Key Takeaways
- LDL is considered “bad cholesterol” because it’s often associated with an increased risk of heart disease, and HDL is considered “good cholesterol” because it’s associated with a lower risk of heart disease.
- Despite what you may have heard, scientific research shows that the one of the best ways to reduce your risk of dying of a heart attack is to reduce your LDL cholesterol levels.
- The four best things you can do to lower your total and LDL cholesterol and increase your HDL cholesterol are: 1. Exercise. 2. Stop smoking. 3. Lose weight. 4. Eat a healthy diet.
Your cholesterol is higher than you want it to be.
Maybe it’s a little on the high end, maybe it’s flirting with “dangerous,” or maybe it’s off the charts.
The bottom line, though, is that it’s high enough that your doctor is worried.
They may have even said that if you can’t take your cholesterol in hand, and fast, they’re going to recommend you take a statin.
You decide to get a second opinion from Google, but after a few minutes of poking around the Internet, you’re more confused than ever.
Most people tell you the traditional advice: stop eating butter, cheese, bacon, eggs and anything else that’s high in saturated fat or cholesterol, and start eating a diet that’s high in “heart healthy” olive oil, whole grains, and seafood.
Some take this further and say that any cholesterol you eat is pushing you closer to a heart attack. The only way to keep your ticker humming along is to follow a zero cholesterol, plant-based or vegan diet.
Dig some more, and you’ll find the most surprising opinion of all.
Another group says that the whole cholesterol hullabaloo is a myth. High cholesterol isn’t bad for you, there’s no such thing as “bad” cholesterol, and trying to lower cholesterol by avoiding certain foods or taking medications does more harm than good.
Some take this even further and say that statins are just an excuse for doctors to line their pockets and enrich “Big Pharma.”
Instead, they blame heart attacks on poor food choices, lack of activity, smoking, and genetics. The solution, they claim, is to cut out foods like gluten, sugar, and dairy, and take the right supplements, micronutrients, and herbs to keep your heart healthy.
Who’s right?
Well, here’s the long story short: If you have high cholesterol, one of the best ways to reduce your risk of heart disease is to lower it. Losing weight is one of the most effective ways to reduce your cholesterol levels, although your activity levels, lifestyle, and other choices will make a difference, too.
By the end of this article you’re going to know . . .
- What cholesterol is
- What the difference is between “good” and “bad” cholesterol
- How cholesterol affects your risk of heart disease
- When and why to lower your cholesterol
- Whether or not you should follow a low cholesterol diet
- Whether you should avoid high cholesterol foods
- How to lower your cholesterol quickly, safely, and naturally
. . . and more.
Let’s get started.
What Is Cholesterol?
Cholesterol is a pale, waxy compound called a sterol, which is a kind of modified steroid that’s chemically similar to fat. It’s present in all cells of the body, and it’s used to make hormones, vitamin D, and chemicals that help you digest your food.
Here’s what pure cholesterol looks like:
Cholesterol is often confused with triglycerides, which are another kind of fat that can be in liquid (unsaturated) or solid (saturated) forms. Triglycerides help you absorb vitamins, create various hormones, keep your skin and hair healthy, provide energy for cells, and much more.
Cholesterol and triglycerides aren’t harmful in and of themselves. The reason they’re considered problematic when it comes to heart health has to do with how they’re transported around the body.
Since they’re both fats, cholesterol and triglycerides aren’t water soluble.
This means they can’t float through the blood on their own (which is mostly water), and they need to be combined with other molecules to make their way around the body.
Hence, the body combines cholesterol and triglycerides with protein to form lipoproteins. These molecules act like taxis, ferrying fat and cholesterol to and from cells.
Thus, when people say “cholesterol,” what they’re really referring to are lipoproteins which contain a combination of cholesterol and triglycerides.
Let’s take a closer look at how these lipoproteins affect your body.
The 5 Kinds of Cholesterol
There are five main kinds of cholesterol-containing lipoproteins in the body:
- Low-density lipoproteins (LDL)
- High-density lipoproteins (HDL)
- Very low-density lipoprotein (VLDL)
- Intermediate-density lipoprotein (IDL)
- Chylomicrons
The reason most of these lipoproteins are named according to their density is because it’s a good indication of what they’re made of.
