Simple Steps to Improve Your Cholesterol

You’ve heard the word “cholesterol” a million times. It’s the villain in every health documentary, the reason your doctor gives you a stern look, and the excuse you use for skipping the extra cheese on family pizza night. But what even is it? Is it really the bad guy it’s made out to be, or is there more to the story about cholesterol levels and their impact on your health?

Let’s talk about it.

Cholesterol gets a bad rap, but your body actually needs this fat-like substance to function. The problem isn’t cholesterol itself, but having too much cholesterol. More specifically, the wrong kind building up in your blood vessels. 

High cholesterol is a sneaky issue because it doesn’t come with flashing warning signs. You can feel perfectly fine while your arteries are slowly getting clogged up, which can lead to serious health problems like heart disease, chest pain (called angina), or even a heart attack.

I'm not trying to scare you into a sad, tasteless diet, but it's important to know what's going on inside your body so you can make informed choices. This post will break down everything you need to know: what cholesterol is, the difference between "good" and "bad" types (hello, HDL and LDL cholesterol), what causes high cholesterol, the key cardiovascular risk factors, and (most importantly) what you can actually do to lower cholesterol.

Table of Contents

What Is Blood Cholesterol?

Let’s get into the weeds for a second. Cholesterol is a waxy, fat-like substance found in every single cell in your body. Your liver produces all the cholesterol you need to do important jobs: building cell membranes, making hormones (think estrogen and testosterone), producing vitamin D, and creating bile acids to help you digest fat.

So, if our bodies make all the cholesterol we need, where does the problem come from? 

The issue comes from dietary cholesterol and too much saturated fat in what you eat, which is usually in animal products like meat, full-fat dairy products, eggs, and even some seafood. 

If you have too much cholesterol and too many saturated and trans fats in your diet, alongside less-than-stellar lifestyle habits, you tip the balance, and that’s when you get those high cholesterol levels your doctor side-eyes on your labs.

For years, the National Heart, Lung, and Blood Institute and the rest of the health care world told us to avoid dietary cholesterol like the plague. 

Now that we know a little more, the advice is to limit saturated and trans fats as the main culprits for raising blood cholesterol levels and causing plaque buildup in your arteries. Still, too much dietary cholesterol doesn’t help, so a heart healthy lifestyle is about a lot more than skipping bacon once a week.

The Good, The Bad, and High Cholesterol Levels (Plus, Triglycerides)

When your health care professional orders that all-important blood test (a lipid profile), what are they even looking at? Here’s your cheat sheet for all the cholesterol travels happening in your bloodstream right now.

Low-Density Lipoprotein (LDL) Cholesterol

This is the notorious “bad cholesterol.” LDL cholesterol, which stands for low density lipoprotein, acts like Uber for cholesterol—only, when you have too much LDL, these cars start double-parking on your artery walls. 

LDL cholesterol picks up cholesterol from your liver and delivers it to tissues, but if there’s too much in the blood, it forms fatty deposits in your arteries.

The science-y term for this junk-in-the-artery-trunk is plaque buildup. This leads to narrowing, stiffening, and sometimes even complete blockage of your blood flow which increases your risk of heart attack or stroke. 

High LDL cholesterol levels are one of the key cardiovascular risk factors and a signal to get your eating habits, health conditions, and lifestyle habits under control. And if you've got a family history of high cholesterol or coronary heart disease, you need to pay even closer attention.

High-Density Lipoprotein (HDL) Cholesterol

On the other hand, high density lipoprotein (HDL cholesterol) is your “good cholesterol.” If LDL is the troublemaker, HDL cholesterol is the bouncer at the club, rounding up excessive cholesterol and dragging it back to your liver, where it can be broken down and ditched. 

Having higher HDL cholesterol actually means reduced risk for cardiovascular disease.

When you get your cholesterol checked, your health care team wants to see higher HDL cholesterol levels—more cleanup crew, less mess in your arteries. Low HDL would be another risk factor you want to address, sometimes by getting serious about your heart healthy lifestyle.

