High cholesterol stands out as a leading cause behind these numbers. Our cardiovascular health faces serious risks from high cholesterol when blood lipid levels rise too much. The human body needs cholesterol to function properly. However, too much low-density lipoprotein (LDL) can cause atherosclerosis and heart problems.
This piece will get into what causes high cholesterol and how to lower it. We’ll learn about different factors that affect our cholesterol, from what we eat and how we live to genetic conditions like familial hypercholesterolemia.
What leads to high cholesterol and how can we reduce it?
High cholesterol can be caused by a combination of factors, including a diet high in saturated fats and trans fats, lack of physical activity, being overweight, smoking, excessive alcohol intake and certain medical conditions or genetic predispositions.
To lower cholesterol, it’s essential to adopt a heart healthy lifestyle: eat more fiber rich whole foods, reduce processed and fatty foods, exercise regularly, quit smoking and maintain a healthy weight. In some cases, supplements or medications may be recommended by a healthcare provider to support cholesterol management and reduce cardiovascular risk.
What is cholesterol and why does it matter?
Cholesterol is a waxy fat like substance in our bloodstream that plays several key roles in keeping our body working properly. Our body needs it, yet many people don’t understand how it works or why keeping proper levels matters for their health.
Types of cholesterol: LDL, HDL and total cholesterol
Our blood carries cholesterol through proteins called lipoproteins. These act as carriers in our bloodstream. Two main types exist and each affects our health differently:
Low-density lipoprotein (LDL): people call this the “bad” cholesterol. LDL makes up most of the cholesterol in our body. High LDL levels can build up on our artery walls and form plaque that narrows blood vessels.
High-density lipoprotein (HDL): known as “good” cholesterol, HDL helps remove extra cholesterol from our bloodstream and takes it back to our liver. But HDL only removes about one-quarter to one-third of LDL cholesterol.
Total cholesterol shows the combined amount of all cholesterol types in our blood. Our doctor checks triglycerides with cholesterol levels because high amounts can affect our heart health too.
How cholesterol functions in our body
Our body needs cholesterol for many vital tasks, unlike its bad reputation suggests:
- Cell membrane structure: it creates protective layers around cells and controls what goes in and out;
- Hormone production: our body needs it to create important hormones, including sex hormones;
- Vitamin D synthesis: it helps make vitamin D;
- Bile production: our liver uses it to make bile, which helps digest fat.
Why high LDL is a concern for heart and brain health
High LDL cholesterol can seriously harm our heart and brain. These particles stick to artery walls over time and mix with other substances to form plaque. This process, called atherosclerosis, makes our arteries:
- Narrower, which limits blood flow;
- Less flexible;
- More likely to get blocked.
Plaque buildup in heart arteries reduces oxygen rich blood flow to our heart muscle, which can cause chest pain (angina). A broken piece of plaque might form a clot that blocks an artery completely, leading to a heart attack.
Brain arteries face similar risks and blockages can cause strokes. Studies show our brain holds about 25% of our body’s cholesterol, so managing it properly matters for brain function. Poor blood flow from atherosclerosis can damage brain areas, affecting memory, movement, speech and swallowing.
On top of that, atherosclerosis affects arteries in our legs, feet and other body parts. This condition, peripheral artery disease, brings pain, numbness and tissue damage.
The scariest part about cholesterol buildup is its quiet nature. Plaque grows slowly without any warning signs.
What causes high cholesterol?
High cholesterol rarely occurs by itself. It usually comes from a mix of lifestyle choices, health conditions and genes. Learning about these mechanisms helps us manage cholesterol levels better.
Diet high in saturated fats and trans fats
Foods rich in saturated and trans fats are the biggest reason behind high cholesterol. Animal products contain lots of saturated fats that increase low-density lipoprotein (LDL) cholesterol.
Common sources of cholesterol-raising fats include:
- Processed meats (hot dogs, sausage, bacon);
- Fatty cuts of red meat and poultry with skin;
- Full-fat dairy products (butter, cream cheese, heavy cream);
- Fried foods;
- Coconut oil and palm oil;
- Trans fats found in some processed and fast foods.
Our body needs some saturated fat to work properly, but most people eat too much without knowing it. Diet plays a vital role in managing cholesterol, though it’s not always easy to control due to limited access, time and community resources.
