Cholesterol is one of the most misunderstood topics in nutrition. Clients often come to me after a lipid panel with numbers they don't fully understand — and questions about what to actually do next. "Eat less fat" and "avoid cholesterol" are the most common things they've heard — and both are significantly incomplete.
Understanding the Panel
Total cholesterol — the sum of all cholesterol in the blood. Above 200 mg/dL is associated with increased cardiovascular risk, but total cholesterol alone is a limited predictor.
LDL cholesterol — often called "bad" cholesterol. LDL particles can deposit cholesterol in arterial walls when present in excess. Below 100 mg/dL for most people is the primary target of cardiovascular risk reduction.
HDL cholesterol — often called "good" cholesterol. HDL transports cholesterol away from arterial walls. Higher is protective. Below 40 mg/dL in men and 50 mg/dL in women is a risk factor.
Triglycerides — primarily influenced by carbohydrate intake and alcohol consumption. Above 150 mg/dL is concerning.
What Actually Raises LDL
For most people, dietary cholesterol has a modest effect. The bigger drivers are saturated fat (red meat, butter, full-fat dairy) and trans fats (partially hydrogenated oils), which raise LDL and lower HDL simultaneously. Excess refined carbohydrates and sugar raise triglycerides.
What Lowers LDL Through Diet
One of the most effective dietary interventions for high LDL is increasing soluble fiber — not eliminating eggs or cutting out fat entirely. Soluble fiber is found in oats, barley, legumes, apples, and psyllium. Replacing saturated fat with unsaturated fat — olive oil, avocado, nuts, fatty fish — consistently reduces LDL and improves the LDL/HDL ratio.
One of the most effective dietary interventions for high LDL is increasing soluble fiber — not eliminating eggs or cutting out fat entirely.
Managing high cholesterol through nutrition? I can help you understand what to actually focus on.
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