
Just saying the word “cholesterol” can make brows furrow and faces crease with worry. Given cholesterol’s connection to heart attacks and stroke, this waxy type of fat in your body carries a well-deserved bad reputation.
Nobody wants high cholesterol, also known as hyperlipidemia. But there’s a form of cholesterol that’s actually good for you, and you can use that to your advantage.
High-density lipoprotein (HDL) is one of two types of cholesterol you’ll find on lipid panel test results that screen for your risk of cardiovascular disease. The other is low-density lipoprotein (LDL).
“Think of HDL as the good, or helpful, cholesterol,” says cardiovascular medicine specialist Leslie Cho, MD of Cleveland Clinic, Ohio. LDL, meanwhile, is the “lousy and less desirable” cholesterol.
So, we want HDL high and LDL low. That’s easy enough to remember, but how high and how low, exactly?
To keep your system running at optimal levels, you want to keep your HDL high. Ideally, that’s 50 milligrams per deciliter of blood or higher. (The normal range is 40 to 59 mg per deciliter.) When HDL levels dip below 40 mg per deciliter, your risk of heart disease rises.
It’s also critical to keep your LDL low — ideally, under 100 — from an early age, given the accumulating damage caused by bad cholesterol. A study published in 2020 shows the increased risk that comes with long-term high levels.
“Although medications can increase HDL cholesterol, research has shown they do not necessarily alter your risk of heart disease. So, we often focus on suggesting lifestyle changes that can boost HDL levels and reduce your LDL,” says Dr. Cho.
The food you eat can help drive your cholesterol levels down, says Dr. Cho. Trademarks of a heart-healthy diet include ample amounts of fruits and vegetables, foods high in fiber, such as oats, whole grain cereals and legumes, and fish that are rich sources of omega-3 fatty acids.
Eating heart-healthy foods is important. So is ensuring that the not-so-healthy stuff only makes an occasional guest appearance on your plate. Animal fats and other saturated fats can send cholesterol levels soaring. That means it’s a good idea to limit your intake of fatty and processed meats, fatty dairy products like whole milk and butter, egg yolks, salt and fried fast food
The Mediterranean diet and DASH diet and are two eating plans noted for their heart-healthy approach to food.
Physical activity can also increase HDL levels, shares Dr. Cho.
Numerous studies show that moderate- to high-intensity exercise can boost your all-important HDL numbers. As an added bonus, working out also pushes your LDL numbers down.
Long term, you should be shooting for at least 150 minutes of moderate-intensity physical activity per week, or 75 minutes per week of vigorous-intensity activity. If that feels ambitious — or, frankly, impossible — start slow and build up the time and intensity gradually. Even a little bit of extra activity can make a big difference.
You’ve probably heard that carrying extra pounds tends to increase LDL levels and push down your HDL count. In many cases, that’s true, but the relationship between weight and heart health is complicated. Not all people with overweight or obesity have high cholesterol, and there are plenty of people with BMIs in the normal range who have hyperlipidemia.
Work with your provider to determine if your current weight is heart-healthy in light of your specific medical history. If weight loss is the right choice for you, there’s good news: It doesn’t take much to see a measurable difference in your cholesterol. In fact, the American Heart Association says that a weight loss of just 5% to 10% can improve both your HDL and your LDL numbers.
Cholesterol issues often go hand-in-hand with high blood sugar (Type 2 diabetes) and high blood pressure (hypertension). A healthy diet, regular exercise and weight management are all key to maintaining, or improving, your health.
High cholesterol often doesn’t announce itself. That’s why you should have it checked through a blood test (lipid panel) at least every four to six years, according to the U.S. Centers for Disease Control and Prevention (CDC). Testing should be more frequent if you or your biological relatives have a history of heart disease or diabetes.
It’s not just adults who should be tested either. The CDC also recommends that children have their cholesterol checked at least once between ages 9 and 11. The agency also recommends a test between ages 17 and 21.
Test results can open discussions with your doctor about unique risk enhancers such as family history, metabolic syndrome, preeclampsia, and inflammatory conditions such as rheumatoid arthritis.
“Improving your cholesterol begins by knowing there’s an issue,” says Dr. Cho. “Getting lipid panel test results can help guide you toward lifestyle adjustments and potential treatments that can improve good cholesterol and lower the bad.”