Healthy citizens are the greatest asset any country can have.
Winston S. Churchill
High cholesterol is very common in the U.S., but being commonplace doesn’t make it any less serious. While 95 million U.S. adults over the age of 20 are believed to have high cholesterol, it’s possible there are many more undiagnosed cases.  Oftentimes, people who have high cholesterol don’t know they have it. This is concerning considering the fact that high cholesterol is associated with serious health issues such as heart attack and stroke.
Despite its widespread nature, there are many things most of us don’t know about cholesterol. From understanding the differences between “good” and “bad” cholesterol to determining what you can do to improve your levels, there’s a lot to learn about this health phenomenon. Luckily, even if you’ve been diagnosed with high cholesterol or have a family history of the condition, there are many risk factors within your power to change. Explore what you need to know about high cholesterol below.
What is High Cholesterol?
Cholesterol is a waxy substance naturally produced by the liver. It’s a type of lipid which is crucial to the development of cell membranes, vitamin D, and key hormones. Yet, while it plays a critical role in these functions, having high cholesterol can be dangerous—particularly when there’s too much “bad” cholesterol. Thus, to understand the ways in which cholesterol can impact our health, it’s important to first explore the different types.
Types of Cholesterol
Because cholesterol can’t dissolve or move through blood on its own, it must be attached to proteins to be transported throughout the body successfully. The combination of cholesterol and proteins is referred to as a lipoprotein. There are two main forms of lipoproteins:
- Low-density lipoprotein (LDL): Also known as the “bad” type of cholesterol, LDL carries particles of cholesterol through the blood. It can also accumulate within the artery walls, causing them to harden and narrow.
- High-density lipoprotein (HDL): Commonly referred to as the “good” cholesterol, HDL carries excess cholesterol back to the liver.
If your body has too much LDL, you could face an increased risk for serious health issues. Alarmingly, however, high cholesterol exhibits no symptoms, and the only way to test for high cholesterol is to have a blood draw.
Causes of High Cholesterol
The causes of high cholesterol span far and wide. Some contributing factors are within an individual’s control to change, while others are not. For example, while diet, weight, and exercise levels can influence HDL, factors such as age, gender, and genes can also contribute to LDL or HDL levels. Thus, the best way to maintain healthy cholesterol levels and thus support better cardiovascular health, is to focus on the factors within your control to change. Let’s take a closer look at the causes behind high cholesterol.
- Diet: Cholesterol comes from two sources. While the liver produces all the cholesterol the body needs, we also take in cholesterol from foods derived from animals. This isn’t to say that eating meat or dairy products is bad for you. Foods with trans fats, however, cause the liver to produce even more cholesterol, which can lead to high cholesterol levels in some individuals. In addition to heavily processed animal products with trans fats, many baked goods can also trigger the liver to produce excess cholesterol. 
- Exercise Habits: Having a sedentary lifestyle can contribute to high LDL cholesterol. Regular aerobic activity, in particular, can help control LDL and in some cases promote healthy HDL levels. 
- Weight: A large waist circumference and obesity are also associated with high cholesterol. 
- Smoking: Smoking can lower your good HDL cholesterol, but it can compromise cardiovascular health in many other ways. In itself, smoking can increase the buildup of plaque in the blood vessels, damage the cells that line the blood vessels, and cause the vessels to thicken and narrow. 
- Age & Gender: Cholesterol levels tend to rise naturally as we age. Prior to menopause, women’s total cholesterol levels tend to be lower than their male peers. After reaching menopause, however, their LDL cholesterol levels tend to rise, and HDL may also decrease. 
- Hereditary Factors: Genetics play a role in the amount of cholesterol the body produces. High cholesterol can run in families, so individuals with relatives who have high cholesterol should be especially proactive in getting their levels checked.
Dangers of High Cholesterol
Having high LDL cholesterol increases the risk for heart disease, the leading cause of death in the U.S.  Heart disease refers to a range of conditions which can affect the heart, many of which can lead to heart attack or stroke. Also known as hypercholesterolemia, high LDL increases fatty deposits within the arteries, thereby also increasing the risk of blockages. When cholesterol builds up on the artery walls, it forms what’s known as a cholesterol plaque. This plaque can restrict blood flow, also increasing risk for blood clot. Should a blood clot block the artery in the heart or brain, it can lead to a heart attack or stroke.
The good news is that high cholesterol can be treated with medication and managed through lifestyle modifications. First, however, you must know where you stand. Here is a general scale of LDL cholesterol numbers and what they mean.
- Less than 100: optimal
- 100-129: near optimal
- 130-159: borderline
- 160-189: high
- 190 or higher: very high 
Keep in mind that in addition to having high LDL, having low HDL (again, the “good” cholesterol) can also put you at risk for heart disease. Thus, this too should be measured, with an ideal score of 60 or more. If HDL is less than 40, it could be considered a risk factor. 
