A desirable level of LDL (“bad”) cholesterol is less than 100 mg/dL – the lower your LDL, the better in terms of heart disease risk. Levels between 139 and 150 mg/dL are borderline high and those between 160 to 189 mg/dL are considered high, while LDL levels above 190 mg/dL are classed as very high. According to the American Heart Association, the mean level of LDL cholesterol for American adults age 20 and older is 115.0 mg/dL.
Cholesterol is then returned to the liver by multiple routes. In the first route, cholesterol esters may be transferred from HDL to the apo B–containing lipoproteins, such as very–low-density lipoprotein (VLDL) or intermediate-density lipoprotein (IDL), by CETP. These lipoproteins undergo metabolism and subsequent uptake by the liver, primarily by a process mediated by the B,E receptor. In the second route, HDL particles may be taken up directly by the liver. In the third, free cholesterol may be taken up directly by the liver. Finally, HDL cholesterol esters may be selectively taken up via the scavenger receptor SR-B1.
Try to eat it two to four times a week. “Not only are the omega-3 fats in fish heart-healthy, but replacing red meat with fish will lower your cholesterol by reducing your exposure to saturated fats, which are abundant in red meat,” Samaan says. The catch? Some types, like shark, swordfish, and king mackerel, are high in mercury. That can increase your risk for heart disease. Instead, choose wild salmon, sardines, and bluefin tuna.
A cup of tea does more than soothe on a stressful day. Both green and black tea can help lower cholesterol levels. Green tea is prepared from unfermented leaves and black tea from fully fermented leaves of the same plant. Researchers believe that catechins, a type of antioxidant found in tea, are responsible for its cholesterol-lowering effect. The more fermented the tea leaves, the lower the catechin content and the higher the caffeine content.
What is the difference between HDL and LDL cholesterol? The body needs cholesterol, but too much bad cholesterol can be harmful and is a major risk factor for heart disease and stroke. In this article, learn about the difference between HDL and LDL — “good” and “bad” — cholesterol, as well as how they are measured. What steps can you take to lower LDL and increase HDL? Read now
Treatment of high cholesterol usually begins with lifestyle changes geared toward bringing levels down. These include losing weight if you’re overweight, and changing your diet to emphasize vegetables and fruits, fish, particularly cold water fish such as wild Alaskan salmon, mackerel, herring and black cod that provide heart healthy omega-3 fatty acids. If lifestyle changes don’t help or if you’re unable to make the changes your doctor recommends, cholesterol-lowering drugs may be prescribed. These include statins, which effectively lower LDL cholesterol; bile acid sequestrants that may be prescribed along with statins to lower LDL; nicotinic acid to lower LDL cholesterol and triglycerides and raise HDL; drugs called fibrates that may be prescribed to lower cholesterol and may raise HDL; and a drug called Ezetimibe to lower LDL by blocking the absorption of cholesterol in the intestine.
In humans, diets high in saturated fat and cholesterol raise HDL-cholesterol (HDL-C) levels. To explore the mechanism, we have devised a mouse model that mimics the human situation. In this model, HuAITg and control mice were studied on low fat (9% cal)-low cholesterol (57 mg/1,000 kcal) (chow) and high fat (41% cal)-high cholesterol (437 mg/1,000 kcal) (milk-fat based) diets. The mice responded to increased dietary fat by increasing both HDL-C and apo A-I levels, with a greater increase in HDL-C levels. This was compatible with an increase in HDL size observed by nondenaturing gradient gel electrophoresis. Turnover studies with doubly labeled HDL showed that dietary fat both increase the transport rate (TR) and decreased the fractional catabolic rate of HDL cholesterol ester (CE) and apo A-I, with the largest effect on HDL CE TR. The latter suggested that dietary fat increases reverse cholesterol transport through the HDL pathway, perhaps as an adaptation to the metabolic load of a high fat diet. The increase in apo A-I TR by dietary fat was confirmed by experiments showing increased apo A-I secretion from primary hepatocytes isolated from animals on the high fat diet. The increased apo A-I production was not associated with any increase in hepatic or intestinal apo A-I mRNA, suggesting that the mechanism of the dietary fat effect was posttranscriptional, involving either increased translatability of the apo A-I mRNA or less intracellular apo A-I degradation. The dietary fat-induced decrease in HDL CE and apo A-I fractional catabolic rate may have been caused by the increase in HDL particle size, as was suggested by our previous studies in humans. In summary, a mouse model has been developed and experiments performed to better understand the paradoxical HDL-raising effect of a high fat diet.

