Your body needs cholesterol to repair cell membrane and synthesize hormones. But, too much cholesterol puts a strain on your system – and it can have deadly consequences.
High cholesterol increases your risk of cardiovascular disease, which can bring about complications like stroke and heart attack. The excess cholesterol leads to fatty plaque buildup (known as atherosclerosis), which obstructs blood vessels and causes the damage to your heart and internal organs.
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High Cholesterol
Nearly 94 million US adults have total cholesterol levels that put them at risk for serious complications. [1] Since high cholesterol has minimal (if any) symptoms, many will learn about their condition after heart disease has already developed.
But, there is good news:
We understand cholesterol metabolism better than ever. There are effective lifestyle changes, supplements, and medications you can take to reduce your cardiovascular risk and live a longer, healthier life. Here is what you should know about high cholesterol – its causes, risk factors, and managing it efficiently:
Causes
Let’s start by breaking down cholesterol:
Cholesterol is a fatty, wax-like compound that your body uses to build cell membranes, produce hormones, bile acid, and vitamin D. [2] Since cholesterol is a lipid (lipids are the larger chemical group that also includes fats and waxes), it repels water and it can’t be dissolved in your blood, which is water-based.
LDL And HDL Cholesterol
So how does the body get the cholesterol to the cells that need it? It packs it with protein to form lipoprotein particles. The lipoprotein have a hydrophilic (water-attracting) outer part and a water-repelling core. There are five different types of lipoprotein– chylomicrons, very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL).
Out of these, LDL and HDL lipoprotein are the key players in high cholesterol conditions. Cholesterol travels to the cells as LDL. HDL then picks up excess cholesterol and brings it back to the liver.
This is why LDL is often called “bad” cholesterol – if you have too much of it floating around, the LDL can cause plaque buildup in your blood vessels. HDL, on the other hand, “cleans up” your blood from the cholesterol, escorting it back to the liver.
That’s why your total cholesterol doesn’t really offer a full picture. What you should be aiming for is a healthy range of total cholesterol, as well as low LDL levels, to reduce your heart risk. While high LDL increases your chances of cardiovascular disease, high HDL is linked to better health [3] – hence, the “good” cholesterol nickname.
Why Is My Cholesterol High?
For most people, cholesterol increases with age and risk factors like an unhealthy diet, sedentary lifestyle, smoking, excessive drinking, etc. As you grow older, you are more likely to develop vessel-blocking plaques, which can obstruct blood flow to vital organs or break down, shedding blood clots. Since high cholesterol is a crucial factor in plaque formation and growth, virtually all heart associations recommend managing your cholesterol levels to reduce your risk.
For a small percentage of people, high cholesterol can also be genetic. Familial hypercholesterolemia happens when you inherit one or two defective genes for the LDL receptor. This makes it impossible to remove LDL from the blood, leading to high cholesterol and a higher risk for heart disease.
The good news? While one in 250 people might have a defective LDL receptor gene[4], even severe forms can be treated with a proper diet and medication. [5]
Whether your high cholesterol is purely lifestyle-related or there is a genetic factor, managing your risk is the best thing you can do to keep a healthy heart. Here is how to do that:
Risk Factors
You can’t control what genes you inherited or what sex you were born (men have higher LDL and lower HDL [6]). However, you can modify multiple risk factors and behaviors, and they will make a significant difference in your cholesterol levels, heart risk, and overall health.
Improve Your Diet
A diet rich in saturated fats and trans fats can increase your LDL cholesterol. It also puts you at risk for cardiovascular issues, obesity, and a range of other conditions[7]. But, it’s not the nutrient itself that boosts your risk. You can enjoy healthy saturated fats like full-fat dairy or coconut oil – the latter even increases HDL [8].
Cutting out highly processed and fast food from your diet is what really makes a difference. To reduce your cholesterol, base your diet around whole foods like fresh fruit and vegetables (bonus points, because they are high in fiber), pasture-raised meat, and dairy.
Try to introduce more unsaturated oils to replace the unhealthy fats. This includes plant oils like olive oil, fish and seafood, which are rich in omega-3s, as well as nuts like almonds and pistachios.
It’s also a good idea to reduce “fast” carbs in your diet. Items like white bread, pasta, and sweets get absorbed very quickly, raising your insulin and contributing to insulin resistance, diabetes, and obesity. Replace them with whole-grain products, which come with a range of health benefits [9], plus they satiate you for longer, making it easier to avoid overeating and maintain a healthy weight.
Do you want a shortcut to a heart-healthy diet? The Mediterranean diet, which is rich in monounsaturated fats, fiber, and omega-3 fatty acids.
Maintain A Healthy Weight
Being overweight increases your risk of high cholesterol, heart disease, and multiple other health conditions.
But, if you’re struggling to lose weight, you are not alone. Obesity is an epidemic in the US, affecting more than one in three adults [10]. If you are not at your healthiest weight, your healthcare provider can recommend strategies to drop the pounds. But, remember that this is a lifestyle change and not a quick fix – ‘fast diets’ are actually counterproductive, and most people gain the weight back (plus more.)
Regular exercise is one of the safest steps toward a healthy weight and a happier heart. The WHO recommends at least 150 minutes of moderate-intensity workouts per week to adults over 65. This can be anything you enjoy – swimming, water aerobics, jogging, pilates, yoga, or simply a long walk. Moving your body will enhance both your physical and mental health – and, yes, it will help reduce your cholesterol.
Quit Smoking
If you’re a smoker, it’s high time to kick the habit. The toxins in cigarette smoke increase your risk of all major ‘killers’ – and yes, that includes heart disease.
