standard cholesterol test misses key risk factor for one in three

A standard blood test for cholesterol does not reveal how efficiently the body absorbs it, according to research from the University of Helsinki published in the Journal of Internal Medicine.

About one in three people absorb dietary cholesterol unusually well due to genetic predisposition. This makes their LDL particles—already harmful—structurally even more dangerous, increasing the risk of cardiovascular disease.

“The problem is that you can have perfectly normal cholesterol levels, yet the LDL particles carrying it may still be of very poor quality,” said Katariina Öörni, a professor specialising in lipid metabolism.

LDL particles transport cholesterol in the blood. When absorption is high, these particles more easily stick to artery walls and clump together, contributing to heart problems.

While absorption can be measured in research settings, the method is expensive and complex. Öörni hopes future testing will allow for more personalised assessment of cholesterol metabolism to better evaluate heart disease risk.

For now, if cholesterol levels are high, diet, exercise, or medication—such as statins or absorption inhibitors—can help. A low-cholesterol diet, physical activity, and plant sterols may reduce LDL, while saturated fats and excess sugar should be limited.