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5 Myths about Managing Cholesterol

Nina Ghamrawi, MS, RD, CDE
November 10, 2022
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Have you ever thought that getting headaches or blurred vision was a sign of high cholesterol? What about those old recommendations to avoid eggs when you have high cholesterol? Well, there are some old facts that have now been proven false with research, and there are also things that are just simply not true. Let’s go through some common myths.

Myth #1: All cholesterol is bad for you

This is not true. Your body needs cholesterol to do the most important jobs, like making hormones and building cells. While cholesterol itself is not bad, the transporters that carry it through your body might be. Cholesterol travels through the blood on two types of lipoproteins:

  • LDL (low-density lipoprotein), or “bad” cholesterol, makes up most of your body’s cholesterol. High levels of LDL cholesterol raises your risk for heart disease and stroke.
  • HDL (high-density lipoprotein), or “good” cholesterol, carries cholesterol back to the liver. The liver then flushes it from the body. High levels of HDL cholesterol can lower your risk for heart disease and stroke.

When your body has too much LDL cholesterol, it can build up in the walls of your blood vessels, there, it's called plaque. Over time, the more plaque that builds, the more narrow the blood vessels. This leads to restricted blood flow, causing high blood pressure, and even eventually blocked blood flow to and from your heart and other organs, causing angina (chest pain) or a heart attack.

Not all dietary fats are the same... Eating foods high in saturated fat- like butter, lard, fatty meats, and coconut and palm oils- will raise your LDL (we don't want this). Healthy fats from most other plants and also fish will raise your HDL (we do want this)!

Myth #2: If I had high cholesterol, I’d feel it

This is not true. High cholesterol usually has no signs or symptoms. You may not know you have high cholesterol until it is too late - when you have chest pains, a heart attack, or a stroke. That’s why it’s so important to get your cholesterol levels checked at least every 5 years, or annually if you have a history or family history of it, and every 6 months if it's high.

In rare cases, people can develop yellowish growths on their skin called xanthomas, or cholesterol-rich deposits. People with xanthomas may have high cholesterol levels.

Myth #3: Eating high cholesterol foods will raise my cholesterol levels

This is totally false. While all foods coming from animals will usually have cholesterol, research finds that it is not the cholesterol in the food that raises blood cholesterol. In fact, it is the fat.

Foods from or made from animals, like red meat, butter, and cheese, are high in cholesterol but usually also have a lot of saturated fat. Since saturated fat can make your cholesterol numbers higher, it’s best to choose foods that are fat free or lower in saturated fat. Eggs, in this case, are a pretty healthy protein source.

Also, eat foods with plenty of fiber, such as oatmeals and beans, and healthy unsaturated fat, such as avocados, olive oil, and nuts. Foods containing these will help to actually lower cholesterol.

Talk with your care team and health care provider about ways to manage your cholesterol.

Myth #4: I can’t do anything to change my cholesterol levels

False. Don’t lose hope! You can do many things to improve your cholesterol levels and keep them in a healthy range!

  • Get tested every 5 years or more often. Unless told otherwise by your doctor.
  • Make healthy food choices. Limit foods high in saturated fats. Choose foods naturally high in fiber and unsaturated fats.
  • Be active every day. The Physical Activity Guidelines for Americans recommends that adults get 150 to 300 minutes of moderate physical activity each week. Learn more about physical activity basics and tips.
  • Don’t smoke or use tobacco products. Smoking damages your blood vessels, and greatly increases your risk for heart disease. If you don’t smoke, don’t start. If you do smoke, try to quit to lower your risks. Learn more about tobacco use and ways to quit at CDC’s smoking and tobacco use website.
  • Talk with your doctor about ways to control your cholesterol; if they give you any medications to manage your cholesterol, take them as they are prescribed. They may be necessary to control the cholesterol, or they may simply be for prevention.
  • Know your family history. If your parents or other immediate family members have high cholesterol, you probably should be tested more often. This genetic predisposition to high cholesterol is called familial hypercholesterolemia (FH).

Myth #5: I don’t need medications. I can manage my cholesterol with diet and exercise

Neither true nor false. Many people can have healthy cholesterol levels by eating healthfully and getting enough exercise. Some people may also need medications, usually statins, to lower their cholesterol levels.

You may need statins or other medications in addition to diet and exercise if you have:

  • Familial hypercholesterolemia (FH) or people with very high levels of “bad” cholesterol. FH is a genetic condition that causes very high LDL (“bad”) cholesterol EVEN at a young age. If left untreated, cholesterol levels keep worsening. This raises the risk for heart disease, heart attack, and stroke at a young age.
  • Cardiovascular disease (CVD). People with CVD may already have narrowed arteries because of too much plaque. Medicines that lower cholesterol may help reduce the risk for heart attack or stroke.
  • Diabetes. Type 2 diabetes lowers HDL or “good” cholesterol levels and raises “bad” cholesterol levels. This combination raises your risk for heart disease and stroke.

Other groups of people may also need medicines to manage their cholesterol, including people who have a high risk for cardiovascular disease. Always talk to your doctor and care team about the best ways to manage your cholesterol.

Takeaways

Cholesterol is an old condition with a lot of new and old research surrounding it. While the heart can feel like a mystery, there are some things that we now know to be true. Dietary cholesterol is not the enemy here, fat is. If you exercise and eat healthfully, you can likely keep your arteries free and clear, but at some point, or if you have a strong family history or otherwise high risk of cholesterol issues, medications may be necessary. Talk to your care team about ways you can manage your cholesterol and improve your heart health.

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