Your body needs cholesterol. It is part of the structure of cells, the production of hormones and the formation of bile acids, which help digest fats. The body produces cholesterol, mainly in the liver, and also gets it from food. The concern is an excess of particles that promote the build-up of cholesterol in the arteries.

In short

The concern is an excess of particles that build up in the arteries, not cholesterol itself.
High HDL does not make up for high LDL, and your LDL target depends on your cardiovascular risk.
Fiber, the quality of fats and your overall eating pattern matter more than any “miracle” food.
High cholesterol usually causes no symptoms. Don't stop medications on your own.

LDL, HDL and VLDL: the carriers

Because cholesterol does not dissolve in blood, it travels in particles called lipoproteins. LDL, HDL and VLDL are types of these particles. In your test, LDL-C and HDL-C show how much cholesterol they carry.

LDL: watch out for excess

It carries cholesterol to the tissues. When there are too many circulating LDL particles, they can become trapped in the artery walls, contributing to atherosclerotic plaques. That is why lowering LDL is a central part of cardiovascular prevention.

HDL: think “H for hero”

HDL helps carry cholesterol from the tissues back to the liver. The word “hero” helps you remember its role, but it doesn't mean guaranteed protection: high HDL doesn't make up for high LDL. It needs to be interpreted alongside the rest of the test and your health history.

VLDL: mainly carries triglycerides

Produced by the liver, VLDL carries triglycerides as well as cholesterol. Its remnants can contribute to atherosclerosis. Triglycerides are another type of fat: they are not the same as cholesterol.

Look beyond total cholesterol

The total number is a clue. The fractions and their clinical context tell a more complete story.

How is the total made up?

Put simply: total cholesterol ≈ LDL-C + HDL-C + VLDL-C. This is a teaching approximation, since there are other particles and differences between laboratory methods. VLDL-C is often estimated; it is not the triglyceride value itself.

Same total, different profiles

Illustrative example, in mg/dL. Profile A: LDL 140 + HDL 70 + VLDL 20 ≈ total 230. Profile B: LDL 170 + HDL 40 + VLDL 20 ≈ total 230. The totals are the same, but the second profile has more cholesterol in the atherogenic fractions. The first may also need treatment: an LDL of 140 is not an appropriate target for everyone.

HDL: is there an ideal value?

HDL below 40 mg/dL in men and 50 mg/dL in women is considered low by widely used criteria. These thresholds help with assessment, but they are not stand-alone treatment targets. Exercise may raise HDL; genetics and other conditions also influence the result. You shouldn't try to raise it at any cost.

So what should my LDL be?

The target depends on your cardiovascular risk. Diabetes, high blood pressure, smoking, kidney disease, family history and a previous heart attack or stroke all change this assessment. There is no single “normal” value that fits everyone.

Other information that can help

Non-HDL cholesterol (total minus HDL) brings together the cholesterol in potentially atherogenic particles. Depending on the clinical indication, ApoB and lipoprotein(a), or Lp(a), can complement the assessment. Thyroid, blood sugar, medications and family history also deserve attention. Not everyone needs every test.

Food that makes a difference

A functional approach considers foods, metabolism, digestive tolerance and your routine.

1. Include fiber every day

Oats, beans, lentils, chickpeas, fruit and vegetables help enrich your diet. Soluble fibers, like those in oats, may help lower LDL. Increase them gradually, with adequate hydration and respect for your gut tolerance.

2. Improve the quality of your fats

Replace part of the butter, cream, fatty meats, processed meats and very fatty cheeses with olive oil, nuts, seeds and avocado, in measured portions. Coconut oil is rich in saturated fat and is not a strategy to lower LDL. Removing fat and adding sugar in its place doesn't help either.

3. Vary your protein sources

Alternate beans and other legumes, fish, skinless chicken and lean cuts. Sardines are an affordable option. If you don't like fish, use chicken or plant proteins such as tofu and lentils. These options vary your protein, but they don't have the same omega-3 content as fish.

4. Look after your triglycerides too

Cut back on soft drinks, sugary juices, frequent sweets and excess alcohol. Choose whole fruit and whole grains. Rice and other carbohydrates can be part of the plan: portion size and meal composition matter. Don't start drinking to raise your HDL.

5. Think about your eating pattern

Vegetables of many colors, minimally processed food and consistent meals are worth more than a “miracle” food. Eggs don't need to be automatically banned: quantity, what you eat them with and your individual profile should be assessed. There's no reason to cut out gluten or lactose just because of high cholesterol.

What about the orthomolecular approach? Adequate nutrient intake and correcting identified deficiencies can be part of care. Supplements are not mandatory and do not replace prescribed treatment. Omega-3 is mostly used in specific situations of high triglycerides; it is not a universal solution for high LDL.

Putting it on your plate

An educational example of one day. Portions and choices need to be adapted to your needs.

Breakfast: Oats with unsweetened plain yogurt and fruit, with the fat content adjusted to your plan. Alternative: whole-grain bread with chickpea spread and a piece of fruit.
Lunch: Half the plate with leafy greens and vegetables; on the other half, brown rice or another grain, beans and a source of protein such as fish, chicken or tofu. Finish with a small amount of olive oil.
Snack, if hungry: Whole fruit with a small portion of unsalted nuts. The snack is not mandatory: it depends on your hunger, routine and plan.
Dinner: Roasted or sautéed vegetables, lentils and shredded chicken or tofu. Another option: repeat the balanced structure of lunch, adjusting the portions.

Your test deserves an individual plan

In the consultation, I assess your history, tests, diet and routine to build a strategy you can actually keep. Follow-up makes it possible to adjust choices and monitor your response, in partnership with medical assessment when needed.

Book a consultation

Dra. Daniely Catharino TooleyClinical, functional and orthomolecular nutritionist · CRN3/6794

References (5)+

American Heart Association: What Your Cholesterol Levels Mean (2026); HDL, LDL and Triglycerides (2026).
American Heart Association. 2026 Dietary Guidance. DOI: 10.1161/CIR.0000000000001435.
American Heart Association. Dietary Fats and Cardiovascular Disease (2017).
NHLBI/NIH. Blood Cholesterol: Diagnosis; Treatment.
MedlinePlus/NIH. HDL: The Good Cholesterol (2025).

Educational content for adults. This guidance does not replace an individual consultation, diagnosis or treatment.

High cholesterol: where to start?