I’ve been noticing a troubling trend lately. Young people—teens, even people in their twenties—are coming in for routine checkups or minor complaints, and we decide to run some basic tests. But when I look at their ultrasound scans, I’m surprised to see something that was once rare in young patients: a “whitish” liver. Almost all of them are diagnosed with grade 2 fatty liver. This isn’t something you’d expect to see in someone so young.
In the past, fatty liver and high cholesterol were problems associated with middle age or beyond. But now, more and more young people are facing these silent threats. It’s not just the liver scans that reveal the problem. A quick look around explains a lot: fewer kids are out playing sports, riding bikes, or just being active. Instead, they’re spending hours glued to screens, scrolling on social media, or gaming. Add to this the constant access to fast food—pizzas, burgers, sugary drinks—and it starts to make sense why we’re seeing such a rapid rise in conditions like high cholesterol in young people.
What is High Cholesterol?
So, what exactly is high cholesterol? Cholesterol is a type of lipid—a waxy, fat-like substance that the liver produces. It’s vital for building cell membranes, producing certain hormones, and creating vitamin D. Our bodies need it, but only in the right amounts. When we consume too many unhealthy fats, cholesterol levels can rise to harmful levels.
Since cholesterol doesn’t dissolve in blood, it needs a “ride” to travel through the bloodstream. That’s where lipoproteins come in. Lipoproteins are particles made from fat and protein that carry cholesterol through the body. The main types of cholesterol are:
- LDL (Low-Density Lipoprotein): This is the so-called “bad” cholesterol. LDL carries cholesterol to the arteries, where it can accumulate as plaque, narrowing the blood vessels and increasing the risk of heart disease.
- HDL (High-Density Lipoprotein): Known as the “good” cholesterol, HDL helps clear excess cholesterol from the blood, transporting it back to the liver for processing and removal. Higher levels of HDL protect against heart disease.
- Triglycerides: Though not cholesterol, triglycerides are another type of fat in the blood that the body uses for energy. High triglyceride levels, particularly when combined with high LDL or low HDL, can increase the risk of heart disease.
When there’s too much LDL and triglycerides and too little HDL, it creates the perfect environment for plaque to build up in the arteries, a condition known as atherosclerosis. Over time, this restricts blood flow and raises the risk of serious health problems, including heart attacks, strokes, and even liver disease.
The Link Between High Cholesterol, Fatty Liver, and Lifestyle
High cholesterol and fatty liver are closely connected, especially in young people who are developing these conditions faster than ever before. Why? It’s largely lifestyle-driven. When I think about the young patients I see, most have a combination of:
- Poor Diet: Fast foods high in saturated and trans fats, sugary beverages, and snacks low in nutritional value are often the go-to meals. These foods contribute to both high cholesterol and the buildup of fat in the liver.
- Lack of Physical Activity: Children and teens today spend more time on screens than on playgrounds. The absence of physical exercise means their bodies are storing more fat, which contributes to fatty liver and elevated cholesterol.
- Smoking and Alcohol: While this doesn’t apply to all young people, some start smoking or drinking at an early age, both of which increase cholesterol and liver fat accumulation.
Why High Cholesterol in Youth is Dangerous
High cholesterol is often a silent condition with no obvious symptoms, especially in young people. This is why it’s so dangerous. By the time they feel the effects, it might be in the form of a more serious condition, like a heart attack or fatty liver disease. According to the CDC, a high total cholesterol level is anything above 240 mg/dL. But for many young people, they won’t know they have high cholesterol until they’re tested, which is why early cholesterol screening is so important.
What Are the Symptoms of High Cholesterol?
High cholesterol itself doesn’t cause symptoms, but over time, it contributes to other health issues that do have symptoms, like:
- Chest Pain (Angina): Caused by restricted blood flow to the heart.
- Numbness or Coldness in Extremities: Blockages in arteries can reduce blood flow to hands and feet.
- Fatigue or Shortness of Breath: Reduced blood flow due to blocked arteries can make people feel tired or out of breath.
- Yellowish Patches Around the Eyes (Xanthomas): These fatty deposits can appear in people with extremely high cholesterol.
