Are My Genes to Blame for My High Cholesterol?
We've got some bad news — high cholesterol runs in the family. So if your relatives have higher levels of the sticky plaque in their blood vessels, you're predisposed to the condition as well.
You can't change your genes, but you can adjust your lifestyle and create daily habits that support better heart health. In fact, lifestyle does play a pretty significant role in your chances for developing high cholesterol. So just because your parents or grandparents struggle with high cholesterol, it doesn't mean you will, too. Nothing is inevitable.
Despite the genetic component, a healthy lifestyle that incorporates heart-healthy foods, limits saturated and trans fats (those are found in meat, dairy, and snack foods), and includes regular fitness and rest can help you avoid experiencing high cholesterol later in life. Here's what to know if high blood cholesterol runs in your family so you can better prepare yourself for a lifetime of optimal cardiovascular health.
How Genetics Impact Your Cholesterol Levels
"Many people inherit genes from their parents that cause them to have too much cholesterol," says Dr. Sadi Raza, MD, a cardiologist practicing in Dallas. This disorder is known as familial hypercholesterolemia, or FH. "FH is dangerous because it can cause premature atherosclerosis, and thus heart disease and strokes at a younger than expected age," he explains. Your doctor can order a test that will detect the presence of the disorder.
It is hard to say to what degree genetics matter more than lifestyle, but regardless, you should change your lifestyle to decrease your risk.
"I will say this: If you have a strong genetic predisposition for elevated cholesterol, it is even more important to have good lifestyle habits because the effect is additive and compounds the issue," Dr. Raza says.
"Genetics can play a strong role in your risk for high cholesterol by increasing the amount produced by the liver and so in those who have high cholesterol but also have a healthy lifestyle, it's more likely that genes are at play," says Kelly Jones MS, RD, CSSD, LDN.
While we need cholesterol, high levels of these lipoproteins can mean build up of plaque in the arteries and an increased risk of heart attack. A blood test will measure HDL and LDL levels, where HDL is the "good" kind of cholesterol and LDL is the "bad" kind.
"HDL should be above 40 for men and 50 for women, while it's desirable for LDL to be below 100, and total cholesterol should be between 125 and 200 mg/dL," Jones says.
You can manage risk with lifestyle adjustments, or act more aggressively if your numbers are already elevated: "Those with genetic high cholesterol are more likely to be prescribed statin drugs early, but should also be aware that being more diligent with diet and exercise may help, too," Jones says.
How Strong Is the Effect?
Although some people are genetically predisposed to high cholesterol, far more have an elevated cholesterol level due to lifestyle. Lifestyle includes diet, exercise, smoking or exposure to second-hand tobacco, and of course obesity. Yet, there are still some cases where the genetics are simply too strong — this is all based on the individual though.
Those with genetic links may still have high cholesterol levels even with a healthy lifestyle, but it's important to remember that without a balanced diet and exercise, levels may be much higher.
For some, genetic links can be stronger than for others, and complete prevention may not be possible.
"I've worked with triathletes who have great eating patterns and still have high numbers, and we've seen numbers improve by switching to more plant-based diets, but it can be hard to get total and LDL numbers in the normal ranges without working with a dietitian to determine what diet is best for you and without having a very high activity level," Jones says.
A Lifestyle for Lower Cholesterol Levels
Regardless of how strong that hereditary factor is, don't shy away from the work of eating well and exercising. While you can't change your genetics, you can feel empowered knowing that you are doing what you can to offset them.
"Diet is a major risk factor for high cholesterol, as high intakes of saturated fats, which are highest in animal products as well as coconut oil, will increase liver production of cholesterol," Jones says.
Reduce your intake of red meat and pork, which are high in saturated fat. Make room in meals for legumes like beans or lentils, as well as fruits and veggies; they can help usher out cholesterol that's already in your body. Load up on the greens and high-fiber foods, too.
"Diets rich in whole plant foods provide soluble fiber, plant sterols, and even antioxidants and may reduce blood cholesterol levels," Jones says. And while fruits and vegetables are important, so are whole grains, legumes, nuts and seeds, as they provide a greater variety of nutrients.
"Fruits, seeds and legumes, as well as oats provide plenty of soluble fiber, the kind that binds to and excretes cholesterol from the body, and many plant fats also offer plant sterols, which can block cholesterols absorption in the digestive tract," Jones says.
And of course, limit booze and smoking, since both increase cholesterol levels. "These habits damage blood vessels so that cholesterol and plaque stick more easily, and also disrupt normal lipid metabolism," Jones says.
The same goes for sugar intake, suggests Dr. Raza, as diabetes and prediabetes are also correlated with an increase risk of high cholesterol levels. Instead, seek out low-sugar options, and focus on natural sources in moderation, like fresh fruit.
Exercise can also keep HDL levels high and reduce LDL and VLDL, the latter two contributing to high cholesterol. "At least 150 minutes per week of moderate intensity activity is recommended to maintain health, but start with something realistic for you and add on as you go," Jones says. "That may be a 10-minute walk or 10 minutes of body weight exercise a day to start." Increase intensity or duration from there.