Cholesterol is usually termed as unhealthy. However, your body needs cholesterol to build healthy cells, produce certain hormones, vitamin D, and bile to aid digestion. Your body produces enough cholesterol that it needs but it can also be gotten from animal-based foods.
Cholesterol is a wax-like type of fat (lipid) that is present throughout your blood and body. Fats are insoluble organic materials found in all the cells of your body. In the body, cholesterol is produced by the liver.
Cholesterol is essential to every cell in the body. Body cells use cholesterol as the material to make layers of the cell membranes. These layers guard the contents of the cell and determine what can enter or leave the cell.
As good as cholesterol is, it is dangerous at high levels. It can increase your risk of developing heart disease, heart attacks, and stroke. This is possible due to the types of cholesterol that we have.
Lipoproteins are substances in the blood that transport cholesterol in the blood. These lipoproteins define the types of cholesterol. They are:
Low-density Lipoprotein (LDL)
Low-density lipoprotein (LDL) is a main lipoprotein. It is referred to as “the bad cholesterol”. This is ironic to some people because we are often advised to keep our cholesterol levels low. LDL is called bad cholesterol because of how it affects our health. LDL can deposit along the inner walls of your arteries.
Arteries are the blood vessels that transport oxygen-rich blood from your heart to all other organs in the body. When these fat particles form plaque and line the arterial walls, they cause them to be narrower and may cause blockages. This build-up leading to reduced delivery of blood and flexibility is called atherosclerosis. Narrowed and blocked arteries can predispose you to chest pain (angina), heart disease, and stroke.
Saturated fats and trans fat are fats that are linked to LDL. They are also the type of fats we are advised to cut down on in our diet. Saturated fats are solid or become like wax at room temperature. Saturated fats are mostly found in animal-based foods like meat, milk, cheese, and butter.
Trans fat is a form of unsaturated fat. They can be found naturally in meat and animal milk. Most trans fats however are formed when vegetable oil is put through an industrial process called hydrogenation. The oil then becomes solid at room temperature. Trans fats are considered very unhealthy because they increase your “bad cholesterol”. They are found in fast foods and fried foods. They are also used in producing processed foods such as cakes, cookies, margarine, and creams because they increase their shelf-life.
High-density Lipoprotein (HDL)
High-density lipoprotein (HDL) is the second main type of lipoprotein and it carries about one-fourth to one-third of the cholesterol in the blood. HDL is referred to as “the good cholesterol”. It absorbs all kinds of cholesterol, carries them away from the arteries, and transports them to the liver. The liver then helps to remove them from the body. It lowers the risk for plaque build-up, heart disease, and stroke.
Very-low-density Lipoproteins (VLDL)
Very-low-density lipoproteins (VLDL) are substances in the blood that transport triglycerides. Triglycerides are a form of fat made in the body. Several factors can result in high levels of triglycerides. They include:
- Obesity or being overweight
- Smoking cigarette
- Physical inactivity
- Drinking alcohol in excess
- Eating a diet high in carbohydrates
When people have elevated levels of triglycerides, they usually have a high total cholesterol level including high LDL (bad cholesterol) levels and low HDL (good cholesterol) levels.
It is recommended that people aged 20 and above should get their cholesterol levels checked at least once every five years. Your healthcare provider will order a blood test that will show how much cholesterol is present in your blood. This blood test will give the numbers of your cholesterol levels. Another test that may be ordered is referred to as a lipid panel or a lipid profile. The panel provides you with the following numbers:
- Total cholesterol
- LDL levels
- HDL levels
- VLDL levels and triglycerides
- Non-HDL cholesterol
- The ratio between cholesterol and HDL
There are other advanced tests that break down other parameters like the size and shapes of LDL particle numbers and give LDL particle numbers. They are usually used as better indicators of those at risk for heart disease.
