The holiday season might bring much joy to your year, but it can also reap havoc on your heart health.

In fact, research shows that bad cholesterol levels spike the most during this time of year, by nearly 20%.

“[We] notice around the holidays that there’s a pretty consistent 3, 4, 5-pound weight gain as people start to eat a bit more around [the holidays] and [drink] more alcohol,” Dr. Norman Lepor, a cardiologist at Cedars Sinai in Beverly Hills, California, told Healthline.

The combination of splurging on unhealthy food and drinks and experiencing stress caused by the busyness of shopping, traveling, attending parties, and more may leave less time for mindful eating and exercising. All this combined can have a negative impact on the heart.

“The three days that have the largest number of heart attacks in the calendar are December 25, 26, and Jan 1,” said Lepor.

How cholesterol levels can affect your health

There are two kinds of cholesterol.

LDL (low-density lipoprotein) cholesterol, often called “bad” cholesterol, makes up most of the body’s cholesterol. Having elevated LDL puts you at risk for heart disease and stroke.

Lepor explained it this way: Cholesterol travels in the arteries and veins, and gets into the blood vessel wall inducing the formation of plaque.

“I use the analogy of rust; it starts a process of rusting the arteries,” said Lepor. “This process of rusting the arteries pre-disposes you to the development of heart attacks if it’s in the coronary arteries, or [if cholesterol is in] the carotid circulation, it predisposes you to stroke.”

In Western society, he said many people have too much LDL cholesterol.

“We really consider someone who has an LDL cholesterol over 100 milligrams per deciliter as having an elevated cholesterol,” said Lepor.

HDL (high-density lipoprotein) cholesterol, which is considered “good” cholesterol, absorbs cholesterol in the blood and carries it back to the liver, which then eliminates it from the body. Having high levels of HDL cholesterol can lower risk for heart disease and stroke.

Additionally, triglycerides, a type of fat in the blood used for energy, plays a part in heart health. The combination of high levels of triglycerides with low HDL and/or high LDL cholesterol levels can increase the risk of a heart attack.

“High triglycerides can lead to inflammation in the vessel walls, which makes it easier for plaque to build over time,” Amy Pierce, a nurse practitioner and clinical lipid specialist at Norton Heart & Vascular Institute, told Healthline.

How lifestyle choices can help manage your cholesterol

About 15 to 20% of cholesterol levels are affected by lifestyle habits like diet and exercise whereas 85% of cholesterol is made in the liver and is under genetic control.

“High cholesterol is predominately caused by genetics. While diet and exercise are important and can assist in the treatment of many diseases, it is very hard to control cholesterol with diet and exercise alone,” said Pierce.

The good news, she added, is that by decreasing the amount of saturated fats in your diet and getting routine exercise that consists of at least 30 to 45 minutes of aerobic and weight-bearing movement, 4 to 5 times weekly, you can reduce LDL cholesterol up to 10-20%.

Pierce suggested consuming the following to help lower cholesterol levels:

- Soluble fibers (such as those found in Metamucil, Cheerios, and oatmeal) can help reduce cholesterol up to 10%
- Foods infused with plant sterols and stanols, in combination with a balanced diet, can help lower cholesterol
- Some oils and butters can help increase HDL, thus reducing LDL minimally
- Nuts provide a good source of fiber and contain good fats that help to increase HDL and in turn reduce LDL minimally

Additionally, she suggested limiting foods high in sugar and carbohydrates to keep triglyceride levels down, though this approach should not be confused with no-carb diets.

Lepor suggested the Mediterranean diet as a go-to diet because it’s low in saturated fat. The American Heart Association (AHA) agrees and states that aMediterranean-style diet can help achieve the AHA’s recommendations for a healthy dietary patternTrusted Source that focuses on:

- Vegetables, fruits, whole grains, beans, and legumes
- Low fat or fat-free dairy products, fish, poultry, non-tropical vegetable oils, and nuts
- Limited added sugars, sugary beverages, sodium, highly processed foods, refined carbohydrates, saturated fats, and fatty or processed meats

Medication’s place in cholesterol management

Nearly 50% of Americans have cholesterol levels that are elevated enough to warrant medication, but many are not treated for it, said Lepor.

“Probably the reason…the number 1 cause of death is…atherosclerosis, thickening or hardening of the arteries, either from coronary or carotid disease is that there are so many people with elevated cholesterol who should be treated and are not treated,” he said.

While he believes doctors could be more assertive about treating cholesterol, he said patients also need to comply with effective cholesterol-lowering treatments like statins.

In addition to diet and exercise, Pierce said statin therapy is a first-line treatment.

“Not only do statins lower the total cholesterol, LDL (bad), triglycerides, and help increase the HDL (good), but they are also able to decrease inflammation in the vessel walls and stabilize plaque, thus providing cardiac protection,” she said.

If statins are not tolerated or do not reduce the levels enough, she said there are other options to discuss with your healthcare professional.

For instance, Lepor said a new treatment called Leqvio, is an HCP-administered injection that is considered an add-on therapy to a statin regimen and diet and exercise routine. It is administered twice yearly after two initial injections.

“We don’t downplay lifestyle modifications, but they also need to be associated with the use of pharmacology,” he said.

Why the end of the year is a great time to think about heart health

The holiday season is a good time to look at your current eating and exercise habits and to consider possible ways to become healthier in the new year.

“Once you set these goals, following up with your healthcare provider can help keep you focused and help you reach your goals in the healthiest way possible,” said Pierce.

Being proactive is the best thing you can do for your heart, added Lepor.

“Many people don’t even know they have coronary artery disease until they have an event, which can be a heart attack [or] sudden death. One of the important things is patients have to advocate for themselves,” he said.

Start by asking your doctor to perform a coronary calcium scan, which identifies hard plaque. Lepor recommends it for men over the age of 45 and women who are perimenopausal or older. He said it can identify plaque buildup years before it would cause an event, allowing for the opportunity to use preventive treatment.

“We have the capability to achieve optimal cholesterol levels in almost all patients, so there’s no excuse from availability of medications and lifestyle modifications. Know your cholesterol,” he said.

Whether you make an appointment with your doctor now or after the new year, Lepor stressed, “It’s important to be assertive about having [your] physician on top of things when it comes to recommendations for a healthy lifestyle and to identify the presence of disease.”