Cholesterol
Cholesterol is a compound of the sterol type found in most body tissues. Cholesterol and its derivatives are important constituents of cell membranes and precursors of other steroid compounds, but a high proportion in the blood of low-density lipoprotein (which transports cholesterol to the tissues) is associated with an increased risk of coronary heart disease.
Cholesterol forms part of the outer membrane that surrounds every cell. It’s used to insulate nerve fibers (and so make nerve signals travel properly) and make hormones, which carry chemical signals around the body.
Without cholesterol, your body wouldn’t work – it’s vital to ensure the body’s normal function. Too much cholesterol in the blood, however, increases the risk of coronary heart disease and disease of the arteries.
Cholesterol is both good and bad. At normal levels, it is an essential substance for the body. However, if concentrations in the blood get too high, it becomes a silent danger that puts people at risk of a heart attack.
Cholesterol is present in every cell of the body and has important natural functions when it comes to digesting foods, producing hormones, and generating vitamin D. The body produces it, but people also consume it in food. It is waxy and fat-like in appearance.
Cholesterol Types
Cholesterol travels through the blood on proteins called “lipoproteins.” They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. Different types of lipoproteins have different purposes:
- LDL (low-density lipoprotein), sometimes called “bad” cholesterol, makes up most of your body’s cholesterol. High levels of LDL cholesterol raise your risk for heart disease and stroke.
- HDL (high-density lipoprotein), or “good” cholesterol, absorbs cholesterol and carries it back to the liver. The liver then flushes it from the body. High levels of HDL cholesterol can lower your risk of heart disease and stroke.
- VLDL (very-low-density lipoprotein). Some people also call VLDL “bad” cholesterol because it too contributes to the buildup of plaque in your arteries. But VLDL and LDL are different; VLDL mainly carries triglycerides and LDL mainly carries cholesterol.
Knowing your cholesterol level isn’t, on its own, enough to tell you your personal risk of heart disease. You also need to know about lipoproteins. These are special molecules that carry or transport cholesterol around the body.
Cholesterol High
With high cholesterol, you can develop fatty deposits in your blood vessels. Eventually, these deposits grow, making it difficult for enough blood to flow through your arteries. Sometimes, those deposits can break suddenly and form a clot that causes a heart attack or stroke.
High cholesterol can be inherited, but it’s often the result of unhealthy lifestyle choices, which make it preventable and treatable. A healthy diet, regular exercise and sometimes medication can help reduce high cholesterol.
High Cholesterol Causes
High cholesterol can cause a dangerous accumulation of cholesterol and other deposits on the walls of your arteries (atherosclerosis). These deposits (plaques) can reduce blood flow through your arteries, which can cause complications, such as:
Chest pain. If the arteries that supply your heart with blood (coronary arteries) are affected, you might have chest pain (angina) and other symptoms of coronary artery disease.
Heart attack. If plaques tear or rupture, a blood clot can form at the plaque-rupture site — blocking the flow of blood or breaking free and plugging an artery downstream. If blood flow to part of your heart stops, you’ll have a heart attack.
Stroke. Similar to a heart attack, a stroke occurs when a blood clot blocks blood flow to part of your brain.
Prevention of High Cholesterol
The same heart-healthy lifestyle changes that can lower your cholesterol can help prevent you from having high cholesterol in the first place. To help prevent high cholesterol, you can:
- Eat a low-salt diet that emphasizes fruits, vegetables, and whole grains
- Limit the number of animal fats and use good fats in moderation
- Lose extra pounds and maintain a healthy weight.
- Quit smoking
- Exercise on most days of the week for at least 30 minutes
- Drink alcohol in moderation, if at all
- Manage stress.
High Cholesterol Symptoms
A person with high cholesterol levels often has no signs or symptoms, but routine screening and regular blood tests can help detect high levels.
A person who does not undergo testing may have a heart attack without warning because they did not know that they had high cholesterol levels. Regular tests can help to reduce this risk.
Cholesterol Level
Cholesterol levels vary by age, weight, and gender. Over time, a person’s body tends to produce more cholesterol, meaning that all adults should check their cholesterol levels regularly, ideally about every 4 to 6 years.
Cholesterol is measured in three categories:
- Total cholesterol
- LDL, or ‘bad cholesterol”
- HDL, or ‘good cholesterol”
The struggle for most people is balancing these levels. While total and LDL cholesterol levels should be kept low, having more HDL cholesterol can offer some protection against a person developing heart-related illnesses including heart attacks and strokes.
Cholesterol levels and age
Cholesterol levels tend to increase with age. Doctors recommend taking steps earlier in life to prevent dangerously high levels of cholesterol developing as a person ages. Years of unmanaged cholesterol can be much trickier to treat.
Children are least likely to have high levels of cholesterol and only need to have their levels checked once or twice before they are 18 years old. However, if the child has risk factors for higher levels of cholesterol, they should get monitored more frequently.
