Rules to Lower Cholesterol: Take Control of Your Heart Health

Cholesterol is a waxy substance that is essential for many bodily functions, such as producing hormones, digesting food, and making vitamin D. However, having too much cholesterol in your blood can increase your risk of developing heart disease and stroke, which are among the leading causes of death worldwide. Therefore, it is important to keep your cholesterol levels within healthy ranges and prevent them from getting too high.

In this article, you will learn about:

Are your cholesterol levels consistently high?
Dietary Recommendations
How to Address High Triglycerides?
Lifestyle Changes to Lower Cholesterol
Frequently Asked Questions
References

Are your cholesterol levels consistently high?

Cholesterol is a waxy substance that is essential for the production of hormones, vitamin D, and bile acids that help digest fat. However, too much cholesterol in the blood can lead to plaque buildup in the arteries, which increases the risk of heart disease and stroke. According to the American Heart Association, nearly one in three American adults has high cholesterol, which is defined as a total cholesterol level of 240 mg/dL or higher.

Although the liver produces most of the cholesterol that the body needs, dietary choices can also affect cholesterol levels. Some foods, especially those high in saturated and trans fats, can raise the amount of low-density lipoprotein (LDL) or “bad” cholesterol in the blood. LDL cholesterol is the main contributor to plaque formation and cardiovascular problems. Saturated fats are mainly found in animal products, such as meat, poultry, eggs, cheese, and butter, as well as some plant oils, such as coconut and palm oil. Trans fats are artificially created by adding hydrogen to liquid vegetable oils, making them more solid and shelf-stable. They are often used in fried foods, baked goods, margarine, and shortening. Both saturated and trans fats can lower the level of high-density lipoprotein (HDL) or “good” cholesterol, which helps remove excess cholesterol from the blood and protect against heart disease.

The current dietary guidelines recommend limiting saturated fat intake to less than 10% of total calories per day and avoiding trans fat as much as possible. Research suggests that reducing saturated fat intake by 5% and replacing it with unsaturated fat, such as olive, canola, or sunflower oil, can lower LDL cholesterol by about 9 mg/dL. Similarly, replacing trans fat with unsaturated fat can lower LDL cholesterol by about 11 mg/dL. Therefore, choosing healthier fats and oils can have a significant impact on cholesterol levels and cardiovascular health.

Dietary Recommendations

One of the most effective ways to lower LDL cholesterol is to adopt a healthy diet that emphasizes plant-based foods and limits animal products and processed foods. The American Heart Association provides the following dietary recommendations for lowering LDL cholesterol:

Food Group	Recommendations
Vegetables, fruits, and whole grains	Increase intake of these foods, as they are rich in fiber, antioxidants, and phytochemicals that can lower LDL cholesterol and protect the blood vessels. Aim for at least 4.5 cups of fruits and vegetables and at least three 1-ounce servings of whole grains per day.
Low-fat dairy, poultry, fish, legumes, non-tropical plant oils, and nuts	Consume moderate amounts of these foods, as they provide high-quality protein, healthy fats, and essential nutrients that can support heart health. Choose low-fat or fat-free dairy products, skinless poultry, fatty fish (such as salmon, tuna, or mackerel), beans, lentils, soy, olive oil, canola oil, and unsalted nuts and seeds. Limit intake of cheese, butter, cream, and fatty meats.
Sweets, sugary drinks, and red meat	Limit intake of these foods, as they are high in calories, added sugars, saturated fat, and cholesterol that can raise LDL cholesterol and increase the risk of heart disease and diabetes. Choose water, low-fat milk, or unsweetened tea or coffee instead of sugary drinks. Opt for lean cuts of meat, such as sirloin, tenderloin, or round, and limit portion sizes to no more than 5.5 ounces per day.

In addition to these food group recommendations, the American Heart Association advises to develop a dietary pattern where only 5-6% of calories come from saturated fat, and to avoid trans fat as much as possible. Saturated fat is found mainly in animal products, such as meat, dairy, eggs, and lard, and some plant oils, such as coconut and palm oil. Trans fat is found in partially hydrogenated oils, which are used in some margarines, baked goods, fried foods, and snack foods. Both saturated and trans fat can raise LDL cholesterol and lower HDL cholesterol, the “good” cholesterol that helps remove excess cholesterol from the blood.

A recent study found that following a dietary pattern that meets the American Heart Association’s recommendations can lower LDL cholesterol by 11% and reduce the risk of cardiovascular events by 25% over a 10-year period. The study also suggested that adding foods that contain plant sterols or stanols, such as fortified margarines, cereals, or juices, can further lower LDL cholesterol by 6-15%. Plant sterols and stanols are naturally occurring substances that block the absorption of cholesterol in the intestine.

