Cholesterol, a waxy fat-like substance in your blood that is made by the liver, is essential to help your body build healthy cells. Too much cholesterol, however, can be dangerous and can increase your risk of heart disease, the number one killer of men and women in the U.S. In fact, high cholesterol is one of the main risk factors for heart disease – the higher your cholesterol, the greater your risk. Excess cholesterol can build up in the walls of your arteries, making it harder for the blood to flow through these blood vessels. When this happens, your heart may not get enough oxygen-rich blood, increasing your risk of heart attack and stroke (as blood flow to the brain is also decreased).
Your doctor can determine your cholesterol level with a blood test that measures the total milligrams of cholesterol per deciliter of blood (mg/dL). There are different types of cholesterol, and typically you will see each of these in your test results:
The numbers of greatest concern to your doctor are your LDL and total cholesterol. If these are borderline or high, your doctor may recommend treatment.
High cholesterol is caused by some factors that you can control, and some you that you cannot. High cholesterol can be inherited, but more often it’s caused by unhealthy lifestyle choices – poor diet and exercise habits, and being overweight. Following are some of the most common risk factors for high cholesterol:
Having high cholesterol in and of itself does not cause any symptoms, so many people don’t know their levels are too high. That’s why it’s important to have your cholesterol tested at least once every four to six years. Rare lipid disorders, which tend to run in families and cause very high cholesterol levels, may sometimes cause symptoms such as bumps in the skin, hands or feet, as a result of deposits of cholesterol and other fats.
High cholesterol can sometimes be managed through lifestyle changes alone. The “TLC Diet” is a low-saturated-fat, low-cholesterol diet that calls for less than seven percent of calories from saturated fat and less than 200mg of dietary cholesterol daily, with only enough calories to maintain a desirable weight and avoid weight gain. Following the TLC means eating a variety of healthy foods, including fruits, vegetables, whole grains, low-fat dairy products, fish, poultry without the skin (not fried) and lean meats in moderation.
Adding soluble fiber to the diet (found in oatmeal and beans, among other sources) is sometimes recommended if LDL cholesterol is not lowered sufficiently from the TLC diet alone. Additional lifestyle changes include losing weight if you’re overweight, quitting smoking and exercising regularly (at least 30 minutes daily). Supplements that may help lower cholesterol include niacin, which blocks the liver from removing HDL cholesterol and lowers triglycerides, and omega-3 fatty acids (found in fish and flax seed oils), which raise HDL levels and lower triglycerides.
There are several types of cholesterol-lowering medications available. However, even if you are taking one of these medicines it’s important to continue maintaining your lifestyle changes as part of your treatment plan to help lower your total and LDL cholesterol and keep the medication dose as low as possible. Medications include:
Diet plays a large role in helping reduce high cholesterol. It’s important to choose foods that are low in saturated fat, such as fat-free or low-fat dairy products, lean meats, fish, poultry without the skin, whole grains, and fruits and vegetables. Avoid any processed foods that have trans fats (typically listed on the label as partially-hydrogenated oils), and minimize or eliminate junk and fast foods. Look for margarines or other plant-based butter substitutes that are low in saturated fat, and avoid or limit foods that are high in cholesterol like liver and other organ meats, egg yolks, red meat and full-fat dairy products. Increasing the amount of soluble fiber in your diet can also help lower cholesterol. Foods high in soluble fiber include oats/oatmeal, oranges, pears, vegetables, dried peas and beans. Foods high in omega-3 fatty acids can raise “good” HDL levels, including oily fish like salmon, mackerel and herring, walnuts, almonds and flax seeds. Whey protein, one of two protein types found in dairy products, has been shown to lower both LDL and total cholesterol. A wide variety of whey protein powders, which you drink after mixing with water, low- or non-fat milk or juice, are available.