High blood cholesterol, or hypercholesterolemia, is a significant health concern that contributes to cardiovascular diseases such as heart attacks and strokes. There are a variety of causes, that once understood, can prompt interventions to reduce or minimize blood levels. 

Internal Causes 

Genetics. Familial hypercholesterolemia is a genetic disorder that leads to high cholesterol. This condition is caused by mutations in genes responsible for removing low-density lipoprotein (LDL) cholesterol from the blood. Individuals with this condition often have very high levels of LDL cholesterol from a young age, increasing their risk of heart disease. 

Metabolic Syndrome. Metabolic syndrome is a cluster of conditions, including high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels. This syndrome can significantly increase the risk of heart disease and type 2 diabetes. High triglycerides and low levels of high-density lipoprotein (HDL) cholesterol are common in metabolic syndrome, contributing to overall high cholesterol. 

Other Medical Conditions. Conditions such as diabetes, hypothyroidism, and kidney disease can also contribute to high cholesterol levels. For example, diabetes can increase LDL cholesterol and lower HDL cholesterol levels, while hypothyroidism can lead to increased levels of total cholesterol and LDL cholesterol. 

Dietary Causes 

Saturated and Trans Fats. Diets high in saturated and trans fats can be significant sources of high cholesterol.  

Saturated fats exist in animal products such as meat, butter, and cheese, as well as in some plant oils like coconut and palm oil.  

Although fortunately, the Food and Drug Administration has banned the use of trans fats, they can still be created from oils in the heating process. So, they can exist in processed foods, including baked goods, snack foods, and fried items. 

Saturated and tans fats both increase LDL cholesterol levels and lower HDL cholesterol, increasing heart disease risk.

Cholesterol-Rich Foods. While counterintuitive, dietary cholesterol (found in animal products like egg yolks, shrimp, and organ meats) has less impact on blood cholesterol levels than saturated and trans fats. However, it can still contribute to high blood cholesterol, especially in individuals who are more sensitive to dietary cholesterol. Moderation is key to maintaining healthy cholesterol levels. 

High Sugar Intake. Excessive sugar consumption, especially in the form of sugary drinks and processed foods, can cause weight gain and an increase in triglycerides, which can lower HDL cholesterol levels and raise LDL cholesterol levels. Therefore, reducing sugar intake can help manage cholesterol levels and overall heart health.

Alcohol. Excessive alcohol can increase triglycerides and contribute to high cholesterol levels. Moderate consumption, defined as up to one drink per day for women and up to two drinks per day for men, may have some heart benefits, but excessive consumption is harmful to cholesterol levels and overall health. 

Conclusion 

Managing high blood cholesterol involves understanding both the genetic and dietary factors that contribute to this condition. While genetic factors like familial hypercholesterolemia and metabolic syndrome play a significant role, dietary choices also have a profound impact on cholesterol levels. By reducing intake of saturated and trans fats, cholesterol-rich foods, sugar, and alcohol, individuals can lower their risk of high cholesterol and its associated health complications. Regular exercise, maintaining a healthy weight, and working with healthcare providers, particularly registered dietitians, are key to preventing, managing, and even reversing high blood cholesterol. 

Patrick Traynor, PHD, MPH, RD, CPT has an insurance based registered dietitian practice with MNT Scientific, LLC. He has offices in South Lake Tahoe, CA, Sacramento, CA, and Minden, NV and also works via telemedicine. Inquiries can be directed to Dr. Traynor at (530)429-7363 or info@MNTScientific.com.