Here’s a simple and fun way I learned in school to remember the difference: L stands for "Lousy" (leaves plaque), while H stands for "Healthy" (helps prevent it)!

Triglycerides and Health Problems

Triglycerides are another kind of blood fat that tag along with your cholesterol. Eat too much saturated fat, sugar, or refined carbs, and you’ll see your triglyceride levels shoot up which is a dangerous combo with high blood cholesterol.

High triglycerides join forces with LDL to build plaque and increase your risk of cardiovascular disease and heart disease. These are often overlooked, but high levels worsen the risks.

Total Cholesterol

Total cholesterol is exactly that—all the cholesterol: LDL cholesterol, HDL cholesterol, and 20% of your triglyceride levels added up. But don’t get too attached to this number. If your total cholesterol is in the “normal” range but your LDL is sky-high and your HDL has left the chat, you’re still at higher risk for health problems related to blood cholesterol levels and cardiovascular disease.

What Causes High Cholesterol Levels?

Why does your neighbor, who seems to survive on bread and cheese, have lower cholesterol than you? Welcome to the complicated world of cholesterol and all the other risk factors you didn’t know were working against you.

Lifestyle Factors You Can Actually Change

Diet High in Saturated and Trans Fats:

Diets high in saturated and trans fats are strongly associated with increased low-density lipoprotein (LDL) cholesterol levels, a key risk factor for atherosclerosis and cardiovascular disease. Research consistently shows that excessive intake of these fats contributes to plaque buildup in arterial walls.

Saturated fat is any fat that is solid at room temperature (think coconut oil) and typically from animal sources, such as meat, butter, and milk. According to the Dietary Guidelines for Americans, less than 10% of daily calories should come from saturated fat, so aim to get most of your dietary fats from plant-based sources like olive oil, avocado, nuts, and seeds.

Similarly, trans fats are created during the process of hydrogenation, found in many processed and fried foods. The Dietary Guidelines for Americans recommend avoiding trans fats as much as possible.

Focusing too much on Dietary Cholesterol:

While reducing dietary cholesterol can help lower LDL levels, studies indicate that dietary cholesterol alone has a less pronounced effect compared to saturated and trans fats.

Instead of cutting out cholesterol from your diet, you should focus more on limiting saturated and trans fats, and eating a healthful diet high in unsaturated fats, fiber, and phytosterols, which have been shown to improve lipid profiles.

Physical Inactivity:

Sedentary behavior is linked to dyslipidemia (aka reduced HDL cholesterol and elevated LDL cholesterol.) Regular physical activity, defined as at least 150 minutes of moderate exercise per week combined with two days of strength training, plays a crucial role in maintaining healthy cholesterol levels.

Brisk walking, cycling, or swimming can help improve cholesterol levels by increasing good HDL cholesterol and lowering bad LDL cholesterol. Additionally, strength training exercises, such as weightlifting or bodyweight exercises, contribute to your metabolic health and can significantly reduce the risk of heart disease.

Smoking:

Smoking (and vaping) accelerates oxidative damage and inflammation in the vascular system, decreasing HDL cholesterol and impairing its protective anti-inflammatory functions. Smoking doesn’t just mess with your lungs, it also puts your heart at serious risk.

Smoking can lead to problems like endothelial dysfunction (basically, when your blood vessels stop working the way they should) and even atherosclerosis. Quitting smoking is one of the best things you can do for your heart health. It’s not easy, but it’s totally worth it trying or talking to your healthcare provider about.

Obesity and Related Health Conditions:

Abdominal obesity is a significant contributor to dyslipidemia, characterized by elevated LDL cholesterol and triglycerides and decreased HDL cholesterol. This is often compounded by insulin resistance, a hallmark of type 2 diabetes, and hypertension, both of which contribute to metabolic syndrome and further elevate cardiovascular risk.

Evidence shows that even modest reductions in body weight (5–10%) can improve lipid profiles, insulin sensitivity, and blood pressure.

