What Is LDL Cholesterol?

Low-Density Lipoprotein or Bad Cholesterol

LDL Cholesterol Testing

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Low-density lipoprotein (LDL) is what many refer to as "bad fat" because high levels in the blood put you at higher risk of developing heart disease. LDL particles transport cholesterol around the body.

At high blood levels, excess LDL particles—and the cholesterol it transports—can stick to the walls of the arteries making them hard and narrow, a condition known as atherosclerosis. The two main ways to lower your LDL cholesterol are lifestyle changes and medication.

Health Effects of LDL

When LDL cholesterol forms plaques in the arteries, it limits blood flow to and from the heart. If the heart does not get enough oxygen from the blood it can cause chest pain or angina. If complete blockage of a vessel occurs and no oxygenated blood is able to get through, a person may experience a heart attack.

High LDL levels can lead to:

  • Chest pain
  • Heart attack
  • Stroke (a blood clot in the brain)

On the other hand, high-density lipoprotein (HDL) is called good fat because it carries excess cholesterol back to the liver. A healthy diet contains high levels of HDL and low levels of LDL. People need a little bit of both because cholesterol—the waxy, fat-like substance contained in cell walls—is essential to cellular function.

Factors Affecting LDL Levels

Poor diet, lack of exercise, obesity, and diabetes can increase LDL levels. In fact, LDL cholesterol is the main target for assessing heart disease risk. For every 10% increase in LDL cholesterol there’s a 10% higher risk of having a heart attack or stroke.

Lifestyle choices such as the foods you eat, smoking, and physical activity usually make the biggest impact on your LDL levels. But there are some genetic conditions such as familial hypercholesterolemia (FH) or medical conditions such as chronic kidney disease, diabetes, and HIV/AIDS that can cause higher LDL levels.

Age and gender also play a role. Over time cholesterol levels rise in both men and women, but men tend to have a rise in LDL earlier in life whereas women’s LDL level tends to rise after menopause.  

Tests and Screening

A blood test can measure your cholesterol levels. These include LDL, triglycerides, and HDL—all of which play a major role in heart health. Age, prior health conditions, risk factors, and family history dictate when and how often a person should get tested.

Current guidelines suggest that children and younger adults should get tested every five years beginning at ages 9 to 11. Men ages 45 to 65 and women ages 55 to 65 should have it every one to two years. People over age 65 should be tested yearly.

If you or a loved one has a family history of high blood cholesterol, heart attack, or stroke you should talk to your doctor about getting tested more frequently.

Interpreting Results

For LDL levels, the general rule of thumb is the lower, the better. The results are reported in milligrams per deciliter (mg/dL).

LDL Ranges

  • Optimal: 100 mg/dL or lower
  • Near or above optimal: 100 to 129 mg/dL
  • High: Over 130 mg/dL

Those with levels between 130 and159 mg/dL can sometimes reach near-optimal levels with therapeutic lifestyle changes (exercise, weight management, and heart-healthy eating) alone.

People with consistently high LDL levels may be recommended a cholesterol-lowering drug called a statin. The intensity of the statin, that is how much and how potent a statin is needed, depends on how much the person's cholesterol needs to be lowered.

Want to better understand what your test results mean? Start by inputting your results into our lipid test analyzer below. It can help you see what your values may mean for your health so you can follow up appropriately with your doctor.

Lifestyle Changes to Lower LDL

If you have high LDL, you can lower it through lifestyle changes or medication.

Lifestyle changes include:

  • Heart-healthy diet: Eat a heart-healthy diet such as the DASH eating plan or a diet low in saturated and trans-fat.
  • Weight management: Losing excess weight can lower LDL cholesterol levels.
  • Physical activity: Perform at least 30 minutes of moderate-intensity cardio exercise or weightlifting per day.

Foods that increase HDL levels and decrease LDL levels include whole grains, nuts, beans, olive oil, and fatty fish. 

Foods That Raise LDL

People with high LDL levels, older adults, and those with a history of obesity, diabetes, or a family history of heart disease are at the highest risk of developing heart disease, stroke, and peripheral artery disease. They should therefore be especially mindful of maintaining a heart-healthy diet.

Still, high LDL levels can negatively impact anyone, so everyone should consider maintaining a heart-healthy diet. Some foods that you may want to avoid include:

  • Deep-fried foods
  • Fatty cuts of meat
  • Butter
  • Processed foods such as pastries, biscuits, and muffins
  • Full-fat dairy products such as milk, cream, and sugary yogurt
  • Many takeout foods such as hamburgers and pizza

Foods That Lower LDL

Adding foods that lower LDL, the harmful cholesterol-carrying particle that contributes to artery-clogging atherosclerosis, is the best way to achieve a low cholesterol diet. These high fiber foods may help:

  • Oats
  • Barley and other grains
  • Eggplant and okra
  • Nuts
  • Apples, grapes, strawberries and citrus fruits
  • Beans
  • Soy

Medications and Treatments

For many people, lifestyle changes alone may not be enough to lower cholesterol levels to optimal levels. This is when medications are needed. There are several types of cholesterol-lowering drugs available, the most common being statins. Statins work by reducing the amount of cholesterol the liver makes. 

Cholesterol-lowering drugs work in different ways and can have different side effects. Talk to your healthcare provider about which one is right for you. While you are taking medicines to lower your cholesterol, you still should continue with the lifestyle changes.

People with genetic conditions such as FH, strict adherence to a heart-healthy diet, exercise, and medication may not adequately lower LDL levels. This small subset of people may receive a treatment called lipoprotein apheresis—a blood-filtering treatment that removes LDL from the blood and returns it back to the person.

Prevention

To prevent high cholesterol levels:

  • Eat a low-salt diet that emphasizes fruits, vegetables and whole grains
  • Limit the amount of animal fats and use good fats in moderation
  • Lose extra pounds and maintain a healthy weight
  • Quit smoking
  • Exercise on most days of the week for at least 30 minutes
  • Drink alcohol in moderation, if at all
  • Manage stress
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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Cleveland Clinic. What is LDL cholesterol?. 2020.

  3. MedlinePlus. LDL: The "Bad" Cholesterol. 2020.

  4. 6. Cholesterol - healthy eating tips. Betterhealth.vic.gov.au. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cholesterol-healthy-eating-tips. Published 2020. Accessed August 27, 2020.

  5. Harvard Health. 11 foods that lower cholesterol. 2020.

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