LDL ('Bad') Cholesterol: The Villain

LDL cholesterol ("bad" cholesterol) plays a vital role in the development of atherosclerosis and, at increased levels, is associated with a higher risk of cardiovascular events. On the other hand, low LDL levels are linked to lower cardiovascular risk levels. When combined with other risk factors like hypertension, smoking, diabetes, poor diet, physical inactivity and obesity, high LDL cholesterol dramatically increases a person's overall cardiovascular risk.

What causes elevated LDL cholesterol and how can it be lowered?
LDL may be increased through exogenous (food) or endogenous (excessive production or insufficient elimination) mechanisms. If it is caused by food intake, it is treated through diet and physical activity; if it is caused by endogenous mechanisms, it is most often necessary to treat with medications, which are usually very effective and reasonably safe.

Foods high in saturated fat (fatty meat and whole-milk dairy products) or hydrogenated vegetable oils (margarine, etc) raise LDL levels. Various commercially baked products, processed foods and nondairy creams may be classified as "cholesterol free," yet still contain high amounts of saturated fat, which stimulates the body's production of LDL.

  • Cholesterol also exists naturally in various foods such as:
  • Red meat and its byproducts: cold cuts, sausage, offal/entrails
  • Whole-milk dairy products: lard, shortening, creams, cheese
  • Egg yolks: one egg yolk contains 71% of the recommended daily intake of cholesterol: 300 mg/day
  • Chicken skin, and the skin of other types of poultry
  • Mollusks and crustaceans: lobster, crab, shrimp.

When choosing dietary fat, there should be a preference for unsaturated (sunflower, corn, soy) or monounsaturated (olive, peanut, canola) oils, because these are less atherogenic and help reduce blood cholesterol levels. Total fat consumption should not exceed 30% of all calories consumed in a day, and saturated fat should not exceed 10% of daily calories.