March 13, 2025, 2:30 pm | Read time: 5 minutes
Erectile dysfunction, calcified arteries, heart attacks — when the body no longer functions properly, high cholesterol levels are often seen as the cause. Dr. Matthias Riedl, one of Germany’s leading cholesterol experts, explains to FITBOOK what lies behind elevated blood lipid levels and how they can be lowered naturally.
Too much alcohol, fatty food, and little exercise. Poor blood lipid levels are widespread but often go unnoticed by those affected. Dr. Matthias Riedl, nutritionist and medical director of Medicum Hamburg, estimates that about 60 percent of adults in Germany have elevated cholesterol levels. This is “often discovered incidentally — or only after a heart attack or stroke has occurred.” Excessive levels are caused by fats that are deposited on the walls of blood vessels, causing them to become increasingly narrow over time. The good news is that cholesterol can usually be lowered naturally. FITBOOK also explains when the values are considered too high.
Overview of Cholesterol
What Is Cholesterol?
Cholesterol is an essential component of cell membranes and a naturally occurring fat (lipid). It also plays an important role in numerous metabolic processes — including hormone production. The human body produces almost 80 percent of cholesterol itself, while the rest is absorbed through food.
Not All Cholesterol Is the Same
Cholesterol is a cellular building block that is vital for humans and animals. It ensures the normal formation of vitamin D and testosterone and also plays a decisive role in the digestion of fat. Because it is so important for the normal functioning of the body, it is produced in the organism itself. The cholesterol measured in the blood, i.e., total cholesterol, is made up of two different parts: LDL and HDL.
- LDL means: Low Density Lipoprotein (lipoprotein with low density)
- HDL means: High-Density Lipoprotein (lipoprotein with high density)
It’s important to note that cholesterol is not uniform. There is “good” (HDL) and “bad” (LDL) cholesterol. HDL protects the blood vessels by transporting excess cholesterol in the blood from the artery walls back to the liver and, thus, presumably preventing harmful changes to the vessel walls. Conversely, the harmful LDL transports fat particles to the cells, where they can accumulate and potentially lead to dangerous vascular calcifications.
If LDL levels are elevated, cholesterol is increasingly deposited in the walls of the blood vessels. This is particularly dangerous for two reasons:
- These deposits (also known as plaques) can lead to a narrowing of the vessels (arteriosclerosis) and, in the worst case, can even become blocked.
- In addition, plaques promote inflammatory reactions that damage the vessel walls. In response, the body then tries to repair small injuries with blood platelets and new tissue, but this makes the vessel walls increasingly narrow, stiff, and brittle.
This increases the risk of deposits rupturing and dangerous blood clots (so-called thrombi) forming, which can block an already constricted vessel. The latter are often the cause of heart attacks and strokes.1
Which Values Should Not Be Exceeded?
Total cholesterol levels usually increase with age. Young women often have lower levels than young men. This difference evens out with age, with women then even having slightly higher levels on average than their male peers. But how much is too much? “The value for total cholesterol should be below 200 milligrams per deciliter,” explains Riedl at FITBOOK.
Values for LDL and HDL cholesterol
LDL cholesterol, on the other hand, should not exceed 150 milligrams per deciliter. “However, if you are a smoker, have high blood pressure, or are overweight, a value of 100 milligrams per deciliter is better for you in order to reduce the cardiovascular risk,” adds the expert.
In contrast to LDL cholesterol, HDL cholesterol can be slightly higher. It transports excess cholesterol from the tissue back to the liver and, thus, presumably prevents harmful changes to the blood vessel walls. Prof. Dr. Med. Johannes Wechsler, President of the Association of German Nutritionists, recommends: “HDL should be above 45 milligrams per deciliter for women and above 40 milligrams per deciliter for men.”
By the way, as blood lipid levels fluctuate throughout the day, blood samples should always be taken by the doctor in the morning on an empty stomach.
Check Levels Once a Year with a Rapid Test
To prevent serious health conditions, it’s advisable for everyone to have their cholesterol levels checked annually. “This can be done with a quick test in many, but not all, pharmacies,” says Ursula Sellerberg, pharmacist and deputy spokesperson for the German Chamber of Pharmacists. If the detected values deviate from the guideline values, it’s recommended that patients consult a physician.
Tendency to High Cholesterol Partly Inherited
The unfortunate news is that the predisposition to elevated cholesterol levels is partly hereditary. “Lipid metabolism disorders often play a role here, which are passed on to the next generation. There is little that can be done about this,” says Riedl. “Around 15 percent of Germans also have high triglyceride levels. These fats are formed by the body from excess carbohydrates and, like cholesterol, are stored in fatty tissue.”
The encouraging news is that we can positively impact our blood lipid levels through our lifestyle choices.
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Lower LDL Levels Naturally
If you want to influence your blood values without medication, you can do this through a balanced diet. “Consume plenty of fiber, valuable vegetable oils, and unsaturated fatty acids from nuts or sea fish such as salmon, herring, or mackerel,” recommends Dr. Riedl. Sausage, high-fat dairy products, soft drinks, or carbohydrate-rich snacks, on the other hand, should rarely be on the menu.
In addition to diet, exercise is the best way to combat high cholesterol levels. “Burning calories actively lowers blood lipid levels,” says Riedl. Targeted strength training is a good way of effectively lowering cholesterol and triglyceride levels. The doctor recommends training with relatively light weights and completing as many repetitions as possible. He also recommends endurance training — such as running or walking. Jogging or cycling stimulates the production of the “good” HDL cholesterol. Thus, high cholesterol levels are not inevitable. On the contrary: “A healthy diet, no nicotine, and plenty of exercise are the key to healthy blood values.”