High Cholesterol

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Cholesterol is vital for the existence of life. Without it, the human body could not function.

Cholesterol is a fatty substance known as a lipid, forming part of the outer membrane of every cell. Cholesterol serves three main functions essential for ensuring the smooth passage of chemical signals around the body:

  • it creates steroid and sex hormones
  • it insulates nerve fibres 
  • finally, it helps the liver to produce bile acids, necessary for the digestion of fats.

What is high cholesterol?

Although cholesterol itself is essential, health problems arise when the cholesterol level becomes too high. High cholesterol can lead to heart disease, the UKs biggest killer. Here you can find lots of helpful information explaining what high cholesterol means and how you can prevent it.

When there is too much cholesterol in the bloodstream, there is a risk of cholesterol deposits building up and causing blockages. This greatly increases the danger of blood clots, strokes and heart attacks.

Although these conditions cannot be entirely prevented, maintaining a healthy lifestyle will help avoid the event of a blood clot, a stroke or a heart attack.

Enjoying regular moderate exercise and avoiding saturated fats found in processed foods will help lower cholesterol levels, as will a diet rich in fibre.

Is cholesterol all bad?

Not all cholesterol is 'bad'. Having the right amount of the right type of cholesterol is the most important thing. There are usually a number of lipid types analysed in a cholesterol level test, including the three different types of cholesterol.

  • LDL (low density lipoprotein)- is the ‘bad type’. 

Protein is the densest substance found in cholesterol. As its name suggests, LDL contains a very low amount of protein and consists mostly of fats. This means LDL is more likely to stick to arterial walls and, when levels become too high, can cause blockages leading to strokes and heart attacks.
  • HDL (high density lipoprotein)- is the ‘good type’ because it helps remove build-ups of cholesterol from arterial walls. HDL carries the ‘bad cholesterol’ to the liver, ready to be excreted from the body. Unlike LDL, high levels of HDL cholesterol can help protect against coronary heart disease, whereas low levels have been attributed to an increased risk.
  • VLDL (very dense lipoprotein)- is a form of lipoprotein usually regarded as existing initially in an undeveloped form. Its job is to aid the transportation of fat in the bloodstream. Eventually VLDL can become LDL, the ‘bad type’ of cholesterol, which often causes heart disease.

Cholesterol is not the only lipid (fat) to pose a risk to the vital organs. Doctors also test for: 

  • Triglycerides- whereas cholesterol builds and maintains cell membranes and creates hormones, triglyceride maintains the transportation and storage of energy. Like cholesterol levels, triglyceride levels can be lowered by avoiding certain fatty foods.

What are the risks of having high cholesterol?

An individual with high cholesterol is more likely to develop serious conditions such as coronary heart disease, stroke and TIA (mini stroke).

  • Coronary Heart Disease 

If the blood supply contains a high amount of cholesterol, there is a greater risk of fatty deposits breaking off and sticking to arterial walls. This accumulation causes a narrowing of the passage known as ‘atherosclerosis’, which restricts the blood-flow to the heart. The arterial walls, now sticky and rough with the build-up of fatty deposits (referred to as plaque), can cause clotting of the blood. This can in turn cause a heart attack.

  • Stroke

Like a heart attack, a stroke can be caused by a blood clot or an accumulation of fatty deposits caused by high cholesterol. This blockage can restrict or entirely block the blood flow to the brain, leading to a stroke. Symptoms of a stroke include facial droopiness, limb paralysis, slurred speech and confusion.

  • TIA

A transient ischaemic attack, otherwise known as a mini-stroke, is similarly caused by a slight restriction of blood to the brain. With a TIA, symptoms drastically reduce within the first 24 hours.

Who is at risk from high cholesterol?

There are a number of reasons why certain people are more likely to suffer from high cholesterol than others.

  • Overweight or Obese people

Daily dietary habit has been found to play a large role in determining cholesterol levels. A number of scientific studies have suggested a strong link between high-fat diets and high levels of cholesterol and heart disease. Many individuals who are overweight or obese often eat foods high in fat and tend not to exercise enough. An excess of fat puts increased strain on the internal organs and heightens risks of high blood pressure, high cholesterol, heart disease and a wealth of other related problems. The good news is that these risks can be reduced by following a number of simple lifestyle changes.

  • Older people 

Many factors cannot be changed. For example, individuals over the age of 40 are thought to be more likely to suffer from high cholesterol.

  • Ethnic group 

Individuals from Indian, Pakistani, Sri Lanken or Bangladeshi decent have been found to be at a higher risk of high cholesterol than other ethnic groups.

  • Family History- 

A small percentage of individuals will have inherited metabolic defects such as ‘familial hypercholesterolemia’, which can increase the risk of high cholesterol. People who suffer from hypercholesterolemia often lack LDL-absorbing receptors found on the surface of liver cells. This can result in a build-up of LDL cholesterol leading to an increased danger of heart disease.

In very rare cases a child may have inherited the disorder from both parents. In this case, individuals often develop heart disease at a young age and may require repeat organ transplants throughout their life, regardless of lifestyle habits.

Individuals diagnosed with extremely high levels of cholesterol (over 300mg/dl) are advised to encourage other family members to undergo testing as a precaution.

