What is cholesterol?
Cholesterol is a waxy, fat-like substance found throughout the body. Your body needs cholesterol for critical functions like maintaining cell structures and making vitamin D, hormones, and bile acids. The liver is the primary source of cholesterol in our bodies, making all the cholesterol we need. About 20% of the cholesterol in your blood comes from the foods you eat. Cholesterol tends to have a bad reputation because of its role in cardiovascular diseases. Still, we must be aware that it is found in every cell in our bodies and is essential for important functions. Your body has a system that helps rid itself of excess cholesterol, but sometimes that system can be flawed or overloaded, which is when trouble starts to brew. There are 3 types of cholesterol to be aware of HDL, LDL, and VLDL. Keep reading to find out what each of these entails.
TABLE OF CONTENTS
What are the different types of cholesterol: HDL, LDL, LDVL?
What factors affect my cholesterol levels?
Should I get my cholesterol checked?
What can I do now?
Lifestyle Recommendations
Dietary Recommendations
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Types of Cholesterol: HDL, LDL, and VLDL
Before I get into the types of cholesterol I think it’s important to define lipoprotein. A lipoprotein is a combination of lipids and proteins that travels through your bloodstream. Fat and cholesterol can’t dissolve in water or blood. The body packages fat and cholesterol into these protein-covered lipoproteins. Some of these particles are large and flowy, while others are small and dense. These lipoproteins have 2 functions: delivering cholesterol to tissues or picking up extra cholesterol and carrying it away to the liver for elimination.
HDL cholesterol refers to high-density lipoproteins, they are made mostly of protein. HDL is referred to as “good" cholesterol because it removes excess cholesterol from arterial walls and your blood. It then carries the excess cholesterol to your liver for breakdown and excretion. Your HDL cholesterol is a number you want to keep high. The general target level for HDL is 60 mg/dL or higher, there are some variations in this level depending on age and biological sex.
LDL cholesterol refers to low-density lipoproteins. These particles are mostly pure cholesterol. These lipoproteins move cholesterol around the body, delivering it to tissues, cells, and sometimes arterial walls, giving it its reputation as the “bad" cholesterol. High levels of LDL can lead to a build-up in those arterial walls, forming a hardened plaque (atherosclerosis), and increasing the risk of cardiovascular disease and stroke. It is best if LDL levels stay below 100 mg/dL, but if you have a history of atherosclerosis, it is advised that you keep LDL levels below 70mg/dL.
VLDL cholesterol refers to very low-density lipoproteins produced in the liver. VLDLs carry triglycerides and cholesterol to tissues throughout the body, and their protein content is low. Triglycerides make up most of the fat you eat and that travels through your bloodstream. Triglycerides are the vehicle for transporting fats to cells, but at high levels can be unhealthy. LDL and VLDLs are equally atherogenic, meaning they can both promote plaque build-up in arterial walls.
What factors affect my cholesterol levels?
Age: As with most things in life, as you get older you, are more susceptible to rising cholesterol levels.
Diet: Dietary cholesterol is a waxy, fat-like substance found in animal products such as meat, seafood, poultry, eggs, and dairy. For most people, the amount of cholesterol eaten has only a modest impact on the amount of cholesterol circulating in the bloodstream. Some individuals are more sensitive to dietary cholesterol and are referred to as “responders.” Their blood responds strongly to the amount of cholesterol eaten, but this is not the majority. There is no way to determine how responsive an individual is to cholesterol in food other than by trial and error. This sensitivity is thought to be determined by genetic factors.
The biggest influence on blood cholesterol level is the mix of types of fats and carbohydrates in your diet, and not the amount of cholesterol you eat from food. Saturated fats and trans-fats in foods you eat raise your LDL levels, which is the cholesterol you want to keep low. Excess intake of these types of fats over extended periods will raise your LDL. An excess of these fats, along with refined sugars- white and brown sugars, fructose, and sweeteners can contribute to high cholesterol Reducing your intake of saturated and trans fats can help lower your cholesterol. High-sugar diets can cause an excess of caloric intake, which leads to the production of triglycerides, which also raises LDL cholesterol.
Exercise: Regular exercise can raise your HDL, which is deemed the “good guy." Exercise increases the activity of lipoprotein lipase in skeletal muscles, called the “reverse cholesterol transport”, removing cholesterol from circulation. Aerobic exercise increases the concentration of HDL particles in the blood. Exercise and a healthy diet are considered a first-line intervention in managing blood lipid levels.
Genetics: Your genes and family history partly determine how much cholesterol your body makes. High cholesterol may run in your family and put you at a higher risk for elevated LDL and cardiovascular disease.
Should I get my cholesterol checked?
How often you receive a cholesterol test depends on your age and your risk factors for heart disease. Everyone should get their cholesterol checked. Your PCP can make recommendations on how often your cholesterol should be checked. Knowing your LDL, HDL, and total cholesterol numbers is important in assessing your risk. If you get annual blood work done, that is a perfect opportunity to receive and review a lipid panel test with your health care provider. You will likely receive an elevated lipid panel reading BEFORE your body shows symptoms of high cholesterol, if left unaddressed, it can lead to heart attack, stroke, and other blood flow complications.
