High Cholesterol Prevention and Management

Need to Reduce Your High-Cholesterol? Orange County Looks to Hoag for Cardiovascular Risk Reduction.

From Long Beach to San Clemente, Brea to Mission Viejo, residents of communities across Orange County turn to Hoag’s Jeffrey M. Carlton Heart & Vascular Institute for the most patient-focused preventative care and to help reduce their risk factors for heart disease.

That includes our commitment to those with high cholesterol, and the many serious conditions that can result from this often-silent issue. From monitored exercise and dietary programs that help patients lower cholesterol and drop pounds, to the latest and most advanced therapies, Hoag is dedicated to helping every person in Orange County live a heart-healthy life.

Read on for what you need to know about cholesterol from Hoag, including key terms, types, causes and more. 

What is Cholesterol?

Cholesterol is a waxy, fat-like substance that’s found in all the cells in your body. It’s essential for many important functions, including building cell membranes, producing Vitamin D, helping digest food and making hormones including testosterone and cortisol.

Even if you don’t eat any cholesterol from outside sources, a properly-functioning liver can make all the cholesterol the body needs to stay healthy. However, you can also get cholesterol by eating meat and other foods that come from animals, including eggs and dairy products like milk or butter.

While having cholesterol in the blood is normal, having high levels of LDL cholesterol — what’s commonly referred to as high cholesterol — can be harmful to your health. For some people, eating a diet with too many LDL cholesterol-rich foods can result in a condition called atherosclerosis, in which a sticky substance called plaque builds up in the circulatory system, creating fatty deposits on the walls of the arteries.

Due to the risk of atherosclerosis, having unhealthy LDL cholesterol levels can increase your risk for several different types of heart disease, including coronary artery disease, renal artery disease, stroke and other health issues.

What are the Different Types of Cholesterol?

There are several different types of cholesterol, but the two types you’ll likely hear most about are LDL cholesterol and HDL cholesterol.

Low-density lipoprotein (LDL) cholesterol: High levels of LDL cholesterol in the blood can contribute to the buildup of plaque in the arteries, increasing the risk of heart disease and stroke. That’s why LDL is considered the “bad” type of cholesterol. Foods that are high in LDL cholesterol include:

• Red meats like beef, pork or lamb
• Processed meats like hot dogs, pepperoni, salami or bologna
• Full-fat dairy products like whole milk, ice cream, butter and cheese
• Fried foods cooked in grease, like fried chicken, french fries and doughnuts
• Baked goods and sweets

High-density lipoprotein (HDL) cholesterol: HDL cholesterol is considered “good” cholesterol, because it helps remove LDL cholesterol from the blood and transport it back to the liver so it can be expelled from the body. High levels of HDL cholesterol in the blood are associated with a lower risk of heart disease.

Unlike LDL cholesterol, which you can get by eating certain animal products, HDL cholesterol is primarily produced by the liver. As such, there are no “high HDL” foods you can eat. However, there are certain foods you can eat that promote the body’s natural production of HDL. These foods include:

• Fatty fish like salmon, tuna, sardines, herring and mackerel, which are rich in an HDL-promoting substance called omega-3 fatty acids
• Avocados
• Certain nuts and seeds, including almonds, walnuts, chia and flax seed
• Olive oil
• Certain soy products like tofu and tempeh, which contain compounds called isoflavones that may boost HDL

Other types of cholesterol include:

• Very-low-density lipoprotein (VLDL): VLDL is also considered a “bad” type of cholesterol because it helps transport a type of blood fat called triglycerides throughout the body. High VLDL levels can also contribute to plaque buildup in arteries.
• Chylomicrons: Also called ultra low-density lipoproteins (ULDL), chylomicrons are tiny particles made up mostly of triglycerides. Produced in the small intestine after you eat, chylomicrons transport fat from the intestines to other parts of the body, where it can be used for energy or stored as body fat.

What are Saturated Fats, Unsaturated Fats and Trans Fats?

There are three types of fats in the foods we eat: saturated fats, unsaturated fats and trans fats. Saturated fats and trans fats can contribute to high cholesterol, so they should be limited in your diet.

