High cholesterol is an imbalance of elevated of cholesterol in the blood typically with high LDL cholesterol and low HDL cholesterol. High cholesterol, along with 2 or more risk factors of coronary heart disease, is very dangerous. One of the major risk factors of coronary heart disease (CHD) is elevated serum cholesterol and more important low serum HDL cholesterol. This condition typically exists with accumulation of excess body fat and sedentary lifestyle. The modification of diet, exercise, and lifestyle habits remain the cornerstone of efforts to reduce total serum cholesterol concentrations. Some people cannot be correct high cholesterol with diet alone and require prescription medication. 

New methods are becoming increasingly available for testing, identifying and diagnosing high cholesterol for treatment. They will be discussed in the near future.

Currently the standard diagnoses includes CHD risk factors in addition to blood test to measure the cholesterol, LDL, and HDL cholesterol. The presence or absence of CHD or risk factors along with blood cholesterol levels determine the severity of risk and treatment for high cholesterol. Careful laboratory testing and consideration of CHD risk is vital to the treatment of the disease. 

All of the following would require nutrition intervention for high cholesterol:

People with no evidence of CHD and fewer than 2 risk factors:

• Total Serum Cholesterol ≥ 240 mg/dL

• HDL Cholesterol > 40 mg/dL

• LDL Cholesterol < 160 mg/dL

Individuals with CHD:

• LDL Cholesterol ≥ 100 mg/dL

Without CHD and fewer than 2 risk factors:

• LDL Cholesterol ≥ 160 mg/dL

Without CHD and two or more risk factors:

• LDL Cholesterol ≥ 130 mg/dL

Risk Factors for CHD

Age

• Male > 45

• Female > 55 or premature menopause without estrogen replacement

Family History of Premature CHD

Myocardial infarction or sudden death before age 55 in father or other male first-degree relative, or before age 65 in mother or other first-degree relative

Other Factors

• Current Cigarette Smoking

• Hypertension: Blood pressure ≥ 140/90 mm Hg or taking antihypertensive medication

• Total Cholesterol: > 200 mg/dL

• Low HDL Cholesterol < 40 mg/dL

• Diabetes Mellitus

Individuals with elevated serum cholesterol, elevated LDL-Cholesterol, and other identified risk factors are at risk for:

• Development of coronary heart disease

• Cerebrovascular accident, with familial hypertension present

• Death from coronary heart disease

For people at risk for CHD, due to elevated blood lipids, treatment of this condition through nutrition intervention, exercise, and in some cases medication, is important.

Medical Nutrition Therapy

Adequate consumption of adequate calories, carbohydrate, protein, fat, fiber sodium, and micronutrients to achieve and maintain a reasonable body weight.

To achieve the goal serum lipid levels for total cholesterol and LDL-Cholesterol: