When test results show high cholesterol levels, many people immediately panic and decide to stop eating all fatty foods. However, this may not be the right approach.
In fact, the body still needs fat to perform various essential functions. The key isn't to eliminate fat completely, but rather to choose healthier types and manage their amounts wisely.
This condition is not uncommon. The 2023 Indonesian Health Survey (SKI) recorded that approximately 39.5% of Indonesian adults had cholesterol levels above the normal range—that's nearly 2 in 5 adults around us.
What is Cholesterol?
Cholesterol is a fatty substance naturally produced by the liver and also obtained from food. The body needs cholesterol to help build cells, produce hormones, and produce vitamin D and bile acids, which play a role in digestion.
Problems arise when cholesterol levels, particularly LDL cholesterol, often called "bad" cholesterol, are too high. This condition can lead to plaque buildup in blood vessels, increasing the risk of heart disease and stroke.
What Cholesterol Level Is Considered Normal?
As a general overview, the following levels are usually used as a reference by doctors (results of a 9–12 hour fasting blood test):
- Total cholesterol: ideally below 200 mg/dL.
- LDL (“bad”): below 100 mg/dL for most people. If you have had a heart attack or are at very high risk, the latest guidelines set an even stricter target of under 55 mg/dL.
- HDL (“good”): should be above 40 mg/dL for men and above 50 mg/dL for women — the higher the better.
- Triglycerides: ideally below 150 mg/dL.
Target numbers can vary from person to person depending on other risk factors such as diabetes, hypertension, or a history of heart disease, so they should be interpreted with a doctor.
Not All Fats Are Bad
One common mistake is avoiding all types of fat. However, some fats are actually beneficial for health.
Fats that should be limited
This type of fat can increase LDL cholesterol levels if consumed in excess, including:
- Fried food that is cooked repeatedly.
- Fast food.
- Fatty meat.
- Chicken skin.
- Certain butters and margarines.
- Cakes or snacks that contain trans fats.
Of all the types of fat that need to be limited, saturated fat and trans fat are the ones that have the greatest effect on raising LDL - it's not just about "fried" or "greasy", but the saturated fat content is the key.
Better fat for the body
Some types of fat can actually help maintain heart health if consumed in appropriate amounts, such as those found in:
- Fatty fish, such as salmon, tuna, or sardines.
- Avocado.
- Nuts.
- Grains.
- Olive oil and canola oil.
The key is to choose healthier sources of fat and stick to consuming them in appropriate portions.
Apart from fat, what else do you need to pay attention to?
Controlling cholesterol isn't just about cutting back on fatty foods. Several other habits also play a crucial role, such as:
- Increase consumption of vegetables and fruit.
- Choose high-fiber foods, such as oatmeal and nuts.
- Reduce foods and drinks high in sugar.
- Exercise regularly.
- Maintain ideal body weight.
- Quit smoking and limit alcohol consumption.
Lifestyle changes made consistently will provide greater benefits than a strict diet that only lasts a short time.
Does High Cholesterol Always Cause Symptoms?
No.
Most people with high cholesterol don't experience any symptoms. This is why high cholesterol is often referred to as a "silent condition," as it's only discovered after a medical examination or when complications have already arisen.
Therefore, regular cholesterol checks are crucial. Current health guidelines even recommend the first cholesterol check at age 20 , followed by a repeat every 4–6 years if the results are normal and there are no risk factors. Screening should be performed more frequently and earlier for those with a family history of high cholesterol, diabetes, hypertension, obesity, or smoking.
Should You Avoid Eggs?
Many people also immediately stop eating eggs when they find out their cholesterol levels are high.
A 2025 study published in the American Journal of Clinical Nutrition directly tested the effects of eggs versus saturated fat in people with high LDL. The results showed that LDL increases were more related to the amount of saturated fat in the diet, rather than the cholesterol from eggs. In fact, the group that ate two eggs per day but was low in saturated fat actually experienced a decrease in LDL.
This means that for most people, consuming eggs in moderate amounts can still be part of a healthy diet. What's more influential in increasing blood cholesterol is overall diet, including excessive consumption of saturated fats, trans fats, and sugar, as well as lack of physical activity.
Because everyone's condition is different, it's best to consult your doctor or nutritionist about your diet to get appropriate recommendations.
When Should You Consult a Clinical Nutrition Specialist?
You should consult if:
- The test results showed high cholesterol.
- Have a history of heart disease or stroke.
- Have diabetes, hypertension, or obesity.
- Confused about determining the right diet.
- I've been maintaining my diet but my cholesterol levels haven't improved.
A clinical nutrition specialist will help evaluate your eating habits and health condition, and develop a diet tailored to your needs. This way, you can better control your cholesterol levels without depriving your body of essential nutrients.
Conclusion
Having high cholesterol doesn't mean you have to stop eating all fatty foods. Your body still needs fat, but choose healthier sources and limit saturated and trans fats—including eggs, which are now proven not to be the primary culprit as previously thought.
In addition to improving your diet, lifestyle changes such as regular exercise, maintaining a healthy weight, and regular health checkups also play a crucial role in controlling cholesterol levels. If you're still unsure about the right diet, don't hesitate to consult a clinical nutrition specialist to receive treatment tailored to your specific health condition.
The article was written by Dr. Yuliyana Kusaeri, M.Gizi, Sp.GK (Clinical Nutrition Specialist at EMC Cibitung & Pekayon Hospital).
Compiled with reference to Carter et al., American Journal of Clinical Nutrition (2025); Guidelines for the Management of Dyslipidemia, Indonesian Cardiovascular Specialist Association (PERKI); and the 2023 Indonesian Health Survey (SKI), Ministry of Health of the Republic of Indonesia.