Cholesterol is a fatty substance that is essential for the body to function normally. Cholesterol can be found in a variety of foods and is also produced naturally by the liver. Cholesterol joins with proteins (mainly HDL and LDL) in your body to be transported to cells where it is needed or to the liver for storage or excretion. The combination of this fatty wax and the protein is commonly known as “good cholesterol” (HDL) and “bad cholesterol” (LDL).
Cholesterol is a fatty substance in the blood that plays a vital role in the function of all cells in the body. Total cholesterol is broadly subdivided into high-density lipoprotein (HDL), “good” cholesterol and, low-density lipoprotein (LDL), “bad” cholesterol. A high level of LDL is referred to as “high cholesterol” as this type can build up in the arteries and increase the risk of heart attack or stroke. Speak to your doctor to find out the breakdown of your cholesterol levels and what this means.
The main causes of high cholesterol are related to lifestyle. For example, eating a lot of saturated fats increases LDL in your blood, and smoking inhibits the body’s ability to transport cholesterol to the liver, promoting build-up in the vessels. Having diabetes or high blood pressure (hypertension) also increases the risk of high cholesterol, as does having a family history of stroke or heart attack.
Low-density lipoprotein (LDL) is the substance that carries cholesterol to the cells that need it. Too much LDL cholesterol in the blood is known as hypercholesterolaemia and can build up in the arteries and cause them to become blocked. High-density lipoprotein (HDL) is responsible for carrying cholesterol away from cells to the liver, where it can be stored or broken down and passed from the body as a waste product. Unlike LDL, a high level of HDL is good for you.
If left untreated and uncontrolled, high cholesterol can have serious health complications. High cholesterol increases your risk of:
High cholesterol doesn’t usually have symptoms and is diagnosed using a blood test. It is only when high cholesterol has been present for some time and caused serious damage that it may result in physical symptoms such as a heart attack or stroke. Your doctor may recommend that you regularly have your cholesterol checked if you are overweight, have high blood pressure, or smoke, as these increase the risk of developing high cholesterol.
High cholesterol is usually diagnosed with a blood test which reports your total cholesterol, LDL levels, HDL levels and triglyceride levels. You may be asked not to eat or drink anything other than water in the 12 hours preceding your test for accurate results.
The first step to lower your cholesterol is to make some lifestyle changes such as losing weight, stopping smoking and improving your diet.
However, your doctor may also recommend medication to help you. Statins are the most commonly prescribed treatment for high cholesterol and work by blocking an enzyme in the liver which helps produce cholesterol. There are five different types of statin available on prescription in the UK. Low-intensity Statins, including simvastatin, fluvastatin and pravastatin, are sufficient for lowering cholesterol in most patients. Atorvastatin and rosuvastatin are high-intensity statins and are more suitable for patients with very high cholesterol levels.
Ezetimibe is a medication that blocks the absorption of cholesterol into the blood. While it is less likely to cause side effects than statins, it is less effective. Alternatively, a doctor may prescribe a low daily dose of aspirin, which can help prevent blood clots from forming.
The best way to manage high cholesterol is by making changes to your diet and lifestyle. If you require treatment, statins are the most commonly prescribed medication and are thought to be the most effective.
The best way to reduce your cholesterol without medication is to limit your intake of foods that contain saturated fats and trans fats. These include fatty cuts of meat, processed meat products, butter, ghee and lard, cream and ice cream, cheese, cakes and biscuits, chocolate, coconut oil and cream, and palm oil. In addition, consuming foods containing omega-3 fatty acids, such as oily fish, in moderation, can lower triglyceride levels. Exercising regularly and losing weight if you are overweight or obese can also help lower cholesterol levels naturally. If you smoke, stopping smoking can have a positive effect on your cholesterol levels.
High cholesterol can be prevented by leading a healthy lifestyle. Eat a nutritious diet low in saturated fat and high in fibre, and try to maintain a healthy weight. Exercising regularly helps to boost your overall well-being as well as keeping cholesterol in check. Avoid drinking alcohol excessively and don’t smoke.
The UK government recommends that saturated fats should not exceed 11% of a person’s food intake. Women should eat no more than 20g of saturated fat per day, men should eat no more than 30g, and children should eat even less. Try to choose lean cuts of meat over fatty ones, and avoid processed meat products. Cut down on butter, ghee and lard, cream, cheese, cakes and biscuits, chocolate, and avoid using too much coconut oil or palm oil when cooking. Include plenty of fruits, vegetables and whole grains for a high-fibre diet, and consider increasing your omega-3 fatty acid intake from oily fish and avocados.
Too much LDL, the “bad” cholesterol, can lead to a build-up of cholesterol in the arteries. When the arteries become narrowed, blood flow and oxygen supply to the heart, in particular, becomes compromised. This can cause chest pain (angina) and, if blood flow to a part of the heart is completely cut off, heart attack.
Studies have been conducted, with mixed results, that suggests there may be a link between high cholesterol in mid-life and a heightened risk of developing dementia later in life. However, further research is needed for conclusive results.
Vegetarians can have high cholesterol. This is because plenty of vegetarian foods are likely to increase cholesterol, including foods containing saturated fats and trans fats, which contain hydrogenated vegetable oils. These include foods like fried foods, cakes and biscuits, creams and cheese.
High blood pressure and high cholesterol are closely linked. When the arteries become narrowed, the heart has to work harder to pump blood around the body, which causes blood pressure to become raised. Narrower arteries also reduce oxygen supply to the heart, increasing heart disease and heart attack risk.
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