Nearly 1 in 3 Canadian adults have high cholesterol! It’s another silent, invisible condition that slowly worsens over time until it’s ‘suddenly screaming and very visible’, for instance as a heart attack or stroke. As cholesterol builds up, your risk of blood vessel disease and kidney problems increase as well. Good news: your lifestyle significantly influences how at risk you are for all of this, and the more you know (and action), the better you can prevent and manage your cholesterol.
(Short on time? Click here for The Bottom Line)
Dyslipidemia (dis-lip-ih-DEE-mee-uh) is one of the 5 major chronic diseases I get to help people with everyday. This term refers to abnormal lipid levels in your blood. Lipids are fats found in the body, including various types of cholesterol. You may have also heard of related terms such as Hyperlipidemia (blood lipid levels too high) and Hypercholesterolemia (blood cholesterol levels too high).
Did you know we do not actually need to consume any cholesterol at all?
Your liver produces all the cholesterol you need for the body’s functions. Aside from what the body produces, in reality, we do also consume cholesterol in our dietary intake… especially in our current food environment. The more cholesterol increases, the more it builds up, and the more problems that follow.
So, where does it all come from?
Here are the main culprits:
- Ultra-Processed and Highly-Processed Foods
- Deep-Fried Foods
- Some Packaged and Baked Snacks
- Fatty Meats
- Processed Meats
- Full-Fat Dairy Products (milk, cheese, butter, etc.)
- Lard
- Margarine (partially hydrogenated)
- Palm Oil and Coconut Oil
The above foods are significant sources of saturated fat (the unhealthy type of dietary fat). Trans fat (even worse; banned in Canada and elsewhere) is a fat that must be absolutely and completely avoided.
Similar to other “silent killer” chronic conditions such as Diabetes and High Blood Pressure, which we have recently explored, Dyslipidemia also tends not to have overt signs or symptoms for the first few decades. A blood test at the lab is how you learn about your levels, usually starting at age 40, and repeated every 5 years.
Your Primary Care Provider or Family Physician screens for this as a part of preventative health care, and certain populations such as South Asians or Indigenous Peoples, or people with risk factors (specific related family history, Obesity, Diabetes, Smoking, etc) may be screened and tested at an earlier age. Below is a simplified approach to interpret the numbers once you have your bloodwork results:
| Total Cholesterol | Lower is better |
| Triglycerides | Lower is better |
| LDL Cholesterol (“bad”) | Lower is better |
| HDL Cholesterol (“good”) | Higher is better |
Click here for a more detailed refresher on these terms.
You will also see a number for “Non-HDL Cholesterol”, which is your Total Cholesterol minus your HDL Cholesterol. Lower is also better here. There are 2 other important cholesterol blood tests to know:
-
Lp(a) (Lipoprotein A)
- A genetic marker correlated with risk of heart disease from having clogged arteries.
- Only needs to be tested once in a lifetime.
-
ApoB100 (Apolipoprotein B)
- More accurate measure of risk of plaque build up if triglycerides are higher than a specific value.
- Can be measured more than once and the specific timeline / intervals vary from patient to patient.
Whether your blood test results are normal or worrisome, remember, you have the power to impact how well you prevent or manage cholesterol diseases!
The pillars of Lifestyle Medicine shine once again: prioritize whole food plant-predominant meals, keep physically active regularly, quit smoking, reduce (or ideally eliminate) alcohol, and get a good night’s sleep as often as you can.
Medications can also help, whether statins or alternatives, but for high cholesterol, these will not be a cure nor a replacement for your lifestyle.
Honing in on nutrition specifically is the most powerful for cholesterol:
- Read the Label: look for the % Daily Value for cholesterol on foods you choose (5% or less is a little, while 15% or more means a lot)
- Portfolio Diet: food choices that help you naturally remove excess cholesterol in the body (more on this later)
- Monounsaturated Fat: healthier fats that are good for you (think: avocados, nuts, and olive/canola/safflower oils or non-hydrogenated margarine)
- Polyunsaturated Fat: omega-3 and omega-6 (more on this later, but for now prioritize getting more omega-3 especially, from foods such as fish, flaxseeds, chia seeds, or tofu)
- Saturated Fat: eat this as little as possible (see culprits list above for what to avoid)
As always, remember to chase progress, not perfection.
The Bottom Line
High cholesterol affects 1 in 3 Canadians and untreated it leads to heart attacks and strokes! AVOID saturated fats from ultra-processed foods, deep-fried foods, meats, dairy (cheese, milk, butter), and palm or coconut oil. See your Family Doctor to get a screening blood test for cholesterol if you are over the age of 40, or younger with risk factors. HDL is good cholesterol (higher is better), but otherwise lower is better for the other blood cholesterol lab test results. Consume healthy fats (mono- and poly- UNsaturated fats) like avocados, nuts, seeds, fish, and olive oil. Prioritizing plant foods, whole-food fibre, regular physical activity, quality sleep, and reducing stressors and substances, will all significantly improve your cholesterol levels.