What is Cholesterol?

Is your head spinning over the conflicting messages you hear about fat and cholesterol? That’s not surprising. Researchers continue to learn more about cholesterol and saturated fat, too. And, as they learn more, nutrition advice may change.

What is Cholesterol?

Cholesterol is a waxy substance found in our body’s cells. It’s also found in animal-based foods. Our bodies need some cholesterol. However, our bodies make all the cholesterol we need. Cholesterol in the body is used to make hormones and vitamin D. It also plays a role in digestion.

If there is too much cholesterol in the body, it builds up. The waxy buildup, called plaque, sticks to the insides of the arteries. As the arteries narrow and clog, it is difficult for the blood to flow through them. The blockage can lead to a blood clot, stroke or heart disease.

There are three main types of cholesterol in the body:

• High-density lipoprotein, or HDL. Often called “good” cholesterol, HDL helps to remove excess cholesterol from your body.
• Low-density lipoprotein, or LDL. Generally considered "bad” cholesterol. It can lead to a buildup of plaque in the arteries.
• Very low-density lipoprotein, or VLDL. VLDL also promotes plaque buildup.

Another item included when cholesterol levels are checked are triglyceride levels. Triglycerides are a specific type of fat in the blood. Certain risk factors may increase your risk of elevated triglycerides, such as excess body fat or uncontrolled Type 2 diabetes. Excess calories, especially from refined carbohydrates such as added sugars and ultra-processed foods, may increase triglycerides. Alcohol also may increase triglyceride levels.

Am I at Risk for High Cholesterol?

Many things may increase your risk for high cholesterol, including:

• Genetics: High cholesterol runs in some families.
• Age: As we age, our cholesterol levels rise.
• Medicines: Certain medications can elevate cholesterol levels.
• Obesity: Individuals with an elevated body mass index are at greater risk for high cholesterol.
• Diet: Eating foods high in saturated and trans fats can raise LDL cholesterol levels, whereas consuming unsaturated fats can help boost HDL cholesterol.
• Inactivity: Physical activity helps to elevate HDL cholesterol.
• Smoking: Tobacco products decrease HDL and increase LDL. The link between smoking and high cholesterol is greater for women.

I Have High Cholesterol. Now What?

Everyone with high cholesterol can benefit from a heart-healthy lifestyle. However, your doctor might also recommend additional support to manage your cholesterol levels, such as cholesterol-lowering medications, if your cholesterol is high because of genetics. If you are at risk of developing high cholesterol, simple lifestyle changes can help reduce that risk. These include eating a heart-healthy diet, being physically active and achieving or maintaining a healthy body weight.

When it comes to a healthy eating plan, four dietary changes may help keep your cholesterol in check:

Enjoy Foods with Plant Sterols and Stanols

Some foods — fruits, vegetables, vegetable oils, nuts, seeds and whole grains — contain substances called plant sterols and stanols. Eating foods rich in these substances may help reduce total and LDL cholesterol levels.

Limit Your Intake of Saturated Fat

Saturated fats are predominantly found in animal-based foods such as meats, whole-fat dairy products, butter, tallow, coconut oil and foods made with these ingredients — such as baked goods or fries. Higher intakes of saturated fat have been found to elevate LDL cholesterol. Studies have shown that replacing sources of saturated fat with unsaturated fats can help decrease your total and LDL cholesterol levels. To help reduce your intake of saturated fat:

• Cook with vegetable oils, such as olive, canola, sunflower and safflower.
• Eat foods rich in omega-3 fatty acids such as salmon, walnuts and ground flaxseed.
• Choose low-fat or fat-free dairy products, such as 1% or skim milk and non-fat yogurt or low-fat cheeses, such as reduced-fat feta and part-skim mozzarella.
• Swap out butter, lard and tallow for vegetable oil options, which offer unsaturated fats.

Select Lean Protein Foods

Lean protein foods provide less calories from fat. To choose lean cuts:

• Check the package for the words loin or round.
• Remove the skin from chicken and turkey to reduce the saturated fat.
• Limit fatty, marbled meats, fried or deep-fried foods and other foods that are high in saturated fat, such as organ meats
• Choose healthier options when eating out by selecting foods that are baked, broiled or grilled.

Look for Dietary Fiber

Dietary fiber is found in fruits, vegetables, beans, lentils and whole grains. Getting adequate amounts of dietary fiber from a variety of foods is important for everyone.

Research has shown that some sources of fiber may help to lower LDL cholesterol. This happens when certain sources of fiber form a thick, jelly-like substance, which binds with cholesterol from foods you’re eating and helps remove it from the body.

Put the focus on dietary fiber by:

• Eating a variety of different colored fruits and veggies
• Including more plant-based or vegetarian meals with protein sources such as beans, lentils and soy
• Focusing on whole forms of produce, including fresh, frozen, canned and dried varieties, rather than juices
• Being selective when choosing canned foods, such as canned fruits packed in water or juice and low-sodium canned veggies or varieties with no added salt

Whole grains also are a great way to get the benefits of dietary fiber:

• Try barley (not pearled) and oats
• Make sure the food label on bread says 100% whole-grain or lists a whole grain as one of the first ingredients
• Limit refined carbohydrates, especially sources of added sugars, such as desserts and sugar-sweetened beverages

One note of caution: As you increase your fiber intake, also increase the amount of water you drink. This will help to reduce your risk of becoming constipated. If you find it difficult to get enough dietary fiber daily through your foods, ask your health care provider before considering a fiber supplement.