To summarize, a healthy diet that lowers LDL cholesterol consists of increasing intake of vegetables, fruits, and whole grains, consuming moderate amounts of low-fat dairy, poultry, fish, legumes, non-tropical plant oils, and nuts, limiting intake of sweets, sugary drinks, and red meat, and reducing the percentage of calories from saturated and trans fat. Additionally, adding foods that contain plant sterols or stanols can enhance the cholesterol-lowering effect of the diet.

How to Address High Triglycerides?

Triglycerides are a type of fat that circulates in the blood and can contribute to heart disease and stroke if they are too high. According to a 2020 literature review published in The BMJ, several lifestyle factors can increase triglycerides, such as:

Drinking too much alcohol, which can interfere with the liver’s ability to process fats
Eating too much refined sugar, especially fructose, which can overload the liver and cause it to produce more triglycerides
Eating too much saturated fat, which can raise the level of low-density lipoprotein (LDL) cholesterol, also known as “bad” cholesterol, and lower the level of high-density lipoprotein (HDL) cholesterol, also known as “good” cholesterol
Eating too many calories, which can lead to weight gain and obesity, which are risk factors for high triglycerides
Being physically inactive, which can lower the metabolism and reduce the use of fat as energy

To lower triglycerides, the review suggests some effective strategies, such as:

Strategy	Explanation	Expected Effect
Weight loss	Reducing body weight can improve insulin sensitivity and lower inflammation, which can help lower triglycerides	A 5-10% weight loss can lower triglycerides by 20-50 mg/dL
Low-carbohydrate diet	Limiting carbohydrate intake, especially from refined sources, can reduce the amount of fructose and glucose that the liver has to process and convert into triglycerides	A low-carbohydrate diet (<26 15-22="" by="" calories="" can="" dl="" lower="" mg="" of="" td="" triglycerides="">
Healthy fats	Replacing saturated fats with monounsaturated fats, such as olive oil, avocado, and nuts, can lower LDL cholesterol and increase HDL cholesterol, which can help lower triglycerides	A higher intake of monounsaturated fats (15-20% of calories) can lower triglycerides by 10-15 mg/dL
Alcohol moderation	Reducing or avoiding alcohol consumption can prevent the liver from producing excess triglycerides and improve its function	Abstaining from alcohol can lower triglycerides by 35-40 mg/dL

While natural fruit consumption is generally beneficial for health, some people may have high triglycerides due to excessive fructose intake from fruits. Therefore, it is important to monitor your fruit intake and choose fruits that are lower in fructose, such as berries, citrus fruits, and kiwis.

Lifestyle Changes to Lower Cholesterol

High cholesterol can be managed and reduced by making some changes in your daily habits and routines. Here are some lifestyle tips that can help you lower your cholesterol levels and improve your heart health:

Exercise regularly: Physical activity can help you burn calories, lose weight, and lower your LDL (bad) cholesterol and triglycerides. It can also raise your HDL (good) cholesterol, which protects your arteries from plaque buildup. Aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic exercise per week, or a combination of both. You can also do some strength training exercises twice a week to build muscle and boost your metabolism. Some examples of aerobic exercises are walking, jogging, cycling, swimming, dancing, and playing sports. Some examples of strength training exercises are lifting weights, doing push-ups, squats, lunges, and planks.
Eat a healthy diet: A balanced and nutritious diet can help you lower your cholesterol levels and prevent or manage other chronic diseases. Choose foods that are low in saturated fat, trans fat, cholesterol, and sodium, and high in fiber, protein, and antioxidants. Some foods that can help you lower your cholesterol are oats, barley, beans, lentils, nuts, seeds, fruits, vegetables, fish, lean poultry, and low-fat dairy products. Avoid foods that can raise your cholesterol, such as red meat, processed meat, butter, cheese, cream, pastries, cakes, cookies, and fried foods. You can also use healthier cooking methods, such as baking, grilling, steaming, or boiling, instead of frying or deep-frying. Limit your intake of alcohol and sugary drinks, and drink plenty of water to stay hydrated and flush out toxins.
Quit smoking: Smoking can damage your blood vessels, increase your blood pressure, and lower your HDL cholesterol. It can also increase your risk of heart attack, stroke, and other cardiovascular diseases. Quitting smoking can improve your cholesterol levels and your overall health. Within 20 minutes of quitting, your blood pressure and heart rate drop. Within three months, your blood circulation and lung function improve. Within a year, your risk of coronary heart disease is half that of a smoker. There are many resources and support groups that can help you quit smoking, such as nicotine patches, gums, lozenges, inhalers, sprays, medications, counseling, and apps.
Manage your stress: Stress can affect your cholesterol levels and your heart health in various ways. It can make you crave unhealthy foods, skip exercise, smoke, drink, or overeat. It can also raise your blood pressure, cause inflammation, and trigger the release of hormones that increase your blood sugar and cholesterol levels. Managing your stress can help you lower your cholesterol levels and improve your mood and well-being. Some ways to cope with stress are meditation, yoga, breathing exercises, relaxation techniques, hobbies, music, reading, writing, or talking to someone you trust. You can also seek professional help if you feel overwhelmed or depressed.

