According to the Centers for Disease Control and Prevention, about 38% of adults in the United States have high cholesterol.
If you’re among this group of more than 90 million American adults, bringing your cholesterol numbers down could decrease your risks for heart disease, heart attack, and stroke.
In this article, I’ll explain what cholesterol is, and what it means when your levels are “high.”
I’ll describe the symptoms of high cholesterol, and outline some ways to lower your numbers if they’re elevated.
Finally, I’ll tell you when you should talk to a doctor about your cholesterol levels, and how K Heath can help.
What is Cholesterol?
Cholesterol is a waxy, fat-like substance produced by your liver and found in your blood.
You actually need some cholesterol—it helps you digest fatty foods, and is used to produce certain hormones.
Cholesterol moves through your blood by attaching to proteins, becoming what is called a lipoprotein.
There are two types: low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
LDL is considered “bad” cholesterol, whereas HDL cholesterol is considered “good.”
When there is an excess of LDL in the blood, these cells can form deposits of fat in the arteries called plaque which narrows the arteries and limits blood flow.
These plaque build ups can also burst and cause blood clots.
HDL, high-density lipoprotein, is “good” cholesterol.
It carries cholesterol from the bloodstream back to the liver where it can be flushed from the body.
This is what makes it the “protective” and “better” type of cholesterol. Higher levels of HDL are associated with lower risks of heart disease and stroke.
When your total cholesterol levels are 240 mg/dL or more, you have “high” cholesterol.
High cholesterol can be the result of genetics, diet, lifestyle, and other factors.
Symptoms of High Cholesterol
When you have high cholesterol, you usually do not notice any symptoms.
Blood tests are the only way to detect if you may have elevated cholesterol levels.
That is why it is important to visit your doctor and get your cholesterol checked regularly, especially if you have a family history of high cholesterol.
Very rarely, people can develop xanthomas on their skin.
Xanthomas are cholesterol-dense deposits that appear as yellowish growths on the skin.
This may be a sign of very high cholesterol.
How To Lower Cholesterol
Healthy changes to your lifestyle, including exercise, diet, and recreational activities, can help lower your cholesterol.
There are also a number of effective medications to keep your cholesterol in check and minimize your chances of life-threatening incidents.
Regular exercise helps increase HDL, the “good” cholesterol.
Studies suggest that moderate aerobic exercise, as well as resistance training, can help improve cholesterol levels.
Some common forms of aerobic exercise include things like running and walking, as well as activities like swimming and cycling.
For those who have lived a relatively sedentary lifestyle, start slow.
For example, begin with a slow, 15-minute walk or jog, and build up to 30 minutes.
Remember to allow your body time to warm up and cool down.
The American Heart Association recommends that adults get more than 150 minutes a week of moderate-intensity activity.
This may sound like a lot, but it’s just over 20 minutes a day, or 30 minutes every weekday.
Moderate-intensity exercise means your heart is beating faster, and you are perhaps breathless, but not so much that you cannot hold a conversation.
Less trans fats
In the past, dietary advice to lower cholesterol was often to go on a low-fat diet, but new research shows that not all fat is bad.
When it comes to lowering cholesterol, the recommendation is to limit trans fats, otherwise thought of as “bad” fats.
Trans fats increase LDL cholesterol and decrease HDL cholesterol.
Trans fats are mostly found in processed foods, including refrigerated dough, fried foods, frozen pizzas, shortening, and some baked goods.
Read the labels on food products, looking for ingredients like hydrogenated vegetable oil, which is a trans fat.
Soluble fiber can help decrease the amount of cholesterol in your bloodstream, and reduce your LDL cholesterol.
Soluble fiber “pulls in” water and can help slow down your digestion.
Foods high in soluble fiber include oatmeal, seeds, beans, fruits like apples, and vegetables like broccoli, peas, and brussel sprouts.
You can also try including more whole grains in your diet.
Adult men should aim to eat 30-38 grams of fiber per day. Women should try to eat 21-25 grams daily.
Fish, shellfish, and plant-based proteins like beans, nuts, and peas are lean, heart-healthy sources of protein.
Plant-based proteins do not contain saturated fats and, as a bonus, often provide fiber.
When it comes to animal protein, opt for chicken or other white meats, and choose skinless versions.
Red meats like beef, pork, and lamb tend to have more saturated fat.
A recommended heart-healthy portion of cooked meat is 3 ounces.
That is equal to a small thigh or drumstick of a chicken, a piece of meat the size of a deck of cards, or two pieces of sliced meat.
