There is so much talk about the dangers of “high cholesterol,” you may start to think that all cholesterol is bad. In truth, your body needs cholesterol. This waxy fat, or “lipid,” is necessary for digestion, building cells, making certain hormones, and for ensuring normal organ function. However, as it is with many things that are good for you in the right amount, too much of it can cause serious health problems.

Your liver produces all of the cholesterol your body needs. Your body also absorbs cholesterol directly from certain foods you eat. When you intake some cholesterol from your diet, your body is normally able to adjust the amount produced by your liver to avoid having too much. Eating too many high-cholesterol foods, and having conditions that cause your liver to produce too much can lead to high blood cholesterol levels sometimes known as lipid disorder, hyperlipidemia, or hypercholesterolemia.

When there is more cholesterol in your blood than you need, it collects on the sides of your arteries. Arteries are the blood vessels that carry blood from your heart to the rest of your body. This build-up of cholesterol, called plaque, narrows your arteries and hardens them, reducing the flow of blood to your body’s tissues and organs. Over time, enough plaque can block an artery completely. The plaque will sometimes split open and form a clot that can also block an artery. If an artery supplying blood to your heart becomes clogged, a heart attack can occur. If an artery supplying blood to your brain becomes clogged, a stroke can occur.

The Center for Disease Control (CDC) reports that the number of adults with cholesterol levels outside of the healthy range has been decreasing over the past couple of decades. This is partly due to the increased number of adults who are checking their levels regularly and treating high cholesterol with lifestyle changes and medication when necessary. CDC still reports, however, that only half of the adults in the United States who could benefit from cholesterol medications are actually being treated. In this article, we want to learn about high cholesterol, look at how to treat it and talk about when medication can help.

What is a good cholesterol level?

To understand cholesterol levels, it is first helpful to understand how cholesterol is measured. Cholesterol is not floating around in your bloodstream by itself. If it was, it would just be globs of fat that would not be able to use. For cholesterol to be useful, it attaches to proteins before it enters the blood. These combinations of cholesterol (a lipid) and proteins are called “lipoproteins.” There are several types of lipoproteins, but the two that receive the most attention are:

Low-Density Lipoprotein (LDL)

This lipoprotein is commonly known as “bad cholesterol.” LDL is what carries cholesterol to the parts of your body that need it to function. It is also what builds up on artery walls when there is too much of it. Higher levels of HDL in the blood are linked to a higher risk of heart disease and stroke.

High-Density Lipoprotein (HDL)

This lipoprotein is commonly known as “good cholesterol.” HDL removes excess cholesterol from the blood and carries it to the liver to be eliminated from your body. Increasing your “good cholesterol” can lower your “bad cholesterol” and lower your risk of heart disease and stroke.

To determine your cholesterol level, a doctor will order a blood test called a “lipid panel.” The test will measure:

Total Cholesterol (the total of all types of cholesterol combined)

1. Levels under 200 milligrams per deciliter (mg/dL) are desired for adults.

LDL (bad cholesterol)

1. Levels under 100 mg/dL are desired for adults.

HDL (good cholesterol)

1. Levels at or above 60 mg/dL are desired for adults.

Triglycerides (another type of fat that is linked to heart disease and stroke)

1. Levels under 150 mg/dL are desired for adults.

The recommended levels listed above are desired for most adults. However, your recommended levels may differ from these if you have one of several diseases or high cholesterol risk factors. You should talk to your doctor about the healthiest cholesterol levels for you.

What is considered high cholesterol?

Lipid panel results that fall outside of the desired range place you at higher risk of heart disease and stroke:

Total Cholesterol (the total of all types of cholesterol combined)

1. Borderline High – 200 to 239 mg/dL

2. High – at or above 240 mg/dL

LDL (bad cholesterol)

1. Near-Optimal – 100 to 129 mg/dL

2. Borderline High – 130 to 159 mg/dL

3. High – 160 to 189 mg/dL

4. Very High – at or above 190 mg/dL

HDL (good cholesterol)

1. Borderline Low – 40 to 59 mg/dL

2. Low – below 40 mg/dL

Triglycerides (another type of fat that is linked to heart disease and stroke)

1. Borderline High – 150 to 199 mg/dL

2. High – 200 to 499 mg/dL

3. Very High – at or above 500 mg/dL

How do I know if my cholesterol is too high?

There are no symptoms that can warn you when your cholesterol level is high. You can have high cholesterol and never know it. A lipid panel blood test is the only way to determine whether or not you have high cholesterol.

It is generally recommended that men and women over 20 years of age should have their cholesterol levels checked every 5 years. However, if your test results are outside of the recommended range, you should check them more often. Other factors related to your health, your family medical history and your lifestyle will also affect how often you should have your cholesterol levels checked. As always, talk to your doctor about the frequency that is best for you.

What causes high cholesterol in a healthy person?

Age, gender and genetics are factors that can contribute to the risk of high cholesterol.

Age:

As both men and women age, their livers become less able to remove LDL. Men aged 45 years or older and women aged 55 years or older have an increased risk of high cholesterol

Gender:

Statistics show that premenopausal women have healthier cholesterol levels than men of the same age. There is evidence that estrogen boosts HDL levels, helping to keep all cholesterol in check. This changes, however, after menopause. When their estrogen levels drop, women statistically have higher cholesterol than men of the same age.

Genetics:

Your risk of high cholesterol may increase if your father or brother had heart disease before age 55, or if your mother or sister had heart disease before age 65. Parents can pass certain genes on to their children that cause their bodies to create too much cholesterol or remove too little. High cholesterol can run in the family.

