8 facts that may change the way you think about cholesterol

Too much cholesterol isn’t a good thing. We hear that all the time. But did you know that your body needs cholesterol? It’s important for making new cells and hormones.  Cholesterol also converts sunlight into vitamin D.  

This waxy substance comes from two sources. Your liver produces blood cholesterol, which your body needs to function. Dietary cholesterol comes from foods that you eat, such as eggs, meat, dairy, and cheese.   

The problem starts when there is too much cholesterol floating around in your bloodstream. Over time, cholesterol can build up in the arteries, raising the risk of heart disease or a stroke.  

Here are some things that you might not have heard about cholesterol. Find out the facts that can help you stay healthy. 

Fact 1: Lowering cholesterol isn’t always the goal  

High total cholesterol levels (more than 200 mg/dL) can pose health risks. But your overall cholesterol level doesn’t tell the whole story. There are two types of cholesterol.  

High-density lipoprotein (HDL) is known as “good cholesterol,” and low-density lipoprotein (LDL) is “bad cholesterol.” Too much LDL in the system can build up in the artery walls, making them narrower. This can up the risk of heart disease and stroke. 

HDLs are good because they remove some of the LDLs from the bloodstream and the artery walls.  

A simple blood test measures your total cholesterol level, which includes HDL and LDL. The goal is to have high levels of HDL and low levels of LDL. Healthy cholesterol levels for adults are: 

• LDL that’s lower than 100 mg/dL 
• HDL that’s higher than 60 mg/dL 

Fact 2: Cholesterol-free foods can raise cholesterol  

It's true that cholesterol can be found in animal products such as egg yolks. But the real concern is foods that are high in saturated fat or trans fats. 

Saturated fat can interfere with how cholesterol is processed in the liver. Trans fats, found in some fried foods, can also increase LDL while lowering HDL.  

That’s why the best way to lower your cholesterol is to reduce your intake of saturated and trans fats. These fats are found in red meat, shellfish, whole-milk dairy foods, hydrogenated oils, and many fried foods and baked goods. (In good news, the Food and Drug Administration has banned trans fats from processed foods.)  

Even if a food is labeled “cholesterol-free,” it can still contribute to higher cholesterol levels if it contains these fats. 

Fact 3: Kids can have high cholesterol  

Be sure to tell your child’s doctor about your family health history. That includes any problems with heart disease, stroke, and high cholesterol. Genetics can play a role in high cholesterol, so some kids and teens may benefit from testing.   

Kids should be screened at least once between age 9 and 11, says the Centers for Disease Control and Prevention.  

Treatments for kids with high cholesterol are similar to those for adults:   

• A healthy diet low in saturated and trans fats  
• Maintaining a healthy weight 
• Keeping active 
• In some cases, cholesterol-lowering medication 

Fact 4: Slim people can have high cholesterol 

You don’t have to be overweight to have high cholesterol. If you don’t really pay attention to what’s in the foods you eat, you might be downing more saturated and trans fats than you realize.  

Plus, some people are genetically prone to high cholesterol.  

Fact 5: Levels should be checked at age 20 

Cholesterol levels should be checked at age 20, and again every 4 to 6 years. It may be more often depending on your family history and risk factors. These include: 

• Age. Everyone’s risk goes up with age.  
• Gender. Men tend to have lower HDL (“good”) cholesterol than women. 
• Smoking  
• High blood pressure  

These are the recommendations from the American Heart Association (AHA) — even if you aren’t in a high-risk group.  

Fact 6: Public screenings don’t tell the whole cholesterol story 

Public screenings, as well as at-home tests, can be accurate if they’re done properly. But only your primary care provider can take into account everything about your health profile, ensure that the test is done right, and help you create an action plan. That’s why your provider should do the test, says the AHA.  

There’s no harm in getting screened at a health fair or when giving blood. But don’t let that be your only measure. Your provider may recommend at-home tests as a follow-up. They can walk you through the process and interpret the results. 

Fact 7: Smoking lowers “good” cholesterol 

Do you smoke cigarettes? Kicking the habit can help lower your cholesterol levels and reduce your risk of heart disease. If you don’t use tobacco, be sure to avoid secondhand smoke as well. Some research suggests that regularly breathing other people’s cigarette smoke can negatively affect cholesterol.  

Fact 8: Sometimes lifestyle changes are enough to make a difference  

You might be able to bring down high LDL cholesterol and raise good HDL cholesterol by:  

• Avoiding tobacco smoke 
• Maintaining a healthy weight 
• Exercising regularly 
• Eating a heart-healthy diet   

In fact, even genetically linked high cholesterol may be controllable with these habits. If not, your provider can prescribe medications to help improve your numbers.  

Article sources:  

Cholesterol overview: National Heart, Lung, and Blood Institute; Cleveland Clinic 

Trans fat ban: U.S. Food & Drug Administration 

Saturated fat: American Heart Association 

Family history of high cholesterol: Centers for Disease Control and Prevention  
Cholesterol testing guidelines: Centers for Disease Control and Prevention; American Heart Association 

Study on smoking and cholesterol levels: Open Heart