Authored By Anuja Madar
Medically Reviewed By Zach Hermes, J.M., M.D.
We’ve heard about cholesterol all our lives, but most of us don’t know what it is, why we need it, and how it impacts our health. About 86 million US adults have high cholesterol, according to the Centers for Disease Control and Prevention, so it’s likely to impact you or someone you care about. But fear not: We’re here to give you the basics and answer some common questions about cholesterol.
Cholesterol: What it is and what it does
Cholesterol is a type of fat that lives in our blood and cells. It’s produced almost entirely by the liver, using fat from what we eat, and is essential to our survival. There are two main types of cholesterol:
- Also known as: Low-density lipoprotein or “bad” cholesterol
- What it does: Carries cholesterol and other types of fat throughout the body
- Why too much is bad: It can build up on the walls of your arteries and narrow them, making it hard for blood and oxygen to reach the heart, brain, kidneys, and other parts of the body.
- Also known as: High-density lipoprotein or “good” cholesterol
- What it does: Takes the extra cholesterol left behind by LDLs to the liver, where it’s eliminated from the body
When we talk about cholesterol, triglycerides, the most common type of fat in the body, are usually part of the conversation. High cholesterol and high triglycerides typically go hand-in-hand, posing similar health risks.
Why cholesterol is important
While too much cholesterol is a negative thing, it performs essential functions in the body. In addition to playing a major role in the creation and maintenance of the protective membranes around our cells, cholesterol:
- Critical for making vitamin D
- Helps improve digestion
- Is vital in making cortisol (the stress hormone), estrogen, testosterone, and progesterone
- Helps brain cells communicate
- Makes up the thin, protective covering around the brain
What is the normal range for cholesterol levels?
A healthy level of total cholesterol in adults is about 150 milligrams per deciliter (mg/dL). Anything above 200 mg/dL is considered high, and a level above 240 mg/dL can put you at risk for heart attack, stroke, or heart disease. While rare, low cholesterol (below 120 mg/dL) may also come with mental and physical health risks.
High cholesterol tends to come with age (for both males and females), but estrogen helps premenopausal women stay within a normal range. However, many women see their “good” cholesterol drop and “bad cholesterol” rise at the onset of menopause.
While some people report issues like blurred vision, joint pain, or headaches, high cholesterol doesn’t cause any symptoms. The American Heart Association recommends adults 20 and older get screened every four to six years and more often if you take medication or have other risk factors such as family history, diabetes, or obesity. And if you’re wondering if skinny people can have high cholesterol, the answer is yes. Factors like metabolic disorders and high levels of visceral adipose tissue (the fat lining your internal organs) can lead to elevated cholesterol levels regardless of your body mass index (BMI), which means even a thin person can have high cholesterol.
Healthy ways to lower and manage your cholesterol
Health conditions, including type 2 diabetes and obesity, and family history can put you at risk for high cholesterol, but your lifestyle can also play a big part. While we can’t control things like family history, we can work on managing what we eat and how much we move our bodies.
Focus on food
One of the simplest ways to try to lower your cholesterol is to start with what you eat and drink. If you’re wondering ”Does my sodium intake affect my cholesterol?” or if quitting alcohol will help lower your level, consider this: foods and beverages high in saturated fat, sugar, and salt are the biggest contributors to high cholesterol.
If you’re worried about high cholesterol, avoid or minimize consumption of:
- Red meat (e.g., beef)
- Organ meat (e.g., liver, kidney)
- Processed meat (e.g., lunch meat, cold cuts)
- Frozen meals
- Fast food
- Fried food
- Foods with partially hydrogenated oils
- Commercially baked goods and sweets
To help prevent or lower high cholesterol, try to include more:
- Fresh fruits
- Fresh vegetables
- Nuts (e.g., walnuts, almonds)
- Seeds (e.g., sunflower, hemp, chia)
- Whole grains (e.g., oats, quinoa)
- Beans (e.g., black, kidney, lima, and pinto are good for cholesterol)
- Fish (e.g., salmon, tuna)
- Olive oil
Another way to lower your cholesterol is to add movement to your routine. Working out regularly may:
- Boost your “good” and lower your “bad” cholesterol
- Reduce your triglyceride levels
- Help lose or maintain a healthy weight
- Prevent clogged arteries
- Reduce stress hormones
If going to the gym, taking a fitness class, or running aren’t your thing, that’s ok. Brisk walking 30 minutes a day, five days a week can decrease your risk of high cholesterol, according to the American Heart Association, and lifting weights twice a week may decrease your “bad” and total cholesterol levels. Learn more about the benefits of walking and how to incorporate it into your daily life.
When it comes to your health, it’s never too early to start learning. While we’ve provided an overview of what cholesterol is, talk to your healthcare provider about getting screened and what you can do to maintain or lower your level.