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High cholesterol runs in my family. My brother is skinny and only 30 and his is 250. My mom is only about 20 pounds overweight maybe (eats almost Vegetarian diet) and hers is also high and she's on Lipitor. My dad's is high too.
Mine used to be terrible when I was heavier- 289! The good kind outweighed the bad kind, but still, for my age that was rather alarming. Now it's over a hundred points less on what is basically Atkins, but I don't abuse it (not much in the way of fatty meats, minimal cheeses) and get most of my fats from monounsaturated sources, plenty of veggies, etc.
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