Heart and Vascular

What is cholesterol and why does it matter?

A dad is holding his daughter and they are happy and laughing.

02/03/2025

Cholesterol is frequently misunderstood. Essential for several vital functions, cholesterol has both beneficial and harmful aspects that can significantly impact overall well-being.

 

By Sunny Intwala, MD, MBA, Head of Preventive Cardiology at Nuvance Health 

 

You’ve spent years taking care of everyone else — your kids, your partner, your career. But what about your heart? Cholesterol is often painted as the enemy, but the truth is more complicated. Some types protect your health, while others put you at risk of serious medical conditions. Understanding the difference can be a game-changer for your health.

 

So, let’s clear up the confusion and talk about what cholesterol really means for you — and how you can take charge of your well-being for the years ahead.

 

What is cholesterol?

 

Cholesterol is a waxy, fat-like substance found in every cell of the body. It plays a critical role in producing hormones, vitamin D and bile acids that help digest fats. While the liver naturally produces cholesterol, it is also obtained from dietary sources such as meat, dairy products and eggs.

 

 

There are two main types of cholesterol LDL and HDL.

 

Low-Density Lipoprotein (LDL)

 

Often referred to as “bad cholesterol,” high levels of LDL can lead to plaque buildup in the arteries, increasing the risk of heart disease and stroke. Certain foods can increase or help lower LDL. Keep reading for healthy diet tips to keep your cholesterol in check.

 

Cholesterol is measured through a blood test called a lipid panel and measured in milligrams per deciliter (mg/dL). Generally, an LDL cholesterol of less than 100 mg/dL is ideal for adults.

 

High-Density Lipoprotein (HDL)

 

Your liver produces HDL. Known as “good cholesterol,” HDL helps remove LDL from the bloodstream, transporting it to the liver for elimination. HDL helps keep your arteries healthy, and, in turn, can protect against heart disease and stroke. Generally, HDL cholesterol higher than 60 mg/dL is good for adults.

 

 

What is total cholesterol?

 

Total cholesterol is the sum of your LDL, HDL and your triglyceride levels. Triglycerides are a type of fat. Generally, a total cholesterol of less than 200 mg/dL is good for adults.

 

Monitoring total cholesterol matters because elevated levels can increase the risk of cardiovascular diseases. However, it’s important to consider total cholesterol in the context of other risk factors, including blood pressure, smoking status and family history.

 

Why does cholesterol matter?

 

Maintaining healthy cholesterol levels is essential for cardiovascular health. High cholesterol itself often has no symptoms, but over time, it contributes to the narrowing and hardening of arteries (atherosclerosis), leading to serious conditions such as heart attacks and strokes. Regular cholesterol screenings help identify and manage potential risks early.

 

 

What are the top three ways to manage cholesterol?

 

  1. Diet: A heart-healthy diet rich in fruits, vegetables, whole grains and healthy fats can help manage cholesterol levels. Limiting saturated fats, trans fats and processed foods is crucial.

  2. Exercise: Engaging in regular physical activity can raise HDL (good cholesterol) levels while lowering LDL (bad cholesterol). 

  3. Medications: In some cases, lifestyle changes alone may not be enough, and cholesterol-lowering medications such as statins may be recommended by your healthcare provider.

 

 

What foods help lower cholesterol?

 

  • Fruits and vegetables: Apples, oranges, berries, leafy greens (e.g., spinach, kale), cruciferous vegetables (e.g., broccoli, Brussels sprouts)

 

  • Whole grains: Oats, barley, quinoa, whole-grain bread and pasta

 

  • Legumes and beans: Lentils, chickpeas, black beans, kidney beans

 

  • Healthy fats: Nuts (e.g., almonds, walnuts), seeds (e.g., chia, flaxseeds), avocados

 

  • Fish and omega-3 fatty acids: Salmon, mackerel, sardines, tuna

 

  • Plant-based proteins: Tofu, tempeh

 

  • Healthy oils: Olive oil, avocado oil, canola oil

 

  • Herbs and spices: Garlic, turmeric, ginger (anti-inflammatory properties)

 

  • Foods fortified with sterols and stanols: Some orange juices and yogurts (just watch out for added sugar!)

 

  • Green tea: Contains catechins, which may support healthy cholesterol levels

 

 

What foods increase bad cholesterol?

 

  • Trans fats: Found in deep-fried foods, packaged baked goods, margarine and shortening

 

  • Saturated fats: Present in fatty cuts of meat, processed meats (bacon, sausage) and full-fat dairy products

 

  • Highly processed foods: Chips, packaged snacks, instant noodles

 

  • Sugary foods and beverages: Soft drinks, candy, desserts with refined sugar

 

  • Refined carbohydrates: White bread, white rice, regular pasta

 

  • Excessive alcohol: Can lead to elevated triglycerides and poor heart health

 

What is the best lifestyle to manage cholesterol?

 

  • Eat plant-based foods as much as possible. Remember, moderation is key so you can still enjoy your favorite foods. 

 

  • Reduce red meat and processed meat consumption. In addition to managing your cholesterol, you can lower your risk of diabetes, certain cancers, like colorectal cancer and maintain a healthy weight by eating lean protein, such as chicken and fish, more often than red and processed meat, such as beef, pork and sausages.

 

 

  • Choose heart-healthy cooking methods such as grilling, steaming or baking.

 

  • Engage in at least 150 minutes of moderate exercise per week. Find an activity you look forward to, so it feels more fun rather than a chore to exercise, whether it’s dancing, walking groups or playing with your dog.

 

 

  • Prioritize prevention: See your primary care provider annually for wellness exam and routine blood work to monitor your cholesterol and understand your risk for high cholesterol and heart disease. If you have risk factors, like a strong family history, your primary care provider may recommend you see a cardiologist for further evaluation and support.

 

 

The bottom line: Cholesterol plays a crucial role in overall health, and an imbalance can significantly increase the risk of cardiovascular disease. Understanding your cholesterol levels and taking proactive steps through diet, exercise and medical guidance can help maintain heart health and overall well-being. Regular screenings and personalized preventive strategies are key to living a heart-healthy life.