High cholesterol has no symptoms, which is exactly why it is dangerous. It slowly builds fatty plaque in the arteries, raising the risk of heart attack and stroke. The only way to know your levels is a blood test called a lipid panel.
Understanding the numbers
A standard lipid panel measures:
- Total cholesterol: below 200 mg/dL is desirable
- LDL (“bad”) cholesterol: below 100 mg/dL is optimal for most people, and lower targets apply if you have heart disease or diabetes
- HDL (“good”) cholesterol: 40 mg/dL or higher for men and 50 or higher for women, with higher being protective
- Triglycerides: below 150 mg/dL is normal
What matters is your overall cardiovascular risk, which also includes age, blood pressure, smoking, diabetes and family history, not just one number.
Foods that help
Soluble fiber binds cholesterol in the gut. Oats, barley, beans, lentils, apples and citrus fruit are good sources. A bowl of oatmeal in the morning is a simple start.
Healthy fats can replace saturated fats. Swap butter and ghee for olive oil or canola oil where you can, and eat nuts, seeds and avocado. Fatty fish such as salmon, sardines and mackerel twice a week also helps lower triglycerides.
Plant sterols found in some fortified foods can lower LDL modestly when eaten daily.
Foods to limit
- Saturated fat: fatty red meat, full-fat dairy, processed meats, and some fried foods
- Trans fats: often found in packaged baked goods and some margarines, on labels as “partially hydrogenated oils”
- Added sugar and refined carbohydrates: these can push triglycerides up
Eggs are no longer considered a major problem for most people, but if you have diabetes or high LDL, ask your doctor about how many are right for you.
Move more
Regular aerobic exercise raises HDL and lowers triglycerides. About 150 minutes a week of brisk walking, cycling or swimming is a good target. Adding resistance training twice a week supports weight and blood sugar control too.
Other lifestyle factors
Losing 5 to 10% of body weight if you carry extra can lower LDL and triglycerides. Quitting smoking raises HDL within weeks. Limiting alcohol helps triglycerides in particular.
When medication makes sense
Lifestyle change lowers LDL by around 10 to 20% for most people, and that is enough for some, but not everyone. Statins are the most commonly prescribed medicines and are well studied. They reduce heart attacks and strokes in people who need them. Your doctor will recommend one if you’ve had a cardiovascular event, have diabetes and are over 40, have an LDL of 190 mg/dL or higher, or have a high ten-year risk score.
Common side effects are mild, such as muscle aches in a minority of people. If you notice unusual muscle pain or weakness, tell your doctor rather than stopping on your own. There are other drug options too.
Recheck and follow up
After starting changes, repeat the lipid panel in about three months, and then every year or as directed. Adults over 20 should be tested at least every four to six years.
Frequently asked questions
Can young or slim people have high cholesterol?
Yes. Genetics, including familial hypercholesterolemia, can cause very high cholesterol at any weight and age.
Do I need to fast for a cholesterol test?
Not always. Many labs now accept non-fasting tests, but your doctor may ask for fasting if triglycerides are high.
How quickly can diet lower cholesterol?
Some people see a drop within four to six weeks of consistent changes.
Cura Editorial Team
Contributor at Cura Health Journal.