If you notice any of these symptoms, especially in combination, it’s worth getting a cholesterol test. But remember, high cholesterol usually has no symptoms, so routine testing is key.
Cholesterol Levels: What’s Normal?
A cholesterol test, or lipid panel, measures different types of cholesterol. Here’s what’s generally considered healthy for adults:
| Cholesterol Type | Optimal Level |
|---|---|
| Total Cholesterol | About 150 mg/dL |
| LDL | About 100 mg/dL or less |
| HDL | At least 40 mg/dL for men, 50 mg/dL for women |
| Triglycerides | Less than 150 mg/dL |
For LDL levels specifically:
| LDL Cholesterol Level | Category |
|---|---|
| Below 100 mg/dL | Optimal |
| 100-129 mg/dL | Near/Above Optimal |
| 130-159 mg/dL | Borderline High |
| 160-189 mg/dL | High |
| Above 190 mg/dL | Very High |
What Causes High Cholesterol?
High cholesterol can result from several factors:
- Diet: Foods high in trans fats, saturated fats, and dietary cholesterol—such as red meat, butter, and fast food—raise LDL levels.
- Lack of Exercise: A sedentary lifestyle can lower HDL and raise LDL and triglycerides.
- Smoking: Smoking lowers HDL and damages blood vessels, allowing plaque to build up more easily.
- Genetics: Familial hypercholesterolemia is an inherited condition that prevents the body from clearing LDL from the blood.
- Medical Conditions: Diabetes, hypothyroidism, and obesity all raise the risk of high cholesterol.
Cholesterol Test: Why and When to Get Tested
If you’re over 20 or at risk, a cholesterol test every 4-6 years is recommended. Your doctor might suggest more frequent tests if you have risk factors. The test measures your total cholesterol, LDL, HDL, and triglycerides to give a full picture of your heart health.
How to Lower Cholesterol Naturally
If you have high cholesterol, lifestyle changes can often bring it under control:
- Heart-Healthy Diet: Add more fiber from fruits, vegetables, and whole grains. Choose lean protein sources and avoid foods high in trans fats and saturated fats.
- Exercise Regularly: Even 30 minutes of moderate activity, like walking, can raise HDL and lower LDL.
- Quit Smoking: Quitting smoking improves HDL levels and reduces plaque buildup.
- Limit Alcohol: Excessive drinking can increase triglycerides and lead to fatty liver.
- Maintain a Healthy Weight: Losing even a small amount of weight can significantly improve cholesterol levels.
Medications for High Cholesterol
If lifestyle changes aren’t enough, medications may be necessary. Statins are the most common drugs for lowering cholesterol by blocking the liver’s cholesterol production. Other options include:
- Niacin
- Bile Acid Sequestrants
- Cholesterol Absorption Inhibitors
- PCSK9 Inhibitors
Each has potential side effects, so discuss with your doctor which medication might be right for you.
Natural Supplements for Cholesterol: Do They Work?
Some natural supplements like garlic, red yeast rice, plant sterols, and flaxseed claim to lower cholesterol. However, the evidence is mixed, and they shouldn’t replace prescribed medications. Always consult your doctor before starting any supplement.
Foods to Avoid with High Cholesterol
If you have high cholesterol, it’s wise to avoid:
- Red Meat and Organ Meats: High in saturated fats.
- Fried Foods: Often cooked in oils with trans fats.
- Sugary Beverages: Raise triglycerides.
- Full-Fat Dairy Products: High in saturated fat.
Prevention: Protecting Your Heart and Liver
Preventing high cholesterol starts with healthy habits:
- Eat a balanced diet rich in fiber.
- Stay physically active to raise HDL and lower LDL.
- Quit smoking and limit alcohol.
- Get regular check-ups to monitor cholesterol early.
Takeaway: The Real Impact of High Cholesterol
High cholesterol may be silent, but its consequences are not. By understanding what raises cholesterol and taking steps to lower it, you can reduce the risk of heart disease, fatty liver, and other serious complications. Start with small changes—replacing sugary drinks, adding more vegetables, or taking a daily walk—and build from there.
Remember, managing high cholesterol is not just about the numbers on a report; it’s about protecting your heart, your liver, and ultimately, your future.
