Elevated Cholesterol Levels: Causes and Lifestyle Adjustments

Health check inquiry

I just received the report from my school entrance examination, indicating that my cholesterol level is 248 mg/dL, which is 48 mg/dL higher than normal.
However, I don't eat excessively; I generally have homemade toast with fried eggs and lettuce for breakfast, and I don't add mayonnaise.
Occasionally, I eat out for dinner (such as fried rice or dry noodles).
I usually only drink plain water and engage in at least two hours of moderate exercise each week.
Why is my cholesterol still so high? What adjustments do I need to make? I later discovered that four years ago, my cholesterol level was already over 200 mg/dL (207 mg/dL).
Thank you!

Meizi, 20~29 year old female. Ask Date: 2015/11/06

Dr. Chen Bozhang reply Family Medicine

Dear Miss,
Regarding your school entrance examination report, your cholesterol level is 248 mg/dL, compared to 207 mg/dL four years ago.
The ideal total cholesterol standard is between 130-200 mg/dL.
Cholesterol metabolism is significantly influenced by genetic factors as well as personal lifestyle habits, particularly physical activity.
I recommend that you consult with a family medicine or general internal medicine specialist.
The physician will assess your high-density lipoprotein (HDL) and low-density lipoprotein (LDL), commonly referred to as "good" and "bad" cholesterol, and inquire about other factors to evaluate your cardiovascular disease risk associated with cholesterol levels, which will help determine the appropriate management plan.
Everyone has a unique constitution, so there is no need to worry excessively; discussing your concerns with a physician is the correct first step.
Additionally, you mentioned that you occasionally have dinner.
For normal gastrointestinal function and metabolic physiology, it is essential to have regular meals three times a day.
If you are only eating one meal a day for weight loss or other reasons, it can be detrimental to your health, leading to nutritional deficiencies and placing a significant burden on your digestive system.
I hope this information is helpful to you.
Sincerely,
Dr.
Po-Chang Chen
Department of Family Medicine
Keelung Hospital, Ministry of Health and Welfare

Reply Date: 2015/11/06

More Info

Elevated cholesterol levels can be concerning, especially when they exceed the normal range. In your case, a total cholesterol (CHO) level of 248 mg/dL indicates that you are above the desirable threshold, which is typically considered to be less than 200 mg/dL. Understanding the implications of this result and making appropriate lifestyle adjustments is crucial for managing your cholesterol levels and reducing your risk of cardiovascular diseases.

Understanding Cholesterol Levels
Cholesterol is a waxy substance found in your blood, and it is essential for building cells and producing certain hormones. However, not all cholesterol is created equal. Cholesterol is carried in the blood by lipoproteins, which include:
1. Low-Density Lipoprotein (LDL): Often referred to as "bad" cholesterol, high levels of LDL can lead to plaque buildup in your arteries, increasing the risk of heart disease and stroke.

2. High-Density Lipoprotein (HDL): Known as "good" cholesterol, HDL helps remove LDL cholesterol from the bloodstream. Higher levels of HDL are generally associated with a lower risk of heart disease.

3. Triglycerides: These are another type of fat found in the blood, and high levels can also contribute to heart disease.

Possible Causes of Elevated Cholesterol
Even with a seemingly healthy diet and regular exercise, several factors can contribute to elevated cholesterol levels:
1. Genetics: Familial hypercholesterolemia is a genetic condition that results in high cholesterol levels regardless of diet or lifestyle.

2. Dietary Choices: While you mentioned that your diet is relatively healthy, it’s important to consider hidden sources of saturated fats and trans fats, which can raise cholesterol levels. Foods like fried items, processed snacks, and certain oils can contribute to higher cholesterol.

3. Weight and Body Composition: Even if your BMI is within a normal range, body fat distribution and muscle mass can affect cholesterol levels.
4. Physical Activity: While you engage in regular exercise, the type and intensity of your workouts can also play a role. Aerobic exercises, such as running or cycling, are particularly effective at improving cholesterol levels.

5. Stress: Chronic stress can lead to unhealthy eating habits and increased cholesterol levels.

Lifestyle Adjustments
To manage your cholesterol levels effectively, consider the following adjustments:
1. Dietary Modifications:
- Increase Fiber Intake: Incorporate more fruits, vegetables, whole grains, and legumes into your diet. Soluble fiber, found in oats, beans, and apples, can help lower LDL cholesterol.

- Healthy Fats: Replace saturated fats (found in red meat and full-fat dairy) with healthier fats, such as those found in olive oil, avocados, and nuts. Omega-3 fatty acids, found in fatty fish like salmon and mackerel, can also help improve cholesterol levels.

- Limit Processed Foods: Reduce your intake of processed and fried foods, which can contain unhealthy trans fats.

2. Exercise: Aim for at least 150 minutes of moderate-intensity aerobic exercise each week. Activities like brisk walking, cycling, or swimming can help raise HDL cholesterol and lower LDL cholesterol.

3. Weight Management: If you are overweight, losing even a small amount of weight can help improve your cholesterol levels.

4. Regular Monitoring: Keep track of your cholesterol levels through regular check-ups. This will help you and your healthcare provider assess the effectiveness of your lifestyle changes.

5. Consult a Healthcare Professional: Given your previous cholesterol levels and current readings, it may be beneficial to consult with a healthcare provider or a registered dietitian. They can provide personalized advice and may recommend further testing or treatment options if necessary.

Conclusion
Elevated cholesterol levels can be managed effectively through lifestyle changes, even if you feel you are already living a healthy lifestyle. By focusing on dietary adjustments, increasing physical activity, and managing stress, you can work towards lowering your cholesterol levels and reducing your risk of heart disease. Regular monitoring and consultation with healthcare professionals will also play a critical role in your cholesterol management journey.

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