Can anything other than diet cause high cholesterol?

Yes, there are several factors other than diet that can contribute to high cholesterol levels. While an unhealthy diet high in saturated fats and cholesterol is a major risk factor, genetics, being overweight or obese, physical inactivity, diabetes, and certain medications can also lead to elevated cholesterol.

Quick Answers

Here are quick answers to common questions about non-dietary causes of high cholesterol:

  • Genetics – Family history of high cholesterol increases your risk.
  • Being overweight/obese – Excess weight often leads to higher LDL and triglycerides.
  • Lack of exercise – Physical inactivity causes LDL to rise and HDL to decrease.
  • Diabetes – Uncontrolled diabetes raises triglycerides and lowers HDL.
  • Medications – Drugs like steroids, birth control pills, and immune suppressants can increase cholesterol.
  • Age/gender – Levels naturally rise as we age. Men under 45 and women under 55 tend to have lower totals.
  • Pregnancy – Cholesterol levels rise during pregnancy and typically return to normal after giving birth.

Genetic Factors

For some people, high cholesterol runs in the family. Having a parent or sibling with elevated cholesterol levels increases your risk of also developing high cholesterol. This is because genetics plays a role in how your body produces and metabolizes cholesterol. Familial hypercholesterolemia is a genetic disorder that causes very high LDL cholesterol levels beginning at a young age. It is an inherited condition caused by genetic mutations that lead to higher concentrations of LDL particles in the bloodstream. If you have a family history of premature heart disease or persistently high cholesterol, getting screened is important to detect any genetic predispositions early.

How Genetics Affect Cholesterol Levels

Your genes influence your cholesterol levels in a few ways:

  • LDL receptor activity – Genetic mutations can affect the function of LDL receptors that remove LDL from the blood, leading to buildup of LDL.
  • Production of cholesterol – Your body naturally produces all the cholesterol it needs. Genetic abnormalities can cause overproduction of cholesterol.
  • Conversion of VLDL to LDL – Genes impact the rate at which very low-density lipoprotein (VLDL) is converted into LDL particles.

While some genetic patterns will greatly increase the risk for high cholesterol, poor lifestyle habits can further exacerbate the problem. Following a heart healthy diet, maintaining a healthy weight, exercising regularly, not smoking, and limiting alcohol can all help manage cholesterol levels even if you are genetically predisposed.

Being Overweight or Obese

Carrying excess weight, especially around the waistline, substantially raises your risk for elevated cholesterol. Adults who are overweight (BMI between 25-29.9) or obese (BMI over 30) are more likely to have unhealthy cholesterol levels, including:

  • Higher LDL cholesterol
  • Higher triglycerides
  • Lower HDL (“good”) cholesterol

Abdominal obesity seems to be the most risky in terms of cholesterol and heart health. Fat stored around the belly releases fatty acids and cytokines that damage artery walls and promote systemic inflammation. This makes cholesterol more likely to accumulate in blood vessel walls and form dangerous plaques. Even losing just 5-10% of your body weight can significantly improve cholesterol markers.

How Excess Weight Impacts Cholesterol

Here are some of the ways carrying extra weight can negatively alter cholesterol balance:

  • Increases circulating fatty acids – These end up converted into LDL particles.
  • Raises inflammation – Damages arteries and enables cholesterol accumulation.
  • Changes hormone response – Being overweight disrupts hormones that control cholesterol production.
  • Decreases HDL production – Abdominal obesity is tied to lower HDL levels.

Modest weight loss through diet, exercise, and other lifestyle changes can go a long way towards getting your cholesterol under control if excess weight is an issue.

Lack of Exercise

Leading a sedentary lifestyle with minimal physical activity can alter cholesterol profiles for the worse. Regular exercise is vital for healthy cholesterol levels. It helps lower LDL and triglycerides while raising beneficial HDL. Physically inactive adults tend to have higher LDL levels and lower HDL levels compared to active individuals. Just 150 minutes per week of moderate activity like brisk walking can make a difference.

How Exercise Helps Cholesterol

Here are some of the beneficial effects exercise has on cholesterol:

  • Burns fat – Reduces LDL levels and raises HDL levels
  • Builds muscle – Muscle tissue helps clear fat and LDL from blood
  • Increases HDL – Exercise boosts HDL production from the liver
  • Lowers triglycerides – Burns triglycerides and limits production in the liver

Aim for 150 minutes per week of moderate cardio activity like brisk walking. Strength training 2-3 times a week also provides cholesterol benefits. Moving more throughout your day with activities like taking the stairs further helps lower cholesterol.


Having diabetes, especially uncontrolled diabetes, significantly impacts cholesterol balance. High blood sugar and insulin resistance cause an increase in VLDL production by the liver. VLDL is converted into LDL particles, resulting in higher LDL cholesterol. Diabetes also reduces HDL cholesterol. Together, these changes create a very atherogenic lipid profile that accelerates cardiovascular disease. Getting blood sugar under control via medication, exercise, and diet is critical.