• Saturated fats are usually solid at room temperature and most commonly consumed in the U.S. from animal products. Saturated fats should be eaten in moderation. Examples of foods high in saturated fats include meat, eggs, dairy products like cheese, butter and whole milk and “tropical oils” like coconut oil and palm oil.
• Unsaturated fats are usually liquid at room temperature. Generally considered better for a heart healthy diet, there are two types of unsaturated fats, including:
  • Monounsaturated fats such as avocados, nuts, seeds and healthier oils like canola oil and extra virgin olive oil..
  • Polyunsaturated fats include Omega-3 fatty acids (found in oily fish like salmon, mackerel and tuna, as well as in flaxseeds, chia seeds and walnuts) and Omega-6 fatty acids (found in vegetable oils like sunflower oil or corn oil, as well as certain seeds and nuts).
• Trans fats, also called trans-unsaturated fatty acids, are considered the most unhealthy type of fat you can eat. While trans fats occur naturally in some animal products like meat and dairy, the biggest threat to health comes from artificial trans fats. Created through a process that adds hydrogen to liquid vegetable oils to make them solid and less likely to spoil without refrigeration, artificial trans-fats increase LDL (“bad”) cholesterol and decrease HDL (“good”) cholesterol. Foods that may be high in trans fat include store-bought baked goods like cookies, cakes or crackers, fried foods like French fries, donuts or chicken nuggets and processed foods like frozen pizza.

What Causes High Cholesterol?

High cholesterol is usually caused by eating a diet high in saturated fats and/or trans fats, which can cause the liver to produce too much cholesterol. Other factors that can cause or contribute to high cholesterol include:

• Genetic predisposition, as having high cholesterol can run in families. For example, familial hypercholesterolemia (FH) is an inherited condition that can cause a person to have very high levels of “bad” LDL cholesterol from the time they’re born.
• Leading a sedentary lifestyle with little physical activity
• Obesity
• Smoking tobacco
• Drinking too much alcohol

How Are Cholesterol Levels Measured?

Cholesterol tests require the drawing of a small amount of blood so the sample can be examined in a lab. Once the sample reaches the laboratory, cholesterol levels are usually measured through a special blood test called a lipid panel (or lipoprotein panel), which provides your health care team with detailed information about the different types and amounts of cholesterol and fats in your blood.

How Often Should Cholesterol Be Checked?

How often you should have your cholesterol checked depends on whether you have major risk factors for high cholesterol, including being overweight, not getting enough exercise, eating a diet that’s high in carbohydrates and fats, a family history of high cholesterol or cardiovascular disease and other issues.

According to information published by the National Institutes of Health, healthy children with no major risk factors for high cholesterol should start getting screened between the ages of nine to 11, with testing repeated every five years. Children with a family history of high cholesterol, stroke or heart attack may begin cholesterol screening as early as two years old.

Adults between the age of 20 to 65 should be screened at least every five years. It’s recommended that men between the age of 45-65 and women between 55-65 be screened for high cholesterol every one to two years.

Anyone older than 65 should undergo high cholesterol screening annually

How Would I Know That I Need My Cholesterol Checked?

Early detection of high cholesterol can help keep the issue under control, allowing it to be treated before it can begin to cause harm to blood vessels, organs and tissues.

High cholesterol is often the result of lifestyle choices, including eating a diet that’s high in carbohydrates, saturated fats and trans fats, not getting enough exercise or gaining fat in the belly. If you have any major risk factors for high cholesterol (there’s a more exhaustive list of risk factors below), consider having your cholesterol checked every year or two, even if you’re younger.

Having certain medical conditions can also raise your risk for high cholesterol, including polycystic ovarian syndrome, kidney disease, liver disease and hypothyroidism, a condition characterized by having an under-active thyroid gland.

If you have one of these conditions, be sure to get your cholesterol checked at least every few years. Those with a family history of high cholesterol and cardiovascular issues like stroke or heart attack are also at increased risk for high cholesterol, and should have their cholesterol levels checked more often as well.

