High Cholesterol – What You Should Know

The number one cause of mortality in the United States is heart disease, according to the CDC. The most common cause of heart disease is coronary artery disease, which means plaque buildup from cholesterol. There is a lot of misconception and fear when it comes to cholesterol. It is often thought that the lower the number, the better off you are. However, you can have too low cholesterol just like you can have it too high. There are different types of cholesterol, some that help make you healthier and some that will hinder your health. Cholesterol is important to have in what we call the “Goldilocks level.” Not too high due to the damage it does to our blood vessels and heart, but not too low because of how important it is for our brains, hormones and more.

Cholesterol is often given a bad reputation

Like almost anything in the body, it is extremely important to have in the right amount. Cholesterol surrounds our cell membranes to provide a layer or protection for all that resides inside the cell including your DNA as well as your mitochondria (the power house of your cells that produce cellular energy).

It’s also important for:

  • Making hormones including estrogen, testosterone, progesterone and thyroid hormones
  • Vitamin D production and absorption
  • To make bile salts, which are necessary for the breakdown of fats
  • The absorption and break down of fat soluble vitamins such as vitamins A, E and K
  • Used in brain and nervous system for the creation of neurotransmitters such as serotonin and dopamine
  • The creation of myelin sheaths for nerve conductance
  • Surrounding the brain for protection and nerve firing

There are two main types of cholesterol; low-density lipoprotein (LDL) and high-density lipoprotein (HDL). It is the LDL that gives cholesterol its bad reputation.

LDL - Low-Density Lipoprotein

75% of the cholesterol found in your body is made up of LDL. It is the type of cholesterol that is most involved in cell damage, but is also extremely important in tissue repair and protection. It is referred to as “bad cholesterol” because when the levels are high, it increases your chances of having buildup of cholesterol in the arteries, thereby increasing the likelihood of heart disease and peripheral artery disease. According to the CDC, 71 million American adults (33.5%) have high LDL. Part of what makes LDL so ‘dangerous’ is its size. Being so small it can pass through artery walls and is easily interacts with free radicals and becomes oxidized. The oxidized LDL is the true problem because it causes extreme damage to the arterial wall, causing inflammation and increases the risk for heart disease (1). Oxidation occurs from free radical production, which are formed from poor diets, poor air quality, tobacco smoke, alcohol and poor water quality amongst other things. These free radicals are very damaging to our bodies, hence why “antioxidants” are so important – they prevent oxidation of free radicals and thereby protect the body from damage.

HDL - High-Density Lipoprotein

HDL is known as the “good cholesterol” because it’s biggest job is to carry cholesterol from other parts of the body back to the liver where it is broken down and removed from the body. This is why higher levels of HDL are associated with a decreased chance of developing heart disease. Lower levels of HDL can be as dangerous or even more dangerous than high levels of LDL. This is due to the fact that cholesterol does not dissolve in the blood. Therefore, the only way to get rid of cholesterol is with the use of HDL. There are very simple ways to increase your HDL. When good fats such as monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) are used to replace simple carbohydrates, we see an increase in HDL. Sugar has shown to decrease a person’s HDL (2). Beyond your diet, increasing physical activity and the cessation of smoking can increase your HDL as well. The only time these changes will not affect your cholesterol levels is if you have familial hypercholesterolemia.

High Cholesterol Foods You Don’t Have to Avoid

When helping patients with dietary changes, there are often recommendations we make that surprise people with high cholesterol. There is a large misconception on what foods are bad due to old research showing it will “increase your cholesterol.” Just because a food has cholesterol in it does not mean it will cause your “bad” cholesterol to spike. Here are the most common food mistakes:

1.) Eggs

Eggs (3) are very high in dietary cholesterol, which is why it is often feared by an individual with high cholesterol. Research actually shows that consuming eggs may improve your HDL while having extremely little to no effect on LDL. Eggs also contain many important nutrients such as choline, vitamin E and other antioxidants that help decrease the oxidation process of LDL (4). Remember, the oxidation process is what makes LDL so harmful.

2.) Grass-fed beef or lean beef

Research shows lean beef and grass-fed lean beef are interchangeable with chicken concerning their effects on LDL and HDL. In one research article (5), 38 men with high cholesterol were given two diets: one with chicken and the other with lean beef. Both groups showed a decrease in their total cholesterol and a decrease in LDL within just five weeks.

3.) Dark chocolate

This knowledge is always met with delight when we talk with patients about the good that is found in dark chocolate (6). Flavanols are very high in dark chocolate, which are a potent antioxidant that is known to promote a healthy heart. These antioxidants may also lower cholesterol.

Using Food to Lower Your Cholesterol

There are ways to lower your cholesterol without taking medication. There are known foods to lower a person’s cholesterol and when consumed in high amounts can push your cholesterol and LDL to the normal limits, thereby decreasing your chances for atherosclerosis and heart disease.