Lack of physical activity and prolonged sitting
Poor exercise habits link closely to unhealthy cholesterol levels. Exercise helps boost high-density lipoprotein (HDL) levels, which help remove excess LDL from our blood.
Sitting too long and staying inactive throws off cholesterol balance in many ways. Our body doesn’t process fats well without movement, leading to higher LDL and lower HDL levels. A lack of activity often leads to weight gain, which makes cholesterol problems worse.
Smoking, alcohol and chronic stress
Smoking hurts blood vessels and lowers HDL cholesterol while raising LDL. Cigarette smokes chemicals make blood thicker and stickier through the lungs, making clots more likely. Smoking also stops HDL from moving LDL out of arteries effectively.
Alcohols effects aren’t straightforward. Small amounts might raise HDL, but drinking too much (over two drinks daily for men or one for women) pushes up total cholesterol, LDL and triglycerides.
Stress hormones like cortisol boost cholesterol production. Studies show that people under high work stress have more LDL cholesterol and triglycerides, with lower HDL. Even young, healthy people show higher cholesterol when stressed.
Medical conditions like diabetes and hypothyroidism
Several health issues can substantially change how cholesterol works:
- Diabetes mellitus doubles heart disease risk and associates with poor cholesterol levels;
- Hypothyroidism changes how our body handles fats, raising cholesterol;
- Chronic kidney or liver disease affects cholesterol processing;
- Extra weight raises LDL while lowering HDL;
- Polycystic ovary syndrome disrupts cholesterol balance;
- Sleep apnea goes hand in hand with bad cholesterol profiles.
These conditions need specific medical care along with cholesterol treatment.
Genetic factors such as familial hypercholesterolemia
Some people have high cholesterol mainly because of inherited gene changes. Familial hypercholesterolemia (FH) affects about 1 in 250 adults, according to research.
FH happens when genes that should remove LDL cholesterol from blood don’t work right, usually due to LDL receptor gene problems. People born with FH start life with high LDL, which keeps rising whatever they eat.
Without treatment, FH increases heart attack risk five times higher than normal, often striking in their 40s or earlier. This happens because these people have high LDL from birth.
How to lower cholesterol through lifestyle changes
Lifestyle changes form the foundation of cholesterol management. These changes can improve cholesterol levels without medication. Research shows several proven approaches work well.
Adopting a heart healthy diet rich in fiber and healthy fats
Our food choices can substantially affect our cholesterol profile. Studies show we can lower LDL cholesterol by 8-10% when we reduce saturated fat intake to less than 7% of daily calories. Our cholesterol levels improve when we eliminate trans fats from margarines and processed foods.
Our body blocks cholesterol absorption in the digestive tract with 10-25 grams of soluble fiber daily, according to research. Oatmeal, beans, apples and prunes serve as excellent sources. Plant sterols and stanols (2 grams daily) also prevent cholesterol absorption.
Heart-healthy diets like Mediterranean, DASH and TLC (Therapeutic Lifestyle Changes) focus on:
- Fruits, vegetables and whole grains;
- Fish rich in omega-3 fatty acids;
- Healthy oils like olive oil:
- Limited red meat and full fat dairy.
Incorporating regular aerobic and resistance exercise
Exercise helps raise HDL cholesterol and can lower LDL levels. Our body moves “bad” cholesterol to the liver for removal with regular exercise. Our cholesterol profile improves with 150 minutes of moderate intensity aerobic activity weekly, according to studies.
Aerobic activities (walking, swimming, cycling) and resistance training both offer cardiovascular benefits. Research shows resistance training has the strongest link to improved HDL levels compared to other types of exercise.
Maintaining a healthy weight and waist circumference
Our weight plays a crucial role in cholesterol levels. A 5-10% reduction in body weight can lower total cholesterol, LDL and triglycerides. Weight affects cholesterol through reduced body fat, less inflammation and better insulin sensitivity.
Quitting smoking and moderating alcohol intake
Our cholesterol profile improves faster when we quit smoking. Smoking lowers HDL cholesterol and makes it less effective at removing LDL from arteries. HDL levels usually match those of non-smokers within a year after quitting.
Alcohol needs moderation. Light drinking might slightly increase HDL levels. However, drinking more than two drinks daily for men or one for women raises total cholesterol, LDL and triglycerides.
Supplements and natural compounds that support cholesterol balance
Natural compounds and supplements can support healthy cholesterol levels beyond lifestyle changes. These options might help people who want additional ways to manage their cholesterol.
