Years ago, high cholesterol was not readily treatable and led to many heart attacks and stroke. Thankfully today, we know more about it and have effective treatments. And while having high cholesterol is no longer the health threat it once was, it’s important to know which type of cholesterol is high (LDL or HDL), what food can affect this, and how it can be treated.
What is Cholesterol?
Cholesterol is a fatty substance found in the blood. It has many important functions, including keeping cells healthy and forming different types of hormones and vitamins. Although the body tries to maintain cholesterol at a relatively constant level, it may become elevated, which can increase a person’s risk for heart attack and stroke.
There are two types of cholesterol (also called lipoproteins*):
- Low-density lipoprotein (LDL), or “bad” cholesterol, is the main cause of cholesterol buildup in arteries. When the blood contains too much LDL cholesterol, the cells lining our arteries may become clogged with it, leading to reduced blood flow, which may result in a heart attack or stroke.
- High-density lipoprotein (HDL), or “good” cholesterol, helps remove fat and bad LDL cholesterol from cells and transport them back to the liver, where they are eliminated. A healthy HDL-cholesterol level may protect against heart attack and stroke.
Understanding the difference between these two types of cholesterol is key, so if your doctor tells you that you have high cholesterol, ask them which type — LDL or HDL — is high.
What Causes Cholesterol to Go Up?
One of the things that cause cholesterol levels to rise is the food we eat. In particular, large amounts of saturated fat and trans fat can contribute to high cholesterol levels.
- Saturated fat
Saturated fat, which is found mainly in animal products, can drive up cholesterol levels (especially harmful LDL levels). For this reason, it’s important to limit consumption of things like red meat and full-fat dairy products, including cheese. Substituting these foods with chicken, fish, and low-fat dairy products can help keep high cholesterol levels at bay.
- Trans fat
Trans fat is found in commercially produced baked goods, snacks (such as potato chips), fried foods, and margarine. Eating too much of these foods can lead to a “double whammy” because not only does trans fat raise LDL (or bad) cholesterol, it also lowers HDL (or good) cholesterol.
It’s important to note that eating recommended portions of foods that are high in cholesterol (like eggs and liver) probably does not raise your blood cholesterol very much. In the past, it was thought that high-cholesterol food caused cholesterol levels to go up. Research now suggests that this may not be the case; however, it’s still a good idea to not eat too much of these foods, as they usually also contain large amounts of saturated fat.
The American Heart Association recommends that adults consume no more than 300 mg of cholesterol per day and no more than 30 percent of their calories from fat per day, of which less than 5-6 percent should be saturated fat. By focusing on eating plenty of fruits and vegetables and avoiding the high-fat foods mentioned above, this goal can easily be achieved.
What Helps Lower Cholesterol Levels?
While the foods mentioned above have a negative effect on cholesterol levels, there are others that have a positive one. Foods that have the most significant impact on cholesterol include those that are high in:
- Soluble and insoluble fiber | Try to eat 25-35 grams/day
Fiber – as found in whole grains, beans, and peas – binds with cholesterol and its precursors in the digestive system and drags them out of the body before they ever get into circulation.
- Polyunsaturated fats | Make these 10-15 percent of your daily calories
These are the “good” fats and eating these fats in place of saturated fats reduces harmful LDL cholesterol and improves the cholesterol profile. Polyunsaturated fats include omega-3 fats and are found in salmon, tuna, and mackerel; sunflower and sesame seeds; walnuts; and soybeans.
- Plant sterols and stanols | Try to eat 2 grams/day
Also known as “phytosterols,” these are naturally occurring compounds found in plants that block the body from absorbing cholesterol. Phytosterols are found in foods like nuts, vegetable oils, corn, and rice, as well a fortified food like margarine spreads, orange juice, milk, bars, and baked products. The effectiveness of phytosterols in lowering bad LDL cholesterol is so strong that the National Cholesterol Education Program recommends people with high cholesterol consume two grams of phytosterols each day. Take a closer look at ways to add phytosterols to your diet.
If Changing Your Diet Doesn’t Work, There Are Medications to Treat High Cholesterol
While it is always preferable to use lifestyle changes to treat a health condition, sometimes it’s necessary to consider medication. If someone is unsuccessful in changing their diet, or if the changes do not lower their cholesterol, there are many drugs that can be used to help.
Cholesterol drugs such as statins or PCSK9 inhibitors require a prescription from your doctor. Once you start taking one of these drugs, your doctor will monitor your blood tests to see if the drugs are working. Once there is a reduction in your cholesterol, you will not need to have your blood tested as often. One final point, though, you must continue taking these medications for your entire life. If you stop taking them, your cholesterol will go back to the same level as before treatment.
When Should You Have Your Cholesterol Checked?
The American Heart Association recommends that all adults 20 or older have their cholesterol and other traditional risk factors checked every four to six years as long as their risk remains low. After age 40, your health care professional will evaluate your 10-year risk of having a heart attack or stroke. People with cardiovascular disease, and those at elevated risk, may need their cholesterol and other risk factors assessed more often.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The information on this website is for general information purposes only. Always seek the advice of your physician or health care provider on any matters relating to your health.*Technically speaking, lipoproteins aren’t cholesterol. They are the vehicles that cholesterol molecules use to travel through the body. Want to learn more about lipoproteins? Here’s an explanation that’ll really float your boat (that’s a promise).