You have high cholesterol! Now what?
Picture this: you recently had your blood drawn at your doctor’s office and that was followed up with a call that your numbers were not normal. You have high cholesterol. Dang. You may have been told to try to lose weight and come back in three months for another blood draw.
Suddenly, you’re worried about the health implications of high cholesterol and you’re starting to get nervous. Your mind immediately goes to…
- “What diet do I need to follow?”
- “What does Dr. Google say?”
Hi, I’m Kelly – an Intuitive Eating dietitian. In my practice, I help my clients achieve true, lasting health without restrictive dieting or feeling anxious about eating. In this article, I’ll arm you with information and strategies you can use to improve your cholesterol, without pursuing weight loss.
These kinds of doctor appointments and conversations can be especially triggering for anyone with a complicated relationship with food, so please know that I am here to support you and will not be recommending any kind of restrictive diet or weight loss plan.
Let’s dive in!
You don’t need a restrictive diet
If you have a long history of yo-yo dieting or even an eating disorder, the news that you have high cholesterol is even more complicated. It can send you reeling. You might feel like you’re caught in an impossible situation:
- Do you risk harming your relationship with food to improve your cholesterol?
- If you let your high cholesterol go unchecked, you fear that your health might suffer.
The good news is that high cholesterol does not mean you need to follow a restrictive diet plan. There are many things to consider when you get a high cholesterol diagnosis, but restriction and dieting do not have to be the answer.
If your doctor or primary care provider is recommending that you diet and restrict foods, you might feel overwhelmed. I want you to know that you can partner with your medical team to make behavior changes. I’ll be writing an article on this very topic, so be sure to sign up for my newsletter if this topic is of interest to you.
As an intuitive eating dietitian, I have clients who are faced with this news quite frequently. And we work together to help them feel good around food, while also pursuing their health goals. This often involves tailoring what they eat, as well as educating them on the causes of high cholesterol and what is, and what is not, in their control.
Intuitive Eating might be a completely new approach to you. If you’d like to better understand what it means to be a “non-diet dietitian,” check out this post: Are you curious about what it’s really like to work with a non-diet dietitian?
Meanwhile, let’s do a quick cholesterol 101 so that you can better understand what these numbers mean.
What do all these cholesterol numbers mean?
Cholesterol comes in many forms. Broadly speaking, cholesterol is a waxy substance that has many jobs in your body.
Cholesterol is a part of all cell membranes. It is also a building block for your body to make certain hormones and vitamin D.
Cholesterol in our blood comes from two places; the food we eat and from our liver where it is made.
Luckily, it’s easy to measure cholesterol! It’s just a simple blood draw that is covered by insurance in most cases. The only thing you need to do before is fast for 9 to 12 hours for an accurate result. That means you can only drink water or black coffee and tea the morning of your blood draw.
The most common types of cholesterol tested in a lipid profile are:
Total Cholesterol is all cholesterol in your blood; HDL, LDL, and Triglycerides.
The recommended value for total cholesterol is below 200 mg/dL.
High-Density Lipoprotein (HDL)
HDL is sometimes known as “good cholesterol.” HDL protects your heart and blood vessels. Unlike other cholesterol numbers, a higher number is better. Typically, women have higher levels of HDL, particularly before the menopause transition. This is because the hormone estrogen helps keep levels lower.
The recommended value for men is greater than 40 mg/dL; and for women, greater than 50 mg/dL.
Low-Density Lipoprotein (LDL)
LDL are larger and less dense molecules in the blood and are also known as the “bad” cholesterol. The LDL can be responsible for damage to blood vessels and the heart.
The recommended value for LDL is less than 130 mg/dL.
Triglycerides are fats in our bloodstream that our body isn’t currently using for energy. They circulate in the blood and high levels can lead to heart disease.
The recommended value for triglycerides should be lower than 150 mg/dL.
What are the causes of high cholesterol?
In our culture, we’re often led to believe that every single health condition we face is something that we can control with diet and exercise. However, this is a false narrative that we should challenge.
For many people, the greatest cause of their high cholesterol is family genetics. What I want you to know is that if your parents, grandparents, aunts, and uncles all have high cholesterol your risk of developing it increases too.
Also, the older we get, our cholesterol increases.
Our body’s ability to clear cholesterol from our bloodstream decreases as a natural part of aging. For women specifically, the hormonal changes that occur during perimenopause and menopause tend to increase total cholesterol and LDL, and decrease HDL. As women, we can also experience body shape and weight changes through perimenopause and menopause.
While it is true that cholesterol levels are somewhat influenced by what we eat, some people with high cholesterol due to genetics will never achieve normal cholesterol levels through dietary and lifestyle changes alone.
Having said that, there are some lifestyle changes you can make to improve your numbers (and how you feel). Let’s explore those next!
Non-Diet Ways to Improve High Cholesterol:
The good news is that you don’t have to diet to improve your cholesterol.
1. Consider medication. For many people, medication to lower cholesterol is a necessary part of treatment. Forgoing medication because of fear can leave people vulnerable to significant health effects.
Even though I do support clients in making dietary or lifestyle changes before starting medication for a short-term period (3 to 6 months), if cholesterol levels do not normalize, I encourage them to speak to their doctor about a cholesterol-lowering medication.
The most common medication is called a “statin.” Statins bind to the cholesterol in the body and help the body excrete the excess cholesterol. This helps many people achieve healthier levels, decrease their risk of heart attack and stroke, and live longer, healthier lives.
