Cholesterol Part 1

This is another post written by an intern. It is a long one so we will be doing it in segments. Enjoy!

A familiar scenario…. So you get your blood work done in April and the results of your lipid panel show that your cholesterol is at 250 mg/dL. Your doctor tells you that you have high cholesterol (called hypercholesterolemia) and that your diet and lifestyle need to change in order to lower your cholesterol below 200 mg/dL and reduce your risk for heart disease.
Maybe your first thoughts were….”Huh?? Me? But I’m healthy. I exercise fairly regularly and eat my fruits and vegetables”. Or maybe your first thoughts were….”hmmm, yeah I could probably eat a little healthier and stand to lose a few pounds. I was wondering when all those double cheeseburgers would catch up to me”.

Either way for the next month you religiously heed the doctor’s advice- you don’t smoke, if you drink it’s only in moderation, you exercise very regularly and maybe you even lose a few pounds. You follow a low cholesterol diet cutting out red meat, eggs and whole milk. You even increase your fiber with more fruits, vegetables and whole grains, after all the cereal box advertises that you can lower your cholesterol with fiber right?
One month later in May you go in for a follow-up and find that your cholesterol has lowered to 220 mg/dL and you are now considered only “borderline high”. You’re thrilled with your improvement and relieved to see that your hard work is paying off, but you are determined to see that number below 200 without any association of the word “high” and would rather try and accomplish it without medication. You set-up another appointment for July determining that at this rate, two months should be plenty of time to see some superior results. You continue your regimen, but come July your blood work shows your cholesterol is 210 mg/dL, improved but still elevated. You think to yourself “what gives”?


First, something to consider…. Cholesterol not only comes from the foods that we consume but our bodies have the ability to make our own endogenous cholesterol. This explains why cholesterol is not an essential nutrient and why all cholesterol is found in only animal-derived foods. That being said, genetics can play as large a role in cholesterol levels as diet and exercise. That doesn’t mean you should give up on these healthy habits and admit defeat to your genetic code, it just means that you may have to work harder than others at keeping your cholesterol levels in check, especially if hypercholesterolemia runs in your family.
In fact diet and exercise have just as much of an impact as medication and that’s why a lifestyle change is first recommended to treat high cholesterol. Not to mention all of the many other benefits that come from a better diet and exercise- reduced risk for heart disease, cancer, diabetes, osteoporosis, better blood sugar control, better sleep, less stress, more confidence…the list goes on and on. Research shows that even a 5-10 lb weight loss can improve cholesterol levels and even if you’re not overweight exercise will raise your HDL cholesterol “good” cholesterol. You want your HDL number high because it has the ability to lower LDL “bad” cholesterol.
Take home message….Even if you’re a victim of your ancestors hypercholesterolemia genes, lifestyle factors can greatly affect your health for the better or worse. And if you choose to take a cholesterol lowering medication don’t negate the importance and power of diet and exercise.
Kaloni Hepworth, Dietetic Intern
Emily Fonnesbeck RD,CD