The ultimate truth about cholesterol you need to know

There are some things that happen in your body, that you have to understand in order to make the right nutrition choices. Cholesterol is one of them. We all heard once or twice of something called cholesterol, maybe in correlation with a visit at your GP.

What is cholesterol?

Cholesterol is a “waxy” substance produced by the liver, but it can also be found in some foods. It’s essential for life, since our bodies need it to make hormones, vitamin D and substances which help with a proper food digestion.

Basically, cholesterol travels through our blood systems in small 'packages' called lipoproteins.

What most people mean with “cholesterol” is actual “lipoprotein”. You have to understand that these are two different things. Together with other molecules like triglycerides, cholesterol is a part of lipoprotein.

Low Density Lipoprotein (LDL)

LDL is referred as the “bad” lipoproteins, because it deposits the cholesterol on the walls of the arteries. Having high levels of it can lead up to plaque buildup, clog your arteries and make them less flexible, which can result in heart diseases, atherosclerosis and strokes.

High Density Lipoprotein (HDL)

HDL (high-density lipoprotein) takes the cholesterol out of your blood from your arteries and brings it back to the liver, where it is broken down and flushed out of the body. Aiming for a healthy level of HDL may reduce the risk of heart attack and strokes.

Total cholesterol

Your total cholesterol is the measurement of the total amount of cholesterol in your blood. It is based on the levels of HDL, LDL and triglycerides. If you want to get a good blood test, make sure that it’s not just checking your total cholesterol, but also your LDL, HDL and triglyceride levels. Total cholesterol alone doesn’t tell you that much.

In fact, your total cholesterol can be high and it doesn't have to be a bad thing, because your HDL is high. Which is what you are actually aiming for.

What are triglycerides?

Triglycerides are the type of fats in your blood, that your body uses for energy. Having a high level of triglycerides in combination with low HDL levels or high LDL levels can increase your risk of heart diseases. Basically triglycerides are not a form of cholesterol, but they are a type of blood lipids that are often lumped together with cholesterol.

How do I feel when my LDL is too high?

If you are over the age of twenty, you should aim to get a blood test done every 5 years, especially when you have a family history of heart diseases, high blood pressure, diabetes or strokes.

You may ask yourself if you're already suffering from a bad LDL or a too low HDL level without even recognising it.

The problem is that there are no specific symptoms associated with an early build up of fatty plaques in the arteries. There has to be a significant blockage in the arteries to notice that something is wrong.

That's when people complain about chest pain, pain in the arms, nausea, sweating or shortness of breath. Therefore, for the majority of people the first sign may be a heart attack or stroke.

What exactly causes a high blood cholesterol?

Your lifestyle can increase your risk of developing high blood cholesterol, such as an unhealthy diet and eating a huge amount of saturated and trans fats. Those unhealthy life habits will raise LDL levels in your blood stream.

Furthermore, chemicals found in cigarettes, called acrolein stop HDL transporting cholesterol to the liver, leading to narrowing of the arteries, which can also cause atherosclerosis.

Suffering from diabetes or hypertension (high blood pressure) can raise your LDL, too. Drinking alcohol on a regular basis will also increase your LDL and even your triglyceride levels.

What can I do to improve my LDL and HDL ratio?

If you already got your blood tested and your LDL and triglycerides are too high, or your HDL is too low, you have to swap food containing saturated or trans fats for fruits, veggies and wholegrain cereals. Start to exercise regularly and stop smoking (I know you may not wanna hear that). Here are a few tips to keep your levels in check.

1. Increase your physical activity

Exercise can improve your cholesterol. And you don't have to go all-in. Even moderate activity can help raise your HDL.

Simply start by taking the stairs instead of the lift or take the bike to work can make the difference.

2. Quit smoking

Quit smoking and you won't only benefit from an improved HDL level. Smoking can raise your LDL and lower your HDL. Studies have shown, that people who stopped smoking saw their HDL rise 5% in one year.

3. Watch your alcohol intake

Yes, a glass of red wine per day may be cardio-protective, but anything more than that will increase your LDL. Alcohol stimulates the liver to produce more LDL, and the risk of inflammation increases too.

4. Increase your soluble fiber intake

Dietary fiber binds to cholesterol and lowers LDL by about 5%. Focus on foods like beans, legumes, fruits and vegetables. It is a cheap and easy method to improve your LDL, HDL and triglycerides levels.

5. Focus on omega-3 fatty acids

Choosing fish and veggies over red meat and french fries is the best you can do to improve your cholesterol levels. Also a good choice are chia seeds or flax seeds.

I know it can be hard to eat a healthy diet consistently, but you have to start somewhere. And you will feel better after a short time. Promise!

6. Consider Supplements

Eating fish is good for your heart. But if you don't like fish, you can try omega-3 supplements, such as fish oil capsules. No, they don't taste like fish, but they contain the healthy fats in a concentrated dosage.

7. Lose excess weight

Carrying a few extra pounds contributes to a higher LDL level. Start by checking your eating habits and daily routine. Remember, even small changes add up.

Eating when you're bored or frustrated won't help you with that. Take a walk instead. If you want to snack something, munch on carrots. Don't eat mindlessly.

What does healthy look like?

Here are the numbers to check if your blood test results are good:

LDL: the lower the better (measurements in miligrams per deciliter)

  • less than 100 mg/dl is optimal
  • 101–129 mg/dl: near optimal
  • 130–159 mg/dl: borderline high risk
  • 160–189 mg/dl: high risk
  • over 190 mg/dl: very high risk

HDL: the higher the better

  • less than 40mg/dl: a major risk factor for heart disease
  • 40–59 mg/dl: it’s okay, but you can do better
  • 60 mg/dl and higher: considered protective against heart disease


  • less than 150 mg/dl: normal
  • 150–199 mg/dl: mildly high
  • 200–499 mg/dl: high
  • 500 or higher: very high

If healthy lifestyle changes don't help you bettering your LDL, HDL and triglyceride levels, make sure to contact your GP. If your GP recommends medication, take it as prescribed, but continue your lifestyle changes. This will help you keep your medication dose low.

Medication only improves the symptoms, nutrition improves the cause!

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