How Diabetes Disrupts Cholesterol Levels

Here are some ways diabetes drives dyslipidemia:

  • Increases VLDL production – This gets converted into LDL particles.
  • Decreases HDL – Chronic hyperglycemia suppresses HDL.
  • Raises triglycerides – Insulin resistance causes more VLDL formation.
  • Increases small, dense LDL – These are more prone to oxidation.

Careful monitoring and management of diabetes through medication use, maintaining healthy blood sugar levels, exercising, and eating well can all help minimize its effects on cholesterol profiles.

Certain Medications

Some prescription drugs are known to alter cholesterol levels. Medications that can raise total and LDL cholesterol include:

  • Corticosteroids
  • Birth control pills and hormone replacement therapy
  • Immunosuppressant drugs
  • Retinoids like isotretinoin
  • Antiretroviral drugs
  • Beta blockers
  • Thiazide diuretics

These medications are often still recommended and prescribed since the benefits usually outweigh the side effect of increased cholesterol. However, monitoring lipid profiles and making lifestyle adjustments can help counteract negative changes in cholesterol.

How Medications Impact Cholesterol

Here are some of the ways certain drugs can influence cholesterol levels:

  • Increase cholesterol synthesis – Examples are glucocorticoids and anabolic steroids.
  • Alter liver metabolism – Some drugs disrupt VLDL and HDL production and clearance.
  • Reduce LDL clearance – Certain medications inhibit LDL receptor activity.
  • Change triglycerides – Increased VLDL production raises triglyceride levels.

Talk to your doctor about getting your cholesterol monitored if you are taking medications that may affect lipid profiles. Lifestyle changes can help counter medication-related increases in cholesterol.

Age and Gender

Cholesterol levels tend to rise as we age in both men and women. Prior to menopause, women tend to have lower total cholesterol levels compared to men of the same age. This cholesterol-lowering effect of estrogen is lost after menopause, and a woman’s risk for high cholesterol approaches a man’s risk. Here are some age- and gender-related factors that impact cholesterol levels:

  • Men under 45 years old tend to have higher total and LDL cholesterol levels than women under 45. Males have a higher risk of high cholesterol at younger ages.
  • Women over 55 years old lose the protective effects of estrogen after menopause. Their LDL levels rise and approach male levels.
  • Older adults over 65 have higher total cholesterol levels on average than middle-aged adults. Production of cholesterol gradually increases with age.

Maintaining healthy cholesterol levels becomes increasingly important as we age, especially for postmenopausal women. Nutritional and lifestyle changes that lower cholesterol risk are beneficial at all life stages.


During pregnancy, a woman’s cholesterol profile changes significantly as lipid metabolism ramps up to support fetal development. Total cholesterol, LDL cholesterol, and triglycerides typically rise by 25-50% during the second and third trimesters. After giving birth, levels usually return to normal within 3-6 months. Only more pronounced elevations need to be monitored and treated during pregnancy itself.

Cholesterol Changes During Pregnancy

Here are some of the ways cholesterol levels change during pregnancy:

  • Increases hepatic production – More cholesterol is synthesized to meet demands of the fetus.
  • Elevates LDL and triglycerides – These help meet fetal nutritional requirements.
  • Rises estrogen levels – Estrogen boosts HDL production.
  • Decreases LDL clearance – LDL receptors become less active.

Cholesterol levels should be monitored after pregnancy and managed with lifestyle changes if they remain elevated. During pregnancy itself, treatment is only recommended in cases of familial hypercholesterolemia or very high values.

Other Contributing Factors

Some other factors that may contribute to high cholesterol include:

  • Stress – Chronic stress promotes higher LDL and total cholesterol.
  • Smoking – Lowers HDL and increases LDL particle density.
  • Heavy alcohol use – Raises both HDL and triglycerides.
  • Liver or kidney disorders – Can affect cholesterol production and clearance.

While managing these factors can help control cholesterol, genetic and lifestyle factors tend to be bigger overall contributors in most cases.

Key Takeaways

  • Diet is not the only factor that influences cholesterol levels. Genetics, being overweight, inactivity, diabetes, medications, and age/gender also play a role.
  • Familial hypercholesterolemia is a genetic condition that causes very high LDL cholesterol beginning at a young age.
  • Carrying excess weight from fat stored in the midsection often leads to poorer cholesterol profiles.
  • Regular cardiovascular exercise helps lower LDL and triglycerides while raising HDL.
  • Uncontrolled diabetes increases VLDL production and suppresses HDL, negatively impacting cholesterol balance.
  • Some commonly prescribed medications can adversely affect cholesterol as a side effect.
  • Total and LDL cholesterol naturally rise as we age, especially after menopause in women.
  • Pregnancy causes temporary elevations in total cholesterol, LDL, and triglycerides.


While following a heart-healthy diet low in saturated fat and cholesterol is important for managing high blood cholesterol, other influences like genetics, weight, activity levels, and medical conditions also play a role. Having an awareness of non-dietary contributors can help you understand your personal risk factors and determine the most effective combination of lifestyle changes and medical treatment. Work with your healthcare provider to develop a cholesterol-lowering plan tailored to your individual cholesterol profile and health needs.

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