LDL Cholesterol

What is LDL cholesterol?

LDL or low-density lipoprotein cholesterol is a type of lipoprotein in your blood. Lipoproteins are particles made of lipids (fats) and proteins that carry fats through your bloodstream.

Because of their structure, fats can’t move through your blood on their own. So, lipoproteins carry fats to various cells in your body. LDL particles contain a large amount of cholesterol and a smaller amount of proteins.

You may hear people call LDL “the bad cholesterol.” LDL cholesterol itself isn’t bad. That’s because cholesterol performs important functions in your body. But too much LDL cholesterol can put you at a higher risk of a stroke or heart attack.

Why is LDL “bad cholesterol?”

LDL cholesterol has a reputation for being the “bad cholesterol.” This is because excess LDL cholesterol contributes to plaque buildup (atherosclerosis) in your arteries when your LDL level is high. This plaque buildup may lead to:

• Coronary artery disease (affecting your heart)
• Cerebrovascular disease (affecting your brain)
• Peripheral artery disease (affecting your legs and arms)
• Aortic aneurysm (affecting your aorta, your largest artery)

This is why healthcare providers encourage you to have a healthy level of LDL cholesterol.

What are normal levels of low-density lipoprotein?

Most adults should keep their LDL cholesterol below 100 milligrams per deciliter (mg/dL). If you have a history of atherosclerosis, your LDL goal should be below 70 mg/dL.

Healthcare providers use the following categories to describe your LDL cholesterol level:

What range of LDL is bad?

An LDL level above 100 mg/dL raises your risk of cardiovascular (heart and blood vessel) disease.

Healthcare providers check your cholesterol levels (including LDL) through a simple blood test called a lipid panel. When you receive your results, it’s important to talk to your provider about what your cholesterol numbers mean. These include both your LDL and your HDL cholesterol. HDL (high-density lipoprotein) is the “good cholesterol” that helps remove extra LDL cholesterol from your blood.

Generally, healthcare providers encourage higher HDL cholesterol levels (ideally above 60) and lower LDL cholesterol levels to reduce your cardiovascular disease risk. If your LDL is too high and your HDL is too low, your provider may recommend lifestyle changes and/or medications to get your cholesterol numbers into the healthy range.

What causes high LDL cholesterol?

Many factors — some of which you can’t change — can give you high levels of LDL. Factors that affect your LDL include:

• What you eat. Fatty meats (like sausage), full-fat dairy products (like cheese) and bakery (like doughnuts) and fast foods (like french fries) contain high amounts of saturated fat and, in some cases, trans fat. These two types of fat raise your LDL cholesterol.
• Your body weight. Having overweight/obesity can raise your LDL cholesterol.
• Tobacco products. Tobacco use (even smokeless tobacco and vaping) lowers your HDL cholesterol (the kind that gets rid of extra LDL cholesterol). Less HDL leads to a raised LDL level.
• Medications. Some medicines you take to manage other conditions can make your LDL level go up. Blood pressure medicines and HIV medicines are common examples.
• Medical issues. You can have a higher LDL level if you have diabetes, chronic kidney disease or HIV.
• Age. As you get older, your cholesterol levels naturally go up.
• Sex assigned at birth. People assigned female at birth (AFAB) typically have higher LDL levels after menopause.
• Your genes. If your close biological family members have high cholesterol, you may face a higher risk, too.

How can I lower my LDL cholesterol?

There’s a lot you can do to lower your LDL cholesterol. For many people, starting with lifestyle changes can make a big difference. Here are some changes you can make:

• Eat heart-healthy foods like those in the Mediterranean Diet.
• Avoid tobacco use of any kind. This includes vaping.
• Get more physical activity. Aim for 30 minutes of aerobic exercise a day.
• Maintain a weight that’s healthy for you. Ask your provider what your ideal weight range should be.
• Find ways to lower your stress. Long-term stress may raise your LDL and reduce your HDL.
• Discuss your medical regimen with your provider. Some of your medications may make your LDL levels higher.

Your healthcare provider may also prescribe medication to lower your LDL cholesterol. Most providers prescribe statins as a first choice for people with high LDL.

Foods that can lower your LDL cholesterol

Research shows that soluble fiber can lower your LDL cholesterol. This form of fiber (roughage) blocks the absorption of cholesterol in your body. Adding fruits, veggies and whole grains to meals can increase your soluble fiber intake. Talking to a dietitian can help you learn new and creative ways to incorporate these foods into your daily meals.

You can also choose some foods instead of others, like oatmeal instead of other kinds of cereal or low-fat instead of full-fat dairy products.

What should I do if my LDL is low?

If your LDL level is low, you shouldn’t have to make any changes. What you’re doing is working if you have a low amount of low-density lipoprotein.