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8 Common Cholesterol Misconceptions, Debunked

September 1, 2021

Having your cholesterol levels checked can be one of the most nerve-wracking parts of routine bloodwork. High cholesterol impacts nearly one in every three Americans, increasing their risk of cardiovascular disease and stroke.

Cholesterol often gets a “bad rep,” says Vishal Phakey, DO, but it’s easier to keep it under control than many people realize. Below, Dr. Phakey, Family Medicine Physician with Jefferson Health – New Jersey, debunks some of the top misconceptions about cholesterol:

1. All cholesterol is bad cholesterol.

There are two main types of cholesterol: high-density lipoprotein (HDL), or “good” cholesterol, and low-density lipoprotein (LDL), “bad” cholesterol – both of which help the body function, build cells, and make hormones, explains Dr. Phakey.

“HDL transfers cholesterol to the liver, where it’s broken down and then expelled from the body. It also helps rid the body of excess LDL,” said Dr. Phakey. “LDL travels directly to the arteries, so when there is too much of it, it can collect and block the arteries.”

2. Everyone processes cholesterol the same.

You may wonder how you can have the same dietary habits as a friend and still have higher cholesterol levels, says Dr. Phakey. The answer is simple: everyone’s body is different.

Cholesterol is produced primarily in the liver and intestines, as well as the brain, adrenal glands, and reproductive organs. If you have a condition that impacts the functionality of any of these, it plays a role, explains Dr. Phakey.

For some, high cholesterol is linked to genetics. According to the CDC, roughly 1 out of every 250 people with high cholesterol have familial hypercholesterolemia and the low-density lipoprotein receptor (LDLR) gene, causing them to experience significantly elevated LDL levels, regardless of diet. In these cases, medical treatment is paramount.

3. You only have to worry about high cholesterol when you’re older.

High cholesterol risk can increase with age, but it can also affect anyone. It’s standard to start checking cholesterol levels at age 20, notes Dr. Phakey. “However, there are other risk factors that can cause high cholesterol to strike at a younger age, including genetics, as discussed above. This is why having an accurate family history is helpful.”

Liver complications, obesity, poor diet, and a sedentary lifestyle are all key contributors to cholesterol problems, which can take a toll well before the age of 20.

4. High cholesterol only impacts people who are overweight.

The stereotypical “fit” individual couldn’t possibly suffer from high cholesterol, right? Wrong – appearances don’t account for what occurs in the body, continues Dr. Phakey. Many adolescents and young adults have speedy metabolisms, allowing them to maintain a “thin” physique, even while consuming an unhealthy diet that is high in trans and saturated fats. This doesn’t mean their cholesterol levels go untouched.

“In addition to diet, weight, and genetics, smoking is a dangerous habit that is linked to high cholesterol risk, as it damages blood vessels, making them more likely to collect fatty deposits and LDL,” said Dr. Phakey.

5. High cholesterol can only be resolved by diet.

While a low-cholesterol diet is key to lowering LDL levels, physical activity has been shown to help significantly, as it encourages the body to produce more good cholesterol and expel more bad cholesterol, explains Dr. Phakey. “You should try to exercise at least 2-3 times a week; if you can fit in about 30 minutes every day, all the better.”

Studies show that just a few months of regular exercise can make a notable impact on cholesterol levels, lowering LDL by up to 15 percent.

Of course, maintenance medications may also be needed. Cholesterol-lowering medications are known as “statins.” Your primary care provider can recommend which one is best for you.

6. Statin medications have dangerous side effects.

There have been concerns over rare adverse effects of statins, such as memory loss and lower extremity muscle aches. If/when these occur, they are short-lived and are typically relieved as soon as the medication is stopped/switched, explains Dr. Phakey. Overall, statins have been in use for around three decades and are considered generally safe.

Some providers recommend statins be complemented with a CoQ10 (coenzyme Q10) supplement to reduce the likelihood of these side effects.

7. All low/no-cholesterol foods are ‘heart healthy.’

Packaging can be deceiving; there’s more to a “heart healthy” diet than logos. When trying to lower your LDL, you should be extra cautious of nutrition labels and read them fully for trans and saturated fat levels, adds Dr. Phakey. “It’s also important to keep an eye on serving sizes; you can certainly still consume foods with some trans and saturated fats, but while practicing portion control.”

Great go-to foods for lowering cholesterol include:

  • Beans (e.g., garbanzo, black-eyed peas, lentils)
  • Eggplant
  • Okra
  • Nuts (e.g., almonds, walnuts, peanuts)
  • Vegetable oils (in place of butter/margarine)
  • Fresh fruit (apples, grapes, and strawberries are particularly high in pectin, a compound that lowers cholesterol)
  • Fish (in place of red meats)

8. You can ‘cram’ for your cholesterol test.

If your bloodwork snuck up on you, and you know you haven’t been eating right, can you improve your cholesterol numbers a few days before the test? It’s unlikely, says Dr. Phakey.

Cholesterol levels are largely impacted by what you eat over time; it typically takes several months for changes to occur. You can’t reverse the effects of an unhealthy diet that quickly. However, some evidence suggests that foods significantly high in cholesterol (i.e., cheeseburger), as well as alcoholic beverages, may cause an “artificial” spike in cholesterol numbers if consumed a day before your blood is drawn. This is why providers sometimes instruct fasting.

If your cholesterol levels are higher than you expected, don’t give up and face the risks: heart disease, stroke, fatty liver disease, type 2 diabetes, peripheral vascular disease, and more. It’s never too late to get back on track with healthy lifestyle habits, says Dr. Phakey. Your primary care providers are here to help.  

For more information on Primary & Specialty Care services offered at Jefferson Health – New Jersey, click HERE or call 844-542-2273.