What is high cholesterol?
Although cholesterol is essential for good health, having high cholesterol levels may increase your risk of cardiovascular diseases such as stroke and heart disease. However, you are unlikely to notice if your cholesterol is too high, as it does not cause any symptoms by itself. You can only find out you have high cholesterol by having a blood test.
Increased cholesterol levels can cause fatty deposits (plaques) to build inside your arteries. Over time, this can restrict blood flow to your heart and organs, potentially causing angina (pain in your chest). If one of these plaques bursts, it can cause a blood clot and cut off the blood supply to your heart or brain, causing a heart attack or stroke.
How do you feel when your cholesterol is high?
As high cholesterol has no symptoms, those experiencing high levels of cholesterol do not feel any different. The only way to know for sure if your cholesterol is too high or could be a cause for concern is to have a blood test.
Types of cholesterol
Cholesterol is carried around the body in the blood by proteins called lipoproteins. The two main types are high-density lipoprotein (HDL), often called ‘good’ cholesterol, and low-density lipoprotein (LDL), often called ‘bad’ cholesterol. Higher levels of LDL and non-HDL cholesterol are associated with an increased risk of heart and circulatory diseases.
High-density lipoprotein (HDL)
High-density lipoprotein is typically referred to as the ‘good’ type of cholesterol. This is because it helps remove excess cholesterol from your blood vessels. It manages to do this by transporting cholesterol to your liver from your tissues. Your liver then takes the cholesterol and breaks it down, which enables it to be removed from your body. HDL aids in the prevention of cholesterol build-up in your blood vessels, helping reduce the risk of stroke and heart disease.
Low-density lipoprotein (LDL)
Low-density lipoprotein transports cholesterol around your body from your liver to whatever needs it. But if your LDL levels are too high, it can produce fatty deposits in your arteries. This can increase the risk of stroke and heart disease. This is why LDL is often referred to as ‘bad’ cholesterol. Cholesterol is not the only lipid (fat) to pose a risk to vital organs. Doctors also test for triglycerides.
Triglycerides
Whereas cholesterol builds and maintains cell membranes and creates hormones, triglycerides maintain the transportation and storage of energy. Diet and lifestyle changes can help lower triglyceride levels.
What causes high cholesterol?
There are many different factors that can contribute to high cholesterol. If you are over 50, a man, have been through menopause, have a family history, or are of South Asian or sub-Saharan African origin, you may be more likely to have high cholesterol. Eating too much saturated fat, not exercising enough, being overweight, smoking and drinking alcohol can also cause high cholesterol.
Why is high cholesterol bad for your health?
If you have high cholesterol, you are more likely to develop other serious medical conditions such as coronary heart disease, stroke, or TIA (transient ischaemic attack, also known as a 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 (TIA), sometimes known as a mini-stroke, is caused by a temporary disruption in the blood supply to part of the brain. Symptoms are similar to those of a stroke and usually last for a few minutes or hours, before fully resolving within 24 hours.
If you experience symptoms of a TIA or stroke, call 999 immediately and ask for an ambulance. Even if symptoms disappear while you wait, an assessment should still be done at the hospital. If you have previously had symptoms of a TIA and did not get medical advice, make an urgent appointment with your GP.
Who is at risk of developing high cholesterol?
There are a number of reasons why certain people are more likely to experience high cholesterol levels than others.
Living with excess weight
Living with excess weight, particularly around the waist, can increase the likelihood of having high cholesterol and other risk factors for heart and circulatory diseases. Diet and physical activity can also affect cholesterol levels. Making sustainable changes to your diet and lifestyle can help to manage your weight and improve your cholesterol levels.
Older people
The risk of high cholesterol increases with age, and high cholesterol is more likely in people over 50.
Ethnic groups
Individuals of South Asian or sub-Saharan African origin may be at a higher risk of high cholesterol.
Family history
Familial hypercholesterolaemia (FH) is an inherited condition that causes very high cholesterol and increases the risk of heart disease. In very rare cases, a child may inherit a more severe form of the condition from both parents.