Smoking increases oxidation [11] in your body, chemically altering cholesterol to make it “stickier” to blood vessels. Smokers are also more likely to develop blood clots [12] – and, since plaque breakdown and clotting are a significant cause of heart attacks and strokes, this increases their chances of dying from cardiovascular disease.
But, even if you’ve been a heavy smoker for decades, quitting will quickly have a positive effect on your health. Studies show that even those who stop smoking after age 65 or a heart event still have remarkably lower chances of getting sick or dying. [13]
If you are having trouble with smoking cessation, nicotine replacement therapy, as well as supplementary techniques like acupuncture and hypnotherapy, can be beneficial. Explore these with your healthcare provider – they are there to help.
Signs, Symptoms & Complications
High cholesterol, by definition, is not a disease but a condition. Excessive cholesterol levels are a lab finding, but they might not be accompanied by symptoms. In fact, most people with high cholesterol don’t know about it until a complication develops – or until they are screened for it.
What can clue you in about high cholesterol?
Since heart disease is the most common complication, any cardiovascular warning signs should get you to your doctor’s office.
This includes:
- Chest pain and discomfort, whether on exertion or when you’re resting.
- Shortness of breath when you’re doing your normal activities.
- Pain or numbness that radiates toward your neck, jaw, upper abdomen, or back.
If you have a family history of heart disease, checking your cholesterol levels is crucial. First-degree relatives of those with cardiovascular issues are more likely to develop a condition themselves. Managing your risk factors can help you stay healthy, even if you have a family predisposition.
Diagnosis
All adults should check their cholesterol at least every five years. [14] The American Heart Association (AHA) recommends those with heart disease risk factors get blood work more frequently. Your doctor will determine when you need a cholesterol screening based on individual characteristics – history of heart disease, lifestyle, family history, etc.
This is why it’s very important to be open and honest with your healthcare provider about your risk factors. If you’re a smoker, for instance, say so. While some people are apprehensive about admitting ‘unhealthy’ behaviors, your physician isn’t there to pass judgment – they are there to support you toward optimal health.
Treatment
If your doctor discovers abnormally high cholesterol levels, they will likely prescribe a cholesterol-lowering drug.
The most common class of medications is called statins, and they work by altering an aspect of cholesterol metabolism. Today, statins are prescribed based on overall cardiovascular risk, not just on your cholesterol levels. While there is some controversy around this medication, the overwhelming amount of evidence shows it is safe and beneficial, adding as much as six years of life for certain people. [15]
Natural Ways To Lower Your Cholesterol
While drugs have played a major part in reducing heart disease mortality, it takes more than a tablet to stay healthy. Diet and lifestyle changes, as well as supplementation, can help you reduce your cholesterol naturally and minimize your heart disease risk, so you don’t have to start statins in the first place.
Some of the best natural ways to reduce your cholesterol include:
- Banish trans fats. Trans fats are chemically altered to be more stable, but they’re known to increase LDL and decrease HDL. [16] Shortening, some pastries and fast food are extremely high in trans fats. To reduce your consumption, avoid highly processed foods and make sure to read the labels – trans fats will usually appear as “partially hydrogenated” oil.
- Boost your fiber intake. Your gut is full of beneficial bacteria that reduce LDL cholesterol. These microbes feed on the fiber in your diet while protecting you from high cholesterol. By introducing fiber-rich foods like whole grains, fruit, and veggies, you can feed your good bacteria and starve cholesterol. [17] You can also supplement with psyllium, which effectively lowers your LDL. [18]
- Adopt the Mediterranean diet. The Mediterranean diet has been proven time and time again to reduce heart disease morbidity and mortality. It is a whole-food-centered regimen with olive oil as the main fat source, plenty of fruit and vegetables, legumes and seafood, and a moderate amount of whole-grain carbs.
- Quit smoking and avoid secondhand smoke. Your heart, lungs, and entire system will thank you.
- Include heart-healthy supplements. Plant sterols show a lot of promise in lowering LDL cholesterol [19], and so does red yeast rice (RYR) extract [20]. A daily red yeast rice supplement can reduce your LDL by as much as 25%. Fish oil also seems beneficial for minimizing heart disease risk [21], and so does green tea or green tea extract [22].
Heart disease is the world’s leading cause of death, and high cholesterol puts you at higher risk. However, this is not a reason to panic. There is plenty you can do to lower your cholesterol, reducing your chances of a cardiovascular issue. And, most of it isn’t popping tablets, either. Simple lifestyle interventions like a healthy diet and exercise can make all the difference. What are you doing to keep your heart healthy today?
References:
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000950
- https://pubmed.ncbi.nlm.nih.gov/22217824/
- https://pubmed.ncbi.nlm.nih.gov/2642759/
- https://pubmed.ncbi.nlm.nih.gov/28864697/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC161432/
- https://pubmed.ncbi.nlm.nih.gov/12485966/
- https://www.cdc.gov/cholesterol/risk_factors.htm
- https://pubmed.ncbi.nlm.nih.gov/30395784/
- https://pubmed.ncbi.nlm.nih.gov/17760498/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228640/
- https://pubmed.ncbi.nlm.nih.gov/15986573/
- https://pubmed.ncbi.nlm.nih.gov/17979794/
- https://pubmed.ncbi.nlm.nih.gov/9072291/
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000625
- https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31357-5/fulltext
- https://www.cdc.gov/pcd/issues/2019/19_0121.htm
- https://pubmed.ncbi.nlm.nih.gov/28356275/
- https://academic.oup.com/ajcn/article/108/5/922/5098499
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163911/
- https://pubmed.ncbi.nlm.nih.gov/31687098/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745982/
- https://nutritionj.biomedcentral.com/articles/10.1186/s12937-020-00557-5
