Aurelio Rojas, cardiologist: "These are the three most common reasons why you can have high cholesterol without eating fat."

While taking care of your diet is essential, it's not always a guarantee of success. Hypercholesterolemia isn't always the fault of what we eat, according to a doctor.

We're so used to receiving all kinds of messages from experts about all the foods that can help us achieve this or that goal... because it's proven that nutrition plays a fundamental role in all aspects of our health.

However, since there are no absolute truths in nutrition, diet can achieve some goals but not others; it can be influential but not decisive. This is the case with high cholesterol . According to cardiologist and science communicator Aurelio Rojas, in a video posted on his social media, there are three possible answers to this common question: " Why do I have high cholesterol even though I don't eat fat ?"

According to experts from the Spanish Society of Internal Medicine , cholesterol is a substance necessary for life, being a fundamental component of cell membranes (their envelopes) and various hormones. Since it is a fat, it is not soluble in water or aqueous solutions, so it must be transported in the blood (an aqueous solution) within particles called lipoproteins.

When we talk about high blood cholesterol (hypercholesterolemia), it's almost always due to an increase in bad cholesterol (LDL). High LDL cholesterol is associated with an increased risk of cardiovascular disease (primarily myocardial infarction and stroke). Although the inherited tendency to have high cholesterol (family history) can be worsened by a habitual high-fat diet, not all of the blame lies with what we eat. In some cases, factors that are more difficult to control come into play.

Cardiologist Aurelio Rojas tries to make people understand that hypercholesterolemia "isn't always synonymous with eating poorly, with an inadequate diet. The human body employs complex and multifaceted mechanisms to regulate cholesterol levels, with diet being just one aspect involved. Therefore, it's a mistake to blame only dietary fat ." According to the expert, there are three common causes, other than food, that can explain high cholesterol despite our best efforts.

"Inflammation, genetics, and carbohydrate metabolism are elements of the body that play an equal or more important role than diet in raising cholesterol," the doctor begins by explaining. There is a misconception that the cholesterol circulating in the body comes only from the foods we eat. Dr. Rojas explains that more than 70% of the cholesterol in the blood is generated by our own liver, regardless of what we eat. "If you don't eat fat, the liver can compensate by producing more, especially if there is inflammation or a genetic predisposition."

Although we associate cholesterol with fat consumption, there are foods that camouflage it perfectly but contain significant amounts of refined sugars, which are absolutely not recommended for cholesterol. "A diet rich in sugars, refined flours, and ultra-processed foods will activate hepatic lipogenesis , generating cholesterol and triglycerides. And all this happens regardless of whether you've been careful and haven't consumed fats in your diet."

These foods, loaded with "hidden" sugars, cause insulin resistance , which transforms excess glucose into fatty acids that increase total cholesterol levels. This process increases cardiovascular risk.

"There are people who have a genetic disorder that prevents the liver from removing LDL cholesterol from the blood. In these cases, diet has less influence, and early diagnosis is key ." With this statement, cardiologist Aurelio Rojas refers to the genetic predisposition that causes altered cholesterol metabolism, with the resulting cardiovascular risk. In these cases, medical diagnosis is essential.