Cholesterol is often demonized, but it’s important to realize that not all cholesterol is bad. Actually, cholesterol is needed to make cells and hormones. The issue is when the “bad” LDL cholesterol is too high and leads to a higher risk for heart disease — the number one killer in the U.S. Meanwhile, increased levels of the “good ” HDL cholesterol facilitate the removal of surplus cholesterol from the blood. Cholesterol management is a combination of diet and lifestyle.
Nutrition is one of the most powerful levers you can pull to change your blood lipids. High saturated and trans fat foods — think: fried foods, processed meats, and a lot of packaged snacks — can increase your LDL. To reduce LDL while maintaining HDL, swap these for heart-healthy fats, like those in olive oil, nuts, seeds and fatty fish such as salmon. Adding soluble fiber, which is present in oats, beans, apples and Brussels sprouts, also can help block absorption of cholesterol in the digestive system.
Plant-based foods also have natural compounds called phytosterols that inhibit cholesterol absorption by competing with cholesterol. You can also eat foods fortified with phytosterols — like some types of fortified margarine or nut butter — to help maintain healthy cholesterol levels.
Regular exercise has a two-pronged effect: it raises HDL cholesterol and lowers LDL. Aim for at least 150 minutes of moderate-intensity aerobic activity per week, such as walking, swimming and cycling. And while it’s easy to dismiss them as “not exercise,” gardening, dancing and running up the stairs all count toward this goal.
There’s a close connection between weight and cholesterol. Even modest weight loss can lead to significant improvements in LDL and triglycerides, as little as 5% of body weight loss. Good nutrition and regular exercise contribute to both healthy weight and healthy lipids.
Quit smoking and drink in moderation – both will also help your cholesterol. Quitting smoking raises HDL cholesterol and is one of the most powerful actions you can take for lifelong heart health. Some research has indicated moderate consumption of alcohol might increase HDL to a small degree, but those positive effects need to be balanced against other health risks so it’s very important to not drink excessively and to consult your doctor individually.
Routine screening for cholesterol enables people to learn their numbers — total cholesterol, LDL, HDL, triglycerides — and monitor progress over time. Providers can also provide guidance tailored to you and let you know if diet and exercise are enough or if you might need medication.
In viewing cholesterol through the lens of a broader set of lifestyle behaviors, Americans can take important steps toward better heart health and a lower risk of chronic disease.
