What really raises your cholesterol (and what you should avoid)

Cholesterol is a vital lipid in our bodies, essential for creating cell membranes, certain hormones, and even vitamin D. While our body needs cholesterol, an excess of it, particularly the “bad” kind, can become a serious health concern. Too much cholesterol in the blood, especially LDL cholesterol (low-density lipoprotein), can increase the risk of cardiovascular issues like heart attacks and strokes. But what really contributes to high cholesterol levels, and what should we avoid to keep it in check?

The Two Types of Cholesterol: Good vs. Bad

Cholesterol travels through the bloodstream attached to proteins, forming what’s known as lipoproteins. The two main types are HDL cholesterol (high-density lipoprotein), often referred to as “good cholesterol,” and LDL cholesterol (low-density lipoprotein), known as “bad cholesterol.” HDL is the protective type, helping to remove excess cholesterol from the arteries and transporting it to the liver for elimination. On the other hand, LDL, when in excess, can deposit cholesterol on the walls of arteries, forming plaque that leads to a condition called atherosclerosis.

The danger lies in having too much LDL cholesterol, which can clog arteries and increase the risk of heart disease, strokes, and other serious cardiovascular conditions.

The Main Causes of High Cholesterol

In many cases, high cholesterol is largely driven by poor dietary habits. According to Dr. Jean-François Renucci, a vascular specialist, common causes of high cholesterol include diets rich in saturated fats and cholesterol-heavy foods. For example, egg yolks, processed meats, red meats, cheese, butter, and full-fat dairy are all culprits that can elevate cholesterol levels. Over time, these fats can accumulate in the liver, potentially leading to fatty liver disease, also known as steatosis.

Additionally, genetics play a role in some cases. Familial hypercholesterolemia (FH) is a genetic condition where high cholesterol levels are present from birth. This genetic trait makes the body produce an excess of cholesterol, regardless of diet. People with FH often face higher cardiovascular risks, as their bodies cannot eliminate cholesterol effectively. In these cases, the liver produces a disproportionate amount of cholesterol, sometimes as much as 80% of the body’s total cholesterol.

Medication and Other Health Conditions

Some medications can also contribute to high cholesterol levels, though this is less common. Certain antiretroviral drugs, used to treat HIV, and beta-blockers, used for high blood pressure, are examples of medications that may cause cholesterol levels to rise. Similarly, people with hypothyroidism (underactive thyroid) may see an increase in their cholesterol due to metabolic imbalances caused by insufficient thyroid hormone production.

Interestingly, body weight doesn’t necessarily correlate with cholesterol levels. Dr. Renucci clarifies that some people who are overweight may not have high cholesterol, while others with a slim build can still struggle with it. Excess weight can, however, raise triglyceride levels, another type of lipid, which, while less harmful than cholesterol, can still contribute to cardiovascular problems.

Managing High Cholesterol

For those with elevated cholesterol, the first line of defense is often dietary changes. Reducing foods high in cholesterol and saturated fats can help lower cholesterol levels. If cholesterol remains high after a few months of dietary adjustments, medications may be considered. The most commonly prescribed medications for high cholesterol are statins, which work to reduce LDL levels. In cases of familial hypercholesterolemia or when other treatments are ineffective, more advanced options like PCSK9 inhibitors—injections that help lower LDL cholesterol—might be recommended.

What to Avoid

To manage your cholesterol levels effectively, avoid foods that are high in saturated fats and trans fats, which are known to raise LDL cholesterol. This includes:

• Processed meats (like sausages, bacon, and salami)
• Full-fat dairy products (such as whole milk, butter, and cheese)
• Fried foods and commercially baked goods that contain partially hydrogenated oils
• Egg yolks and other cholesterol-heavy foods

Instead, focus on eating more fiber-rich foods, healthy fats like those found in olive oil and avocados, and omega-3 fatty acids from fish such as salmon and mackerel. These changes can help lower LDL cholesterol and boost HDL levels, contributing to better heart health.

Conclusion

Maintaining healthy cholesterol levels is essential for overall cardiovascular health. While diet plays a significant role, genetics and other health conditions also contribute to high cholesterol. By avoiding high-cholesterol foods, embracing a heart-healthy diet, and considering medication when necessary, you can keep your cholesterol in check and reduce your risk of heart disease. Remember, small changes in your lifestyle can lead to big benefits for your heart.