Did you know that slender people can have high cholesterol? Or that getting older — even if you’re physically fit — can cause LDL, or the ” bad” cholesterol, to rise?
There are plenty of misconceptions about cholesterol, and that can make some adults candidates for life-altering events, such as a heart attack or a stroke.
Cholesterol circulates in the blood and can mix with other substances to form a thick, hard deposit on the inside of the arteries. This can narrow the arteries and make them less flexible – a condition known as atherosclerosis.
If a blood clot forms and blocks one of these narrowed arteries, a heart attack or stroke can result. This is why high cholesterol is one of the major risk factors for heart disease.
Nearly one of every three U.S. adults have high levels of “low-density lipoprotein cholesterol” (LDL-C), which is considered the bad cholesterol because it contributes to fatty plaque buildups and narrowing of the arteries. About 94.6 million, or 40 percent, of U.S. adults have total cholesterol of 200 mg/dL or higher. LDL-C (or bad cholesterol) levels of 100 mg/dL or lower are linked to lower rates of heart disease and stroke.
Your “medical dashboard” consists of three essential numbers, representing the top three risk factors for cardiovascular disease: blood pressure, cholesterol and blood sugar, said Theodore Feldman, M.D. , medical director of prevention and community health at Miami Cardiac & Vascular Institute  at Baptist Health South Florida. Other factors include: nutrition, physical activity, weight and smoking status.
High cholesterol is one of the major controllable, or modifiable, risk factors for coronary heart disease, heart attack and stroke. If you have other risk factors such as smoking, high blood pressure or diabetes, your risk increases even more.
While being overweight or obese — often the result of poor nutrition and lack of regular physical activity — it doesn’t necessarily mean you have high cholesterol, explains Dr. Feldman. Body type perception fuels one of the top misconceptions linked to high cholesterol.
“There are plenty of people who have diabetes, have high blood pressure and have high cholesterol, but have a normal weight,” Dr. Feldman says. “Also, there are many people who are obese who have normal blood pressure, normal blood sugar and normal cholesterol. Having said that, though, the greater your weight, the more likely you are to have high blood pressure, high cholesterol, and diabetes or heart disease. But it’s not an absolute within any given category.”
The bottom line: You need to know each of big three risk factors that makes up your medical dashboard, he says.
“And if you are overweight or obese or a smoker, then it becomes even more important that you know your numbers because if you more favorably impact your medical dashboard — and you’re in a higher-risk lifestyle group — then the higher the benefit you will get,” says Dr. Feldman.
Here are some of top misconceptions about high cholesterol, according to the American Heart Association.
Misconception: Thin people don’t have high cholesterol
Overweight people are more likely to have high cholesterol, but thin people can also suffer from this condition. A person with any body type can have high cholesterol. People who don’t easily gain weight are often less aware of how much saturated and trans fat they eat. Nobody can “eat anything they want” and stay heart-healthy. You should have your cholesterol checked regularly regardless of your weight, physical activity and diet.
Misconception: Only diet and physical activity dictate your cholesterol level
Diet and physical activity do have a major impact on overall blood cholesterol levels, but other factors do as well. Being overweight or obese tends to increase bad cholesterol (LDL) and lower good cholesterol (HDL). Getting older also causes LDL cholesterol to rise. For some, heredity may even play a role. Nonetheless, a heart-healthy diet and regular physical activity are important to everyone for maintaining cardiovascular health.
Misconception: With medications, no lifestyle changes are needed
Medications can help control cholesterol levels, but making diet and lifestyle changes is the best way to reduce heart disease and stroke risk. To lower your cholesterol, eat a heart-healthy diet and get a minimum of 40 minutes of moderate- to vigorous-intensity aerobic exercise, three to four times a week. You should also take your medication exactly as your doctor has instructed.
Misconception: If the Nutrition Facts label shows no cholesterol, a food is “heart-healthy”
A food’s Nutrition Facts label can be helpful for choosing heart-healthy foods. But many foods marketed as “low-cholesterol” have high levels of saturated or trans fats, both of which raise blood cholesterol. Even foods billed as “low-fat” may have a surprisingly high fat content. Look for how much saturated fat, trans fat and total calories are in a serving.
Misconception: Omega 3 supplements are good for your heart and can lower your cholesterol
Omega-3 fatty acids benefit the heart of healthy people, and those at high risk of — or who have — cardiovascular disease. But they are most beneficial when consumed as part of a heart-healthy diet — and not as supplements. Omega 3s are very important if from natural food sources, such as fish. “Eating them from supplements are not as beneficial as eating them from fresh and natural sources,” says Dr. Feldman. “We find that, in a lot of circumstances, when we put things inside a pill form, it’s not as beneficial to the body as when we eat them from natural sources.” A large review of randomized trials last year determined that fish oil supplements containing omega-3 fatty acids are ineffective for the prevention of heart disease. The analysis, published in JAMA Cardiology, pooled data from 10 randomized trials focusing on people who had had cardiovascular disease or were at high risk for heart disease.