However, although low levels of HDL predict increased cardiovascular risk, particularly in healthy individuals with no history of cardiovascular events, the relationship between HDL and CHD risk is complex, with HDL-C and cardiovascular disease having a nonlinear relationship. For example, research found that HDL levels above approximately 60 mg/dL showed no further improvement in prognosis, and the EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk and IDEAL (Incremental Decrease in End Points through Aggressive Lipid Lowering) studies showed that very high levels of HDL may actually be associated with an increased risk of atherosclerotic disease. [5, 6, 2]
Why is one form of cholesterol considered good and another bad? There are actually as many as 18 kinds of cholesterol, but to save confusion, doctors divide them into two categories: LDL (bad) and HDL (good). Your liver manufactures most of your cholesterol, and small amounts of it go toward a variety of healthy purposes, including creating hormones that help turn food and exercise into muscle. Serving as cholesterol chauffeurs are fat/protein bunches called lipoproteins, and that’s where the fun begins: Low-density lipoproteins tend to deposit cholesterol on artery walls, where it builds up and eventually interferes with blood flow. But the high-density variety seems to take cholesterol back to the liver, where it can be eliminated from the body.
8. Foods fortified with sterols and stanols. Sterols and stanols extracted from plants gum up the body's ability to absorb cholesterol from food. Companies are adding them to foods ranging from margarine and granola bars to orange juice and chocolate. They're also available as supplements. Getting 2 grams of plant sterols or stanols a day can lower LDL cholesterol by about 10%.
Paying close attention to what you eat can help you reduce your risk of developing atherosclerosis. Atherosclerosis is the narrowing of arteries caused by plaque build-up inside the arteries. As the arteries narrow, blood can't flow properly through the arteries. Theis can lead to a heart attack or stroke. If the artery-clogging process has already begun, you may be able to slow it down by making changes in your lifestyle, including your diet.

Oatmeal is one of the best cholesterol-fighting foods because it is so high in beta-glucans, the soluble fibers that cause oats to bulk up in liquid when you make oatmeal. Soluble fiber lowers your LDL, or "bad," cholesterol by forming a sticky layer in the small intestine that blocks cholesterol from entering your bloodstream. Make oatmeal and skip the instant packs with lots of added sugar. (In a rush? See our picks for best instant oatmeals.) Add fruit to your oatmeal to naturally sweeten it and boost the soluble fiber content even more.
Resistance training is a form of physical activity that forces your muscles to contract, building up strength and endurance. Some research also shows that resistance training could have beneficial effects on heart health as well and may decrease total and LDL cholesterol. (31) Weight lifting and bodyweight exercises like squats or lunges are some examples of resistance training that you can add to your routine.
Beans and legumes of all kinds are known to be an asset to a heart-healthy diet pattern because they’re rich in a type of fiber—soluble fiber—which helps to block cholesterol from being absorbed through the intestines into the blood stream. By increasing your intake of beans, like chickpeas, you can decrease LDL levels, which results in a higher percentage of HDL cholesterol. You can blend chickpeas with garlic, tahini, and lemon juice to make the perfect homemade hummus, or mix them with peanut butter and dark chocolate to make a decadent, high protein, edible cookie dough! Blogger Chocolate Covered Kate has a great recipe.
But keep in mind that not all cholesterol is created equally. LDL cholesterol, also known as “bad cholesterol,” is the form that can build up on the artery walls and increase your risk of heart disease. HDL cholesterol, on the other hand, is often dubbed “good cholesterol” because it travels through the bloodstream, removing harmful cholesterol from the arteries to help enhance heart health.
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society
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