Cholesterol: What You Need to Know
Cholesterol: What You Need to Know
Cholesterol has long been associated with heart disease risk, but some claim it’s an outdated measure of health. That’s simply not true. While cholesterol levels are just one measure of heart disease risk and our understanding of what impacts cholesterol has evolved, it remains a critical marker of cardiovascular health.
More importantly, cholesterol in food and cholesterol in the blood are two different things—a distinction that many people still don’t fully understand. Let’s break it all down.
What Is Cholesterol, and Why Does It Matter?
Cholesterol is a type of fat-like substance that the body needs for essential functions, including:
Building cell membranes
Producing hormones like estrogen and testosterone
Making vitamin D
Supporting digestion through bile production
Since humans (and all animals) produce cholesterol naturally, it is found only in animal-based foods like meat, dairy, and eggs. However, dietary cholesterol doesn’t necessarily translate into high blood cholesterol. Instead, blood cholesterol is influenced more by overall diet, genetics, and lifestyle.
Understanding the Different Types of Cholesterol
A cholesterol test, or lipid panel, measures several components:
Total Cholesterol – The sum of all cholesterol in the blood
LDL (“Bad” Cholesterol) – Can build up in arteries, increasing heart disease risk
HDL (“Good” Cholesterol) – Helps remove excess cholesterol from the bloodstream
Triglycerides – A type of fat that, in excess, raises heart disease risk
There’s also attention focused on LDL particle size, further differentiating risk. Small, dense LDL particles are more concerning than larger, fluffier ones.
Common Myths About Cholesterol
Myth: “Vegetarians and vegans don’t get high cholesterol.”
Truth: While dietary cholesterol comes from animal products, the body makes cholesterol and genetics still play a role. A vegetarian diet high in saturated fats and refined carbs can contribute to high cholesterol.
Myth: “If my family has high cholesterol, I will too.”
Truth: Genetics influence cholesterol, but lifestyle choices—like diet, exercise, and smoking—have a significant impact. Many people with a family history of high cholesterol can still manage it with the right approach.
Myth: “I don’t eat high-cholesterol foods, so I don’t need to worry.”
Truth: Blood cholesterol is more affected by saturated fat, trans fat, and refined carbohydrates than dietary cholesterol.
What Do Your Cholesterol Numbers Mean?
When you get the results of your cholesterol test or lipid panel, check them against the optimal cholesterol ranges:
Total Cholesterol: Ideally is below 200 mg/dL
LDL (“Bad” Cholesterol): Preferred is below 100 mg/dL (below 70 mg/dL for high-risk individuals)
HDL (“Good” Cholesterol): Aim for above 60 mg/dL (but extremely high levels can be problematic)
Triglycerides: Should be below 150 mg/dL
Why It’s Important to Fast Before a Cholesterol Test: Eating before a test can temporarily raise triglycerides, affecting LDL calculations, a 12-hour fast provides the most accurate results.
How Diet and Lifestyle Affect Cholesterol Levels
I always promote what to eat more than what to cut out. So, here’s what to eat more of to support healthy cholesterol:
To Increase HDL (Good Cholesterol):
Fatty fish (salmon, sardines, mackerel)
Nuts and seeds (almonds, walnuts, flaxseeds)
Olive oil and avocado oil
Legumes and whole grains
To Lower LDL (Bad Cholesterol):
Soluble fiber (oats, beans, lentils, apples, citrus fruits)
Nuts and seeds
Healthy unsaturated fats (olive oil, avocado)
To Lower Triglycerides:
Cut back on added sugars and refined carbs
Choose whole grains instead of white bread and pasta
Include more omega-3-rich foods like fish and flaxseeds
Reduce alcohol intake
Lifestyle Factors That Affect Cholesterol
Several lifestyle factors - things you can change - affect levels beyond diet and genetics. These include:
Exercise: Regular physical activity helps raise HDL and lower triglycerides. Aim for at least 150 minutes of moderate exercise per week.
Smoking: Quitting smoking can boost HDL levels and improve overall heart health.
Alcohol Consumption: Moderate drinking may raise HDL slightly, but excessive alcohol raises triglycerides and increases heart disease risk.
TLC: The First Step Before Medication
Before turning to medications like statins, most healthcare providers [should] recommend Therapeutic Lifestyle Changes (TLC) for 6-12 months to improve cholesterol levels naturally. TLC focuses on:
A heart-healthy diet (Mediterranean or DASH diet)
Regular exercise
Weight management
Smoking cessation
If lifestyle changes alone aren’t enough, medication may be necessary—but starting with dietary and lifestyle shifts is always the first step.
Final Thoughts and Getting Additional Guidance
Cholesterol is still a key marker of heart health, and understanding your numbers is crucial. The good news is that you can control many factors influencing cholesterol levels.
Instead of fearing cholesterol or overlooking it, focus on small, meaningful changes that support heart health. It’s not about cutting out foods; it’s about balance, inclusion, and consistency.
I can assist you if you’re uncertain where to begin or need guidance in making realistic, sustainable changes to enhance your cholesterol and overall health. I can help you with the TLC and create a nutrition and lifestyle plan that suits your needs—without restrictive diets or misinformation.
Schedule an introductory call today to discuss your goals and how we can collaborate to support your heart health. Let’s create lasting changes that fit your real life!
