How to Lower Cholesterol, According to a Cardiologist and Sports Dietitian


Some cyclists might assume they have normal cholesterol levels because they ride many miles each week or follow a plant-based diet. But heart health relies on more than just aerobic fitness or going meatless, and getting your cholesterol levels tested is key to understanding what’s going on inside your body in terms of overall health.

Cholesterol is one of the most commonly misunderstood and complex topics when discussing general health, and while aerobic exercise does help to lower cholesterol and protect your heart, cycling on its own isn’t always enough to keep high cholesterol at bay. For more facts on this health marker, we spoke with a cardiologist and a sports dietitian who also explain how to lower cholesterol.

What is cholesterol?

Michael Barber, M.D., Ph.D., a board-certified cardiologist and Medical Director at Strata Integrated Wellness in Colorado Springs, describes cholesterol as a naturally occurring, waxy substance that’s found in the blood—and it’s not necessarily bad unless you have too much of it. “You need cholesterol to build healthy cells,” says Barber. “It’s involved in building the structure around the nervous system and the structure of blood vessels throughout the body, among other things.”

The two types of cholesterol are referred to as HDL (high-density lipoprotein) and LDL (low-density lipoprotein). LDL is referred to as “bad cholesterol” because it contributes to fatty buildup in arteries which can lead to heart disease, while HDL, the “good cholesterol,” has good protective qualities, helping to remove LDL from our system and back into the liver where it can be broken down and excreted.

The liver is where blood cholesterol is created and sent throughout the body to make cell membranes, vitamin D, and many of our hormones.

A secondary source of cholesterol, dietary cholesterol, comes from the food that you consume. While eggs are often depicted as public enemy number-one, foods high in saturated fat—fatty cuts of red meat, butter, skin on poultry, and palm oil—as a few examples—may be more likely to elevate LDL levels, explains Nicole Rubenstein, RD, certified sports dietitian and owner of Racer’s Edge Nutrition.

Rubenstein acknowledges that there are continuing studies on whether or not saturated fat should necessarily be labeled “bad,” but experts note the correlation between excessive saturated fat intake and elevated LDL, including the American Heart Association.

Rubenstein also notes that every person is a unique case, and genes may be more of a factor than diet; when a client’s lipid panel shows elevated cholesterol, Rubenstein examines the bigger picture before creating a nutrition plan. “I always take a look at their medical history and family history, because sometimes an active person has familial hypercholesterolemia [a.k.a. high cholesterol]—so it could be genes predisposing them,” she says.

What are considered healthy cholesterol numbers versus high cholesterol numbers?

When you get blood drawn for a basic lipid panel, you’ll find your total cholesterol, which is a measurement of the levels of HDL, LDL, and triglycerides in your blood.

total cholesterol of less than 200 is considered healthy, while a number in the 200 to 240 range is approaching borderline high levels and indicates the need for diet and exercise modifications. Any number over 240 is considered high cholesterol (“hypercholesterolemia”) and will likely require a prompt treatment plan that may include medication.

Why is high cholesterol bad?

Barber explains that high levels of cholesterol, particularly LDL cholesterol, will get deposited in the arteries and cause fatty buildup, commonly termed “atherosclerosis.” High cholesterol in itself does not necessarily come with an immediate batch of signs and symptoms, but if left to progress over time, it can become a serious health threat.

“Fatty buildup compromises an artery’s flow,” Barber says. “In the carotid arteries [which provide your brain’s blood supply], this can cause stroke, in the heart arteries, this can cause a heart attack, in the aorta or the lower extremity arteries it can cause a blood flow decrease to the lower extremities.”

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