Normal Cholesterol Levels
Normal levels of cholesterol vary by age group and sex. The table below spells out the numbers for normal cholesterol levels.
|Age and Sex||Total Cholesterol||Non-HDL cholesterol||LDL cholesterol||HDL cholesterol|
|People aged 19 years and younger||Less than 170mg/dL||Less than 120mg/dL||Less than 110mg/dL||More than 45mg/dL|
|Men aged 20 years and older||125mg/dL to 200mg/dL||Less than 130mg/dL||Less than 100mg/dL||40mg/dL or higher|
|Women aged 20 and older||125mg/dL to 200mg/dL||Less than 130mg/dL||Less than 100mg/dL||50mg/dL or higher|
High Cholesterol Levels
The table below indicates numbers for high cholesterol levels. Numbers for high cholesterol levels also are differ depending on age and sex. The numbers below are for people who have high cholesterol numbers but do not have heart disease.
|Age and Sex||Total Cholesterol||Non-HDL cholesterol||LDL cholesterol|
|People aged 19 years and younger||BorderlineHigh||170-199mg/dL≥200mg/dL||120-144mg/dL≥145mg/dL||110-129mg/dL≥130mg/dL|
|Men aged 20 years and older||Near or above optimal Borderline HighVery high|
|Women aged 20 and older||Near or above optimal Borderline HighVery high|
LDL Cholesterol Levels
The best or optimal LDL cholesterol number is less than 100mg/dL. This is if you do not have cardiovascular disease or are not at risk of developing one. Cardiovascular disease refers to heart and/or blood vessel disease.
However, your healthcare provider might want you to have lower numbers if you have any of the following:
- A cardiovascular disease
- A high risk of developing a cardiovascular disease
|Health Status||Optimal LDL cholesterol|
|Do not have cardiovascular disease/not at high risk for cardiovascular disease||<100mg/dL|
|Have cardiovascular disease/at high risk for cardiovascular disease||<70mg/dL|
Most of the fat in your body exists as triglycerides. Triglycerides are often higher in people who are obese or have diabetes. The numbers are shown in the table below.
HDL Cholesterol Levels
Having elevated HDL numbers is desirable because it is the good cholesterol.
|Poor and a risk for heart disease in men and women||<40mg/dL|
|Good (men)||≥40 mg/dL|
|Good (women)||≥50 mg/dL|
|Optimum and a protection against heart disease in men and women||≥60 mg/dL|
Lifestyle modifications to improve your cholesterol
You must keep your bad cholesterol low and increase your good cholesterol levels. Generally, high total cholesterol levels increase your risk of heart diseases, heart attacks, and stroke. The following are lifestyle modifications that can help prevent the consequences of high bad and total cholesterol levels. If you are already on cholesterol-lowering medications, they can help improve your outcomes.
- Eat Heart-Healthy Foods:
- Cutting down on saturated fats and eating more monounsaturated fats. Saturated fats are found mainly in red meat and full-fat dairy products. They raise your total cholesterol. Consuming lesser quantities of saturated fats and more monounsaturated fats reduce your LDL (bad) cholesterol, increase HDL (good) cholesterol, and reduce harmful oxidation. Foods rich in monounsaturated fats include olives and olive oil, avocados, almonds, walnuts, cashew, hazelnuts, canola oil, and pecans.
- Getting rid of trans fats. Some food labels list Trans fats as “partially hydrogenated vegetable oil”. They increase LDL and total cholesterol and can lower HDL (good) cholesterol by 20%. The Food and Drug Administration banned the use of partially hydrogenated vegetable oils on Jan. 1, 2021.
Trans fats are often used in margarine and processed foods like cookies, crackers, and confectionaries. Eliminating trans fats from your diet will significantly lower your cholesterol levels.
- Eating Omega-3 fatty acids-rich foods. Omega-3 fatty acids are polyunsaturated fats. While omega-3 fatty acids do not affect LDL cholesterol, they have other health benefits. They lower blood pressure, reduce triglycerides, and slow down the formation of plaques in the walls of the arteries. That way, they protect the heart and prevent heart disease and stroke.
Eating at least two servings a week of fish or foods rich in omega-3 fatty acids improves heart health.Omega-3 fatty acids can be found in foods like salmon, sardine, mackerel, cod, herring, lake trout, walnuts, and flaxseeds.
- Consuming more soluble fiber. Soluble fiber helps to lower LDL (bad) cholesterol and total cholesterol levels. Also, it can reduce the rate at which cholesterol is absorbed into your bloodstream. Foods rich in soluble fiber include oats, peas, flaxseed, kidney beans, carrots, citrus fruits, Brussels sprouts, psyllium, barley, apples, and pears.
