High levels of total cholesterol

Medical Q&A [Moderated]
1

Hi Doctors,

I’m a 23 years old strength athlete and I recently made a blood test.
Everything was fine except the cholesterol test results, which made me a little bit confused:

total cholesterol- 334
VLDL- 9
LDL- 225
HDL- 100
Triglycerides- 46

I have low Triglycerides and high HDL, but really high levels of LDL.
I’m 5’10 and weigh 185 pounds.
What do you think it means?
Can eating less cholesterol and saturated fat fix this (I currently eat red meat, eggs and dairy products daily. My diet is also high in fiber)?

2

What’s your family history look like?

3

Both of my parents have a total cholesterol under 170.

4

Okay. Seems like a significant familial hypercholesterolemia syndrome is unlikely here, although that information doesn’t rule out genetic possibilities altogether either.

Hard to say for sure what’s driving it, but I’d probably continue the high-fiber diet and shift your dietary fat intake to primarily unsaturated sources. Some people (upwards of 15-25% of the population) are “hyper-absorbers” of dietary cholesterol. In these people, reducing dietary cholesterol can be beneficial as part of an overall strategy, but it tends to make little difference in the remainder of the population who aren’t hyper-absorbers.

5

Thanks! I was worried I need medications or something…
I’ll change my diet as you suggest: one egg per day, no fat dairy and chicken/fish instead of red meat (I hope you will correct me here if I’m wrong).

And one last question: How long should I eat this way before getting another blood test?

6

I can’t say whether you’re among the individuals who are particularly sensitive to dietary cholesterol (i.e., a hyperabsorber), so the egg limitation may or may not be effective for you.

Dairy products are actually a bit unique and don’t appear to have adverse effects on blood lipids and other cardiometabolic parameters, so restricting yourself to nonfat dairy for this purpose isn’t necessary unless you want to, or if you need it to control total calorie intake.

As for red meat, we have discussed that at length recently as well in a podcast and article. I would agree with consumption of fish on a regular basis, maintaining high fiber intake, and primarily unsaturated sources otherwise.