Higher density lipoproteins tend to contain more protein than cholesterol and triglycerides, and lower density lipoproteins tend to contain more cholesterol and triglycerides and less protein.
Let’s take a closer look at each of these molecules.
1. Low-density lipoproteins (LDL)
Low-density lipoproteins have a greater proportion of fat versus protein, which makes them less dense (fat is lighter and more buoyant than protein). LDL’s main function is to transport cholesterol to cells throughout the body.
When people talk of “bad” cholesterol, they’re referring to LDL.
High levels of LDL in your blood are associated with heart disease, which is why most discussions on cholesterol circle back to lowering LDL levels.
As you’ll learn in a moment, though, there’s more to the story.
2. High-density lipoproteins (HDL)
High-density lipoproteins have a greater proportion of protein versus fat, which makes them more dense. HDL’s main job is to remove cholesterol from the body and transport it to cells that need cholesterol and to the liver for removal.
HDL is often referred to as “good” cholesterol.
High levels of HDL aren’t associated with heart disease the way LDL is, and higher levels of HDL are generally considered protective against heart disease.
This isn’t entirely accurate, either, but we’ll talk more about that in a moment.
3. Very low-density lipoprotein (VLDL)
Very low-density lipoproteins have a greater proportion of triglycerides than cholesterol, which makes them less dense than other kinds of cholesterol. VLDL’s main job is to transport triglycerides from the liver to fat cells for storage or energy.
After delivering triglycerides to fat cells, VLDL turns into LDL cholesterol. VLDL is generally considered another form of “bad” cholesterol, but LDL is a better predictor of heart disease risk, so VLDL isn’t generally measured.
4. Intermediate density lipoprotein (IDL)
Intermediate density lipoproteins have a similar proportion of triglycerides and cholesterol as LDL. The difference is that they’re slightly less dense than LDL but more dense than VLDL.
IDL’s main job is to transport triglycerides from the liver to fat cells for storage and energy.
IDL is also considered a kind of “bad” cholesterol, as it’s associated with a higher risk of heart disease. LDL is a better predictor of heart disease risk, so IDL isn’t generally measured.
5. Chylomicrons
Chylomicrons are composed almost entirely of triglycerides with only a small amount of cholesterol and protein. They’re also known as ultra low-density lipoproteins. Chylomicrons’ main job is to transport dietary fats from the intestines to other cells in the body.
Chylomicrons aren’t a major predictor of heart disease, and the amount in your body mostly depends on the size and composition of your meals.
What Is a Healthy Cholesterol Level?
When you get a cholesterol test from a doctor, you’ll generally get four measurements:
- Your total cholesterol (an estimate of your LDL, HDL, and triglycerides)
- Your LDL cholesterol
- Your HDL cholesterol
- Your triglycerides
Sometimes, your doctor may also look at your non-HDL cholesterol, which includes LDL, VLDL, and IDL. The main ones to pay attention to, though, are your LDL, HDL, total cholesterol, and triglycerides.
Try to decipher what a healthy level is for these tests by browsing the Internet, and you’ll look like this after five minutes:
That’s because all of these numbers are based on massive, complex studies and statistical calculations that can vary based on a long list of factors, including your . . .
- Age
- Sex
- History of heart disease
- Weight and body composition
- History of smoking
- Current medication regimen
And more . . .
For example, if you’re a young, nonsmoking, woman with no history of heart disease and a healthy body composition, then a “healthy” LDL level for you could be very different than it is for an old, overweight, man who’s been smoking since the Flintstones came out.
What’s more, scientists are always updating these ranges based on the latest evidence.
To sift through all of this and figure out what your levels should be you need to talk with a doctor.
That said, you can get a general idea of your heart health by looking at the accepted ranges that have been hashed out over the years.
These are the generally agreed upon values from The Mayo Clinic, The National Heart, Lung, and Blood Institute, The National Institutes of Health, and most scientific journals.
