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What Causes High Cholesterol?

Learn Which Risk Factors You Can Control

Elevated cholesterol levels aren't caused by a high-cholesterol diet alone. The fact is, a combination of factors affect your cholesterol levels. There are two main categories of risks that contribute to high cholesterol—those that you can't change (uncontrollable risks), and those that you can (controllable risks).

Uncontrollable Risk Factors
These variables are out of your control. Although you can't do anything to change them, it's important to know whether you fall into any of these higher-risk categories. How many of these risk factors do you exhibit?
  • Your age. Your risk of developing high cholesterol increases as you age. Men over age 45 and women over 55 are at higher risk than their younger counterparts.
  • Your gender. Overall, men are more prone to high cholesterol than women—until women reach 50 to 55 years of age, that is. Naturally-occurring cholesterol levels in women increase around this age.
  • Your family history. Your family has given you more than your eye color. They've also partly determined your risk for several conditions and diseases. Some people have a genetic predisposition to high cholesterol. Your risk is higher if an immediate family member had high cholesterol and/or its associated problems (like heart disease), especially at a young age (under 55).
  • Your race. Somewhat related to family history, your race can also predetermine part of your cholesterol risk. In the U.S., African Americans, for example, are more likely to develop high cholesterol than Caucasians.
Controllable Risk Factors
Factors that you can control are related to your lifestyle—the choices you make each day about what to eat and whether or not to exercise. These are areas of your life where you can take control to improve your cholesterol levels and enhance your overall health.
  • Your diet. Since your body makes about 80% of its cholesterol, the other 20% comes from the foods you eat. If your diet is high in cholesterol-promoting foods (saturated fat, cholesterol, trans fat) and low in heart-healthy foods (healthy fats, whole grains, fish, fruits and veggies), then your diet is probably contributing to your high cholesterol levels.
  • Your activity level. Inactive people are an increased risk for high cholesterol. Regular exercise naturally decreases the LDL (bad) cholesterol levels in your blood while increasing your HDL (good) cholesterol levels. Exercise does not have to be strenuous to offer benefits.
  • Your weight. Being overweight increases your blood cholesterol levels since your body stores the extra calories you eat as triglycerides. When these triglyceride levels are high, HDL (good) cholesterol levels tend to be low. Losing just 10% of your body weight (if you are overweight), can improve your cholesterol levels.
  • Smoking. Did you know that smoking is the leading preventable cause of heart disease, due to its effects on your arteries, heart, blood pressure, and cholesterol levels? Smoking damages the walls of your arteries and lowers your HDL (good) cholesterol levels. Quitting can stop (and potentially reverse) a lot of the existing damage to your body, and improve your cholesterol.
When you have other existing health conditions, you are compounding your risk of serious complications and disease if you don't lower your cholesterol. Add high risk factors into the picture (family history, age, race) and your risk is compounded even more. The good thing is that you can break that chain of progressive disease at any point by changing what you can control.

Lowering your cholesterol can help improve your health by reducing your risk of heart attack, stroke, and other serious health problems. You should work closely with your doctor to develop a cholesterol-lowering plan that is safe and effective for you. These plans usually involve some combination of dietary changes, regular exercise, medication, and weight loss.

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Member Comments

  • Much of the info about diet is outdated. Research has shown over and over again that high carb diet drives cholesterol up and that saturated fats like butter, do not impact negatively like previously thought. I eat a Low Carb High Fat diet (9 months now) and my cholesterol dropped 90 points!! My HDL is high, LDL is low, my triglycerides are low.
    Sparks seems to print articles that are out of date quite a bit. Please stop
  • How embarrassing for SP to keep recycling outdated nonsense from 2007! This very philosophy is at the core of obesity pandemic. SP please, please stop treating your members as dimwits, provide references based on which these blog posts are written along with the blog authors' credentials!
  • Time to stop touting the low fat mythology. Heart disease, diabetes, and a plethora of other health issues are caused by chronically elevated insulin. Dietary fat does not raise insulin. For most people (especially as we get older) limiting carbs to non starchy vegetables and low sugar fruit works better than measuring teaspoons of fat and going on meds.
  • My DH had terrible side effects with 2 different cholesterol meds - the doctor then prescribed fish oil and healthy diet whihc brought his numbers down.
  • Both of my parents took medication for high cholesterol and for years I just knew that there was a chance that I would have problems as well. I was doing wonderfully until after I hit 55 and then my cholesterol numbers started to climb. Have been trying to get more exercise, reducing the amount of animal products in my diet and just being more conscience of everything I eat so as to avoid having those numbers continue to climb. I have always eaten a lot of fruits and veggies every day, as well as whole grains, but have not increased the amount of fish I eat each week to help with those numbers.
  • Like diabetes, high cholesterol can be caused and controlled by a number of factors, some of which are within our control and others which aren't. I have a family history of both, but was able to get my cholesterol down to normal by maintaining a healthy weight long term, regularly exercising and keeping my dietary cholesterol moderate. Carb cutting wasn't necessary. However, when I developed gestational diabetes like most of the other women in my family, I had to take a closer look at my carbohydrate intake. To keep my levels under control, I essentially couldn't eat carbs in any form first thing in the morning or my blood sugar would skyrocket. Later in the day, my body processed them fine as long as I kept them under about 60 grams at meals and about 30 for snacks, so I was by no means following a low carb diet--carb controlled, yes. It's not recommended that pregnant women consume fewer than 180 carbs per day, so I just had to be extra careful about when those carbs were consumed. Other women I know with GD had different tolerance levels and needed to plan their days' meals differently.

