Cholesterol is often painted as a villain when discussing heart health, but it’s not the enemy. The body needs it to build cells, produce hormones, and make vitamin D. The problem comes when there’s too much of the wrong kind of cholesterol circulating in the blood. I like to compare it to traffic on I-95: when cars move smoothly, everything flows. But when they pile up, lanes get blocked, and before long, nothing moves at all. That’s exactly what happens inside the arteries when cholesterol builds up.
High cholesterol is one of the most important risk factors for heart disease — the leading cause of death for American adults. Stroke, closely linked to heart health, is the leading cause of disability, according to the American Heart Association. The risks are even greater for Black Americans. Yet many people don’t realize their cholesterol is high until a crisis like a heart attack or a stroke.
The good news is, unlike I-95, you have more control over this traffic than you might think. And it’s often the smallest choices that keep blood flowing freely.
The Good, The Bad, The Balance
Cholesterol is a natural, waxy substance found in your blood and cells. You need it to survive, but balance is everything:
- High-density lipoprotein (HDL): The “good” cholesterol. It acts like a cleanup crew, carrying excess cholesterol out of your bloodstream and back to your liver.
- Low-density lipoprotein (LDL): The “bad” cholesterol. It deposits cholesterol into your arteries, where it hardens into plaque that narrows blood vessels and raises the risk of heart attack and stroke.
The goal isn’t to wipe cholesterol out, but to keep more of the good HDL working in your favor and less of the bad LDL from causing damage.
Small Shifts, Big Impact
It’s no secret that healthy eating and exercise are key to heart health. But our culture doesn’t make it easy. Long workdays, constant stress, and fast food on every corner stack the odds against us. At the same time, we have more gyms and fitness centers than ever, yet obesity and heart disease keep climbing.
That tells me the problem isn’t just access. It’s also how our rushed society pushes us toward convenience, and how rarely we stop to think about the lasting impact of our choices.
The encouraging part is that protecting your heart doesn’t require a dramatic life overhaul. I remind my medical students of this every day. After our morning meeting, when it’s time to see patients, they make a beeline for the elevators. That’s when I stop them: “Not the elevator — we’re taking the stairs.”
The truth is, and my students learn this quickly, I always take the stairs. At Jackson Memorial Hospital, there are 11 floors. Jackson South Medical Center has four and Jackson North Medical Center has seven. Even on the busiest days, the stairs are my non-negotiable. They help me reach 10,000 steps each day, but more importantly, they prove that movement doesn’t have to be complicated. Something as simple as choosing the stairs adds up. Build it consciously into your day, and before long, it becomes habit.
This is the same message I give my patients who are working to lose weight, lower cholesterol, or manage other conditions. Yes, medications help, and for some, especially those facing genetics or complex health issues, they’re essential. But medicine only goes so far. The real, lasting change comes from the daily choices you make and the investments in your health that pay out over time.
Strength Is Good, But Cardio Saves Lives
Walking and daily movement are essential, but we also need true cardiovascular exercise, the kind that gets your heart rate up and makes you sweat. In addition to stairs and parking farther from buildings, I make time for the gym a few evenings a week.
What I often notice, especially among younger generations, is that the weight room is packed while the treadmills and bikes are nearly empty. Building muscle is valuable, but not at the expense of conditioning your heart. At the end of the day, your heart is the most important muscle you have.
The American Heart Association recommends 30 to 45 minutes of cardiovascular exercise, three to five days a week. That can mean brisk walking, cycling, swimming, or running, anything that gets your heart working and your body moving. Spread out across the week, it’s a manageable investment of time that delivers enormous benefits.
These benefits reach far beyond the heart. The body isn’t a collection of separate parts; every system is connected. When you strengthen the heart, you also improve circulation, calm inflammation, support digestion, and even lower stress while boosting your mood. Every healthy choice ripples outward, shaping how your whole body feels and functions.
Rethinking What We Put into Our Bodies
Movement is only half the picture. The other is what we put into our bodies. When I travel abroad, I’m struck by how different food culture is. In much of Europe, food is less processed, meals are slower, and fast-food chains aren’t nearly as common. That difference shows up in health.
Here at home, we can’t change the entire food system overnight, but we can be more intentional with the choices we make by picking healthier versions of our favorite meals and snacks
That’s the same principle behind the Mediterranean diet, which I also often recommend. Many people assume it’s restrictive, but in reality, it’s flexible and sustainable. It emphasizes fruits, vegetables, fish, olive oil, whole grains, and nuts but still leaves room for variety and enjoyment. It’s not about cutting things out, but about making substitutions that shift your meals in a healthier direction. Small swaps, made consistently, lead to big changes over time.
Investing in Your Future Self
By moving more, choosing healthier foods, and paying attention to the small decisions you make each day, you can keep cholesterol in check and your heart strong. These changes don’t just guard against heart attack or stroke, but they ripple across your whole body, improving energy, mood, and overall health along the way.
You don’t need perfection to protect your heart. What matters is awareness, consistency, and the willingness to choose better, more often than not. Over time, those choices add up. And that’s how you keep your body, and your life, moving forward.
Bashar Obeidou, MD, is an interventional cardiologist and associate medical director at Jackson Heart Institute.
BASHAR OBEIDOU, MD