Cholesterol is one of those words that grab headlines and spread panic among health-conscious readers. It’s good for you, it’s bad for you, you’re getting too much of the wrong kind – you may think you have heard it all before.
Well, we think it’s time for some facts about cholesterol, so you know why it matters for your health.
Cholesterol is a fatty substance made in the liver from fats in our diet. Although some foods contain cholesterol, most is made by our bodies.
We all need some cholesterol to remain healthy. It is used by the body in hormone and vitamin D production, to insulate nerves, in fat digestion and in making cell membranes.
But high levels of cholesterol in your blood increases your risk of heart disease and stroke, two of the major causes of death in the UK.
Good and bad cholesterol
Cholesterol made in the liver is carried around the body by two types of lipoproteins – high density lipoproteins (HDL) and low density lipoproteins (LDL).
HDL mops up cholesterol from the blood and takes it back to the liver. As it lowers the amount of cholesterol in your blood, your risk of heart disease is reduced. This is why HDL-cholesterol is often called “good cholesterol.”
Cholesterol
LDL transports cholesterol from the liver to the rest of your body. If you have high levels of LDL-cholesterol in your blood, it builds up in the inside of arteries forming plaques. This causes narrowing of the arteries, or atherosclerosis.
The plaques can also make it easier for blood clots to form increasing your risk of heart attack and stroke. LDL-cholesterol is usually known as “bad cholesterol.”
So the more LDL-cholesterol in your blood, the greater your risk of heart disease. Ideally, we want to have more HDL-cholesterol and less LDL-cholesterol.
What levels of cholesterol are healthy?
If you had high levels of cholesterol in your blood, it’s unlikely you would know about it.
Most people with high cholesterol levels don’t have symptoms. The only way to find out is to have a simple blood test done by either your GP or local chemist.
Cholesterol
A cholesterol blood test measures the total amount of cholesterol in your blood in units called millimoles per litre of blood or mmol/L.
To minimise your risk of heart disease, the government recommends that adult should aim for total cholesterol levels of 5mmol/L and less, and 3mmol/L and less for LDL-cholesterol.
Total blood cholesterol levels above 6mmol/L is considered high.
Cholesterol numbers
* Total cholesterol – less than 5mmol/L
* LDL cholesterol – less than 3mmol/L
* HDL cholesterol – more than 1mmol/L
Cholesterol
Who should be tested for cholesterol?
Anyone can have a blood cholesterol test. Although two thirds of adults in the UK have blood cholesterol levels higher than 5mmol/L, your risk of having high cholesterol increases as you get older.
It is more important to get tested if:
* You are over 40
* Are overweight or obese
* Smoke
* Don’t exercise
* Have diabetes
* Have a family history of heart disease
* Have a family history of high cholesterol
* Have high blood pressure
Lifestyle factors to reduce your blood cholesterol
When it comes to cholesterol, the type of fat you eat is the biggest influence on blood cholesterol levels. Foods which contain cholesterol -eggs, liver, prawns- are relatively unimportant compared to these, unless you have a medical condition.
Saturated fats found in pastry, full fat milk and dairy products, butter, lard, cakes and biscuits made from butter, processed meats and sausages help to increase the levels of HDL-cholesterol.
Trans fats, found in foods that use hydrogenated or partially hydrogenated vegetable oils have the same effect on cholesterol levels and should be avoided whenever possible. They are often found in deep-fried foods, some take-aways and baked products. So check the labels.
Healthier fats such as mono-unsaturated fats and polyunsaturated fats (omega-3 and omega-6) can help to reduce LDL-cholesterol in your blood and increase the good HDL-cholesterol. It’s worthwhile switching to healthier fats and oils for cooking such as olive oil.
A combination of maintaining a healthy weight, keeping active and cutting out the bad fats from your diet is the best way to keep cholesterol levels in check.
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Almost half of all heart disease deaths in the UK are due to raised blood cholesterol levels – how’s yours?
What is cholesterol?
Cholesterol is a soft waxy substance found in many different parts of the body including the nervous system, skin, muscles, liver, intestines and heart.
It is needed for a number of bodily processes including the production of hormones, bile acid and vitamin D. It is carried around the body within the bloodstream. Most cholesterol in our bodies is made in the liver, but it’s also found in foods of animal origin such as eggs, offal and shellfish.
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No egg-stra risk to health
Why is it important?
According to the British Heart Foundation, almost half of all heart disease deaths in the UK are due to raised blood cholesterol levels; 59 per cent of men and 60 per cent of women have raised levels.
Is all cholesterol bad?
Cholesterol is ferried around the bloodstream in protein molecules known as lipoproteins. “High-density lipoprotein (HDL, or ‘good’ cholesterol) removes excess cholesterol from the bloodstream and protects the body against heart disease”, explains Melanie Raddon, nurse adviser with the British Heart Foundation.
“Low-density lipoprotein (LDL or ‘bad’ cholesterol), on the other, hand carries cholesterol from the liver to the cells and increases the risk of heart disease.”
How does cholesterol increase heart disease risk?
Heart disease occurs when the blood vessels leading to your heart – the coronary arteries – become stiff and narrowed or ‘furred’ due to the accumulation of a fatty substance called atheroma.
Atheroma is formed when LDL cholesterol is oxidised, the same chemical process that causes apples to go brown when they are exposed to the air. This ‘furring’ of the arteries is known as atherosclerosis.
How is cholesterol measured?
Cholesterol is measured with a blood test. If your overall cholesterol level is raised, your GP will want to check your LDL and HDL cholesterol levels as well as measuring blood fats called triglycerides; high levels are also associated with heart disease and stroke.
What’s a normal level?
In the UK, the average blood cholesterol is about 5.5 to 5.6, which is why heart problems are very common. If you turn that around and ask what is a ‘good’ cholesterol level the answer is the lower the better.
Cholesterol is measured in units called millimols per litre of blood (written as mmol/l). There isn’t an absolute level at which high cholesterol is diagnosed. It all depends on other risk factors.
What affects my cholesterol level?
The following can all affect your cholesterol levels:
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diet
*
weight
*
physical activity
*
gender
*
age
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genes
Does high cholesterol always matter?
For example if you smoke and have raised cholesterol levels your risk of heart disease is increased six-fold, if you smoke and have high blood pressure it is increased nine-fold, if you smoke, have high blood pressure and a raised cholesterol it is increased 16-fold.
If your cholesterol is raised, the doctor will consider other risk factors to calculate your likelihood of having a heart attack.
Other risk factors include:
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physically inactivity
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being overweight
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having diabetes or high blood pressure
What lifestyle changes will help?
“Changing to a healthier diet can reduce cholesterol levels by 5-10 per cent”, according to Melanie Faddon.
That means one that is low in fat overall, and especially in saturated (animal) fats and transfats (found in some processed foods, such as cakes and pastries).
Unsaturated fats from foods of plant origin – vegetables, nuts and seeds – and oily fish, reduce levels of ‘bad’ cholesterol.
The soluble fibre in fruit and vegetables, such as apples and lentils may help; folic acid found in leafy green vegetables or taken as a supplement may also be useful.
What is the medical treatment?
The main drugs used to lower cholesterol are known as statins, which work by altering enzyme activity in the liver, preventing the manufacture of cholesterol.
According to the British Heart Foundation, there’s substantial evidence to show that statins are effective in reducing blood cholesterol levels, so slowing down the development of atherosclerosis and significantly reducing the risk of a heart attack.
Other drugs that may be used to lower cholesterol include fibrates which lower triglyceride levels.