Omega 3 fatty acids from fish oil and flaxseed
Omega 3 fatty acids, especially EPA and DHA found in fatty fish, reduce triglyceride levels. Research shows that omega 3s can improve HDL (good) cholesterol levels slightly. Fish oil has almost no mercury, but taking too much might increase bleeding risk. Omega 3s help remove cholesterol from the body by supporting reverse cholesterol transport (RCT).
Primary sources include:
- Fatty fish (salmon, mackerel, herring, sardines);
- Flaxseeds and flaxseed oil;
- Walnuts and other nuts;
- Algae oil (for vegans/vegetarians).
Plant sterols and stanols
Plant sterols and stanols are like cholesterol in structure and block its absorption in the digestive tract. Research proves that taking 2 grams daily lowers LDL cholesterol by 7.5-12%. Common sources include specially fortified foods such as:
- Margarines;
- Yogurts and yogurt drinks;
- Breads and cereals.
Red yeast rice and its active compounds
Red yeast rices monacolin K has the same chemical structure as lovastatin (a prescription statin). Research shows it can lower total cholesterol by 16-22% and LDL cholesterol by 21-31% in 8-12 weeks. Notwithstanding that, supplement quality varies by a lot, which might raise safety concerns.
Soluble fiber sources like psyllium and oats
Soluble fiber creates a thick gel in the intestines that traps fats before absorption. Oats contain beta-glucan that reduces LDL cholesterol if we keep taking them. We can also find good amounts in psyllium husk, beans, lentils and many fruits.
Antioxidants from polyphenol-rich foods
Plant foods’ polyphenols help balance cholesterol by a lot. Studies show that flavonoids and other polyphenol types link to higher HDL-c levels. Foods rich in these compounds include:
- Extra-virgin olive oil;
- Dark chocolate (with 70% cocoa);
- Berries;
- Green tea;
- Turmeric.
When lifestyle is not enough: medical options
We might need medication if our cholesterol stays high even after lifestyle changes. Medical treatments work to lower cholesterol levels when diet, exercise and supplements don’t cut it. These treatments target different parts of how our body processes cholesterol.
Statins and how they work
Statins top the list of cholesterol lowering medications. They work by blocking hydroxymethylglutaryl-CoA (HMG-CoA) reductase, an enzyme our liver uses to make cholesterol. This process makes our liver create more LDL receptors, which helps clear LDL from our blood.
Research shows that statins reduce the relative risk of major coronary events by approximately 30%.
FDA-approved statins include:
- Atorvastatin (Lipitor);
- Rosuvastatin (Crestor);
- Simvastatin (Zocor);
- Pravastatin (Pravachol);
- Lovastatin (Altoprev);
- Fluvastatin (Lescol XL);
- Pitavastatin (Livalo).
PCSK9 inhibitors and new therapies
PCSK9 inhibitors offer hope to patients who don’t get enough help from statins. These drugs stop PCSK9 proteins from breaking down LDL receptors, which helps remove LDL cholesterol more effectively.
Studies reveal PCSK9 inhibitors can reduce LDL cholesterol by up to 60%. The FOURIER trial showed that evolocumab cut major cardiovascular events by 15-20%.
We can now get these PCSK9 inhibitors:
- Alirocumab (Praluent);
- Evolocumab (Repatha);
- Inclisiran (newer siRNA type).
Ezetimibe and bile acid sequestrants
Ezetimibe blocks our intestines from absorbing cholesterol without affecting fat-soluble vitamins. By itself, it lowers LDL by about 18%. Combined with statins, it works even better.
Bile acid sequestrants (cholestyramine, colestipol, colesevelam) take a different approach. They bind to bile acids in our intestines, which makes our liver turn more cholesterol into bile acids. This process ended up lowering blood cholesterol by 10-28% when used alone, according to studies.
We need a complete approach to manage our cholesterol levels well. This includes lifestyle changes, a better diet and medical treatments when needed. Research shows that basic changes can substantially lower cholesterol. These changes include eating less saturated fat, exercising more and keeping a healthy weight. On top of that, natural supplements like omega 3 fatty acids, plant sterols and soluble fiber help maintain balanced cholesterol levels.
Our success in managing cholesterol depends on our steadfast dedication to heart , healthy practices, regular medical checkups being willing to adjust our approach based on what works for us.
