What Causes High Cholesterol?

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High cholesterol is an extremely common concern around the world. Chances are, you have read about cholesterol and know that it is associated with heart disease or other conditions. Maybe a family member or friend has talked to you about their cholesterol levels.

Now, cholesterol is not all bad. The simple truth is that cholesterol is necessary for our bodies. They make cholesterol to process food and store energy. Cholesterol helps our bodies by transporting fats to different areas so we can use them for energy.

Think of cholesterol molecules like cars on the freeway, pushing through the arteries to get to their destination. When there are lots of cars, then there is a lot of congestion, and the natural flow of traffic slows down. Similarly in our arteries, when cholesterol molecules build up in the arteries, then blood flow is impacted.

Cholesterol is necessary for our bodies, but problems occur when the cholesterol levels in our bodies become unbalanced. Large amounts of LDL cholesterol (“bad” cholesterol) can contribute to problems like heart disease or stroke.  Maintaining an appropriate balance of cholesterol can help reduce the risk of heart disease and ensure your body is using energy efficiently.

Factors like your diet, exercise habits, and genetics play an important role in determining your cholesterol balance, which will be discussed in this article.

LDL

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Diet

Your diet has the biggest impact on your cholesterol levels.

Foods that are rich in saturated and unsaturated fats can raise your cholesterol. To limit intake of high-cholesterol foods, cut back on:

  • Fried foods
  • Red meat
  • Animal-based cooking oils and fats, like lard

Foods filled with fiber, such as leafy green vegetables, whole-grain breads, and fruits, are known to lower your cholesterol levels. Fiber helps to remove cholesterol from the body. 

Healthy Food Can Still Be High in Cholesterol

Some foods such as coconut oil may seem healthy, but they actually cause high cholesterol.

Limiting cholesterol-rich foods and eating more fiber-rich foods is a great way to reduce your cholesterol naturally. 

You can also increase your consumption of certain foods to help improve your HDL cholesterol ("good" cholesterol) levels. Foods such as fish and avocados are good options for boosting healthy cholesterol.

Lifestyle

Living an active and healthy life can help your cholesterol levels, including:

  • Ensuring that you walk or exercise at least 30 minutes five times per week
  • Maintaining a good sleep schedule
  • Quitting smoking

Cigarettes are known to cause heart disease and can make high cholesterol levels even more problematic in the body.

Genetics

Genetics plays a major role in controlling cholesterol levels.

We know that specific genetic disorders like familial hypercholesterolemia can cause extremely elevated cholesterol levels.

If you and several of your family members have extremely high levels of cholesterol, then you may want to have a healthcare provider evaluate your genetic history. Some studies also have shown different cholesterol levels among White, Black, and South Asian populations.

Further research is needed to understand if specific genes might control cholesterol levels. 

Preexisting Conditions

Some disorders—like coronary artery disease, atherosclerosis, diabetes, and hypertension—are commonly connected to high cholesterol levels.

Elevated cholesterol levels can make many of these other conditions worse, heightening the need to get levels under control. Oftentimes, healthcare providers prescribe medications called statins to treat high cholesterol levels. These medications work alongside diet and lifestyle changes to help reduce cholesterol levels.

In addition to statins and lifestyle changes, some people with high cholesterol require additional LDL lowering strategies that may include medications such as PCSK9 inhibitors, fibrates, or bile acid sequestrants.

Frequently Asked Questions

What causes high cholesterol?

High cholesterol can be the result of increased fat in your diet and a reduction in your body's natural ability to process and remove cholesterol.

What are the worst foods for high cholesterol?

Foods to avoid include: 

  • Fried foods
  • Coconut oil (despite its popularity, it is known to cause elevated cholesterol and is extremely high in saturated fats)
  • Red meats
  • Butter or animal lard 
  • Eggs

Besides food, what can cause high cholesterol?

Risk factors like smoking, lack of exercise, and obesity can all lead to high cholesterol.

How can I tell if I have high cholesterol?

Lab tests for cholesterol can be performed at your healthcare provider’s office. Review your results with a healthcare provider to check if your cholesterol levels are balanced.

Summary

Factors like your diet, exercise habits, and genetics play an important role in determining your cholesterol balance.

A Word From Verywell

Cholesterol levels—particularly LDL levels—are closely linked to cardiovascular health. Ensuring your cholesterol levels are balanced is an effective way to reduce your risk of developing heart disease.

You may find articles on the Internet and elsewhere that question the role of cholesterol in heart disease. What we do know, and what research supports, is that managing your cholesterol can reduce your overall risk and supports a healthy lifestyle. If you are able to maintain normal cholesterol levels through lifestyle changes or medications, then you are on your way to living a healthy and full life.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cleveland Clinic. Cardiovascular disease: Prevention & reversal.

  2. MedlinePlus. LDL: The "bad" cholesterol.

  3. Fang J, Zhang Z, Ayala C, Thompson-Paul AM, Loustalot F. Cardiovascular health among non-hHispanic Asian Americans: nhanes, 2011-2016J Am Heart Assoc. 2019;8(13):e011324. doi:10.1161/jaha.118.011324

  4. American Heart Association. Cholesterol medications.

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By Kevin James Cyr
Kevin is a physician-in-training at Stanford University School of Medicine with a focus in cardiovascular disease and bioengineering. His publications have earned international awards, and his work has been featured in major media outlets such as NBC News.