You’re a non-smoker and a regular at your local gym. You indulge in fast food once or twice a month, but otherwise, your meals are filled with vegetables. Your waistline is trim and you feel healthy.

And though your lifestyle and outward appearance are the picture of perfect health, your blood vessels may be telling a different story. High cholesterol levels may be slowly clogging your arteries and, unfortunately, you have little control over the situation.

Did your parents have high cholesterol?

Of course, poor diet, lack of exercise, and obesity are all risk factors for high cholesterol. But, for many years, medical researchers have also known that genetics play an important role in high cholesterol. Individuals with the highest risk have a father or a brother who developed heart disease or had a stroke before he was 55 years old or have a mother or sister to which these things happened before she was 65 years old.

In particular, there are two known genetic conditions that cause high cholesterol: familial hypercholesterolaemia and familial combined hyperlipidemia. Let’s take a closer look at each condition.

Familial Hypercholesterolaemia (FH)

This inherited condition raises LDL (bad) cholesterol because of a mutation on a gene on chromosome 19–the LDLR gene. This gene controls the cell receptors that normally accept LDL cholesterol from the blood and make use of it in the cells. However, with the FH mutation, the receptors don’t develop properly and the cells cannot receive LDL. Instead of being taken into the cells, the LDL cholesterol remains in the bloodstream and clogs up the arteries.

The Familial Hypercholesterolemia Foundation estimates that between 600,000 and two million people are living with FH in the United States. For these people, LDL levels may soar way above 160 mg/dL, more than double the normal levels. Unfortunately, many of them may be unaware of their condition until they suffer a heart attack or stroke.

It’s important to note that the artery-clogging effects of FH begin in the womb. Even young children can have LDL and total cholesterol levels that are extremely high. Because of this, the American Academy of Pediatrics recommends testing children’s cholesterol between the ages of 2 and 10 years old if they have a strong family history of heart disease, heart attack, or stroke.

Familial Combined Hyperlipidemia (FCHL)

This condition raises cholesterol and triglyceride levels. Researchers aren’t sure which genes are involved, but they do know the end results: low HDL (good) cholesterol levels and high levels of small, dense LDL (bad) cholesterol. Experts suspect that 1-percent of people in the United States have FCHL.

Unlike FH, individuals with FCHL develop high cholesterol and triglyceride levels in the teenage years. These individuals are likely to be obese and suffer from diabetes. Without proper treatment, the condition will continue to saturate the walls of the blood vessels with cholesterol and eventually, cause a heart attack or stroke.

Treatment options

Treatment for either of these conditions involves the usual course of lifestyle modifications: lower fat intake, increase exercise, maintain a healthy weight, and avoid smoking. However, in the majority of patients with FH or FCHL, lifestyle changes are not nearly enough to bring their cholesterol levels under control. Nearly all patients will need a heavy dose of cholesterol-lowering medications.

If you have been diagnosed with either one of these genetic conditions, it’s actually a good thing. People who have undiagnosed FH or FCHL are at a much greater risk of suffering a major cardiovascular event. With the proper diagnosis and treatment, you can knowingly take every step needed to lower your cholesterol levels.

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If you’re being medically treated for high cholesterol, your doctor has most likely stressed the importance of a healthy diet. You may have heard recommendations for eating salmon, oatmeal, and olive oil more times than you care to mention. Plus, you’re probably bored with eating the same foods over and over.

It’s time to put an end to that broken record and shake up the list of popular cholesterol-lowering foods. Here are three new foods to add to your cholesterol-fighting diet.

1. Almond Milk

Cow’s milk is a staple in the American diet and it brings an alarming amount of fat along with it. That 2-percent milk you use on your cereal contains nearly 1/6 of the daily recommended allotment of saturated fat. In addition, if you’re using half-and-half in your coffee, you’re serving up 5-percent of your daily allotment of saturated fat with each tablespoon.

Instead of using cow’s milk products, switch to almond milk. Although it’s not as rich and creamy as the fat-filled options, you’ll get a subtle nutty flavor and a little dose of sweetness. This makes it the perfect cholesterol-friendly substitute to use in your cereal and coffee.

Almond milk contains no saturated fat or cholesterol. More than that, nuts are life-savers for your heart. In particular, some researchers say the vitamin E found in almonds and almond milk may help prevent atherosclerosis (the hardening of the arteries).

2. Pears

When it comes to cholesterol, pears pack a mighty punch. Much of their cholesterol-fighting power comes from two special types of natural fiber called pectin and lignin.

Pectin is a soluble fiber—that means that it dissolves in water to form a gel during digestion. While it’s dissolving, it’s also able to hook on to the cholesterol in the intestines and prevent it from being absorbed into the bloodstream.

Lignin, even though it’s an insoluble fiber, acts very much like pectin in the digestive tract. It also binds to cholesterol and prevents it from being absorbed.

In total, one medium pear provides nearly 25% of an adult’s daily recommended allotment of fiber.

3. Tea

Tea contains highly effective antioxidants called catechins and polyphenols. These compounds are heart-healthy and they have a protective effect on the arteries. Studies have shown that they also lower total cholesterol, raise HDL (good) cholesterol, and lower LDL (bad) cholesterol.

Unfortunately, not all teas are created equal when it comes to their cholesterol-blocking abilities. When teas are fermented or processed, their antioxidant content decreases. Fresh-brewed green tea appears to be the best at lowering cholesterol levels and black tea is also helpful. Instant or bottled teas contain far fewer antioxidants.

Although no single food can take the place of cholesterol-lowering medications, eating a healthy diet surely doesn’t hurt. Frequently including these three foods in your diet may be just what you need to knock your cholesterol numbers down for good!

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