- Adding whey protein. Milk is made up of two proteins, whey and casein. When producing cheese, whey is often a liquid by-product that separates from the milk. Whey protein contains the 9 essential amino acids and is low in lactose.
Research shows that taking whey protein as a supplement reduces LDL (bad) cholesterol and total cholesterol levels in the blood. It also lowers blood pressure and the risk for heart disease and stroke. In other studies, it helps lose weight and treats type 2 diabetes.
- Exercise and Physical Activity
Exercise is very beneficial to heart health. Not only does it help lose weight and improve physical fitness, but it also reduced bad cholesterol and increases good cholesterol. Research shows that physical activity that increases the heart rate by 85% increases HDL and decreases LDL. The longer the duration of exercise, the greater its effects.
This can be achieved through aerobic exercises like brisk walking, hiking, jogging, biking or cycling, swimming, rowing, skiing, and so on.
- Quit Smoking
Smoking increases the risk of heart disease by interfering with cholesterol metabolism. Smoking tobacco impairs the ability of the immune cells to return cholesterol from the arterial wall into the blood. Thus, it cannot be carried to the liver to be flushed out. Smoking also reduces HDL (good) cholesterol and increases total cholesterol.
However, quitting smoking can cross out these effects within a short time. For example:
- Within 20 minutes of quitting, your blood pressure and heart rate return to normal levels. Normally, smoking causes these two to spike.
- Within 3 months of quitting, there is improvement in your blood circulation and lung function.
- Within a year of quitting, your risk for heart diseases is reduced by 50% compared to a smoker.
- Lose Weight
When you are obese or overweight, your total cholesterol level is elevated. Hence, losing weight can help you reduce your cholesterol. To lose weight, you have to combine diet with exercise. Diet-based weight loss influences how your body makes and absorbs cholesterol. Studies show that diet-based weight loss increased the absorption of cholesterol from food. It also reduced the quantity of cholesterol produced in the body, decreased LDL (bad) cholesterol, and increased HDL (good) cholesterol.
Watch your calorie intake and replace sugary drinks with tap water. You can also substitute processed snacks, sweets, and juices with healthy nuts, fruits, smoothies and biscuits, and candies with little or no fat. Ensure you add physical activity to your daily routine. It could be as easy as brisk walking, cycling, using the stairs instead of the elevator, and performing hobbies that require standing and bending like gardening, cooking, and painting.
- Limit Your Alcohol Intake
Drinking excess alcohol can raise levels of triglycerides fats in the bloodstream. It can also increase one’s risk of high blood pressure, heart disease, and stroke. Hence, if you drink alcohol, take moderate amounts. This implies one drink daily for women and two drinks for men. Moderate amounts of alcohol have been found to increase HDL (good) cholesterol levels and reduce the risk for heart disease. Moderate intake of alcohol also improves the transport of cholesterol from the walls of the blood vessels and the blood to the liver.
- Try Supplements:
Some supplements have shown promise in managing cholesterol. They include:
- Plant stanols and sterols. These are plant forms of cholesterols and are absorbed like cholesterol from the diet. They compete with human cholesterol and reduce its absorption in the body. According to studies, they can reduce LDL (bad) cholesterol by 15%-20%. They can be found in fortified yogurt, certain oils, vegetable oil, and butter substitutes.
- Fish oil. Fish oil is rich in docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). These are omega-3 fatty acids. Research showed that taking 4-6 grams of fish oil every day reduced the total amount of fat in the bloodstream and increased good (HDL) cholesterol. It was also found to reduce the risk of heart disease.
- Psyllium. This is a soluble fiber made available as a supplement. According to a study, cookies fortified with 8 grams of psyllium reduced total cholesterol and LDL cholesterol by approximately 10%. Another study showed that taking a 5-gram psyllium supplement twice daily decreased LDL and total cholesterol levels by nearly 5%. This was for 26 weeks. It was also found to reduce the risk of heart disease/
- Coenzyme Q10. Coenzyme Q10 helps body cells produce energy and is like a vitamin. It can be produced in the body and as such, there are hardly any deficiencies. However, taking extra Q10 as supplements has cholesterol-lowering benefits. Studies have confirmed that coenzyme Q10 supplements help in reducing total cholesterol.