How can high cholesterol be lowered?
Several simple lifestyle choices can help lower cholesterol. Some ideas can be found below:
Exercising regularly
Exercising on a regular basis can help lower your cholesterol levels regardless of a change in weight. Example activities can range from cycling and walking to running and participating in team sports such as football and netball.
Aim for around 150 minutes of moderate-intensity activity each week. If you aren’t sure that you are doing moderate exercise, try talking and singing when you are taking part – you should be able to talk, but not be able to sing a song.
Don’t smoke
If you smoke, quitting smoking can help improve your HDL cholesterol levels. Not only that, if you stop smoking, your blood pressure and risk of heart attack and heart disease will decrease too.
Medication
Once you are found to have high cholesterol, your GP may give you a prescription to help lower the cholesterol level in your bloodstream. Some cholesterol-lowering medicines can cause side effects. Your GP can discuss the benefits and possible side effects with you. The NHS explains more about medicines to lower your cholesterol and potential side effects.
A low-cholesterol diet
To lower cholesterol, sticking to a balanced diet can help. For a low-cholesterol diet tailored for you, a nutrition professional will be able to help.
Fats
Replacing foods that are high in saturated fat with those that contain unsaturated fats can help lower cholesterol. In the UK, most people consume too much saturated fat, with the highest proportion coming from meat and meat products.
Foods that contain unsaturated fats include:
- oily fish (e.g. mackerel and salmon) – one portion is a similar size to a pack of cards
- nuts (cashews, almonds) – one portion amounts to around 30g
- vegetable oils (olive, walnut, sesame seed, sunflower) – one portion amounts to around 1tsp
- seeds (pumpkin and sunflower) – one portion amounts to around 30g.
Trans fats
Like saturated fats, trans fats can negatively affect cholesterol levels. They can naturally be found in small amounts in foods such as dairy and meat. Artificial trans fats are typically found in processed foods that contain hydrogenated fats such as cakes and biscuits.
For your low-cholesterol diet, aim to cut down on foods that contain trans fats or saturated fats and replace them with other foods that contain unsaturated fats.
Food prep: reduce the fat
When choosing, preparing and cooking food, you should always try to reduce the total amount of fat you consume.
Go for lean cuts of meat and low-fat spreads and dairy products, or simply limit the amount of full-fat products you eat. When cooking your food, instead of frying or roasting, try grilling, steaming, microwaving, boiling or poaching.
Fibre
High-fibre foods can help reduce the amount of cholesterol in the bloodstream and can help reduce the risk of heart disease. In particular, soluble fibre has been shown to reduce total and LDL cholesterol. Foods that are high in fibre include beans, peas, lentils, chickpeas, oats, barley, fruit and vegetables.
Tips for choosing good food
- Try swapping foods that are high in saturated fat for options containing unsaturated fats, such as a handful of unsalted nuts.
- Beans, peas and lentils are filling and can be used as an alternative to fatty cuts of meat in many recipes.
Cholesterol food myths
You may have heard that eggs, prawns, kidneys and liver are naturally rich in cholesterol. For most people, the amount of saturated fat in their diet has a greater effect on blood cholesterol than the cholesterol found in food. However, people with familial hypercholesterolaemia, high cholesterol or a high risk of cardiovascular disease may be advised to limit foods that are high in dietary cholesterol.
If you are unsure about which foods to include in your diet, a nutrition professional can offer personalised guidance.
How can a nutrition professional help you lower your cholesterol?
Diet can play an important role in managing high cholesterol and supporting heart health. A nutrition professional can help you understand how different foods may affect your cholesterol and offer guidance based on your individual needs.
Everybody’s relationship with food is different. A nutrition professional can work with you to make realistic, sustainable changes to your diet and develop an approach that works for you.
Making appropriate changes to your diet may help to lower your cholesterol and support your overall heart health. A nutrition professional can provide personalised guidance and support you in making changes that feel manageable and achievable. Use our advanced search to find a nutrition professional near you.
Further help
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.
