6 Things Besides Food That Can Cause High Cholesterol

Brett A. Wohler, MD
By Brett A. Wohler, MD
July 17, 2018
Waist circumference can influence your cholesterol levels

As a family physician in Alexandria, Virginia, I’m routinely asked by patients, “What should I eat to lower my cholesterol?”

It’s an important question. Cholesterol is a waxy, fat-like substance in all your cells. When you have too much of it, it can stick to the lining of your blood vessels, limit blood flow and increase your risk of heart attack and stroke. Making dietary changes can help, so I offer my patients at Franconia Family Medicine some standard, good advice: limit saturated fat and eat more veggies, beans and whole grains.

I also tell my patients that diet may not be the only cause – or even the main cause – of their high cholesterol. These are six factors besides food that can increase your risk of high cholesterol.

  1. Obesity. When you hear the word “obese,” you probably think of an extremely large person. The reality is that obesity occurs well before that point. It’s defined as having a body mass index of 30 or greater, which describes around 40 percent of U.S. adults, according to the Centers for Disease Control and Prevention. Excess weight can increase the amount of LDL, or “bad” cholesterol, in your blood.
  2. Lack of exercise. If you don’t get 30 minutes of some type of exercise every day, it’s time to start. Exercise helps boost your body’s HDL, or “good” cholesterol, which is associated with a lower risk for cardiovascular disease. Exercise also helps your body get rid of some LDL, moving it from the blood to the liver, where it then gets used for digestion or expelled from the body.
  3. Cigarettes. Smoking cigarettes can lower HDL levels. In addition, it can damage the walls of your blood vessels. The roughed-up walls “catch” cholesterol particles, which can build up and become plaques. When these plaques cause arteries to narrow and restrict blood flow, the condition is called atherosclerosis. You may already know that term, since it’s the typical cause of heart attacks and strokes.
  4. Diabetes. Like cigarette smoking, type 2 diabetes tends to lower good cholesterol. It also raises LDL and triglycerides, a type of blood fat. In people with diabetes, the combination of low HDL, high LDL and high triglycerides is known as “diabetic dyslipidemia.” This condition increases the risk of early heart disease.
  5. A large waistline. Whether you’re overweight or even an average weight, the size of your waistline matters for your health. If you’re a man, your risk of high cholesterol increases when your waist circumference (how big your waist is all the way around) is at least 40 inches. If you’re a woman, the number is 35 inches.
  6. Genetics. Some people have an inherited form of high cholesterol. The most common one is called familial hypercholesterolemia, and it affects about 1 in 500 people. In other words, it’s not very common. But if you have very tough-to-treat high cholesterol, it’s something you and your doctor should talk about.

Whatever the reasons for your high cholesterol, various lifestyle changes, sometimes with the addition of medications, can effectively lower it. However, I know I’m in good company when I tell my patients there’s so much more to health than cholesterol numbers. That’s why MDVIP-affiliated physicians, including my family practice in Alexandria, give patients a unique panel of tests – including advanced tests for cholesterol and inflammation – as part of the annual MDVIP Wellness Program.

This blog reflects the medical opinion of Dr. Bret Wohler, an MDVIP-affiliated, board-certified family practice physician, and not necessarily the opinion of all physicians in the MDVIP national network.


About the Physician
Brett A. Wohler, MD

I am a primary care physician practicing in a personalized healthcare model with an emphasis on prevention, wellness and early detection. As a family physician, I see children and make rounds with my patients admitted to INOVA Alexandria Hospital. My practice is located in Alexandria, Virginia and serves the DC Metro area, including Springfield, Fairfax, Alexandria and Arlington, as well as surrounding areas in Maryland. 

My practice philosophy is focused on getting to know and understand my patients as best I can to help guide them through the maze of our current healthcare system. This commitment involves partnering with patients and continually discussing their health concerns and lifestyle choices. As a private doctor, I like to emphasize the power of the individual and to help him or her using natural treatments (more exercise, stress management, healthier diet and weight management) rather than pharmaceuticals when possible. Similar to concierge medicine practices, I also offer conveniences like same- or next-day appointments that start on time. 

I have been named to the list of Best Doctors in America® for 18 consecutive years.

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