What to look for and what to avoid:

  1. Avoid trans fatty acids and hydrogenated oils. These are they “bad” types of fats that will cause cholesterol and LDL to increase.
  2. Avoid processed foods as much as possible, artificial ingredients and refined grains and sugar
  3. Look for high fiber
  4. Consume monounsaturated fatty acids and polyunsaturated fatty acids
  5. Aim for consuming lean protein that has been pasture raised, grass fed or wild sourced

Specific Foods To Consume When You Have High Cholesterol


It seems obvious, of course, but how many of us are truly eating enough vegetables. I often tell patients that when you split your plate into four, one spot is for your protein, one spot can be for starch or fruit and two spots (1/2 of the plate) should be your vegetables. We aim for 4-6 cups of vegetables per day in our household. Vegetables are a very high antioxidant food that are loaded with phytochemicals that quench free radicals. This stops the oxidation of LDL, leading to a healthier heart and lowering the LDL. Vegetables also contain fiber, which helps lower LDL and will help balance blood sugar.


Nuts contain your MUFAs and PUFAs. They are also high in fiber. Research shows they are a great antioxidant and have a lowering effect on LDL (7). We sprinkle nuts onto our salads to add crunch, flavor and to increase our nutrient intake.

Chia Seeds and Flax Seeds

Flax seeds are very high in omega 3’s, which will help to raise your HDL. Both are high in fiber as well.

Olive Oil

Olive oil is a great anti-inflammatory and contains MUFAs. However, you need to be very careful with olive oil in terms of cooking with it. Research agrees that cooking olive oil above 375 degrees Fahrenheit causes it to become rancid, producing those harmful free radicals that you are trying to avoid. Olive oil is better served cold such as a salad dressing or adding a little extra fat to vegetables or protein after the cooking process is done.


These are very high in MUFAs, have been shown to raise HDL and lower LDL. Avocados also contain fiber, are an anti-inflammatory food and contain glutathione. Glutathione is used very heavily to reduced oxidation processes. Avocado oil can be cooked at higher temperatures than olive oil, making it much safer to cook with.

Salmon, Sardines, Mackerel, Herring

These fish are very high in omega 3’s and lower in mercury content than other fish.

Gluten Free Whole Grains/Ancient Grains

Many of our patients fair better without grains, but for those who can tolerate grains there are ones that are better to consume than others. Whole grains and ancient grains are high in fiber than regular grains. Oats in particular contain beta glucan, which is known for absorbing cholesterol. This is why oatmeal is promoted as heart healthy. However, packets of oatmeal that are coated in sugar and are overly processed are not the type of oatmeal products anyone should be consuming. Steal cut oats and oatmeal that takes longer than a “30 second zap” in the microwave is what research is referring to being “heart healthy.” Mixing oatmeal with a small amount of fruit and throwing in some chia seeds or walnuts is a much healthier option.

Green Tea

Green tea (8) is very high in antioxidants, which helps prevent oxidized LDL from creating atherosclerosis. Green tea has also shown to decrease blood pressure and improve brain function.

Beans and legumes

These are very high in fiber, contain trace minerals for overall health and contain antioxidants.


Many people are familiar with turmeric being an anti-inflammatory. It is used in many Indian dishes and has been used in research for autoimmune conditions, Alzheimer Disease and many more conditions. Turmeric also helps to fight viruses, decrease cholesterol, can prevent clots, increase immune health and so much more.


Raw garlic is an antioxidant, anti-inflammatory, antiviral, antibiotic and an immune system booster. It has shown to decrease cholesterol as well as blood pressure.

Sweet potatoes

Switch out your white potatoes for sweet potatoes! Sweet potatoes are high in fiber, vitamins and antioxidants.


Bergamot (9) is a type of plant that produces citrus fruit. Oil from the peel of the fruit is what gives Earl Gray tea its flavor. Bergamot has been found to decrease plasma lipids and decrease LDL. It is very high in flavonoids.


Flavonoids (10) are found in many fruits and vegetables. They have shown to improve HDL due to being a highly potent antioxidant and decreasing inflammation. There are many different types of flavonoids, anthocyanidins proving to be the best. You can find these in blueberries, cranberries, bilberry, raspberries, blackberries, cherries, eggplant peel, concord grapes, red cabbage, and violet peddles. The trend here is the color. Anthocyanidins are found in dark reds, blues, purples and blacks.

Research has shown over and over again that simply changing your diet to be rich in micronutrients (full of colors) you increase your chances of living a healthier life. Cholesterol will decrease and heart health will increase without the use of medication. The Standard American Diet does not promote healthy living. Our American traditions of fast food, deep fried foods, simple carbohydrates and massive amounts of sugar are leading to high rates of autoimmune diseases, disastrous hearth health, poor functioning brains, and an increase in sedentary life styles due to the inflammatory processes causing so much pain no one wants to get up and exercise because it hurts or because they are too fatigued. The CDC tells us that 1/3 of American adults are obese, that’s 78.6 million people. Pharmaceutical companies are making a fortune off of us because of our poor life styles. Yes, taking a pill is much easier than changing your diet. However, changing your diet has much more positive side effects than any medication. Taking back your health can be as simple as starting with making some of these dietary changes. These simple changes will help you to use your foods as medicine, allowing you to decrease your bad cholesterol and increase your good cholesterol, leading to a healthier heart, healthier brain and healthier you.


Dr. Brianne Holmes

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