As you can see from the list above, not all of the possible causes of high cholesterol can be controlled. However, an unhealthy lifestyle can definitely contribute to unhealthy cholesterol levels. Many of the controllable factors that lead to high cholesterol are related to our level of activity, our diet other behaviors.

Lack of exercise:

30 minutes of daily activity, like walking, can increase your HDL levels and lower your LDL levels.

Poor diet:

Eating certain foods, especially those high in saturated fats and trans fats, can contribute to high cholesterol levels.

Obesity:

Being overweight can also contribute to high cholesterol. A body mass index (BMI) of over 30 puts you at greater risk of higher LDL, lower HDL and higher triglyceride levels.

Smoking:

Smoking and exposure to smoke can lower your HDL. Smoking also damages the lining of your arteries, making it easier for cholesterol to build up and form plaque.

Excessive alcohol use:

Drinking alcohol in moderation will not affect your cholesterol levels much. Moderate drinking is defined as 2 drinks per day for men and 1 drink per day for women. Drinking in excess of these amounts can negatively impact your liver’s ability to create HDL raise total cholesterol levels.

Because some causes of high cholesterol are hereditary, you can still be at risk even if you eat well, exercise regularly, control your weight and reduce all of the other controllable risk factors. You can look, feel and be healthy in all other ways; yet still have high cholesterol. This is why it is important to discuss your risk factors with your doctor.

What foods cause high cholesterol?

Eating foods high in saturated fats and trans fats can raise your LDL and total cholesterol levels. Saturated fats are found in red meats, full-fat dairy products, and many processed foods. Trans fats are sometimes listed on food labels as “partially hydrogenated vegetable oil.” Trans fats are so unhealthy that the Food and Drug Administration has actually banned them as of January 1, 2021. Foods that can contribute to high cholesterol include:

1. Fatty beef, lamb, or pork

2. Poultry with skin

3. Butter, cheese, and other dairy products made with whole milk

4. Lard and shortening

5. Saturated cooking oils

6. Store-bought baked goods

7. Fried foods

8. Many processed foods and snacks

You should read your food labels closely. Even if a label says the food has “No Cholesterol” in big letters on the front of the box, the Nutrition Facts label on the back or side might still tell you that the food contains saturated or trans fats.

It is better to substitute mono-unsaturated fatty acids (MUFA) for saturated and trans fats in your diet. Eating these good fats can actually help you lower LDL levels and total cholesterol. MUFAs are found in many healthy cooking oil choices:

1. Olive oil

2. Avocado oil

3. Canola oil

4. Safflower oil

5. Sunflower oil

6. Sesame oil

7. Peanut oil

A diet that helps you lower your cholesterol can include:

1. Plenty of vegetables and fruits

2. Avocados

3. Tree nuts like almonds, walnuts, and pecans

4. Fatty fish like salmon, trout, tuna, mackerel, herring, and sardines

5. High-fiber foods like oatmeal and oat bran

6. Low-fat dairy foods

Some foods like margarine, yogurt, and orange juice can have sterols or stanols added to them. These plant-based substances help your body block the absorption of cholesterol from your diet and lower LDL levels.

How do you treat high cholesterol?

If at some point your doctor tells you that your cholesterol is high, there is a very good chance that Therapeutic Lifestyle Changes (TLC) will be discussed soon after. TLC includes diet, exercise and weight management. Now, before you roll your eyes and think, “here we go again with the diet and exercise talk,” stop and think about it. A few improvements in the foods you eat, coupled with reasonable increases in your activity, can have a significant impact on your cholesterol levels. If you could put that health impact in the form of a pill, people would probably be willing to stand in line for days to get a bottle. It only takes a few weeks to build new healthy habits, but over time your health will benefit greatly.

When you are not able to lower your cholesterol levels enough through lifestyle changes alone, your doctor may couple those changes with drug therapies. Some of the medications available include:

1. Statins that reduce the amount of cholesterol produced by your liver

2. Bile acid sequestrants that reduce the amount of fat your body absorbs from your diet

3. Cholesterol absorption inhibitors reduce the number of triglycerides in your blood and reduce the amount of cholesterol your body absorbs from your diet

4. Certain vitamins and supplements that stop your liver from removing HDL

5. Omega-3 fatty acid supplements that raise the level of HDL and lowers triglycerides

How can Centric Healthcare help?

Medical Nutrition Therapy

Eating healthy is important to the prevention and treatment of high cholesterol. If you are required to eat a TLC Diet or a Mediterranean Diet to lower your cholesterol, Centric Healthcare offers Medical Nutrition Therapy (MNT) services that can help. A Registered Dietician can help you design a nutrition program that is tailor-made for you. When helping you make a plan, we will take into account factors such as your medical history, your current health needs, your dietary restrictions, your food preference, and many others. Through the MNT services offered by Centric Healthcare, you can make better food choices, eat healthier portions and learn delicious ways to enjoy a healthier lifestyle.

Personal Care Assistant Services

As you age, you are not always able to care for yourself and do all the things you were once able to do on your own. Your diet can sometimes suffer because of this. Centric Healthcare offers Personal Care Assistant services that can help. PCA services are social care programs which assist with non-medical needs of persons who aren’t getting around as well as they once did and allow them to live in their own home instead of being placed in an institution. PCAs can help you meal plan, grocery shop, prepare your meals and assist you with many other basic activities of daily living.