The American Heart Association advises every adult over the age of 20 to have their cholesterol tested every four to six years, but these figures will vary based on the factors outlined above and on previous clinical indications.
Should high cholesterol be discovered in your blood test results, there are many ways to begin controlling it.
How to Lower Cholesterol Levels
Lifestyle and diet changes are among the most effective ways to prevent and lower LDL. Additionally, if you’re a smoker and haven’t already done so, make a plan to quit. Here, we’ll explore some detailed changes that work well for lowering LDL cholesterol.
While there are many wise eating habits you can incorporate into your dietary plan to improve cholesterol levels, the lowest cholesterol levels are found in diets with the highest soluble fibers.  Diets high in soluble fiber often align with the typical anti-inflammatory diet, which emphasize foods like kidney beans, Brussels sprouts, and apples. Soluble fiber has the ability to reduce cholesterol absorption in the blood, making it a powerful nutrient for individuals with high LDL cholesterol. 
Additionally, eliminating trans fats found in margarine and store-bought, processed snack foods can help to reduce cholesterol. Individuals may also wish to incorporate foods rich in omega-3 fatty acids such as walnuts, flaxseeds, salmon, and mackerel. While these foods won’t affect LDL cholesterol themselves, they do have other cardiovascular benefits, such as the ability to help reduce blood pressure.
Regular physical activity can support better cholesterol by increasing HDL.  Generally, most individuals can benefit from 30 minutes of exercise five times per week, or 20 minutes of high-intensity exercise three times a week. With that being said, it’s important for each person to work with an experienced physician who can make exercise recommendations based on the individual’s starting physical health.
Losing weight is another helpful way to control cholesterol, which can often be achieved with a strategic approach to dieting and exercising. Reducing alcohol consumption may also help to control cholesterol levels.
In some cases, medications may be needed in conjunction with the lifestyle and dietary changes described above to control especially high cholesterol levels. Even if medications are needed, maintaining a healthy lifestyle can help keep medication doses as low as possible.
Understanding Your Risk for High Cholesterol – In Conclusion
Because it exhibits no outward symptoms, high cholesterol is a dangerous threat to health, which can have serious implications if left unaddressed. Its impact on heart health cannot be overstated, and while there are some factors which are beyond an individual’s control to change, many behaviors that influence cholesterol can be modified.
At Cenegenics, your individualized treatment plan begins with a comprehensive lab panel to test for underlying health issues, such as high LDL or low LDL cholesterol. Based on the findings, our clinical team devises tailored roadmaps to help you become healthier and enjoy a better overall quality of life. For instance, while our approach to healthy eating and exercise will certainly help to lower high cholesterol with ongoing compliance, it can also support weight loss, improved cardiovascular health, and reduced risk for disease. With the knowledge that the many measures of health are complex and often interconnected, we treat the entire patient, not just a single symptom or isolated condition.
If you’re interested in controlling your cholesterol and optimizing your wellness overall, contact your nearest Cenegenics location for more information.
Next Steps to Controlling Your Cholesterol
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About the Contributor
Global Director of Nutrition & Exercise
Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.
This guide was produced with contributions from the following key resources:
The Cenegenics Education and Research Foundation
The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy
Jeffrey Park Leake, M.D., CPT
Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.
Todd David Greenberg, M.D., CSCS
Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.
 CDC, “High Cholesterol Facts.” 6 Feb. 2019. Retrieved from URL: https://www.cdc.gov/cholesterol/facts.htm
 CDC; see above.
 Cleveland Clinic, “Cholesterol Numbers: What Do They Mean.” 26 July 2017. Retrieved from URL: https://my.clevelandclinic.org/health/articles/11920-cholesterol-numbers-what-do-they-mean
 Cleveland Clinic, see above.
 American Heart Association, “Control Your Cholesterol.” 30 Apr. 2017. Retrieved from URL: https://www.heart.org/en/health-topics/cholesterol/about-cholesterol
 Bhatt, Ami, MD, FACC. “Cholesterol: Understanding HDL vs. LDL.” Harvard Health. 12 Apr. 2018. Retrieved from URL: https://www.health.harvard.edu/blog/understanding-cholesterol-hdl-vs-ldl-2018041213608
 Bhatt, Ami; see above.
 CDC, “Smoking and Heart Disease and Stroke.” 28 Jan. 2019. Retrieved from URL: https://www.cdc.gov/tobacco/campaign/tips/diseases/heart-disease-stroke.html
 Cleveland Clinic; see above.
 Leake, Jeffrey Park, M.D., CPT and Greenberg, Todd David, M.D., CSCS. The Textbook of Age Management Medicine: Volume 1. 2015, Leake-Greenberg Ventures. (125)
 Mayo Clinic. “Top 5 lifestyle changes to improve your cholesterol.” 11 Aug. 2018. Retrieved from URL: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/reduce-cholesterol/art-20045935
 Mayo Clinic; see above.