What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your body needs some cholesterol to work properly. But if you have too much of it in your blood, it can stick to the walls of your arteries and narrow or even block them. This puts you at risk for coronary artery disease and other heart diseases.

Cholesterol is made by your liver. It travels through the blood on proteins called lipoproteins. One type of lipoprotein, LDL, is sometimes called the "bad" cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. Another type, HDL, is sometimes called the "good" cholesterol. It carries cholesterol from other parts of your body back to your liver. Then your liver removes the cholesterol from your body.

What are the treatments for high cholesterol?

The main treatments for high cholesterol are heart-healthy lifestyle changes and medicines. The lifestyle changes include healthy eating, weight management, and regular physical activity.

How can I lower cholesterol with diet?

Heart-healthy lifestyle changes include a diet to lower your cholesterol. The DASH eating plan is one example. Another is the Therapeutic Lifestyle Changes (TLC) diet, which recommends that you:

Choose healthier fats.You should limit both total fat and saturated fat. No more than 25 to 35% of your daily calories should come from dietary fats, and less than 7% of your daily calories should come from saturated fat. Depending upon how many calories you eat per day, here are the maximum amounts of saturated fats that you should eat:

Saturated fat is a bad fat because it raises your LDL (bad cholesterol) level more than anything else in your diet. It is found in some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.

Instead of saturated fats, switch to foods with healthier fats, such as lean meat, nuts, and unsaturated oils like canola, olive, and safflower oils.

Limit foods with cholesterol. If you are trying to lower your cholesterol, you should have less than 200 mg a day of cholesterol. Cholesterol is in foods from animals, such as liver and other organ meats, egg yolks, shrimp, and whole milk dairy products.

Eat plenty of soluble fiber. Soluble fiber helps prevent your digestive tract from absorbing cholesterol. You should try to get 10 to 25 grams of it per day. Foods that are high in soluble fiber include:

• Whole-grain cereals such as oatmeal and oat bran
• Fruits such as apples, bananas, oranges, pears, and prunes
• Legumes such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans

Eat lots of fruits and vegetables. They are important sources of vitamins, fiber, and other nutrients.

Increase plant stanols and sterols in your diet.These are substances that also help prevent your digestive tract from absorbing cholesterol. You should try to get 2 grams of them per day. They can be found in whole grains, nuts, legumes, and oils, such as olive oil and avocado oil. They are also added to some foods, such as certain types of orange juice, margarine, and bread.

Eat foods that are high in omega-3 fatty acids. These special fats can lower LDL and triglyceride levels. They can also help control blood pressure and may lower your risk of heart rhythm problems. If you have heart disease, they may lower your risk of heart attack. Omega-3 fatty acids can be found in:

• Fish such as salmon, tuna (canned or fresh), and mackerel. Most people should try to eat these fish two times a week. But if you are pregnant or breastfeeding, you should avoid fish that could be high in mercury, such as mackerel.
• Plant sources such as walnuts, flaxseed, chia seeds, and canola and soybean oils. But they have smaller amounts of omega-3 acids than the fish sources.
• Fortified foods, such as certain brands of eggs, yogurt, juices, milk, soy beverages, and infant formulas.

Limit salt. You should try to limit the amount of sodium (salt) that you eat to no more than 2,300 milligrams (about 1 teaspoon of salt) a day. That includes all the sodium you eat, whether it's added in cooking, used at the table, or already present in food products. Limiting salt won't lower your cholesterol, but it can lower your risk of heart diseases by helping to lower your blood pressure. You can reduce your sodium by instead choosing low-salt and "no added salt" foods and seasonings at the table or while cooking.

Limit alcohol. Alcohol adds extra calories, which can lead to weight gain. Being overweight can raise your LDL level and lower your HDL level. Too much alcohol can also increase your risk of heart diseases because it can raise your blood pressure and triglyceride level. It's best not to drink, but if you do:

• Have no more than 2 drinks per day if you are a man
• Have no more than 1 drink per day if you are a woman

Nutrition labels can help you figure out how much fat, saturated fat, cholesterol, fiber, and sodium is in the foods that you buy. This can help you eat healthier and lower your cholesterol.

NIH: National Heart, Lung, and Blood Institute