Typically, men tend to have higher levels of cholesterol throughout life than women. A man’s cholesterol levels generally increase as they age. However, women aren’t immune to high cholesterol. A woman’s cholesterol often increases when she goes through menopause.
Recommended levels
Healthy levels of cholesterol don’t vary much for typical adults. Variation of recommended levelsTrusted Source tends to change due to other health conditions and considerations.
Cholesterol levels for adults
Total cholesterol levels less than 200 milligrams per deciliter (mg/dL) are considered desirable for adults. A reading between 200 and 239 mg/dL is considered borderline high and a reading of 240 mg/dL and above is considered high.
LDL cholesterol levels should be less than 100 mg/dL. Levels of 100 to 129 mg/dL are acceptable for people with no health issues but may be of more concern for those with heart disease or heart disease risk factors. A reading of 130 to 159 mg/dL is borderline high and 160 to 189 mg/dL is high. A reading of 190 mg/dL or higher is considered very high.
HDL levels should be kept higher. A reading of less than 40 mg/dL is considered a major risk factor for heart disease. A reading from 41 mg/dL to 59 mg/dL is considered borderline low. The optimal reading for HDL levels is 60 mg/dL or higher.
Cholesterol levels for children
By comparison, acceptable levels of total cholesterol and LDL cholesterol in children are different.
- An acceptable range of total cholesterol for a child is less than 170 mg/dL. Borderline high total cholesterol for a child ranges from 170 to 199 mg/dL. Any reading of total cholesterol over 200 in a child is too high.
- A child’s LDL cholesterol levels should also be lower than an adult’s. The optimal range of LDL cholesterol for a child is less than 110 mg/dL. Borderline high is from 110 to 129 mg/dL while high is over 130 mg/dL.
The best recommendation for children and adolescents to keep cholesterol levels in check is living a healthy, active lifestyle. This includes eating a healthful diet and getting plenty of exercise.
Sedentary, overweight children who eat a diet high in processed foods are most likely to have high cholesterol. Children who have a family history of high cholesterol may also be at risk.
Cholesterol-Lowering Foods
Having high cholesterol levels, especially “bad” LDL – is linked to an increased risk of heart disease. Low “good” HDL cholesterol and high triglycerides are also linked to increased risk.
Your diet has a powerful effect on your cholesterol and other risk factors. Here are foods that can lower cholesterol and improve other risk factors for heart disease.
1. Legumes
Legumes, also known as pulses, are a group of plant foods that include beans, peas, and lentils.
Legumes contain a lot of fiber, minerals, and protein. Replacing some refined grains and processed meats in your diet with legumes can lower your risk of heart disease.
A review of 26 randomized controlled studies showed that eating a 1/2 cup (100 grams) of legumes per day is effective at lowering “bad” LDL cholesterol by an average of 6.6 mg/dl, compared to not eating legumes.
Legumes like beans, peas, and lentils can help lower “bad” LDL levels and are a good source of plant-based protein.
2. Avocados
Avocados are an exceptionally nutrient-dense fruit. They’re a rich source of monounsaturated fats and fiber — two nutrients that help lower “bad” LDL and raise “good” HDL cholesterol
Clinical studies support the cholesterol-lowering effect of avocados. In one study, overweight and obese adults with high LDL cholesterol who ate one avocado daily lowered their LDL levels more than those who didn’t eat avocados.
Avocados provide monounsaturated fatty acids and fiber, two heart-healthy and cholesterol-lowering nutrients.
3. Nuts — Especially Almonds and Walnuts
Nuts are another exceptionally nutrient-dense food. They’re very high in monounsaturated fats. Walnuts are also rich in the plant variety of omega-3 fatty acids, a type of polyunsaturated fat associated with heart health
Almonds and other nuts are particularly rich in L-arginine, an amino acid that helps your body make nitric oxide. This, in turn, helps regulate blood pressure
What’s more, nuts provide phytosterols. These plant compounds are structurally similar to cholesterol and help lower cholesterol by blocking its absorption in your intestines.
Calcium, magnesium, and potassium, also found in nuts, may reduce blood pressure and lower your risk of heart disease. Nuts are rich in cholesterol-lowering fats and fiber, as well as minerals linked to improved heart health.
4. Fatty Fish
Fatty fish, such as salmon and mackerel, are excellent sources of long-chain omega-3 fatty acids. Omega-3s bolster heart health by increasing “good” HDL cholesterol and lowering inflammation and stroke risk.
In one large, 25-year study in adults, those who ate the most non-fried fish were the least likely to develop metabolic syndrome, a cluster of symptoms that includes high blood pressure and low “good” HDL levels
In another large study in older adults, those who ate tuna or other baked or broiled fish at least once a week had a 27% lower risk of stroke
Keep in mind that the healthiest ways to cook fish are steaming or stewing. In fact, fried fish may increase your risk of heart disease and stroke
Fish is a major part of the Mediterranean diet, which has been extensively studied for its benefits on heart health. Some of the heart-protective benefits of fish may also come from certain peptides found in fish protein.
