May 8, 2014 5 min read

Cholesterol is a kind of fat. The cholesterol in our bodies comes from both the cholesterol that our livers make from the foods we eat, as well as directly from the cholesterol that is already in the meat, eggs, and dairy products in our diets.

You may have had your cholesterol checked at a health screening at work or in your community. Your insurance company may have checked your cholesterol when you applied to buy life insurance. Your doctor may have ordered a screening cholesterol test as part of your annual physical.

Why do we care about these cholesterol numbers anyway? For the most part, having high cholesterol doesn’t make you feel bad. A person could walk around for years and never even suspect that they have high cholesterol unless they have a blood test to check it.

However, even though you can’t feel it, cholesterol can be slowly building up inside the lining of your blood vessels, like crud building up inside your bathtub drain. Over time, the blood can have a harder and harder time making it through these narrowed blood vessels, just like the bathtub drains slower and slower. This means that wherever the blood was supposed to be going gets less blood, and therefore less food and oxygen. When this happens in the blood vessels feeding the heart, it is called coronary artery disease; in the blood vessels in the neck which supply the brain, it is called carotid artery disease; and in the blood vessels in the legs, it is peripheral artery disease (it happens in other blood vessels too, but these are common ones).

Sometimes a chunk of this cholesterol build-up will actually break off, leaving a raw spot which attracts materials in the blood that cause a clot to form. The clot can completely block the blood vessel and not allow blood through at all. If this happens to the heart, you have a heart attack. (This is why some people are advised by their doctor to take an aspirin or baby aspirin daily, to prevent this type of clot from forming.)

So, what should we do? Ideally, we would like to prevent this cholesterol build-up from ever happening in the first place. The most basic advice, as for many other health issues (high blood pressure and diabetes, for example), is the combination of diet, exercise, and weight loss. Eating a healthy diet – low in cholesterol and bad fats, high in omega-3 fatty acids and good fats; more vegetables and whole grains, less sugars and starches – is a good idea for everyone. Regular exercise helps keep your good cholesterol up and your bad cholesterol down, and also helps burn off those extra calories to help you maintain a healthy body weight. Losing excess weight is not only good for you in terms of cholesterol, but decreases your risk of other medical problems as well as reducing strain on your back and joints.

In addition to eating healthy, exercising and losing weight, some people choose to take additional supplements to help keep their cholesterol numbers down. If you find it hard to get enough fiber in your diet alone, fiber supplements may help reduce bad cholesterol (and may also help decrease the risk of colon cancer and diabetes). Omega-3 fatty acids are found in fish oils, which also come as a supplement. The nutritional supplement red yeast rice has been gaining in popularity and may also help lower cholesterol through an action similar to some cholesterol-lowering medications. Please remember to talk to your doctor about any supplements that you are taking. Some supplements may interfere with medications or not be safe in people with certain medical problems (liver or kidney problems, for instance).

But, my numbers just won’t come down. Some people can do everything “right” – eat right, exercise, lose weight, take supplements and STILL have high cholesterol. How can this be? How our bodies treat and hold onto cholesterol also has to do with our family history. Some people have inherited genes that increase the likelihood that they will develop high cholesterol anyway. This does NOT mean that they shouldn’t take care of themselves in the ways we have been talking about – or their cholesterol would be even higher!

If a person has very high cholesterol that doesn’t come down with lifestyle changes, or has other factors that increase their risk of cardiovascular disease (high blood pressure, diabetes, family history of early heart disease, etc), then their doctor may recommend that they take a medication to help lower their cholesterol in addition to lifestyle changes. The most common type of cholesterol medication to be recommended is statins. While most people are able to take statins without any problem, it is important to follow up regularly with your doctor and get blood work periodically to make sure the medicine is working and not causing side effects.

Eat right. Exercise. Maintain a healthy body weight. Talk to your doctor. You CAN do something to help keep your cholesterol down and keep your arteries from clogging up!