2. Increasing fiber intake, specifically soluble fiber foods. Like most dietary recommendations I make, I am about ADDING foods to the diet rather than taking foods away. Soluble fiber is a great way to reduce cholesterol in the blood.
Soluble fiber does its magic by binding to cholesterol so it can be excreted from our bodies.
Foods that are a great source of soluble fiber include black beans, apples, pears, figs, artichokes, and barley.
3. If you have high triglycerides, increasing your intake of omega-3 fats, found in fatty fish and flax seeds can help reduce triglycerides.
4. Exercise/movement. Exercise doesn’t have to be intense or punishing to have an impact. Finding movement that you enjoy and engaging in it regularly can help decrease LDL levels and increase HDL levels. Research shows that 30 minutes of activity 5 days a week can have an impact but that can be split up into different sessions.
For more information on beginning an exercise practice that isn’t a form of punishment, check out my article 7 Simple Ways Exercise Can Make You Happy.
5. Improving sleep. Too little sleep has been shown to increase total cholesterol and decrease HDL (“good”) cholesterol. Sleeping at least 7 hours can help improve these numbers. In addition, for those who have sleep apnea, using a CPAP machine helps to improve sleep quality, which has a ripple effect of benefits, including with your cholesterol numbers.
6. Stress reduction. In our busy lives, we are often living in a fight or flight state because of stress.
When we’re stressed, our body is pumping the stress hormone cortisol into our blood. This hormone gives us a burst of energy so that we feel like we can run from a tiger. But in our real lives, most often the stress is coming from a work deadline or from the juggling act of being a wife, mother, partner, and employee – we don’t need that energy to physically run away. Since there is no tiger to run from, we have extra energy in our bloodstream which can raise our triglycerides.
So, reducing your stress can actually have a great impact on lowering your cholesterol levels. Besides, wouldn’t it feel great not to constantly feel like you’re evading danger?
Using techniques like meditation or therapy can help reduce your stress (and your cholesterol levels, to boot!).
Myths about high cholesterol.
There are so many myths about cholesterol that I feel are important to address.
Here are the ones I hear most often.
Myth: High cholesterol is solely caused by the food that you eat.
Fact: You might remember above, how cholesterol is found in both the foods we eat and it’s also made by our liver.
Our bodies need this cholesterol for important functions, like making hormones and vitamin D. Many people (even if they eat a low-cholesterol diet) still have high cholesterol because their body makes more than it needs, or their body struggles to excrete the excess. So, lowering cholesterol is much more complicated than just decreasing how much you eat.
Myth: You can’t eat higher-cholesterol foods like eggs if you have high cholesterol.
Fact: You can still eat higher-cholesterol foods, like eggs and cheese if you have high cholesterol. You may need to limit some foods that are higher in cholesterol and saturated fat, but you should work with a registered dietitian who can design a goal to meet your individual needs.
Myth: Everyone can reduce their cholesterol to doctor-recommended levels through diet and exercise.
Fact: Many people will not be able to reduce their cholesterol to recommended levels with diet and exercise alone. If your family tree is full of people with high cholesterol, you will likely need the assistance of a cholesterol-lowering medication, like a statin, to reduce your cholesterol levels.
Change takes time
If your recent cholesterol labs show that something isn’t optimal, your doctor will either prescribe medication immediately or ask you to pursue some lifestyle goals and come back to have your cholesterol levels measured again in 3 to 6 months.
That’s because it takes at least 3 months for any lifestyle changes to impact cholesterol levels.
Like any lifestyle change, it’s best to pick 1 or 2 changes to start. I recommend choosing from the list above and picking changes that interest you. Slow and steady wins the race!
High cholesterol can be a wake-up call but it’s no reason to panic. Knowing your numbers is empowering.
You don’t need to lose weight or diet to improve your cholesterol. Using the science-backed changes listed above can help you change your cholesterol numbers. Keep in mind that your genetics are also at play here and you can’t change who your parents were.
Working with a non-diet dietitian like me can help you improve your lab numbers without compromising your relationship with food.
If you’re curious about how I can help, I invite you to schedule your complimentary Take Action Call with me. We’ll spend 15-20 minutes on a call that can help us determine if we’d work well together. You’ll have a chance to tell me about you, and your health history and ask questions.
I can’t wait to connect!
National Institutes of Health. Blood Cholesterol Levels. https://www.ncbi.nlm.nih.gov/books/NBK542294/
How to Get Your Cholesterol Tested. American Heart Association. https://www.heart.org/en/health-topics/cholesterol/how-to-get-your-cholesterol-tested
Cholesterol Numbers and What They Mean. The Cleveland Clinic. https://my.clevelandclinic.org/health/articles/11920-cholesterol-numbers-what-do-they-mean
Menopause, Cholesterol and Cardiovascular Disease. Heather Currie, Christine Williams, US Cardiology 2008;5(1):12–4 https://doi.org/10.15420/usc.2008.5.1.12
How Sleep Affects Cholesterol. Web MD. https://www.webmd.com/cholesterol-management/how-sleep-affects-cholesterol
HAES Health Sheets: High Cholesterol. Association for Size Diversity and Health. https://haeshealthsheets.com/high-cholesterol/
Kelly Abramson MS, RD is a dietitian and Certified Intuitive Eating Counselor who works with clients in Alexandria, VA and virtually via telehealth. She guides women as they break free from dieting to find joy in food and their bodies. Kelly blogs regularly at NpowerYou.com and has created a free e-book for download, “7 Steps to Overcome Stress Eating.”