High Cholesterol

Cholesterol is vital for human life, we need it for the following functions:

• To help for the outer layer, or membrane, of all the body’s cells

• To make Vitamin D and steroid hormones which keep your bones, teeth and muscles healthy

• To make bile, which digests the fats in our diet

For these reasons it is essential that we all have cholesterol, but there are ‘good’ and ‘bad’ types, referred to as HDL and LDL cholesterol.

HDL Vs LDL Cholesterol

LDL (Low-density lipoprotein) is known as the ‘bad’ cholesterol because too much of it can lead to health problems. The function of LDL cholesterol is to deliver cholesterol to cells in the body that need it. But if there is an excess it can build up in the arteries. It is important to keep your LDL cholesterol below 3mmol/L and total cholesterol level below 5mmol/L. In the UK, over half of adults have total cholesterol levels higher than 5mmol/L.

HDL (High-density lipoprotein) is known as the ‘good’ cholesterol as it helps to keep the cardiovascular system healthy. It achieves this by removing LDL cholesterol from the arteries and taking it back to the liver where it is broken down and removed from the body. Ideally, we want to have an HDL level of 1mmol/L or higher.

What causes high cholesterol?

There are several reasons why a patient may have high cholesterol:

• Due to a diet high in saturated fat (eg., full-fat dairy products; meat and meat products such as pasties, sausages and pies; biscuits, cakes and pastries; savoury snacks; chocolate; butter, ghee and lard; coconut milk/ cream; and coconut and palm oils).
• Not being active enough, so fats are not being used for energy.
• Due to genetic conditions (eg., familial hypercholesterolaemia) which means that fats are not processed in the normal way.

Risk factors

Factors that put patients at greater risk of high cholesterol and resulting health problems include:

• Smoking

• High blood pressure

• Being overweight

• Having diabetes

• Family history of premature coronary heart disease

• Being of South Asian origin

Why is high cholesterol bad for you?

Too much LDL cholesterol in your blood can lead to the hardening and narrowing of the arteries (atherosclerosis). This reduces the flow of oxygen-rich blood through the arteries, and it can lead to blood clots. Blood clots block the flow of blood which can cause a heart attack or stroke.

Symptoms of high cholesterol

There are no obvious signs or symptoms of having high cholesterol until a major event like a heart attack or stroke occurs. This is why it is important to have your cholesterol levels checked out if you think you may be at risk.

How to lower your cholesterol

Cholesterol levels can be lowered by making some simple lifestyle changes:

• Eat a healthy, balanced diet that is low in saturated fat. Choose foods high in soluble fibre which help to reduce cholesterol levels (eg., oats and oat bran; linseeds; fruits and vegetables; nuts; beans; pulses (peas, soya, lentils and chickpeas). Also, foods that are fortified with plant stanols and sterols, adding 2g of these to your diet each day can reduce your LDL cholesterol by 10-15%. These foods include Benecol/ Flora Pro-Activ spreads, mini drinks, milk and yoghurts.
• Increase physical activity. We advise doing 150 minutes of moderate intensity exercise per week. This could include walking, swimming, cycling, jogging, gym classes, the choice is yours!
• Stop smoking. Smoking causes a build-up of tar in the arteries which makes it easier for cholesterol to stick to your artery walls.

Medicines for high cholesterol

If lifestyle changes fail to lower your cholesterol levels, your consultant may suggest controlling it with medication to reduce the risk of heart attack and stroke. Statins are the most common medicine for high cholesterol and they work by reducing the amount of cholesterol produced in the liver.