However, the evidence also shows much of this benefit comes from the very behaviors that support weight regulation - regular physical activity, increased intake of fiber-rich foods, reduced intake of saturated fats, and consistent sleep and stress management.

In other words, better health is driven more by lifestyle behaviors than the number on the scale.

High Cholesterol Risk Factors You Can't Control

Family History and Genetics: 

Genetic predisposition plays a significant role in cholesterol regulation. Familial hypercholesterolemia (FH), a hereditary condition characterized by abnormally high LDL cholesterol levels from birth, significantly increases the risk of cardiovascular diseases. A family history of myocardial infarction or other cardiovascular conditions further elevates this risk.

Age and Sex:

Cholesterol levels naturally increase with age due to physiological changes in lipid metabolism. Additionally, sex-specific differences exist, with premenopausal women generally having lower LDL levels compared to men, though this difference diminishes post-menopause.

Underlying Health Conditions: 

Certain medical conditions, such as hypothyroidism, chronic kidney disease, or liver disorders, can impair lipid metabolism, complicating cholesterol management. If someone has pre-existing cardiovascular disease or coronary artery disease, these comorbidities can exacerbate the accumulation of cholesterol-related risk factors.

Diagnosing and Getting Your Cholesterol Checked

I don't know who needs to hear this but you can’t “feel” high blood cholesterol.

The only way to know your numbers—total, LDL, HDL, and triglyceride levels—is to get a blood test from your health care professional.

These blood tests are often called a lipid profile, and they’re the only way to really know if you have high cholesterol or a lower cholesterol risk.

How often should you get your cholesterol checked? Depends on multiple risk factors: age, family history, underlying health conditions, and lifestyle habits.

• Young, generally healthy adults: Every 4-6 years.

• Older, or higher cardiovascular risk adults: More often—ask your health care team.

Symptoms are rare until things get ugly: advanced plaque buildup can cause reduced blood flow and chest pain (called angina), but you want to catch high cholesterol levels while you’re still feeling good.

Don’t wait for warning signs because by the time they come, some serious damage has already happened.

Your Heart Health is on the Line

Cholesterol and heart disease are attached at the hip.

All the cholesterol floating around in your blood isn’t the problem, like I said before every cell in your body has cholesterol in it!

It's when you wind up with too much cholesterol (specifically LDL) along with all the other substances and triglycerides, that you get plaque clogging up your blood vessels.

This limits blood flow, starves your heart muscle of oxygen, and eventually can cause a heart attack or stroke.

Don’t ignore cardiovascular risk factors or put off getting your cholesterol checked. Prevention is disease control, not damage control.

How to Lower Cholesterol

You did the blood test. The results? Not amazing.

Managing high cholesterol isn’t about giving up all the joy in your eating habits or never eating real butter again because there are tiny, practical, sustainable lifestyle changes that will work.

Adopt a Heart-Healthy Diet

• Cut Back on Saturated and Trans Fats: Full fat dairy products, fatty cuts of meat, butter, and fried foods. A healthy diet packed with whole grains, lean meats, fish, fruits, reduced-fat dairy, and veggies supports good cholesterol and energy levels all around.

• Eat More Soluble Fiber: Beans, oats, and apples team up with bile acids to drag cholesterol out of your system. They literally work like little street sweepers in your body and bind to cholesterol to keep it out of your bloodstream!

Get Moving

Exercise isn’t just for Instagram models. Movement directly increases HDL cholesterol, helps to lower LDL, and improves your lipid profile. Aim for 150 minutes of moderate activity every week (thats only about 20 minutes a day!) and your blood and your heart will thank you.

Quit Smoking

I know it is easier said than done. But quitting smoking (and vaping) is literally the one thing that will immediately boost your HDL cholesterol and lower your risk of heart disease.

If quitting feels overwhelming, you can also try reducing how much you smoke each day as a starting point because even a small reduction can make a difference in your health.

There are plenty of resources out there to help, whether it’s joining a support group, working with a health behavior coach, or talking to your doctor about nicotine replacement therapies, each step you take brings you closer to a healthier you.