One more thing you should know is that these numbers are an estimate of your risk, not direct measurements of how healthy your heart and blood vessels are. It’s possible to develop heart disease while having low total cholesterol, and it’s possible to have no heart disease with high cholesterol levels.
That’s why it’s generally more accurate to think of these ranges as low-, medium-, and high- risk, instead of “healthy” or “unhealthy.”
Finally, you can’t look at any of these numbers in isolation. For example, having a high HDL cholesterol would generally mean you have a lower risk of heart disease, but if you also have high LDL, you could still have a high risk overall.
With that out of the way, let’s look at the numbers.
What’s a Good Total Cholesterol Level?
The following chart shows what a good total cholesterol level is for most people.
These measurements are shown in milligrams per deciliter of blood, or mg/dL (U.S), and in millimoles per liter, or mmol/L (Canada/Europe).
| Classification | Total Cholesterol (mg/dL) | Total Cholesterol (mmol/L) |
| Low Risk | < 200 | < 5.2 |
| Medium Risk | 200 to 239 | 5.2 to 6.2 |
| High Risk | > 240 | > 6.2 |
What’s a Good LDL Cholesterol Level?
The following chart shows what a good LDL cholesterol level is for most people based on their current health and history of heart disease.
These measurements are shown in milligrams per deciliter of blood, or mg/dL (U.S), and in millimoles per liter, or mmol/L (Canada/Europe).
| Classification | LDL Cholesterol (mg/dL) | LDL Cholesterol (mmol/L) |
| Low risk for people who have heart disease and/or diabetes | < 70 | < 1.8 |
| Low risk for people at risk of heart disease | < 100 | < 2.6 |
| Low risk for people without heart disease. High risk for people with heart disease. | 100 to 129 | 2.6 to 3.3 |
| Medium risk for people without heart disease. High risk for people with heart disease. | 130 to 159 | 3.4 to 4.1 |
| High risk for people without heart disease. Very high risk for people with heart disease. | 160 to 189 | 4.1 to 4.9 |
| Very high risk for people with and without heart disease. | > 190 | > 4.9 |
What’s a Good HDL Cholesterol Level?
The following chart shows what a good HDL cholesterol level is for most people.
These measurements are shown in milligrams per deciliter of blood, or mg/dL (U.S), and in millimoles per liter, or mmol/L (Canada/Europe).
| Classification | HDL Cholesterol (mg/dL) | HDL Cholesterol (mmol/L) |
| Low Risk | > 60 | > 1.5 |
| Medium Risk | 40 to 59 | 1 to 1.5 |
| High Risk | < 40 | < 1 |
What’s a Good Triglyceride Level?
The following chart shows what a good triglyceride level is for most people.
These measurements are shown in milligrams per deciliter of blood, or mg/dL (U.S), and in millimoles per liter, or mmol/L (Canada/Europe).
| Classification | Triglycerides (mg/dL) | Triglycerides (mmol/L) |
| Low Risk | < 150 | < 1.7 |
| Medium Risk | 150 to 199 | 1.7 to 2.2 |
| High Risk | 200 to 499 | 2.3 to 5.6 |
| Very High Risk | > 500 | > 5.6 |
Does High Cholesterol Cause Heart Disease?
The traditional story of how cholesterol causes heart disease goes like this:
- Cholesterol sticks to the walls of your blood vessels like gunk in a pipe.
- As cholesterol levels rise (and LDL in particular), more and more of it sticks to your blood vessels.
- Over time, this buildup of cholesterol forms deposits known as plaque (a process known as atherosclerosis).
- As this plaque grows, it begins to block your blood vessels.
- When one of these plaques breaks loose, it travels through the bloodstream until it gets stuck, blocking blood flow and causing a heart attack or stroke.
- Thus, if you want to avoid having a heart attack or stroke, you should keep your cholesterol levels low.
Additionally, it’s said that eating cholesterol-rich foods, like saturated fat, raises cholesterol levels and your risk of heart disease. If you cut back or eliminate your intake of these foods, then you can reduce your risk of heart disease.
Together, these ideas are referred to as the “lipid hypothesis” or the “diet-heart hypothesis,” and for years they were seen as holy writ by doctors, health gurus, and diet book authors.
