Why high cholesterol is common in your 20s: Are you stress-eating?

Cholesterol is a fatty substance that the body needs to build cells and hormones. It becomes a problem when its levels in the blood rise too high, leading to the buildup of plaque in arteries. This narrows the vessels and makes them less flexible, setting the stage for heart disease. There are two main types of cholesterol. Low-Density Lipoprotein (LDL), often called “bad” cholesterol, deposits fat in arteries. High-density Lipoprotein (HDL), also known as “good” cholesterol, helps clear LDL from the bloodstream.

Maintaining a healthy balance between the two is crucial at any age, but especially in youth when preventive habits can have lifelong benefits.

Why cholesterol levels are rising in young people

Modern lifestyles play a large part in early cholesterol problems. Fast food diets, long hours of sitting and stress-driven snacking have all contributed to unhealthy lipid levels among the young. Processed foods high in trans fats and refined carbohydrates cause spikes in LDL cholesterol while lowering HDL. Inactivity compounds the problem. Regular physical activity helps the body metabolize fats efficiently and maintain a healthy weight. Without it, even normal eating habits can lead to imbalances. Sleep and stress play subtle roles. Chronic stress triggers cortisol release, which affects fat metabolism. Inadequate sleep further disrupts hormonal balance and increases cravings for fatty and sugary foods, worsening lipid levels.

The role of genetics

Sometimes, even with a healthy lifestyle, cholesterol remains high. This could be due to familial hypercholesterolemia (FH), a genetic condition that affects how the body removes LDL from the blood. Such people can have cholesterol levels twice as high as normal, even at a young age. If you have a family history of high cholesterol or heart attacks before the age of 50, it’s worth getting tested. A simple blood test can identify the issue early. In such cases, lifestyle changes alone may not be enough, and medication might be necessary to keep levels under control.

Why cholesterol is stubborn

When cholesterol remains high despite efforts, it’s important to look deeper at potential triggers like hidden fats. Even “healthy” packaged foods may contain trans fats or excessive saturated fats. Smoking and alcohol affect how cholesterol is processed, reducing HDL and increasing LDL. Thyroid issues, polycystic ovarian syndrome (PCOS), and certain medications can raise cholesterol. Even small increases in body fat can impact lipid metabolism.

How to manage cholesterol

All you need are consistent lifestyle habits. Eat a balanced diet, emphasise fruits, vegetables, whole grains, nuts, and lean proteins. Replace saturated fats (like butter and red meat) with healthy fats from olive oil, avocado, and fish. Aim for at least 150 minutes of moderate exercise a week. Brisk walking, swimming, or cycling can improve HDL levels and help maintain a healthy weight. Avoid smoking and limit alcohol. Sleep well and manage stress as they help regulate metabolism and hormones that control fat processing. Do not miss regular check-ups, even if you feel healthy as they help track early changes.

(Dr Chatterjee is senior consultant, internal medicine, specialist, Apollo Hospitals, New Delhi)