Understanding Cholesterol

By Kristi Kalinsky, RD, LD
April 11, 2023

Cholesterol is a common thing that’s tested regularly at your healthcare professional's office and is used as a marker for health. When your cholesterol labs reveal higher than ideal numbers, it can be scary and overwhelming , especially if there is a history of heart disease in your family. It is important to know what the numbers mean, and how you can influence them through diet and lifestyle choices. Let’s dig in a little bit, so you can use your lab work data as a guide for making decisions to better your health. 

What Is Cholesterol? 

Before getting into the nitty gritty of numbers, let’s look at what cholesterol is and why we need it. Cholesterol is in fact very important to the human body. Cholesterol is found in every single cell membrane in our bodies and it provides structure and rigidity to the cells. It also acts like a gatekeeper by letting certain things into the cells and keeping other things out. It also plays a major role in the production of our sex hormones: estrogen, progesterone and testosterone. In addition, cholesterol assists in making bile, which is needed to properly digest the healthy fats we eat, and plays a role in the production of vitamin D.

An important thing to note is that there are two kinds of cholesterol. Dietary cholesterol, which is in the foods we eat, and blood cholesterol, which helps with all of the important functions mentioned above. For today’s purpose of understanding lab work, I’ll focus on blood cholesterol.

The standard cholesterol panel your doctor orders doesn’t always tell you what you need to know about what’s actually happening in your body. A lot of times, when cholesterol creeps above 200 mg/dl, a doctor will want to talk about statin medications. It is important to look at the breakdown of the numbers underneath the total number to determine what is making up the total cholesterol.  

Getting To Know Your LDL Cholesterol 

LDL cholesterol can especially be frightening until you learn more about it because it is often labeled the “bad cholesterol”. LDL cholesterol is one of the main contributors to the development of coronary artery disease or plaque buildup in the arteries. What the standard test doesn’t tell you is the type of LDL you have floating in your bloodstream. Do you have more of the “fluffy” LDL that is not causing damage, or do you have more of the “dense” LDL that is sticking to artery walls and causing a hardening of the arteries? In order to determine this, you can ask your doctor for a NMR profile or a particle density lab test that will break your LDL down into these two categories and shed more light into what is going on internally. 

What if your “dense” or “sticky” LDL is elevated? Shifting your diet and what you eat on a daily basis can influence how much of this plaque-producing cholesterol you have in your bloodstream. Eating processed foods ( foods that come in a bag or box that are made in a factory), consuming damaged oils (vegetable oil, soybean oil, palm oil, etc.) at home or in restaurants, and eating too many starchy carbohydrates (even good carbohydrates like potatoes, rice, fruit, etc.) can cause more of this sticky LDL in your body. On the other hand, limiting your starchy carbohydrates to no more than a ½ cup at meals and snacks, as well as consuming healthy undamaged fats (coconut oil, avocado oil, olive oil, butter, avocado, nuts, etc.) can shift your LDL to the fluffy, non-damaging kind that we want in our bodies.

 4 Steps To Reduce Sticky LDL Cholesterol With Nutrition

1. Reduce intake of processed foods
2. Avoid highly processed and damaged fats
3. Focus on healthy, natural fats
4. Limit starchy, real food carbohydrates to ½ cup at meals and snacks

In addition to your diet, there can be other things playing a role in the formation of sticky LDL in the body. Do you have a lot of inflammation in your body? LDL will be produced and kicked out of the liver to act like patches or band-aids to cover the damage the inflammation is causing. Or do you have elevated homocysteine levels in your bloodstream? Homocysteine is an amino acid that comes from the breakdown of the proteins you are eating in your diet. When homocysteine is floating in the bloodstream, it can cause damage to the blood vessel linings. Again, LDL will be produced to counteract the high homocysteine levels. Maybe your thyroid isn’t working properly or you have an H. Pylori infection that you didn’t know about. Both of these would also increase LDL in the body in order to protect you.

If you have higher than normal markers for inflammation in your body, removing processed foods, taking a high quality Omega 3 supplement and addressing your gut health would be steps in the right direction. High homocysteine levels can be corrected by taking the activated or methylated forms of B6, folate and B12. Medications may be needed to kill an H. Pylori infection. The thyroid can oftentimes be supported by removing gluten, dairy and soy from the diet, ensuring that you are getting enough vitamin D, iodine, zinc and selenium, and potential medication may be needed. Working with a registered and licensed dietitian or nutritionist can help support you if you are experiencing any of these health concerns, which in turn supports your LDL cholesterol.

Need support with inflammation, gut health, thyroid support, and more? Schedule a 1:1 nutrition consultation with a nutritionist or dietitian!

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How’s Your HDL Cholesterol?  

Another important number to pay attention to from your lipid panel is your HDL cholesterol, commonly known as your “good” cholesterol. HDL cholesterol works to scavenge and clear the “bad” cholesterol from the blood stream. It does so by taking it back to the liver so it can be broken down and removed from the body. The higher your HDL, the better. Ideally for men, a lab value of greater than 50 mg/dl and for women greater than 60 mg/dl or higher is desired. There are ways you can influence your HDL and make it rise. Eating foods that are rich in omega 3 fatty acids, such as salmon, sardines or eggs, are helpful in raising your HDL numbers. Omega 3 supplementation is also important to take daily, as it can be difficult to get the required amount of omega 3s just through the diet. Exercise, especially aerobic exercise, is also beneficial in raising HDL numbers. Spending 20-30 minutes of walking, biking, swimming, etc. daily can help increase HDL cholesterol numbers. 

The Scoop On Triglycerides 

The last number you will see on a standard cholesterol panel is your triglyceride number. Triglycerides, just like LDL, can contribute to heart disease and stroke. Triglycerides can also cause fatty liver disease and be an underlying cause of certain medical conditions, such as diabetes, thyroid dysfunction, or kidney disease. The lower the number, the better for your health. The ideal goal is to have triglycerides lower than 75 mg/dl. Triglyceride numbers will reflect how much processed food you are eating and/or how much alcohol you are drinking. Eating whole foods, or foods that are minimally processed (think meat, eggs, vegetables, fruits, etc.) will decrease your triglyceride numbers. Abstaining from or decreasing alcohol can also reduce triglyceride numbers.  

Supporting Your Cholesterol Through Nutrition & Lifestyle 

Getting back numbers from your lipid panel that are outside the recommended ranges can be scary and we are here to help you. To recap, the first thing you can start with is eliminating processed foods and damaged fats while focusing on eating the whole, natural, healing foods like animal proteins, vegetables, and healthy, natural fats.

Next, grab your lab results and make an appointment for a nutrition consultation with a registered dietitian or nutritionist. We can help you find the cause of abnormal cholesterol numbers and fix the root cause of the problem for why your LDL might be elevated in the first place. There are medications that can help control cholesterol, but unfortunately, they come with a lot of side effects. Let’s work together with your health care professionals to make those changes to your nutrition, supplementation plan, and lifestyle to give you the best foot forward. 

For more information on cholesterol, check out these resources:

• Read: Saturated Fat, Cholesterol, and Heart Health
• Listen: What Do Your Cholesterol Numbers Mean?
• Listen: Managing Cholesterol – Ask a Nutritionist
• Inspire: Jim’s Story on lowering blood pressure and cholesterol

Resources:

https://www.heart.org/en/health-topics/cholesterol/about-cholesterol

https://my.clevelandclinic.org/health/articles/23922-what-is-cholesterol
https://chriskresser.com/what-causes-elevated-ldl-particle-number/