Medications

Sometimes, lifestyle factors aren’t enough, especially if you have hereditary high cholesterol or familial hypercholesterolemia.

Statins and other medications your health care professional prescribes can help manage high cholesterol, decrease LDL cholesterol levels, and protect you from health problems tied to cardiovascular disease.

It’s important to remember that medications are not a replacement for lifestyle changes—they work best when combined with healthy choices. It’s an “and” situation, not an “or.” Eating a balanced diet, staying active, and managing stress all play a critical role alongside medications to help you achieve the best possible outcome for your heart health.

A Healthier Future Starts Now

Managing high cholesterol levels isn’t about chasing some impossible ideal. Every small change, from choosing skim milk for your morning latte to taking a brisk walk during your lunch break, gradually reduces cardiovascular risk factors and supports long-term cholesterol management.

Every test, every health care team check-in, every moment you pick heart healthy lifestyle changes over the old habits lowers your risk for heart attack, heart disease, and all the “surprise!” health problems no one wants showing up at their door.

If you need support in creating healthier habits or making the lifestyle changes necessary to lower your cholesterol, let’s work together. As a health behavior coach, I’m here to guide you toward taking control of your blood cholesterol levels and keeping your future open for healthier days.

• References

  Centers for Disease Control and Prevention. (2023). High cholesterol risk factors. U.S. Department of Health & Human Services. https://www.cdc.gov/cholesterol/risk-factors

  News-Medical. (n.d.). Cholesterol: Physiology and functions in the human body. AZoNetwork. https://www.news-medical.net/health/Cholesterol-Physiology.aspx

  Office of Disease Prevention and Health Promotion. (2020). Dietary Guidelines for Americans, 2020–2025. U.S. Department of Health & Human Services. https://www.dietaryguidelines.gov/

  Centers for Disease Control and Prevention. (2023). How much physical activity do adults need? U.S. Department of Health & Human Services. https://www.cdc.gov/physical-activity-basics/guidelines/adults.html

  Franz, M. J., VanWormer, J. J., Crain, A. L., Boucher, J. L., Histon, T., Caplan, W., Bowman, J. D., & Pronk, N. P. (2007). Weight-loss outcomes: A systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. Journal of the American Dietetic Association, 107(10), 1755–1767. https://pubmed.ncbi.nlm.nih.gov/17904936/

  Centers for Disease Control and Prevention. (2023). Familial hypercholesterolemia (FH). U.S. Department of Health & Human Services. https://www.cdc.gov/cholesterol/familial-hypercholesterolemia.htm

  Kraus, W. E., Torgan, C. E., Duscha, B. D., Knetzger, K. J., & Wharton, M. B. (2002). Studies of a targeted risk reduction intervention through defined exercise (STRRIDE): Lipoprotein responses to exercise training. Archives of Internal Medicine, 162(3), 325–334. https://pmc.ncbi.nlm.nih.gov/articles/PMC3399760/

  Shai, I., Schwarzfuchs, D., Henkin, Y., Shahar, D. R., Witkow, S., Greenberg, I., ... & Stampfer, M. J. (2008). Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. New England Journal of Medicine, 359(3), 229–241. https://www.nejm.org/doi/full/10.1056/NEJMoa0708681

  Mullan, B. A., & Blunden, S. (2024). Sleep and metabolic health: The science linking sleep to cholesterol and cardiometabolic risk. Journal of Clinical Sleep Medicine, 20(1), 100–112. https://pmc.ncbi.nlm.nih.gov/articles/PMC11356871/

  Alexander, D. D., Bylsma, L. C., Vargas, A. J., Cohen, S. S., Doucette, A., & Mohamed, M. (2023). Effects of lifestyle interventions on lipoprotein profiles in individuals with dyslipidemia: A systematic review and meta-analysis. Lipids in Health and Disease, 22, 42. https://pmc.ncbi.nlm.nih.gov/articles/PMC5043634/