications from atherosclerosis. It fights inflammation, which stabilizes the plaque. For this reason, statins are often key to treating atherosclerosis.

Will losing weight lower cholesterol? ›

If you are obese and have high cholesterol, losing weight should help lower your cholesterol, as well as your risk for other obesity-related conditions including diabetes and cardiovascular disease.

Is canned tuna good for lowering cholesterol? ›

Replacing meats high in saturated fat with healthier options, like fish, is a smart tactic to improve cholesterol levels. Certain types of fish also provide heart-healthy omega-3 fatty acids. Good choices include salmon, albacore tuna (fresh and canned), sardines, lake trout and mackerel.

Can you eat chicken with high cholesterol? ›

If you have high cholesterol, you should talk with your doctor about what you eat, including meat. There are good, lean choices. For example, you can consider chicken or turkey breasts without skin; pork tenderloin; or beef round, sirloin, or tenderloin. Avoid highly processed meats (bacon, ham, lunchmeat, etc.).

Does Oatmeal Lower cholesterol? ›

Oatmeal contains soluble fiber, which reduces your low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol. Soluble fiber is also found in such foods as kidney beans, Brussels sprouts, apples and pears. Soluble fiber can reduce the absorption of cholesterol into your bloodstream.

What raises cholesterol the most? ›

Factors that can increase your risk of unhealthy cholesterol levels include:
  • Poor diet. Eating too much saturated fat or trans fats can result in unhealthy cholesterol levels. ...
  • Obesity. Having a body mass index (BMI) of 30 or greater puts you at risk of high cholesterol.
  • Lack of exercise. ...
  • Smoking. ...
  • Alcohol. ...
  • Age.
20 Jul 2021

Does lack of sleep cause high cholesterol? ›

A number of studies have linked short-term sleep deprivation with several well-known risk factors for heart disease, including higher cholesterol levels, higher triglyceride levels, and higher blood pressure.

Can one meal affect a cholesterol test? ›

Does what you eat before the test matter? Consuming a double cheeseburger, fries, and a milk shake right before having your blood drawn for a cholesterol test may lead to a follow-up fasting test if the triglycerides are very high. But eating normally has little effect on your lipid levels, including triglycerides.

What should a 70 year old cholesterol be? ›

40 – 49 mg/dL for men and 50 – 59 mg/dL for women is better. 60 mg/dL and higher is best.

Is a cholesterol of 6.4 high? ›

Blood cholesterol is measured in units called millimoles per litre of blood, often shortened to mmol/L. As a general guide, total cholesterol levels should be: 5mmol/L or less for healthy adults. 4mmol/L or less for those at high risk.

What should my cholesterol be at 70? ›

So what are your target numbers? According to Michos, an ideal LDL cholesterol level should be less than 70 mg/dl, and a woman's HDL cholesterol level ideally should be close to 50 mg/dl. Triglycerides should be less than 150 mg/dl.

What is an acceptable cholesterol level? ›

Check what your cholesterol levels should be
ResultHealthy level (mmol/L)
Total cholesterol5 or below
HDL (good cholesterol)1 or above
Non-HDL (bad cholesterol)4 or below
Fasting triglycerides (when you're asked not to eat for several hours before the test)1.7 or below
2 more rows

Does stress cause high cholesterol? ›

Is stress linked to high cholesterol? The short is yes. Feeling under pressure for a long time can raise your risk of high cholesterol and even heart disease. But you can take steps to get your stress under control and protect your heart.

Can you be healthy with high cholesterol? ›

We all need some cholesterol in our blood to stay healthy, but too much can lead to serious health problems such as heart attacks and strokes. Anyone can have high cholesterol, even if you are young, slim, eat well and exercise. That's because high cholesterol can be caused by different things, including your genes.

Does exercise Lower cholesterol? ›

Exercise works to eliminate the dangerous, fatty LDL cholesterol by increasing HDL cholesterol. Losing weight also increases HDL. According to the American Heart Association, high cholesterol is caused by two lifestyle elements that happen to go hand-in-hand: lack of exercise and being overweight (among other factors).

What is stroke level cholesterol? ›

Levels of LDL cholesterol higher than 130 milligrams per deciliter (mg/dL) are linked to an increased risk for ischemic stroke.

What is a dangerously high cholesterol level? ›

A person is considered at high risk for developing heart disease if their total cholesterol level is higher than 240 mg/dL, LDL levels are higher than 160 mg/dL (190 mg/dL is even higher risk), and if the HDL level is below 40 mg/dL.

What drinks are good for cholesterol? ›

Best drinks to improve cholesterol
  • Green tea. Green tea contains catechins and other antioxidant compounds that seem to help lower “bad” LDL and total cholesterol levels. ...
  • Soy milk. Soy is low in saturated fat. ...
  • Oat drinks. ...
  • Tomato juice. ...
  • Berry smoothies. ...
  • Drinks containing sterols and stanols. ...
  • Cocoa drinks. ...
  • Plant milk smoothies.

Does drinking water help lower cholesterol? ›

When people have high cholesterol their LDL (bad) is high and their HDL (good) is low. Eating healthy, regular exercise and drinking plenty of water will help to bring down cholesterol levels within 2-3 weeks.

How does fasting affect cholesterol? ›

Regular fasting can decrease your low-density lipoprotein, or "bad," cholesterol. It's also thought that fasting can improve the way your body metabolizes sugar. This can reduce your risk of gaining weight and developing diabetes, which are both risk factors for heart disease.

How long can you go with high cholesterol? ›

Because high cholesterol causes few symptoms, many people go years without knowing their numbers. “That's dangerous, because the plaque buildup you have in your 20s, 30s, or 40s doesn't go away,” Goldberg says. “It adds up over time, which may mean a heart attack or stroke in your 50s or 60s.”

How long does it take to naturally lower cholesterol? ›

It is possible for lifestyle changes to change cholesterol levels within weeks. However, it may take longer, usually about 3 months — sometimes more. Some doctors recommend adding a cholesterol-lowering drug if a person has not lowered their LDL cholesterol after about 12 weeks of lifestyle changes.

How can I lower my cholesterol in 30 days? ›

Switch to a Mediterranean Diet

High in fruits, vegetables, beans, whole grains, nuts, fish, and olive oil, but low in red meat, this diet encapsulates many of the common dietary suggestions you'll encounter. Not only that, but Mediterranean diet recipes are easy and can use produce from your garden.

What is the most important cholesterol number? ›

An optimal level of non- HDL cholesterol is less than 130 milligrams per deciliter (mg/dL), or 3.37 millimoles per liter (mmol/L). Higher numbers mean a higher risk of heart disease. To calculate your cholesterol ratio, divide your total cholesterol number by your HDL cholesterol number.

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