The Difference Between Serum Cholesterol and Dietary Cholesterol

When we talk about cholesterol, especially in the context of the risk of heart disease, we often turn to the foods we eat, and rightly so. A poor diet alongside a sedentary lifestyle is a leading cause of high cholesterol and increased cardiovascular risk. However, we will address some misconceptions about cholesterol in this article. Before doing so, it’s important to remember that serum cholesterol levels can depend on genetics. Recent research has also questioned how much serum cholesterol is responsible for more significant cardiovascular issues. These questions require more research and study, and we will bring this news to you as it breaks.

First and foremost, it’s essential to understand the difference between serum cholesterol circulating in the blood and dietary cholesterol – what you consume in food. While the medical community believed these were linked for a time, we now know that dietary and serum cholesterol are independent.¹ One of the healthiest, low-fat, and high-protein foods, shrimp, is very high in dietary cholesterol. Yet shrimp and similar foods are not concerning when it comes to cholesterol in the blood. In fact, a diet that includes shrimp as a primary protein would probably show a reduction in blood cholesterol versus, for example, beef as the primary meat. With that said, the true concern about blood cholesterol is a combination of poor dietary choices like saturated fats, sugary foods, and processed meals combined with a sedentary lifestyle. Other habits and even psychological issues like smoking, dehydration, and stress can cause the worsening of cardiovascular disease.

Is High Cholesterol All Your Fault?

Indeed, high cholesterol is primarily caused by poor diet and exercise habits. To that end, most patients can fix their cholesterol issue by eating less saturated fats, losing weight, and her exercising more. However, cholesterol can also be genetic, meaning higher cholesterol levels may run in the family, regardless of your diet or activity level. Knowing your family history of various cardiovascular risk markers is important to understand if you, too, may be predisposed to a problem.

Familial hypercholesterolemia occurs in about 1 in every 250 people and increases the risk of heart disease associated with excess serum cholesterol. Often, kids with this condition may need to start on statins at a very young age.

Reading Your Cholesterol Numbers

Blood or serum cholesterol is determined with a simple blood test. You will notice that most results will have four numbers: total cholesterol, LDL cholesterol (bad), HDL cholesterol (good), and triglycerides. Heart healthy levels are total cholesterol under 200, LDL under 100, HDL over 60, and triglycerides as low as possible and ideally lower than 150. While you can use these absolute numbers to calculate the risk of heart disease, you may also be interested in your cholesterol ratio, which is found by dividing your total cholesterol by your HDL. A higher ratio means a greater risk of heart disease. In other words, we are looking for your HDL to be as large a percentage of your total cholesterol as possible.

Is Cholesterol the Only Measure of Heart Disease Risk?

The short answer is no. We do see patients who have higher cholesterol numbers but do not have significant cardiovascular disease. As such, we take the total of all their risk factors into account when determining how to proceed. Other markers of heart disease risk are high blood pressure or hypertension, larger waist size, high blood sugar, smoking, history of heart disease in the family, and various dietary and exercise habits. Considering all of this, we can better estimate the risk of future heart disease and develop an appropriate screening schedule based on that knowledge.

Most importantly, if you are at risk of heart disease, ensure you are under the care of a highly skilled cardiologist who can identify cardiovascular issues early and offer the broadest range of treatment options. We encourage you to contact our office to schedule a consultation.

Related Topics:

• Healthy Versus Unhealthy Cholesterol
• What Is Cholesterol and Do We Need It or Not?
• National Dietary Guidelines Regarding Cholesterol

Reference:

1. Fernandez ML, Murillo AG. Is There a Correlation between Dietary and Blood Cholesterol? Evidence from Epidemiological Data and Clinical Interventions. Nutrients. 2022 May 23;14(10):2168. doi: 10.3390/nu14102168. PMID: 35631308; PMCID: PMC9143438.