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Cholesterol and lifestyle

Description

Your body needs cholesterol to work well. But cholesterol levels that are too high can harm you.

In the US, blood cholesterol is most often measured in milligrams per deciliter (mg/dL). Extra cholesterol in your blood builds up inside the walls of your blood vessels. This buildup is called plaque, or atherosclerosis. Plaque reduces or stops blood flow. This can cause a:

Your Cholesterol Numbers

All men should have their blood cholesterol levels tested every 5 years, starting at age 35 years. All women should do the same, starting at age 45 years. Many adults should have their blood cholesterol levels tested at a younger age, possibly as early as age 20 years, if they have risk factors for heart disease. Children with risk factors for heart disease should also have their blood cholesterol levels checked. Some expert groups recommend cholesterol testing for all children ages 9 to 11 and again between ages 17 and 21. Have your cholesterol checked more often (probably every year) if you have:

A blood cholesterol test measures the level of total cholesterol. This includes HDL (good) cholesterol and LDL (bad) cholesterol.

Your LDL level is what health care providers watch most closely. You want it to be low. If it gets too high, you will need to treat it.

Treatment includes:

You may also need medicine to lower your cholesterol.

You want your HDL cholesterol to be high. Exercise can help raise it, but only a small amount.

Eating Right

It is important to eat a healthy diet, keep a healthy weight, and exercise, even if:

These healthy habits may help prevent future heart attacks and other health problems.

Eat foods that are low in fat. These include whole grains, fruits, and vegetables. Using low-fat toppings, sauces, and dressings will help.

Look at food labels. Avoid foods that are high in saturated fat. Eating too much of this type of fat can lead to heart disease.

Eat foods that are high in fiber. Good fibers to eat are oats, bran, split peas and lentils, beans (kidney, black, and navy beans), some cereals, and brown rice.

Learn how to shop for, and cook, foods that are healthy for your heart. Learn how to read food labels to choose healthy foods. Stay away from fast foods, where healthy choices can be hard to find.

Get plenty of exercise. And talk with your provider about what kinds of exercises are best for you.

References

American Diabetes Association Professional Practice Committee. 10. Cardiovascular disease and risk management: standards of care in diabetes-2024. Diabetes Care. 2024;47(Suppl 1):S179-S218. PMID: 38078592 pubmed.ncbi.nlm.nih.gov/38078592/.

Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA Guideline on the primary prevention of cardiovascular disease: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;74(10):1376-1414. PMID: 30894319 pubmed.ncbi.nlm.nih.gov/30894319/.

Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC Guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2960-2984. PMID: 24239922 pubmed.ncbi.nlm.nih.gov/24239922/.

Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;73(24):e285-e350. PMID: 30423393 pubmed.ncbi.nlm.nih.gov/30423393/.

Hensrud DD. Diet and nutrition. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 13.

Mozaffarian D. Nutrition and cardiovascular and metabolic diseases. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 29.

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Review Date: 8/5/2024

Reviewed By: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.