How does the GP test cholesterol levels?

Cholesterol levels are usually tested by a GP or nurse practitioner via either a simple blood test or a finger-prick test.

In most cases individuals must refrain from eating for 10-12 hours prior to the test (including time spent sleeping) to ensure that all food has been sufficiently digested. This prevents any possible interference with the results

The blood sample will determine how much HDL and LDL there is in an individual’s blood, which is measured in units called ‘millimoles per litre of blood’.

The UK government recommendation for blood cholesterol levels is under 3mmol/L for LDL and under 5mmol/L for HDL.

The results determine whether the individual has a low, moderate or high risk of getting cardiovascular heart disease or experiencing a stroke within the next 10 years.  

How can high cholesterol be prevented?

There are a number of simple lifestyle choices that can help lower cholesterol. Some ideas can be found below:

Exercise regularly- the benefits of exercise are boundless. Cardiovascular exercise will help burn calories and get rid of excess fat, reducing the risk of cholesterol blockages in the arteries and preventing heart attacks. Just 150 minutes of moderate to intensive exercise a week will help improve your cholesterol levels. 

Drink alcohol in moderation- an excess of alcohol is detrimental to health and has been proven to raise cholesterol and triglyceride levels.Many studies however have suggested that consuming alcohol in moderation can improve levels of HDL, the ‘good cholesterol’.  A small amount of alcohol taken with a meal can also help prevent the formation of blood clots. It thins the blood and prevents the release of a dangerous protein called fibrinogen, which can increase the risk of clotting

It is very important to adhere to the daily drinking guidelines, which state that women should drink no more than 2-3 units a day and men no more than 3-4. For women, this is the equivalent of a 175ml glass of wine, and for men, 1 ½ pints of beer.

Healthy diet- To discover more about how to eat healthily, please visit our Balanced Diet page. 

Medication- Once you are found to have high cholesterol, your GP may prescribe you statins to help lower the cholesterol level in your bloodstream. 

Statins help by reducing the amount of cholesterol produced by the liver. There are a number of different statin types and brand names.

The risks involved when taking statins have been widely debate. In some cases have statins have been proven to have adverse side effects such as liver and kidney problems. Consult your GP for further information. 

Foods you could avoid

Certain types of food should be eaten in moderation. Some products are very high in dietary cholesterol and should be consumed as part of a balanced diet. It is advisable to contact your GP if you are planning to drastically change your diet.

Fat

Fat is a necessary part of a healthy diet and should not be completely avoided. There are two main types of fat: saturated (to be avoided as much as possible) and unsaturated (which can be good for you).
Saturated fat raises cholesterol and should be eaten in moderation. Foods high in saturated fat include:

  • fatty cuts of meat
  • butter and lard
  • cheese- hard cheese in particular
  • biscuits, pastries and cakes
  • savoury snacks such as crisps and cheese twists
  • chocolate confectionary
  • sour cream, cream, ice cream
  • meat products- pies, pasties and sausages.

Tips for avoiding bad food-

  • The trap of ‘lower fat’: Often products that claim they are low in fat have high levels of sugar and regularly have the same or a higher amount of calories than their full fat equivalents.
  • What does ‘high fat’ and ‘low fat’ mean? A high fat product will have more than 5g of saturates per 100g. A low fat product will have less than 1.5g of saturates per 100g.
  • If it looks like it’s going to clog up your arteries, chances are it probably will.

Foods you could include

Fibre

Fibre can help reduce the amount of cholesterol in the blood stream. Foods that are high in fibre include:

  • beans
  • peas
  • lentils
  • chickpeas
  • oats
  • fruit and vegetables.

Unsaturated Fats

Replacing saturated fat products with unsaturated will help to lower cholesterol:

  • oily fish (mackerel and salmon)
  • nuts (cashews, almonds)
  • vegetable oils (olive, walnut, sesame seed, sunflower)
  • seeds (pumpkin and sunflower).

Tips for choosing good food

  • Making a small change such as replacing a packet of crisps with a handful of cashews could help lower your risk of high cholesterol.
  • Beans, peas and lentils are extremely filling and as part of a delicious recipe, could act as a good substitute for fatty cuts of meat.

How can a nutritionist help you have lower cholesterol?

Research strongly suggests that diet is an important factor when it comes to high cholesterol and resulting heart disease.

So why see a nutritionist? Quite simply, a nutritionist knows what’s good to eat and what’s not. They can offer you their expert guidance without the confusion of conflicting theories or commercial dieting fads. 

Everybody’s relationship with food is different. A nutritionist will tailor a nutrition plan to your personal needs and requirements.

A nutritionist may be able to encourage you to eat healthily, which could in turn help you lose weight, lower you cholesterol, reduce your risk of dying of heart disease or experiencing a stroke or heart attack, and maybe even improve your enjoyment of life.

Further help


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All content displayed on Nutritionist Resource is provided for general information purposes only, and should not be treated as a substitute for advice given by your GP or any other healthcare professional. Whilst some people have benefited from nutritional therapy, no claims can be made to treat, cure or heal specific conditions, and we strongly advise individuals with any health problem to seek independent medical advice from their GP before considering nutritional therapy.