    In the end, I think we just need to work with our doctors to find what works for us. Monitor, tweak, monitor.
  • I agree please update this piece and remove the pseudoscience. Thanks, woubbie for your clarifying comment about triglycerides, I will share the info with my h who was hastily given statins this past spring, his panel was done within a few months of a major surgery.
  • Maybe this article information works for some people? My personal experience says I have to agree with the low carb comments. Just had my blood work done last week and posted it on my last blog. My LDL was so low it was untraceable. My history? Dad had high numbers and died from heart disease. Siblings all have high blood pressure. Mom has terrible high blood pressure and diabetes. My husband (who used to take high blood pressure meds) just came from giving blood at the red cross and his blood pressure was 120/89. We eat (and have for years) meats fried in butter, eggs, cream, nuts, berries, lower carb veggies and salads. Skipping bread, grains, potatoes and fruits is worth gaining better health.
  • I agree with AzureSky - this is one of many articles which needs to be updated with more current information.

    And let me point out that triglyceride levels are generally tied most closely with heart disease and stroke risk and there is ONLY ONE THING THAT MAKES TRIGLYCERIDES: CARBOHYDRATE. They are so reliable a marker that when doctors put patients on a low carbohydrate plan they use the tri number to judge the patient's compliance.
    It's time to update this article with more recent studies. Several years ago, I went on a low-carb diet, after eating the "normal" American diet of higher carbs.

    Surprise, surprise! - My cholesterol AND my triglycerides went down to normal ranges. After going back to my higher carb (whole grains, not cakes and cookies), both of those levels went back to above normal.

    Since then, I've cut out processed carbs - I still eat oatmeal, veggies and fruit, and occasionally brown rice, but mostly protein. My cholesterol and triglycerides are back in the normal range again.
  • I should have said that my cholesterol went higher after menopause and I know now it is the hormone issue. Have not tried the substitute hormone therapy but it remains a possible alternative.
  • I had borderline high cholesterol until I hit menopause . My Dr,. allowed me to try the 8 week Chiolesterol Cure muffins regimen suggested by Robert Kowalski. Just eating the regimen of oat bran/day lowered me significantly to ok levels. I also am coming to a newer understanding of cholesterol intake in my diet - and do not see all I eat as bad -- the Spark nutrition tracker allows me to track the amount of my cholesterol intake/day and fats and this has helped me to be conscious of being careful. I also appreciate the way I can track this on recipes. I no longer worry if a recipe uses --say - butter or eggs - because if it is only a small amount/serving then I can use it reasonably. I've also learned how to use egg substitute and egg whites and things like that to make all this easier to deal with.
  • I'm still trying to figure this one out..... after 20 years of being vegetarian/vegan, eating 'healthy', and high exercise levels (racquetball, etc), my Dr had to put me on Rx for high (bad) cholesterol levels.

    Ten years later, and 5 years into being a carnivore, including eggs and pork, and lower exercise levels, my Dr took me off the Rx because my cholesterol levels had dropped to normal.

    I'll be very interested what tests results have to say this year when I go in for blood work.

  • There is no question genetics play a role in cholesterol. My mom is tiny as can be, eats only healthy foods and appropriate portions yet her cholesterol is off the charts. Her good cholesterol is particularly high so the doctors just monitor it. She doesn't exercise a lot but she has been a nurse for years which inherently keeps people moving.

    I control mine with Simvistatin. I also have hypothyroidism which increases my predisposition to high cholesterol. Eating a healthy diet, exercising and medication are my best controls. Eggs and the like don't directly impact my or my moms cholesterol levels.

    It all boils down to monitoring, eating right and exercise but sometimes you can't beat the genetics without meds.

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