This idea has come under attack in recent years, though.
Some say that cholesterol doesn’t cause heart disease, that LDL cholesterol isn’t bad for you, and that trying to reduce cholesterol is often a fool’s errand.
Who’s right?
To answer that question, let’s look at one of the largest studies ever conducted on diet and heart health.
Researchers at The National Heart, Lung, and Blood Institute collected data from over 5,000 men and women for over five decades. Sure enough, they found that total cholesterol was strongly associated with heart disease in men and women.
That is, the people who had the highest cholesterol levels over time also had the most signs of heart disease.
The other two main risk factors were high blood pressure and being overweight.
Now, just because high levels of total and LDL cholesterol are associated with heart disease doesn’t mean they cause it. We need other studies to prove that.
Luckily, those studies have been done and they show the same thing.
Researchers from McMaster University looked at 108 randomized controlled trials involving almost 300,000 people. They found that for every 10% reduction in LDL cholesterol, there was a 10% reduction in the risk of coronary heart disease events (heart attacks of one form or another).
This wasn’t some statistical legerdemain cooked up by Big Pharma, either. These results have been confirmed time and time again by multiple independent scientists.
If you want to reduce your risk of heart disease, you should try to get your total and LDL cholesterol into a healthy range.
That doesn’t stop the naysayers from disagreeing, though.
They point to countries like Finland, who have higher than average levels of cholesterol and a relatively low risk of heart disease.
They also bring up other studies which show that high cholesterol isn’t associated with heart disease, and others that show people with higher cholesterol levels have a lower risk of death from all causes (including heart disease).
Some say that it’s not high LDL that’s the problem, but low HDL levels. In other words, the problem isn’t that you have too much bad cholesterol in your blood, it’s that you don’t have enough good cholesterol.
And all of this is more or less smoke and mirrors.
In the case of Finland, it’s likely that other factors are helping these people live longer despite their higher cholesterol levels (like lower rates of obesity and improved medical care).
Second, the handful of studies that’ve shown cholesterol isn’t associated with heart disease don’t hold a candle to the many, many studies that show it is a factor.
Finally, the idea that HDL is more important than LDL is on shaky ground. The latest research shows that HDL isn’t necessarily protective against heart disease, but is probably just a marker for things that are.
As Dr. Christopher Cannon, professor of medicine at Harvard Medical School puts it:
“We’re now realizing that HDL appears to be a marker for other factors that raise or lower the risk of a heart attack . . .”
In other words, doing things that raise HDL, like exercising, losing weight, and quitting smoking are what’s really improving your heart health—not the HDL itself.
The bottom line is that the vast majority of high-quality, controlled studies on men and women, old and young, and people with and without heart disease show that total and LDL cholesterol are reliable markers for your risk of heart disease. If you want to reduce your risk of heart disease, then, you should get your total and LDL cholesterol into a healthy range.
Does Eating Cholesterol Increase Your Bad Cholesterol?
Several decades ago, it was believed that foods high in cholesterol like eggs, butter, and meat, increased the risk of heart disease.
We now know it’s not that simple.
For instance, eggs have been exonerated, and research shows that while eating processed meat is associated with a higher incidence of heart disease, eating red meat per se isn’t.
Another wrinkle in this idea is the fact that people who eat more dietary fat (a major source of cholesterol) often have a lower risk of heart disease than people who eat more carbs.
It would be premature to say that dietary cholesterol is completely innocent, but most experts agree that it doesn’t affect your LDL or total cholesterol levels enough to matter.
On the other hand, many foods high in cholesterol also contain high amounts of saturated fat, which can increase the risk of heart disease.
The jury is still out on how dangerous saturated fat really is, but as long as you keep it below about 10% of your total calorie intake, you shouldn’t be worried.
For example, if you eat 2,500 calories per day, your daily upper limit on saturated fat would be ~28 grams.
To reach that level, you’d have to eat five ounces of cheddar cheese, 20 strips of bacon, or three large fully-loaded cheeseburgers.