High cholesterol can be sneaky and doesn’t cause symptoms for most people. You could be an aerobics instructor and have high cholesterol. Typically, you won’t start to feel any symptoms until the high cholesterol is causing other complications in the body. This is why it’s important to get it checked regularly! Routine checks are especially important if you are over 40, have a history of diabetes, high blood pressure, heart disease, and/or a family history of heart disease. Behaviors such as smoking, overconsumption of alcohol, extended periods of high stress, lack of physical activity, and poor diet all raise your risk of having high cholesterol.
What can I do to support my cholesterol now?
As mentioned above, diet and exercise are the frontline interventions to this sneaky killer. Some common complications from high cholesterol levels are coronary artery disease, atherosclerosis, peripheral artery disease, and high blood pressure. The main issue with high cholesterol is the building up of plaque on arterial walls. This hardening of arteries threatens the successful blood flow to all bodily systems. Medications, called statins, are an option and can be prescribed by your healthcare provider, but lifestyle changes help make those medications more successful.
Lifestyle Recommendations
Eat less saturated fats. These fats are typically solid at room temperature and include coconut oil, butter, lard, and palm oil. They are found in animal products too. Especially fatty cuts of meat, sausages, bacon, and cured meats. Shortening is often used in biscuits, cakes, and pie crusts. Fast foods contain a high amount of saturated fats. Trans fats must be avoided too, but have technically been banned in the U.S. since 2021- they are still present in deep-fried and fast foods.
If you eat animal protein, rely more on leaner cuts and grass-fed options whenever possible.
Read labels about sodium. Some salt is good, but if a food is deemed “excess sodium”, it is best to find an alternative if possible. If you are cooking the majority of your own meals, you likely do not have to worry about excess sodium.
Limit added sugars,and read labels. *Reminder it is recommended to consume no more than 25-30 grams of added sugars per day. Limit intake of sodas, candy, and simple carbs like white bread, twinkies, oreos, etc.
Do not use tobacco products.
Exercise regularly. 30 minutes/day of physical activity will significantly reduce your risk for all non-communicable diseases.
If applicable to where you live, go for a 10-minute walk after you enjoy a meal.
Limit alcohol to no more than 2 drinks per day.
Develop tools and healthy activities specific to stress management.
Sleeping 7-9 hours every night. Prioritizing the quality of sleep to the best of your ability.
Dietary Recommendations
In addition to lowering the intake of saturated fats, eating foods high in fiber and omega-3 fatty acids, play a significant role in lowering LDL and raising HDL cholesterol levels. Fiber absorbs cholesterol in the intestinal tract, preventing it from being absorbed into the bloodstream. Read about Unlocking the Power of Fiber here.
Salmon, mackerel, sardines, anchovies, and herring. These fish have the highest mg of omega-3s per serving. Tuna is also a good option.
Eating 8oz. of cold-water fish per week is the most impactful change you can implement when trying to increase your omega-3 intake.
Fruits: apples, pears, citrus, bananas, berries, grapes, avocados, pineapple.
Vegetables: cauliflower, broccoli, kale, Brussels sprouts, cabbage, arugula, bok choy, collard/chard greens. All veggies, but these are the superstars.
Whole grains: oatmeal, oat bran, barley, brown rice, whole grain bread/pasta.
Legumes: peas, lentils, peanuts, edamame, etc.
Beans: navy, kidney, garbanzos, red beans, pinto beans, black beans, fava, etc.
Nuts: almonds, walnuts, Brazil nuts, etc.
Seeds: flax seeds, chia seeds, hemp seeds, sesame seeds, pumpkin seeds, etc.
Dark chocolate
Olive oil
Avocado oil
Hydrotherapy… How can it help?
You can learn about our hydrotherapy treatments here. Hydrotherapy has numerous benefits that can support nutrient absorption and reduce inflammation. It works by stimulating the body’s healing mechanisms by improving or restoring normal organ function and circulation. It aids in the strengthening and healing of the digestive system. It nourishes the respiratory and digestive systems which both bring nutrients (via digestion and respiration) into the system.
All therapies, treatments, and recommendations are made based on individualized care. At PCNM you will work with a team of providers who consider each part of your life when making a solution-focused plan for YOU. We want to see you heal and help implement change, not create a temporary fix.
References:
Chiu, S., Williams, P. T., & Krauss, R. M. (2017). Effects of a very high saturated fat diet on LDL particles in adults with atherogenic dyslipidemia: A randomized controlled trial. PloS one, 12(2), e0170664.
Kenneth, R. (2024). The effect of diet on cardiovascular disease and lipid and lipoprotein levels.
Armah, C. N., Derdemezis, C., Traka, M. H., Dainty, J. R., Doleman, J. F., Saha, S., ... & Mithen, R. F. (2015). Diet rich in high glucoraphanin broccoli reduces plasma LDL cholesterol: Evidence from randomized controlled trials. Molecular nutrition & food research, 59(5), 918-926.
Subczynski, W. K., Pasenkiewicz-Gierula, M., Widomska, J., Mainali, L., & Raguz, M. (2017). High cholesterol/low cholesterol: effects in biological membranes: a review. Cell biochemistry and biophysics, 75, 369-385.
Alenghat, F. J., & Davis, A. M. (2019). Management of blood cholesterol. Jama, 321(8), 800-801.
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