By following these lifestyle tips, you can lower your cholesterol levels and reduce your risk of heart disease and other complications. However, if your cholesterol levels are still high after making these changes, you may need to take medication as prescribed by your doctor. You should also check your cholesterol levels regularly and consult your doctor if you have any questions or concerns.

Frequently Asked Questions

What are the normal ranges for cholesterol levels?

Cholesterol is a waxy substance that is found in your blood and cells. It is essential for making hormones, vitamin D, and bile acids that help you digest fat. However, too much cholesterol can build up in your arteries and form plaque, which can narrow or block the blood flow and cause heart disease or stroke. Cholesterol levels are measured in milligrams per deciliter (mg/dL) of blood. There are different types of cholesterol that have different effects on your health:

Total cholesterol: This is the sum of all the cholesterol in your blood. The normal range for total cholesterol is less than 200 mg/dL. A level of 200 to 239 mg/dL is considered borderline high, and a level of 240 mg/dL or higher is considered high.
LDL cholesterol: This is the “bad” cholesterol that can clog your arteries and increase your risk of heart disease and stroke. The optimal level for LDL cholesterol is less than 100 mg/dL. A level of 100 to 129 mg/dL is considered near optimal, a level of 130 to 159 mg/dL is considered borderline high, a level of 160 to 189 mg/dL is considered high, and a level of 190 mg/dL or higher is considered very high.
HDL cholesterol: This is the “good” cholesterol that can help remove excess cholesterol from your arteries and protect your heart. The optimal level for HDL cholesterol is 60 mg/dL or higher. A level of 40 to 59 mg/dL is considered acceptable, and a level of less than 40 mg/dL is considered low. A low HDL cholesterol level can increase your risk of heart disease, especially if your LDL cholesterol level is high.
Triglycerides: These are a type of fat that is stored in your body and used for energy. Triglycerides can also contribute to plaque formation in your arteries. The normal range for triglycerides is less than 150 mg/dL. A level of 150 to 199 mg/dL is considered borderline high, a level of 200 to 499 mg/dL is considered high, and a level of 500 mg/dL or higher is considered very high. High triglycerides can increase your risk of heart disease, especially if you have low HDL cholesterol or diabetes.

Your cholesterol levels can vary depending on your age, gender, genetics, diet, weight, physical activity, smoking, alcohol, medications, and other factors. Therefore, it is important to check your cholesterol levels regularly and follow your doctor’s advice on how to lower or maintain them.

What are the symptoms of high cholesterol?

High cholesterol levels usually do not cause any symptoms, unless they are very high or have caused damage to your heart and blood vessels. Therefore, many people with high cholesterol are unaware of their condition until they develop complications, such as chest pain, heart attack, or stroke. The only way to know your cholesterol levels is to have a blood test, which measures your total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. You should have your cholesterol checked at least once every five years, or more often if you have risk factors for high cholesterol or heart disease.

How does high cholesterol affect the heart and blood vessels?

High cholesterol levels can affect the heart and blood vessels by causing atherosclerosis, a condition where fatty deposits, called plaques, build up on the inner walls of the arteries. These plaques can narrow the arteries, reducing the blood flow and oxygen supply to the organs and tissues. They can also rupture, causing blood clots to form, which can block the arteries and cause a heart attack or stroke. Atherosclerosis can affect any artery in the body, but it is especially dangerous when it affects the coronary arteries, which supply blood to the heart, or the carotid arteries, which supply blood to the brain.

References

National Heart, Lung, and Blood Institute. (2020). High Blood Cholesterol. Retrieved from
Libby, P., Buring, J. E., Badimon, L., Hansson, G. K., Deanfield, J., Bittencourt, M. S., … & Yuan, Z. (2019). Atherosclerosis. The Lancet, 394(10204), 1245-1260.
Mayo Clinic. (2020). High cholesterol - Diagnosis and treatment. Retrieved from

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