So, unless you get most of your calories from junk food, or are going out of your way to consume massive amounts of saturated fat (like cooking all of your meals in coconut oil), then eating saturated fat and cholesterol isn’t a major concern.
How to Lower Your Bad Cholesterol
For all of the complexities surrounding the science of cholesterol and heart health, we know that lowering LDL is generally your best bet. You also want to lower your total cholesterol levels, but most of that should come from a reduction in LDL cholesterol in particular.
Luckily, the steps that move the needle the most are simple. They are:
- Exercise
- Stop smoking
- Lose weight
- Eat a healthier diet
Let’s look at each one.
Step 1 to Lower Bad Cholesterol
Exercise
Exercise is the easiest, simplest, and fastest way to lower your total and LDL cholesterol.
Not only that, but higher levels of exercise are associated with a lower risk of death from all causes (including heart disease). Up to a point, the more you do, the lower your risk.
Either cardio or weightlifting just 30 minutes 5 times per week can cause a significant drop in total cholesterol. If you want to see larger drops in LDL cholesterol specifically, then you need to focus on high-intensity exercise (like strength training).
If you want to learn how to put together a workout routine that will help you lower your cholesterol, check out this article:
Step 2 to Lower Bad Cholesterol
Stop Smoking
Not to beat a dead horse, but here’s the truth:
Smoking increases your risk of dying from all causes by 300%.
It does this partly through increasing the risk of cancer and lung disease, but also by increasing the risk of heart disease.
Smoking increases LDL cholesterol, triglycerides, and total cholesterol, and reduces HDL cholesterol. There’s also evidence that smoking may modify LDL cholesterol into a form that’s more likely to cause heart disease.
It’s not exactly clear how much quitting smoking can lower your total or LDL cholesterol levels, but the bottom line is that it will drastically cut your risk of heart disease, and this is probably due in part to its effect on your cholesterol levels.
Step 3 to Lower Bad Cholesterol
Lose Weight
One of the main causes of high cholesterol and triglycerides is excess body fat.
Although not everyone who is overweight or obese has high LDL or total cholesterol, losing weight generally improves these numbers. The more weight people lose, the more their cholesterol, LDL cholesterol, and triglycerides drop.
The good news is that it doesn’t take much weight loss to move things in the right direction. Just losing a few pounds is enough to make a significant dent in your LDL cholesterol.
And as a cherry on top, weight loss will also likely raise your HDL cholesterol, too.
If you’d like to learn how to lose weight quickly and safely without losing muscle or fighting hunger and cravings the whole time, then check out this article:
Step 4 to Lower Bad Cholesterol
Eat a Healthier Diet
The best diet for lowering LDL cholesterol is still being debated, but here’s what we can say:
- You want to eat enough calories to reach and maintain a healthy weight. (In other words, energy balance matters most).
- Eat a high-protein diet. Protein won’t directly reduce LDL cholesterol, but it can help improve your body composition, which will help over time.
- You want to get most of your fats from monounsaturated sources, limit your intake of polyunsaturated fats, and limit your saturated fat intake to less than 10% of your total calories.
- Eat as little trans fat as possible.
- Eat at least 4 to 6 servings of fruits and vegetables per day (the more, the better).
- Eat at least 30 to 45 grams of fiber per day from fruits, vegetables, whole grains, nuts, seeds, and beans.
- Keep your sugar and junk food consumption under control. A little every now and then is fine; a lot all of the time is not.
If you want to learn how to eat a healthy diet that helps you check all of those boxes, while eating foods you love, then you want to read this article:
The Bottom Line on Cholesterol
Despite what you may have heard, keeping your LDL and total cholesterol levels in check is one of the single best things you can do to take care of your heart.
Figuring out what your cholesterol levels should be, and how to get there, though, can be confusing. That’s why you should work with a doctor to decide on a plan of attack.
Chances are good that they’re going to recommend you follow these four steps:
- Exercise
- Stop smoking
- Lose weight
- Eat a healthier diet
Do that, and you should be able to move your cholesterol levels in the right direction.
What’s your take on lowering your cholesterol? Have anything else to share? Let me know in the comments below!
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