Fatty fish offers high levels of omega-3 fatty acids and is linked to a decreased risk of heart disease and stroke.
5. Whole Grains — Especially Oats and Barley
Whole grains keep all parts of the grain intact, which provides them with more vitamins, minerals, plant compounds and fiber than refined grains.
While all whole grains may promote heart health, two grains are particularly noteworthy:
Oats: Contain beta-glucan, a type of soluble fiber that helps lower cholesterol. Eating oats may lower total cholesterol by 5% and “bad” LDL cholesterol by 7%
Barley: Also rich in beta-glucans and can help lower “bad” LDL cholesterol.
Whole grains are linked to a lower risk of heart disease. Oats and barley provide beta-glucan, a soluble fiber that is very effective at lowering “bad” LDL cholesterol.
6. Fruits and Berries
Fruits are an excellent addition to a heart-healthy diet for several reasons.
Many types of fruit are rich in soluble fiber, which helps lower cholesterol levels. It does this by encouraging your body to get rid of cholesterol and stopping your liver from producing this compound.
One kind of soluble fiber called pectin lowers cholesterol by up to 10%. It’s found in fruits including apples, grapes, citrus fruits, and strawberries. Fruit also contains bioactive compounds that help prevent heart disease and other chronic diseases due to their antioxidant and anti-inflammatory effects.
Eating berries and grapes, which are particularly rich sources of these plant compounds, can help increase “good” HDL and lower “bad” LDL cholesterol
Fruit can help lower cholesterol and improve heart health. This is largely caused by its fiber and antioxidants.
7. Vegetables
Vegetables are a vital part of a heart-healthy diet. They’re rich in fiber and antioxidants and low in calories, which is necessary for maintaining a healthy weight.
Some vegetables are particularly high in pectin, the same cholesterol-lowering soluble fiber that occurs in apples and oranges. Pectin-rich vegetables also include okra, eggplants, carrots, and potatoes.
Vegetables also deliver a range of plant compounds that offer many health benefits, including protection against heart disease. Vegetables are high in fiber and antioxidants and low in calories, making them a heart-healthy choice.
Cholesterol Medications
A healthy lifestyle is the first defense against high cholesterol. But sometimes diet and exercise aren’t enough, and you might need to take cholesterol medications. Cholesterol medications might help:
- Decrease your low-density lipoprotein (LDL) cholesterol, the “bad” cholesterol that increases the risk of heart disease
- Decrease your triglycerides, a type of fat in the blood that also increases the risk of heart disease
- Increase your high-density lipoprotein (HDL) cholesterol, the “good” cholesterol that offers protection from heart disease
Your doctor might suggest a single drug or a combination of cholesterol medications. Here’s an overview of benefits, cautions and possible side effects for common classes of cholesterol medications.
Most cholesterol medications lower cholesterol with few side effects, but effectiveness varies from person to person. If you decide to take cholesterol medication, your doctor might recommend periodic liver function tests to monitor the medication’s effect on your liver. However, the U.S. Food & Drug Administration no longer recommends routine monitoring for statin users.
Remember the importance of healthy lifestyle choices. Medication can help control your cholesterol — but lifestyle matters, too.
Frequently Asked Questions about Cholesterol
What are the symptoms of high cholesterol in the body?
Ask about being tested for high cholesterol. You develop symptoms of heart disease, stroke, or atherosclerosis in other blood vessels, such as left-sided chest pain, pressure, or fullness; dizziness; unsteady gait; slurred speech; or pain in the lower legs.
Does stress cause high cholesterol?
There is compelling evidence that your level of stress can cause an increase in bad cholesterol indirectly. For example, one study found that stress is positively linked to having less healthy dietary habits, a higher body weight, and a less healthy diet, all of which are known risk factors for high cholesterol.
Does Exercise Lower Cholesterol?
Exercise can improve cholesterol. Moderate physical activity can help raise high-density lipoprotein (HDL) cholesterol, the “good” cholesterol. With your doctor’s OK, work up to at least 30 minutes of exercise five times a week or vigorous aerobic activity for 20 minutes three times a week.
Do eggs raise cholesterol?
The science is clear that up to 3 whole eggs per day are perfectly safe for healthy people. Summary Eggs consistently raise HDL (the “good”) cholesterol. For 70% of people, there is no increase in total or LDL cholesterol. Some people may experience a mild increase in a benign subtype of LDL.
Can lack of sleep cause high cholesterol?
Sleeping less than five hours at night raised the risk of high triglycerides and low HDL levels in women. Too little sleep also leads to high levels of LDL cholesterol, according to a study published by the Journal of Cardiovascular Nursing.
What are the worst foods for high cholesterol?
- Fatty beef.
- Lamb.
- Pork.
- Poultry with skin.
- Lard and shortening.
- Dairy products made from whole or reduced-fat milk.
- Saturated vegetable oils, such as coconut oil, palm oil, and palm kernel oil.