Views on cholesterol have changed in the past few years with new medical studies. Is having high levels of cholesterol really that bad? How has medical opinion changed about high cholesterol? Dr Mukesh Goel, senior consultant, cardiovascular and cardiothoracic surgery, heart and lung transplant surgery, Indraprastha Apollo Hospitals, says: “Recent research has revealed that the risks associated with high cholesterol may vary from person to person and depend on overall metabolic health.
Historically, high levels of LDL (“bad” cholesterol) were seen as a major risk for heart attacks and strokes, but new studies show some people can have elevated cholesterol and remain healthy, especially if they do not have other metabolic conditions like diabetes.However, for most individuals, high cholesterol is still linked with increased chances of heart disease, so doctors recommend keeping it in check. The consensus now is that cardiovascular risk should be assessed using multiple factors, including blood pressure, lifestyle, and family history, and not just cholesterol levels alone.”
Can people have high cholesterol and clean arteries? Where else does plaque build up?
Yes, some people with high cholesterol can have clean cardiac arteries, usually when they have healthy metabolic profiles and few other risk factors. But high cholesterol may contribute to plaque buildup not just in the heart but also in other areas like the legs (peripheral arteries) and brain, where it can cause stroke and peripheral arterial disease. Risk comes both from slow narrowing of arteries and from sudden plaque rupture, which can lead to serious events like heart attacks or strokes. Even if the main heart arteries appear healthy, plaque can accumulate elsewhere, risking multiple organ systems.
Is cholesterol in blood a result of one’s body’s metabolism or directly linked to diet?
Cholesterol in blood comes from both dietary sources and the body’s metabolism. The liver produces cholesterol naturally (endogenous), and additional cholesterol enters the body from foods (exogenous). Studies show genetics, obesity, medical conditions, and metabolic factors can strongly affect blood levels, sometimes more than diet alone. The human body has mechanisms that regulate absorption and production, so some people may eat high-cholesterol foods without much change in blood cholesterol levels. Most modern research says saturated fats, trans fats, and excess calories raise blood cholesterol more than dietary cholesterol itself, showing metabolism plays a big role.
Can vegetarians get high cholesterol?
Vegetarians can develop high cholesterol due to genetic factors, excess intake of unhealthy fats, lack of exercise, or metabolic health issues. Even without animal-based foods, processed vegetarian products, and some plant oils (like coconut or palm oil) can increase cholesterol. Studies indicate that vegetarians usually have better cholesterol profiles than meat-eaters, but no diet guarantees complete protection. Factors like family history, body weight, and lifestyle habits are all important, highlighting the need for regular cholesterol checks regardless of dietary choices.