High cholesterol, or lipid disorder, refers to the abundance of fatty substances in your blood. High cholesterol can come from a number of places, but what you eat is the most common source, especially high-fat, low-fiber foods. Keeping your “bad” cholesterol low and your “good” cholesterol high can help prevent many common health problems.
High Cholesterol Overview
By the Healthline Editorial Team Reviewed by Stephanie Burkhead, MPH
What Is High Cholesterol?
Cholesterol is a fatty, wax-like substance that circulates throughout the bloodstream. Your body manufactures some of it, and the rest comes from your diet. Cholesterol is an essential building block of every cell in the human body. High cholesterol—also known as hypercholesterolemia—is a lipid disorder that can significantly raise the risk of heart disease. When the body has more than it can handle, excess cholesterol can build up and clog the arteries, cutting off the blood supply to the heart. That’s why it’s important to have your cholesterol tested regularly and to keep your levels down. Eating a heart-healthy diet and exercising regularly can help prevent high cholesterol.
Types of High Cholesterol
There are several types of cholesterol in the body. When you have high cholesterol, one or all of the types may be within an unhealthy, abnormal range. At the doctor’s office, your physician may talk to you about your total cholesterol, or he may break it down into the different types: low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides. The term “high cholesterol” is actually a bit of a misnomer because, while it’s true we want to keep our LDL and triglycerides down, we should strive to push our HDL up. Low levels of HDL are considered abnormal and are a risk factor for heart disease.
High-Density Lipoprotein (HDL)
High-Density Lipoprotein is the so-called “good” cholesterol that may help protect against heart disease. (You can remember that by thinking “H” is for healthy.) The higher your HDL, the better. That’s because HDL cholesterol sweeps excess LDL cholesterol (the “bad” artery-clogging kind) out of the body. The clinical term for having abnormally low levels of HDL is hypoalphalipoproteinemia (HA). Although there is no cut-off number that diagnoses HA, low HDL levels (less than 40 mg/dL for men and less than 50 mg/dL for women) are associated with a greater risk of heart disease. To protect against heart disease, the American Heart Association recommends that men and women should keep their HDL levels above 60mg/dL.
Low-Density Lipoprotein (LDL)
Low-Density Lipoprotein (LDL) is the “bad” cholesterol that contributes to atherosclerosis, which is the buildup of plaque along the arterial walls. (You can remember this by thinking “L” for lousy.) Atherosclerosis can cause your arteries— which transport blood, oxygen, and nutrients—to harden or rupture and lead to blockages, strokes, and heart attacks. That’s why high levels of LDL cholesterol are a major risk factor for heart disease. Guidelines state that people with no risk of heart disease should aim for an LDL score below 130. However, some medical experts believe that number is too high.
The American Heart Association and the National Heart, Lung, and Blood Institute both state that everyone’s LDL should be below 100 for optimal health. People who are at high risk of heart disease should keep their LDL below 100, and people who have heart disease or are at an extremely high risk of heart disease should aim to keep their LDL below 70.
This is the sum of your HDL and LDL scores. In general, you want to strive to keep your total cholesterol under 200 mg/dL. Although some physicians will only give you this result after you get your cholesterol tested, it’s a good idea to ask them to break it down for you so you know if your HDL is as high as you’d like and your LDL is as low as you’d like. A total cholesterol score of 200 to 239 mg/dL is considered borderline high-risk, while a score of 240 mg/dL or more is in the high-risk category. According to the American Heart Association, nearly half of all American adults have a total cholesterol score above 200 mg/dL.
Triglycerides are another type of lipid (fat) found in the bloodstream. Extra calories that your body doesn’t use get stored as triglycerides. As such, frequently overeating and being overweight may lead to elevated triglycerides. High triglyceride levels, known as hypertriglyceridemia, usually go hand-in-hand with high levels of “bad” LDL and low levels of “good” HDL. A triglyceride level below 150 mg/dL is considered normal. Between 150 and 200 is borderline-high; 200 to 499 is high; and more than 500 is very high.
High Cholesterol Symptoms
High cholesterol has no symptoms, but that does not mean it’s something to take lightly. High cholesterol increases the risk of developing other serious health conditions such as:
* coronary heart disease
* high blood pressure
* peripheral vascular disease
The only way to determine if your cholesterol levels are where they should be is by getting a blood test from your doctor.
High Cholesterol Prevention
For people who do not have familial hypercholesterolemia (a genetic disorder in which the body produces too much cholesterol), high cholesterol is completely preventable. To a large degree, high cholesterol is considered a lifestyle disease. In other words, how healthfully you live your life determines whether or not you will get it. The same healthy habits that can lower your cholesterol can also prevent high cholesterol in the first place.
Smoking cigarettes can have a negative impact on high-density lipoprotein (HDL) cholesterol—the good stuff that helps keep your arteries clear. Smoking also damages blood vessels and speeds up the hardening of the arteries.
Maintaining a Healthy Weight
Being overweight or obese can raise “bad” low-density lipoprotein (LDL) cholesterol. Because it’s much harder to lose weight than maintain a healthy weight, controlling calories to avoid weight gain is optimal. Some experts believe weighing yourself every day is a good way to gauge whether you’re eating too much. If the scale starts climbing, you know it’s time to cut back on how much you’re eating. Extreme dieting can also slow down the metabolism and lead to weight gain. That’s why it’s better to eat a healthy and balanced diet. If you feed your body the nutrients it needs and avoid the junk it doesn’t, you are more likely to keep your weight and your cholesterol down.
Getting 30 minutes of moderate physical activity, like brisk walking, most days of the week can help lower high triglycerides. Bumping up the intensity by climbing hills or stairs or by running can boost “good” HDL cholesterol. What’s more, exercising regularly can lower blood pressure and help overweight individuals lose weight, which can lead to lowering “bad” LDL cholesterol levels.
Eating a Healthy Diet
To keep your weight down and your heart healthy, you should avoid eating more calories than you burn each day. Extra calories are converted into triglycerides—a type of fat—in the blood. Consuming too many calories also leads to weight gain, which can elevate your cholesterol.
What you eat is just as important as how much you eat. When it comes to high cholesterol, saturated fat, trans fat, and refined carbohydrates are some of the biggest dietary culprits. Heart-healthy diets should be low in saturated fat, cholesterol, trans fat, sodium, and sugar. In fact the National Heart, Lung, and Blood Institute recommends a so-called “TLC diet” (Therapeutic Lifestyle Changes)—a low-saturated fat and low-cholesterol eating plan.
Foods that contain high amounts of saturated fat include:
* Red meat
* Processed meats
* Fried food
* Hydrogenated vegetable oil
* Many processed baked goods, such as cookies and cakes
* Dairy products that aren’t low-fat.
You can limit the amount of cholesterol-boosting fat in your diet by swapping saturated fats for healthy monounsaturated and polyunsaturated fats. These kinds of fats can actually lower your cholesterol. Those foods include:
* Olive oil
* Sunflower oil
* Peanut oil
* Canola oil
* Fatty fish
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It’s also important to include plenty of fruit, vegetables, whole grains, and legumes in your diet, because fiber-rich food plays a role in bringing down cholesterol. Limit or avoid foods that have added sugar, like juice drinks, soda, and packaged foods. Excess sugar can boost blood pressure and triglycerides and lower “good” HDL level.