Can High Cholesterol Cause Any Serious Medical Issues?

Having high LDL cholesterol levels puts a person at greater risk of a condition called atherosclerosis, in which a waxy substance called plaque begins to build up on the inner walls of arteries.

Over time, unhealthy cholesterol levels in the blood can cause arteries all over the body to become clogged or narrowed. That can reduce or block the supply of oxygenated blood to tissues and organs, which can put a person at increased risk for a range of serious and even life-threatening types of cardiovascular disease, including:

• Coronary heart disease
• Renal artery disease
• Carotid artery disease
• High blood pressure (hypertension)
• Recurring chest pain
• Heart attack (myocardial infarction)
• Heart failure
• Stroke
• Peripheral artery disease (PAD)
• Aortic aneurysm

How is High Cholesterol Treated?

High cholesterol is usually treated in two ways:

• Reducing harmful lifestyle factors like obesity, a diet high in saturated fat and trans fat, lack of cardiovascular exercise and more
• Taking certain cholesterol-lowering medications. These may include:
  • Statins: The most widely-used cholesterol-lowering drugs, statins work by blocking production of cholesterol in the liver.
  • Bile acid sequestrants: Bile is an important digestive fluid created by the liver, and is largely made up of cholesterol. Bile acid sequestrants prevent bile acids used to digest food in the stomach from being reabsorbed by the intestines. That allows the bile, along with the excess cholesterol the bile contains, to be excreted in the stool.
  • PCSK9 inhibitors: Usually delivered by injection, PCSK9 inhibitors are a newer type of drug that can lower your cholesterol by targeting a protein that increases LDL cholesterol levels.

What are the Risk Factors for High Cholesterol?

There are a number of factors that can put a person at greater risk to develop high cholesterol. These factors include:

• Eating a diet largely made up of foods high in saturated and trans fats, including red meat, partially-hydrogenated vegetable oils, fried foods, processed foods and full-fat dairy products
• Genetics, as high cholesterol can run in families
• Being obese or having a high body mass index reading
• Not getting enough regular exercise
• Having a lot of belly fat (also called visceral fat or abdominal fat)
• Drinking too much alcohol
• Not eating enough soluble fiber
• Having certain medical conditions, including an under-active thyroid (hypothyroidism), kidney disease, liver disease, polycystic ovarian syndrome (PCOS) and others.

Is There Any Way to Reduce My Risk for High Cholesterol?

Some people with high cholesterol have the condition due to inheriting the issue from a parent. Given that, there is no definitive way to prevent a person from developing high cholesterol.

However, there are certain healthy lifestyle changes you can make to reduce your risk of developing the condition or lower your LDL cholesterol levels if they are high.

These lifestyle changes may include:

• Get plenty of cardiovascular exercise and physical activity, which can increase blood flow, reduce levels of bad cholesterol (LDL) and increase levels of good cholesterol (HDL)
• Eat a heart-healthy diet that low in saturated fat and trans fats, includes healthy vegetable oil like canola or olive oil, and plenty of fruits, nuts, leafy greens and whole grains
• Don’t smoke tobacco
• Get regular checkups from a physician, including having your cholesterol, blood pressure and other readings measured at least once a year
• Maintain a healthy weight
• Start reading food labels, paying close attention to the amount of saturated fat or trans fat a food item you’re considering contains
• If you have health problems that can impact heart health or your body’s ability to regulate your blood cholesterol levels or increase your risk of heart disease, be sure to follow your doctor’s instructions exactly, including taking any prescribed medications

Looking to Lower Your Cholesterol in Orange County? Hoag Has You Covered.

At Hoag’s Jeffrey M. Carlton Heart and Vascular Institute, our health care team is always looking for the next big breakthrough in cardiovascular disease prevention and care. We believe in the old adage that an ounce of prevention is worth a pound of cure.

If you are concerned about your cholesterol levels, talk with your primary care provider about getting your cholesterol checked and your risk factors. If you’ve been told that you need help controlling your cholesterol, come see the experts in Orange County. Contact Hoag today through our online form or by calling 949-764-5871.