Cholesterol: Is it Good, Bad, or Both?


This educational content related to heart health and Type 2 diabetes was made possible with support from Trulicity, a partner of Beyond Type 2. 


“I heard cholesterol is bad for you and causes heart disease.” 

Well, I heard cholesterol is good for you and reduces the chances of getting heart disease.” 

Have you had a conversation like this about cholesterol? You’re not alone, there’s a lot of misinformation about cholesterol and how it impacts your health, particularly type 2 diabetes. We’re here to answer the question if cholesterol is good, bad, or both, for your health. Spoiler alert: the answer isn’t so black-and-white.

What is Cholesterol?

To understand what cholesterol is, we need to talk about fat. Cholesterol is a type of fat or lipid that our body needs. Cholesterol has many functions, one of which is to serve as a vital part of cell membranes. The human body is wonderful, and it produces the cholesterol it needs on its own.

Simply put, cholesterol helps to build cells. It is also important for the production of different hormones (including testosterone, progesterone, aldosterone and cortisol). It also plays an important role in the way our body absorbs calcium, which helps with bone health.

Good Cholesterol vs. Bad Cholesterol

Cholesterol is a sticky substance that is produced in our liver. In fact, experts indicate that the liver produces approximately 1,000 milligrams of cholesterol per day. Cholesterol circulates in our bloodstream, but it cannot do it on its own, so it requires the help of lipoproteins, which are a lipid on the inside and a protein on the outside.

You have probably heard that there is good cholesterol that should be high, while the intake of bad cholesterol should be limited. This does not mean that there are two types of cholesterol. There is only one type of Cholesterol and the difference in the name refers to the protein that helps transport it. The names are low-density lipoprotein (LDL) and high-density lipoproteins (HDL) cholesterol.

LDL Cholesterol, known as the “bad cholesterol” is responsible for carrying cholesterol to the tissues, and its excess is associated with the development of arteriosclerosis, which is the hardening of the walls of the arteries. Arteriosclerosis can lead to coronary artery diseases, also known as heart disease.

HDL Cholesterol, known as the “good cholesterol” removes excess cholesterol from cells and plaque from the walls of the arteries, therefore lowering the risk of cardiovascular diseases such as heart disease.

What Does “High Cholesterol” Mean?

When the doctor tells you that you have high cholesterol, it means that you have exceeded the maximum amount that your body requires to maintain functions and it implies a health risk. Cholesterol levels greater than 11.1 mmol/L200 mg/dL indicate that it is outside the healthy range and it requires medical attention.

The Dangers of High Cholesterol

High cholesterol levels do not always cause symptoms. The good news is that there are simple clinical tests to rule out or confirm this clinical data. The greatest risk is directly related to cardiovascular health. High cholesterol levels increase the risk of heart disease. Myocardial infarction (heart attack) is the fifth leading cause of death in the United States.

Where Does Cholesterol Come From?

Although most of the cholesterol we have in our body is produced by the body itself, some of it comes from what we eat. However, there are cases in which, regardless of eating a healthy diet and exercising, you can have high cholesterol levels, which may be due to family inheritance. The presence of “familial hypercholesterolemia” in which there is a genetic mutation that prevents the body from eliminating excess cholesterol.

Whatever the case, food plays a very important role in cholesterol levels, and choosing foods that are low in animal fat and avoiding fried foods can help keep them within the ideal limits as well as physical exercise and, if necessary, the use of medications prescribed by a doctor.

Some facts

  • In 2015 and 2016, more than 12  percent of adults aged 20 years and older had total cholesterol levels greater than 13.3 mmol/L240 mg/dL, and more than 18 percent had less than 2.2 mmol/L40 mg/dL of good cholesterol or high-intensity lipoprotein (HDL).
  • 93 million adults over the age of 20 in the United States have total cholesterol levels greater than 11.1 mmol/L200 mg/dL. About 29 million American adults have cholesterol levels greater than 13.3 mmol/L240 mg/dL.
  • 7 percent of children and adolescents in the United States between the ages of 6 and 19 have a high total cholesterol level.

How to Manage Cholesterol with Food

  • Identify foods that are high in saturated fat. These are found primarily in processed foods like French fries, packaged bakery products, bacon, cold cuts and aged cheeses. Choosing fresh and natural foods such as fruits and vegetables is a good option to reduce cholesterol consumption.
  • Promoting the loss of body weight contributes to the reduction of cholesterol levels as well as cardiovascular diseases.
  • Exercising regularly helps raise HDL cholesterol levels as well as contributing to increased muscle mass and decreased body weight.

Taking care of yourself also involves taking care of your cardiovascular health. Approach your team of health professionals and create a plan to take care of your physical and emotional health with their help.

Reference sources

WRITTEN BY Eugenia Araiza/ Mariana Gómez, POSTED 01/29/21, UPDATED 11/30/22

Eugenia Araiza: Eugenia has a degree in nutrition specializing in diabetes and she is a diabetes educator. She was diagnosed with type 1 diabetes 25 years ago, she is the creator of Healthy Diabetes. She really enjoys studying and helping others in managing their different types of diabetes. She loves studying, managing type 1 diabetes, and nutrition. She especially enjoys writing about the impact diabetes has in her life. She lives surrounded by the love of her family, who are Luis Felipe, who lives with latent autoimmune diabetes in adults (LADA) type diabetes and her teenage son, Indigo.

Mariana Gómez: Mariana is a psychologist and a diabetese educator. In e2008, Mariana started a blog where she shares her life experience with others and started advocating through social media. Mariana worked with the Mexican Diabetes Federation as a communications manager and in other efforts to help build and empower the online diabetes community in Mexico. Today she is the director of emerging markets at Beyond Type 1. She is the mother of a teenager.