Many types of fish are high in omega-3 fatty acids, which help reduce blood pressure and triglycerides, the fat in your blood.
While omega-3s don’t have a direct effect of LDL cholesterol, they are beneficial to the heart and it is recommended that American adults eat at least two servings of fish a week.
Mackerel, herring, tuna, salmon, sardines, and trout are all rich in omega-3 fatty acids.
Shellfish like lobster and shrimp are higher in cholesterol, and less recommended.
Try grilling or baking the fish with olive oil rather than frying to avoid adding extra fat and calories.
Women who are pregnant should avoid eating fish which may be high in mercury or contaminated.
It is possible to take omega-3 supplements if you prefer not to eat fish, but talk to your doctor before beginning any new supplements or medications.
More fruits and veggies
Eating more fruits and vegetables is associated with lower LDL levels: In a 2004 study of more than 4,000 people, scientists found that for each additional serving eaten daily—up to four—LDL levels dropped.
Fruits like apples, strawberries and citrus, are high in pectin, a fiber that lowers LDL.
Eggplant and okra are good examples of low-calorie vegetables that are also high in soluble fiber.
A study released in 2021 by the journal Circulation found that the heart-healthy benefits of eating fruits and vegetables levels off around five servings per day.
According to the research, the optimum daily mix is two servings of fruit per day, and three of vegetables.
This can be achieved by adding small amounts of your favorite fruit or vegetable to every meal.
Try adding berries to your morning oatmeal, a side of chopped veggies at lunch, and a salad with dinner.
For individuals who are overweight, weight loss can help lower the bad LDL cholesterol and fat carried by triglycerides.
In one research review, scientists concluded that for every kilogram (2.2 pounds) of body weight lost, LDL levels dropped by an average of 1.28 mg/dL.
Studies show that light-to-moderate alcohol consumption may help prevent heart disease and may raise “good” cholesterol.
Heavy alcohol consumption may be a factor for cardiovascular disease and risk, and drinking too much alcohol can raise cholesterol and triglyceride levels.
If you are already at cardiac risk, it is best to limit your average alcohol consumption.
There are many reasons smoking is hazardous to your health.
Smoking can damage your blood vessels and heart, it also increases your risk of heart disease, including heart attack, and stroke.
Smoking makes LDL cholesterol “stickier,” so it clings to the arteries and builds up and clogs blood vessels.
It also lowers your HDL, the food cholesterol, as well as damages the walls of your arteries, all increasing your risk of life threatening conditions that may be a result of high blood pressure.
Sometimes lifestyle changes aren’t enough to lower cholesterol and medication is necessary.
There are a variety of cholesterol-lowering drugs on the market; your doctor or primary care provider can help pick the right choice for you based on your lab results and other medical conditions.
Statins help lower LDL cholesterol levels more than any type of drug, by an estimated 20-55%.
Ezetimibe reduces the amount of cholesterol that your body absorbs, which helps lower LDL by up to 25%.
Bile acid resins and nicotinic acid (also called niacin) are also effective LDL reducers.
Fibrates are less effective at lowering LDL cholesterol, but can be helpful in lowering triglycerides.
These drug options have a variety of side effects.
Depending on your cholesterol levels and overall health, one may be a better fit for you than others.
Talk to your doctor or primary care provider to figure out the best option for you.
Remember, while medication can be helpful, it will be even more effective in combination with a healthy lifestyle.
When to See a Doctor
The National Heart, Lung, and Blood Institute suggests people get their cholesterol checked every five years starting between the ages of 9-11.
As individuals get older, screenings should be adjusted to every two years.
Individuals over 65 should get annual cholesterol tests.
Depending on results, your doctor or provider may want to test your blood pressure and cholesterol more frequently.
How K Health Can Help
Did you know you can get affordable primary care with the K Health app?
Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.
Frequently Asked Questions
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
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Cholesterol-lowering effects of dietary fiber: a meta-analysis. (1999).
The Effect of Alcohol on Cardiovascular Risk Factors: Is There New Information? (2020).
Your Guide to Lowering Your Cholesterol With TLC. (2005).
Dietary Reference Intakes. (2005).
Weight Loss and Serum Lipids in Overweight and Obese Adults: A Systematic Review and Meta-Analysis. (2020).
Fruit and Vegetable Intake and Mortality. (2021).
Fruit and vegetable consumption and LDL cholesterol: the National Heart, Lung, and Blood Institute Family Heart Study. (2004).
Cholesterol-lowering effect of concentrated pomegranate juice consumption in type II diabetic patients with hyperlipidemia. (2006).