VLDL cholesterol stands for very-low-density lipoprotein cholesterol. It is a type of low-density lipoprotein (LDL), which people sometimes call “bad” cholesterol.

The body needs some VLDL to work properly. However, too much can increase a person’s risk of developing other health conditions, including heart disease.

This article will explain what VLDL is, what it does, and how to keep the levels within a healthy range.

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Cholesterol is a waxy, fatty substance that the body needs to keep the cells and organs healthy. The liver makes all the cholesterol that the body needs. However, it is also present in many foods, including:

There are two main types of cholesterol: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). People often refer to LDL as “bad” cholesterol and HDL as “good” cholesterol.

LDL takes cholesterol and fats to the body’s cells. HDL takes excess cholesterol to the liver for removal from the body, but it can only do so much.

What is VLDL?

VLDL is a type of lipoprotein cholesterol that the liver makes. Specifically, VLDL is a type of LDL cholesterol. However, while VLDL carries triglycerides, a type of fat, to the body’s cells and tissues, LDL carries mainly cholesterol.

If the body has more VLDL than it needs, the surplus circulates in the blood, contributing to the buildup of plaque.

Plaque is a fatty, sticky substance comprising fat, cholesterol, calcium, and other materials in the blood. Over time, it sticks to the inside of the arteries and then hardens, making them narrower. The term for this process is atherosclerosis.

Atherosclerosis stops the blood from being able to flow freely around the body. Every cell needs a ready supply of oxygen- and nutrient-rich blood to survive.

Therefore, high levels of VLDL can contribute to atherosclerosis, which can make a person more susceptible to heart disease or stroke.

Having too many triglycerides, which are the fats that VLDL carries, can also increase a person’s risk of developing non-alcohol-related fatty liver disease.

According to the American Association for Clinical Chemistry (AACC), a normal VLDL level is anything up to 30 milligrams per deciliter (mg/dl), which equates to 0.77 millimoles per liter (mmol/l).

Measurements above this indicate high VLDL levels, which place the person at risk of heart disease and stroke.

Doctors can check VLDL levels as part of a test called a lipid profile. This blood test looks at the fats and the fat-like substances, or lipids, in the blood.

It does not measure VLDL directly. Instead, it looks at the levels of triglycerides in the blood. Most of these triglycerides will be in the VLDL, which carries them to the cells.

The test may report triglyceride values in mg/dl or mmol/l. Healthcare professionals estimate VLDL by dividing the triglyceride value by five, if the measurement is in mg/dl, or by 2.2 if it is in mmol/l.

A lipid profile will also measure:

  • total cholesterol
  • HDL
  • LDL

According to the AACC, it is standard practice to ask people to fast for 9­–12 hours before the test. During this period, they should not eat anything and only drink water. However, doctors may sometimes decide that this is not necessary.

People should also avoid drinking alcohol for at least 24 hours beforehand.

The Centers for Disease Control and Prevention (CDC) say that high cholesterol has no signs or symptoms. Therefore, a person can only find out whether they have high cholesterol by undergoing a lipid profile test.

Many people will be able to lower their bad cholesterol by altering everyday habits. According to the American Heart Association (AHA), doctors might recommend:

A cardiac diet

Adopting a heart healthy diet means avoiding foods that contain saturated and trans fats. These foods include:

Instead, people should opt for a diet that includes:

Learn more about how to adopt a cardiac diet here.


Being physically active increases the amount of HDL, or good cholesterol, in the body. The more HDL the body has, the more effectively it can remove VLDL from the blood.

The AHA say that people should aim to do at least 150 minutes of moderate intensity aerobic exercise — such as brisk walking, swimming, or cycling — each week, where possible.

Quitting smoking, if applicable

Smoking lowers the levels of good cholesterol in the blood.

It also increases the likelihood of a person developing high blood pressure or diabetes, both of which can lead to heart attack and stroke.

Reaching or maintaining a moderate weight

The AHA state that if someone has overweight or obesity, they are more likely to have high LDL cholesterol and low HDL cholesterol.

However, they note that losing just 5–10% of body weight can help a person with overweight or obesity improve their cholesterol levels.

Reaching or maintaining a moderate weight also reduces the risk of other health conditions, such as type 2 diabetes.

Taking certain medications

Some people may find that changes to their diet and physical activity levels are not enough to manage their cholesterol levels.

In these cases, doctors may recommend medication. The right approach will be different for everyone. Healthcare professionals will work with the individual to determine which medication or combination of medications is best for them.

Examples of medications that doctors may recommend include:

  • Statins: This medication works by stopping the liver from making cholesterol.
  • Ezetimibe (Zetia): This medication stops the intestine from absorbing cholesterol from food.
  • Bile acid sequestrants: These prompt the intestine to remove more cholesterol than it would otherwise.
  • PCSK9 inhibitors: This medication stops a protein that the liver uses to make cholesterol from working properly.
  • Fibrates: Fibrates lower the levels of triglyceride in the blood.
  • Nicotinic acid: This medication limits the amount of fat that the liver can make.

Doctors may also recommend omega-3 fatty acid supplements, such as cod liver oil. These can help lower triglyceride levels in the blood.

High cholesterol has no symptoms, so people with high VLDL levels will be unaware unless they have a lipid profile test.

Most adults should have a regular medical exam every 4–6 years. Doctors will be able to assess the person’s underlying risk of heart disease by looking at multiple factors. As part of the health evaluation, they will carry out a lipid profile test to check the person’s cholesterol levels.

VLDL is a type of bad cholesterol that can contribute to the risk of heart attack and stroke. Adopting a heart healthy diet, doing more physical activity, refraining from smoking, and maintaining a moderate weight are the best ways to manage cholesterol levels.

High cholesterol does not have any symptoms. The only way that people can be sure of their cholesterol levels is to ask a doctor for a lipid profile test. Most adults should ideally have this test every 4–6 years.