You went for health screening and your cholesterol level is high. Suddenly, you’re told to “watch your food” — but what does that really mean? Should you avoid eggs? Stop eating prawns? Ditch all fat?
Not exactly.
Cholesterol is one of the most misunderstood parts of your health report. Many of us fear it without really understanding what it does — or confuse the cholesterol in our food with the cholesterol in our blood.
Let’s break it down once and for all. Because not all cholesterol is bad — and managing it doesn’t mean you have to give up everything you love.
What Is Cholesterol, and Why Does It Matter?
Cholesterol is a waxy, fat-like substance found in every cell of your body. Your body uses it to build cells, make hormones (like oestrogen and testosterone), and even produce vitamin D. [1]
20% of our cholesterol comes from food — but your liver actually makes most of it, making up 80% of our cholesterol. [2]
So why does high cholesterol get a bad reputation?
Because when you have too much of the “bad” cholesterol (LDL), it can start building up in your blood vessels, forming plaques that block blood flow — leading to heart disease and stroke. On the flip side, the “good” cholesterol (HDL) helps carry cholesterol away from your arteries and back to the liver. [3]
Know Your Numbers — And What They Mean
When you do a cholesterol test (lipid profile), here’s what you’ll see [4] :
- Total Cholesterol: The overall amount of cholesterol in your blood. This test gives a quick overview of the cholesterol levels and may prompt further investigation into the levels of LDL, HDL and Triglycerides if too high (>5.2 mmol/L). [4]
- Low-Density Lipoprotein (LDL) Cholesterol: The “bad” cholesterol that clogs arteries. The main target for controlling cholesterol, as it is the “bad” cholesterol that clogs arteries. Your healthy level depends on your heart risk:
Low risk: <3.0 mmol/L
Moderate risk: <2.6 mmol/L
High risk: ≤1.8 mmol/L
Very high risk: ≤1.4 mmol/L
Hence the target LDL will be different for individuals depending on their cardiovascular disease risk so discuss this with your healthcare professional/ health screening centre. [4]
- HDL (High-Density Lipoprotein): The “good” cholesterol that protects your heart. A normal range would be >1.0mmol/L for men and >1.3mmol/L for women. [4]
- Triglycerides: Another type of fat — high levels also raise heart risk. A normal range would be <1.7mmol/L. [4]
- Non-HDL Cholesterol: This is your total cholesterol minus HDL — essentially all the “bad” cholesterol in your blood. It’s a strong predictor of cardiovascular risk, especially if triglycerides are high. A typical target is <3.4 mmol/L for low risk individuals, but your doctor may individualise this based on your risk profile below: [4]
Low Risk: Non-HDL cholesterol target is <3.8 mmol/L.
Moderate Risk: Non-HDL cholesterol target is <3.4 mmol/L.
High Risk: Non-HDL cholesterol target is ≤2.6 mmol/L.
Very High Risk: Non-HDL cholesterol target is ≤2.2 mmol/L.
Similar to your LDL profile, do discuss this with your healthcare professional/ health screening centre to identify your risk profile and therefore target range.
Risk Factors You Can’t (and Can) Control
Some people have higher cholesterol though no fault of their own. Your risk naturally increases with:
Non-Modifiable Factors [5] :
- Age – Cholesterol levels tend to rise with age
- Family history / Genetics – You can inherit a higher cholesterol risk
Modifiable Factors [5] :
- Eating too much saturated or trans fat
- Lack of physical activity
- Poor lifestyle habits such as smoking, getting inadequate sleep
- Uncontrolled Co-morbidities like diabetes, high blood pressure (hypertension), obesity
💡 Good news: Even if high cholesterol runs in your family, lifestyle changes and medical treatment can still make a difference. Speak to your doctor for advice to manage high cholesterol better.
👉 Want to learn more about cholesterol and identifying your heart disease risk? Find out more here MySihatPal
The Real Culprits: Fats That Raise Your Risk
For most people, dietary cholesterol has little effect on blood cholesterol levels. The real issue? Saturated fats and trans fats — these raise your LDL (“bad”) cholesterol far more than dietary cholesterol ever could.
So yes, you can enjoy that egg — but what you really need to watch out for are the hidden fats in foods like fried snacks, santan-heavy dishes, fast food, and packaged baked goods.
Conclusion – Know First, Act Next
You don’t have to be afraid of cholesterol — you just need to understand the difference between the good and the bad. By knowing your numbers early and recognising what truly affects them, you can take charge of your heart health before problems arise.
Stay tuned for Part 2, where we’ll dive into foods that help lower cholesterol naturally and make healthy eating work in your everyday life. Stay tuned!
Written by Dietitian Jonathan
References:
- Centres for Disease Control and Prevention. Cholesterol [Internet]. Available at https://www.cdc.gov/cholesterol/about/index.html. Accessed 8 October 2025.
- Harvard Health Publishing. Cholesterol production in your body [Internet]. Available at https://www.health.harvard.edu/heart-health/how-its-made-cholesterol-production-in-your-body. Accessed 8 October 2025.
- Pappan Net al. Dyslipidemia. StatPearls [Internet]. Available at https://www.ncbi.nlm.nih.gov/books/NBK560891/ . Accessed 8 October 2025.
- Clinical Practice Guideline Management of Dyslipidaemia 2023 6th Edition. Available at https://www.malaysianheart.org/publication/clinical-practice-guidelines/p/clinical-practice-guidelines-management-of-dyslipidaemia-2023-6th-ed. Accessed 8 October 2025.
- Centres for Disease Control and Prevention. Risk Factors for High Cholesterol [Internet]. Available at https://www.cdc.gov/cholesterol/risk-factors/index.html
